Information

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • GTC Personnel

  • Sub-Contractors

  • Postings and Documents: Are the "Employee Right to Know" and SDS location documents posted in common area? Are the GTC Safety and Health Manual with SDS documents located on the job site?

  • Emergency Planning: Does everyone on site know their role in the case of an emergency? First Aid supplies adequate? First Aid and CPR Certified persons on the job?

  • Fire Extinguishers: 25-75 feet from fueling area? Near every door way and stair way? One for ever 3000 sq. feet per floor, not more than 100 feet apart?

  • Housekeeping: Is site neat and clean? Are materials stacked and piled safely? Are impalement and tripping hazards protected?

  • Are all workers wearing required PPE? <br>Hard Hats, Work Boots, Safety Glasses, High Vis, Pants and Shirts.<br>If no, provide photos or note observations.

  • Respiratory: If activity or SDS information requires respirators (more than dust masks), do you have needed equipment?

  • Excavations: Has a qualified person evaluated trenches and excavations prior to workers entering? Are excavations over 5 feet sloped, shored, or shielded to protect workers from cave in?

  • Power Lines: Identified for trucks and equipment? If working with 20 feet, is the line de-energized and grounded or covered by Utility Owner?

  • Ladders: Inspected for defects? Proper ladders being used appropriately? Could scaffolding or lifts be used in place of ladders?<br>If not safe, provide photo or note observation.

  • Fall Protection: Are all edges guarded? Holes covered? And plan in place prior to using PFAS? Does it include 1st-last man and Rescue Plan? Do all workers have Fall Protection training? Please note if assistance is needed, or if corrections were made to unsafe situation.

  • Scaffolding: Inspected prior to use by Competent Person? Guardrails in place inn over 10 ft.? Plumb, level, baseplates, mudsills, and fully planked? If no, provide photos, observation, corrections made, or assistance needed.

  • Tools and Equipment: Have all tools and equipment been inspected by trained user prior to use? Tag out and send back to shop all defective tools and equipment - Do not use! Photo and explain in notes if not safe. Identify the equipment in question.

  • Electrical: Have all cords been inspected for defects? Are GFCIs being used 100% of time? Are all hot panels, junction boxes, and outlets/switch boxes covered?

  • Workers: Is everyone is good-normal condition and ready to work? If hot: is there water on site? If cold: doe everyone have proper cold weather gear? Health or Physical issues that may be exaggerated by planned work? If AT RISK, explain in notes.

  • Other - Add safety related comments or other photos here.

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