Information

  • Site conducted

  • Document No.

  • Completed by

  • Date

  • Customer name

  • Job site name

  • Job site address

Evaluation

Job Site Information

  • Supervisor's name and contact number.

  • General Contractor on job site.

  • Supervisors & employees understand HardHat's injury reporting policy.

  • Please describe.

  • Safety meetings/toolbox talks being conducted by the customer.

  • Please describe.

  • Please list the current work tasks being performed.

Employee Interaction

  • Number of HardHat employees on the job site.

  • Number of HardHat new hires on the job site.

  • Number of HardHat employees interacted with on job site.

  • List safety topics discussed.

  • Safety concerns reported by employees.

  • Please describe.

  • Required PPE worn (hard hat, glasses, gloves and vest/t-shirt).

  • Please describe.

  • Condition of PPE.

  • Please describe.

  • Employees using proper lifting methods.

  • undefined

  • Proper number of employees for each operation.

  • Please describe.

Housekeeping

  • Overall cleanliness of the job site.

  • Please describe.

  • Slip, trip, and fall hazards.

  • Please describe.

  • Silica (dust) engineering controls in-place.

  • Please describe.

  • Availability of fire extinguishers on the job site.

  • Please describe.

  • Job site materials are stored securely to prevent falling, sliding, or collapse.

  • Please describe.

Electrical

  • "No energized work!", emphasized to employees and supervisors.

  • Please describe.

  • Condition of extension cords.

  • Please describe.

  • Ground fault circuit interrupters being used.

  • Please describe.

  • Known electrical hazards identified.

  • Please describe.

Hand, Power & Powder Actuated Tools

  • Are hand, power, or powder actuated tools being used?

  • Hand and power tools inspected regularly and in good working condition.

  • Please describe.

  • Power tool safety guards.

  • Please describe.

Fall Protection

  • Are employees working at heights greater than 6ft. or on lifts?

  • Employees working more than 6' above a lower level are protected by guardrails or personal fall arrest system.

  • Please describe.

  • Harnesses and lanyards fitted and used properly.

  • Please describe.

Ladders

  • Are employees using ladders?

  • Employees using at least 3 points of contact while ascending and descending.<br>

  • Please describe.

  • Ladders are secured on firm ground to prevent slipping, sliding, or falling?

  • Please describe.

  • A-frame ladders in the fully open position.

  • Please describe.

  • No stepping on top two rungs of stepladder.

  • Please describe.

Heavy Equipment

  • Is any heavy equipment being operated by our employees on the job?

  • Operators are certified.

  • Please describe.

  • Equipment is inspected before use.

  • Please describe

  • Seat belts used.

  • Please describe.

Trenches, Excavation & Shoring

  • Are any trenches on the job site?

  • Competent person on hand and inspecting daily.

  • Please describe.

  • Linespot complete and underground lines flagged.

  • undefined

  • Ladder access, steps, or ramp in trenches 4ft. or deeper and located every 25ft.

  • Please describe.

  • Excavations 5ft. or deeper are sloped back or protected inside with shields.

  • Please describe.

  • Material, equipment, and spoil pile are 2ft.+ from trench edge.

  • Please describe.

Review of Findings

  • Hazards & concerns addressed with employees and supervisors.

  • Please describe.

  • Does the site require a follow-up or re-inspection?

  • Re-inspect before

  • Today's date

  • Type name & sign name below

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.