Title Page

  • Conducted on

  • Prepared by

  • Project #

  • Location
  • Fieldflo complete and signed off

  • Required paperwork in place from general contractor

  • Heavy equipment checklist complete

  • Lift inspection checklist complete

  • SDS on site

  • Emergency numbers in Fieldflo

Job site perimeter

  • Controlled access zone is large enough for equipment used with line tags as needed

General safety

  • Adequate light level in work area

  • Temporary lights are safely installed and guarded

  • Emergency access is maintained

  • Shafts, floor holes, and slab edges are guarded

  • 100% use of hard hat and eye protection

  • Fall arrest or restraint properly used

  • Hearing, feet, hands, faces, arms, and other parts protected

  • Toilet facilities adequate

  • Drinking water available

  • First aid kits and eye wash stations

  • All containers are clearly marked and labeled

  • Hand tools

  • Power tools and cords inspected and have proper guards in place

  • Proper pressures and safeguards for pneumatic tools

  • GFCI used and cords have grounds

  • Electric panels are clearly marked

  • Silica controlled using OSHA table 1 standard

  • Fire extinguishers have annual and monthly signature

  • Work area is kept in clean orderly condition

Cranes and rigging

  • Crane operator has certification

  • Trained rigger and signalman

  • Counterweight and swing radius is protected

  • Safety features are in place and functioning

  • Rigging has been inspected before every use and is tagged and marked as required

  • Hooks on rigging and crane have keepers in place and functioning

Ladders

  • Ladder inspection

  • Ladder has proper labeling

  • Ladder is at proper angle, 3' above landing, tied off, and is used properly

Confined Space

  • Proper signage

  • Written plan and documented training

  • Proper permits and enforced

  • Adequate rescue measure available

  • Testing equipment calibrated and used

Compressors and generators

  • Exhaust issues addressed

  • Safety features and safeguard requirements verified(grounding)

Utilities marking, LOTO, and air gapping

  • Area and subgrade is free of electrical, mechanical, gas, ect.

  • Area has been marked for utilities and X rayed if needed

  • If LOTO is used follow procedure fully

Worker safety training

  • Weekly toolbox talks

  • New worker orientations complete

  • Employees trained to task being performed

Other

  • Other

  • Other

  • Other

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.