Information

  • Conducted on

  • Job Number

  • Jobsite Name

  • Type of Work

Are These Items Completed & Up To Date?

  • Project Safety Plan

  • JSA's

  • Crisis Management Plan

  • Project Safety Workbook

  • Tool Box Talks

  • Morning Huddle

Are These General Safety Items Current & Up To Date?

  • Postings (State, Fed, EEOC, Drug, Work Comp)

  • Date Corrected:

  • Safety/MSDS Manual

  • Date Corrected:

  • Emergency Phone Posting (FA/CPR, Map)

  • Date Corrected:

  • OSHA 300 Log (February To April)

  • Date Corrected:

  • First Aid Kit/Eye Wash

  • Date Corrected:

  • Competent Person Inspections

  • Date Corrected:

Housekeeping

  • Trash, Scrap, And Debris Picked-Up

  • Date Corrected:

  • Trailer Clean

  • Date Corrected:

  • Material Stored, Tools/Rigging Organized

  • Date Corrected:

  • Cords And Leads Routed Properly

  • Date Corrected:

  • Stairways, Halls, And Roadways Clear

  • Date Corrected:

  • General Site Conditions (Describe)

  • Date Corrected:

  • Drinking Water

  • Date Corrected:

  • Sanitation (One Toilet Per 20 Workers)

  • Date Corrected:

Personal Protective Equipment

  • Hard Hats

  • Date Corrected:

  • Eye Protection (Glasses/Goggles)

  • Date Corrected:

  • Face Shield (Grinding/Cutting/Welding)

  • Date Corrected:

  • Proper Gloves (Cotton/Leather/Chemical/Kevlar)

  • Date Corrected:

  • Foot Protection

  • Date Corrected:

  • Hearing Protection

  • Date Corrected:

  • Respirators

  • Date Corrected:

  • Proper Attire

  • Date Corrected:

Fall Protection System

  • Harness/Retractable/Positioning Above 6'

  • Date Corrected:

  • Guard Rails Up (At 42"+/-3", Wire Rope Flagged Every 6')

  • Date Corrected:

  • Holes Protected

  • Date Corrected:

  • Leading Edge At 15'

  • Date Corrected:

Fire Protection/Prevention

  • Fire Extinguishers Accessible/Current Within 100' Travel?

  • Date Corrected:

  • Signage of Flammable/Combustible Materials

  • Date Corrected:

  • Signage/Labeling

  • Date Corrected:

  • Fire Watch Required/Used

  • Date Corrected:

Cranes and Forklifts

  • Barricade Up

  • Date Corrected:

  • Daily/Monthly/Annual Inspection Complete

  • Date Corrected:

  • Are Power Lines Further Than 20'?

  • Date Corrected:

  • Set-Up Correctly

  • Date Corrected:

  • Correct Size (Not Over-Loading)

  • Date Corrected:

  • Crane Operator Training (CCO)

  • Date Corrected:

  • Rigging Inspected

  • Date Corrected:

  • Taglines Used

  • Date Corrected:

  • Cribbing In Place

  • Date Corrected:

  • Forklift Training

  • Date Corrected:

Welding and Cutting

  • Cylinders Properly Stored

  • Date Corrected:

  • Flash Arrestors

  • Date Corrected:

  • Hard Hats Under Welding Hoods

  • Date Corrected:

  • Proper PPE Used

  • Date Corrected:

  • Conditions Of Leads

  • Date Corrected:

Access Equipment

  • Extension Ladder (4V:1H, 3' Extension, Secured)

  • Date Corrected:

  • Aerial Lifts

  • Date Corrected:

  • Stairways/Walkways

  • Date Corrected:

Scaffolding

  • Base (Sills/Plates/Jacks/Casters, Secured, Level)

  • Date Corrected:

  • Braces (Installed, Secured, Condition)

  • Date Corrected:

  • Frames (Compatible, Pinned, Condition)

  • Date Corrected:

  • Platform (Complete, Overhang/Secured, Condition)

  • Date Corrected:

  • Access (Integrated Frame, Ladder, Other)

  • Date Corrected:

  • Other (Secured At 4V:1H, Tagged)

  • Date Corrected:

Electrical

  • Panels (Covers In Place)

  • Date Corrected:

  • GFCI (Electrician Weekly Inspection)

  • Date Corrected:

  • Electrical Cords (Condition, Proper Use)

  • Date Corrected:

  • Power Tools

  • Date Corrected:

  • Temporary Lighting

  • Date Corrected:

  • Power Sources/Lines 20' Conductors Away?

  • Date Corrected:

Excavation

  • Spoils 2' From Edge

  • Date Corrected:

  • Access/Egress Ladder Extends At 4' (25' Travel)

  • Date Corrected:

  • Slope, Shoring, & Shielding At 5'

  • Date Corrected:

  • Competent Person

  • Date Corrected:

Additional Comments

Superintendent Signature

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Inspector Signature

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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.