Title Page
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Facility Name
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Time & Date
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Facility Supervisor
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Prepared by
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Location
Management Activities
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First aid kit (i.e. not expired, fully stocked, eye wash station available on site)
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First-aid personnel (i.e. Foreman CPR/AED/FA certified)
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Safety Program Available (i.e. IIPP electronically and/or hard copy, SDS sheets available)
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OSHA 300 Log posted Feb. 1st - Apr. 30th (i.e. ONLY in job trailers/offices on site)
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Medical Clinic map available (i.e. nearest Work Partners and ER)
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Emergency Response posted/known (i.e. Grab N Go packet)
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Cal/Fed OSHA postings/permit (i.e. current year poster in job trailer/office or GC has available on jobsite)
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Toolbox talks/Weekly Safety Meetings (i.e. current week, turned in on time)
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Jobsite checklist/inspection (i.e. conducted weekly by foreman)
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Daily Hazard Assessment (i.e. noted, discussed with crew prior to start of task)
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Sanitary Facilities (i.e. toilets, hand wash stations, properly stocked)
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Refrigerator Clean & FREE of "Science Experiments"
Access
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Clear Walkways/Aisles - (i.e. Wet/Slippery Surfaces, Tripping, & Fall Hazards)
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Perimeter Fencing Locks/Functional
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Clear Work Space around Machines and Benches
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Roof Hatch Access Door Locks/Functional
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Electrical Control Room Locks/Functional
Stairways / Ramps / Ladders
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Lighting Adequate
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Clear of material/trip hazards
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Non Slip Surfaces in good condition
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Ladders - Stored properly / Good Condition / Operated Properly
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Non Compliant Ladders (Beyond Repairing) Discarded
General Safety
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Emergency Shutoff Valve Locations - Known & Identified (i.e. Fire Sprinklers, Water, Electrical, Gas)
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Work Station Ergonomics / Safe Practices
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Housekeeping - Full Facility
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PPE Adequate for Shop Tasks
Fire Equipment & EXITS
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Fire Extinguishers Accessible - Full Facility
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Fire Extinguisher - READILY Available when performing HOT WORK
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Fire Extinguisher - Tagged, Inspected Monthly, and Serviced Adequately
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Fire EXITS Properly Illuminated
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Fire EXITS Clear and Unobstructed
Fire Hazards
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Gas Cans ALL Metal - NO PLASTIC
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Gas Cans Properly Stored
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Hot Work / Compressed Gas Cylinders - Contained, Secured, Stored, & Operated Adequately
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NO OIL Cans or Drums Stored at facility
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Brush & Other Flammable / Combustibles NOT allowed to accumulate near Building Exterior
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Flammable / Combustible Storage Areas Labeled
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NO Smoking Signs Posted
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Freon Storage Area Locked and Stored adequately
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Signage Posted on Freon Storage Area
Electrical
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No Circuit Overloading (i.e. To many cords plugged into a power strip)
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Permanent Wiring Properly Installed (i.e. Covers on Junction Boxes, Plugs in all unused wholes on panels. Exposed wires)
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Clear Access to Electrical Panels & must have a minimum 36" of clearance around
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Electrical Panels "Clearly" Marked
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GFCI in required locations
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Grounding & Bonding intact on all plugs
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NO power strips inside Warehouse / Pre-Fab Shop
Pallets / Racks / General Storage
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Pallets in good condition (i.e. No Splinters or protruding nails)
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NO Leaning Pallets against Walls
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Loads Stacked and/or Properly secured
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Rack Uprights and Shelving properly sized and secured
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Racks Legs/Bases secured with minimum 2 bolts (Diagonal cross pattern with 2 bolts)
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Top Rack Chain/Rope Required if material is not on pallets
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Minimum 24" of clearance around fire sprinkler heads
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Clear access to all stored materials
Machinery / Equipment
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Forklift Condition - Properly maintained and operated
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Trained Forklift Operator
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Forklift Inspection Conducted DAILY (Documented)
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Operator Manual on Forklift
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Warning Signs / Barricades in place during operations
Maintenance Yard
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Air Quality
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Spill Kit
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Annual Hazmat Training for Shop employees
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Hand and Power Tools
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Eye Wash bottles available / Shower in Men's restroom functional
General Comments
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Other 1
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Other 2
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Other 3
