Inglett & Stubbs Preconstruction Checklist

• Document No.

• Jobsite/Number

• Conducted on

  Date

The following form is to be completed by the General Foreman/Foreman upon mobilization of all new projects. This form must be submitted to the Safety Director.

• Prepared by

Exposure

• Has the Emergency Action Plan been completed?

  Yes

  No

  N/A

• Comments?

• Are MSDS for all substances available?

  Yes

  No

  N/A

• Comments?

• Will project include excavations over 4 feet?

  Yes

  No

  N/A

• Who is the competent person for excavation work?

Competent Person

• Name

• Comments?

• Will project include confined space entry (manholes, etc...)?

  Yes

  No

  N/A

• Who is confined space entry supervisor/competent person?

Competent Person

• Name

• Comments

• Is confined space equipment available (monitor, tripod, blower, harness, lighting, communications)?

  Yes

  No

  N/A

• Comments

• Will scaffolding be on site?

  Yes

  No

  N/A

• Who is competent person for scaffolding?

Competent Person

• Name

• Comments

• List fall exposures and equipment needed:

Fall exposure & equipment

• Are first aid supplies available?

  Yes

  No

  N/A

• Comments

• Is Arc rated PPE needed?

  Yes

  No

  N/A

• Comments

• Are LOTO supplies needed?

  Yes

  No

  N/A

• Comments

• Will forklifts/lulls be used?

  Yes

  No

  N/A

• Are forklift/lull operators trained?

  Yes

  No

  N/A

• Comments

• Will scissor or aerial lifts be used?

  Yes

  No

  N/A

• Are scissor/aerial lift operators trained?

  Yes

  No

  N/A

• Comments

Signature

• Foreman/General Foreman

  Sign

• Date

  Date

Send to Kenny Cole or Adrienne Graham for review.