Information
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Document No.
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Job Name
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
General safety
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Hazard communication program
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SDS book available
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Safety day-by-day program
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First aid kit available
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Fire extinguishers
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Eye wash station available
Personal Protective Equipment
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Head protection
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Eye protection
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Are face shields or goggles worn when chipping, grinding, or drilling?
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Is hearing protection required and worn?
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Are personal fall arrest devices used and checked regularly?
Ladders
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No defective ladders in use
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Step ladders only used in open position.
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Step ladders right height for the task
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Straight lasers tired off at the top
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Straight lasers extend three feet above the landing
Scaffolds and Manlifts
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Hand rails and toeboards in place
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Proper access
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Wheels locked when rolling scaffolds are in use by workers
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Workers tired of in aerial lifts
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Workers are trained for the lift they are using
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Equipment inspected daily
Walking and working surfaces
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Guarded floor openings and edges
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Stored material properly stacked and clear of aisles?
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Spills, water, ice, and snow cleared.
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Clear access to all work areas
Gases/fuel
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Oxygen/acetylene properly used
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Gasoline in properly closed and vented container
Power tools
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Power/electric cords in good condition
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Told stored to prevent damage
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GFCI properly in use on all temporary electric cords, at the source.
Rigging
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Slings and Choker in good condition
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Shackles in use to protect slings
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Chains and contains in good condition.
Material handling
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Gloves available
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Proper manual lifting techniques
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Cats on site to move material.
Confirmation
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Comments
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Inspector signature
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Foreman signature
