Title Page
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Conducted on
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Prepared by
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Location
Project & Crew
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Project Name
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Superintendent's Name
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Construction Manager Name
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Project Manager Name
Stock Pile
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Is the stock pile assembled properly?
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Is stockpile safety banner hung up in visible location?
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Is the stock pile neat and orderly?
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Does the tanker have protective layer beneath the outlets and valves?
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Is spill kit available for spill response?
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Eye wash station on tankers operational?
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Are employees wearing all required PPE while at stock pile?
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Are first aid kits readily available onsite?
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Are fire extinguishers readily accessible on site?
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Is sufficient drinking water available on site?
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Are propane tanks secured when not in use?
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Are portable restrooms onsite and stocked?
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Any signs of spills, leaks, or discharges?
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Does the stockpile have adequate escape routes?
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If a night operation, does the stockpile have proper lighting?
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Overall housekeeping?
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Is stockpile free of fire hazards?
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Is stockpile free of slip, trip, and fall hazards?
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Are dog houses secured, orderly, and free of hazards?
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Is a trash container present onsite?
Traffic Control
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Is traffic control assembled properly?
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Are traffic control employees wearing proper PPE?
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Are employees wearing proper rated high viz vests?
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How Is the traveling public responding to current traffic control set up?
Crew Safety
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Are employees wearing all required PPE?
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Are employees wearing proper rated high viz vests?
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Are employees working safely without distractions?
Superintendent
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Is the superintendent wearing proper PPE?
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Has the weekly safety topic been reviewed and all employees signed in?
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Are daily safety meetings being held?
Equipment / Vehicles
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Do all vehicles have sufficient and operational warning beacons?
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Are vehicles clean outside?
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Are vehicles clean inside?
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Are vehicles equipped with fire extinguishers, first aid kits, flares, triangles?
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Are vehicles free of recent or unreported damages?
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Are back up alarms operational on equipment and vehicles?