Title Page

  • Conducted on

  • Prepared by

  • Location

Project & Crew

  • Project Name

  • Superintendent's Name

  • Construction Manager Name

  • Project Manager Name

Stock Pile

  • Is the stock pile assembled properly?

  • Is stockpile safety banner hung up in visible location?

  • Is the stock pile neat and orderly?

  • Does the tanker have protective layer beneath the outlets and valves?

  • Is spill kit available for spill response?

  • Eye wash station on tankers operational?

  • Are employees wearing all required PPE while at stock pile?

  • Are first aid kits readily available onsite?

  • Are fire extinguishers readily accessible on site?

  • Is sufficient drinking water available on site?

  • Are propane tanks secured when not in use?

  • Are portable restrooms onsite and stocked?

  • Any signs of spills, leaks, or discharges?

  • Does the stockpile have adequate escape routes?

  • If a night operation, does the stockpile have proper lighting?

  • Overall housekeeping?

  • Is stockpile free of fire hazards?

  • Is stockpile free of slip, trip, and fall hazards?

  • Are dog houses secured, orderly, and free of hazards?

  • Is a trash container present onsite?

Traffic Control

  • Is traffic control assembled properly?

  • Are traffic control employees wearing proper PPE?

  • Are employees wearing proper rated high viz vests?

  • How Is the traveling public responding to current traffic control set up?

Crew Safety

  • Are employees wearing all required PPE?

  • Are employees wearing proper rated high viz vests?

  • Are employees working safely without distractions?

Superintendent

  • Is the superintendent wearing proper PPE?

  • Has the weekly safety topic been reviewed and all employees signed in?

  • Are daily safety meetings being held?

Equipment / Vehicles

  • Do all vehicles have sufficient and operational warning beacons?

  • Are vehicles clean outside?

  • Are vehicles clean inside?

  • Are vehicles equipped with fire extinguishers, first aid kits, flares, triangles?

  • Are vehicles free of recent or unreported damages?

  • Are back up alarms operational on equipment and vehicles?

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.