Job Site Safety Inspection ( Short Form Template )

• Job Site Safety Inspection

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Yes

  No

  N/A

• Executive Summary (Items Noted)

Think Watch Control

• Think - Preplanning, eyes and mind on task?

  Safe

  At Risk

  N/A

• Watch - Proper lifting? Safe body position?

  Safe

  At Risk

  N/A

• Control - Line of fire hazards? Work area surrounding awareness?

  Safe

  At Risk

  N/A

Fall Protection

• Fall Protection needed? Equipment in good condition?

  Safe

  At Risk

  N/A

• Other ( falling object protection, warning lines )?

  Safe

  At Risk

  N/A

Other High Hazard Tasks

• Any items NOT captured in categories?

  Safe

  At Risk

  N/A

Ladders

• Step or Extension Ladder ( proper use, good condition )?

  Safe

  At Risk

  N/A

• Fixed ladder ( safe access, caged, fall protection )?

  Safe

  At Risk

  N/A

Electrical

• Safe work practices ( LOTO, PPE, arch flash gear )?

  Safe

  At Risk

  N/A

• Extension cords in safe condition? GFCI being used?

  Safe

  At Risk

  N/A

PPE

• PPE in safe condition and being worn ( gloves, glasses, hard hats, ect. )?

  Safe

  At Risk

  N/A

• Specialty PPE ( arch flash, respiratory, Kevlar,ect. )?

  Safe

  At Risk

  N/A

General

• Vehicle(s) parked to pull out?

  Yes

  No

  N/A

• Housekeeping ( proper storage, trash & debris removed )?

  Safe

  At Risk

  N/A

• SDS app available? Employees know location?

  Safe

  At Risk

  N/A

Positive Items Noted

• Were any Safety Best Practices observed?

  Safe

  At Risk

  N/A

• Add signature

  Sign