Information
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Client / Site
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Job Number
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Conducted on
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Location
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Prepared by
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Foreman
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Supervisor
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Personnel
Ground Set-up
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Are grounds clean and free of debris?
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Is the material covered or flagged off?
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Is the crane set up properly and fenced off?
Ladders and Roof Access
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Is the ladder set up with the 4:1 ratio?
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Is the ladder securely tied off?
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Are the workers using the ladder properly?
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Is the ladder in good condition and free of any defects?
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Does the ladder extend at least 3 feet above the roof level?
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If the ladder is fixed, does it have a cage.
Scaffold Tower
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Has the scaffold tower been erected by Quality Roofing or a third-party?
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Is the scaffold tower being inspected daily?
Guard Rail System
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Is the top edge of the guardrail or cable system between 39" and 45"?
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Is the gap between the midrail and toprail 21" or less?
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Can the top and mid-rail withstand enough outward and downward pressure? (200lbs)
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Are the cable clamps installed correctly?
Perimeter Flagging (Warning line)
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Is the warning line at least 6 feet from the roof edge?
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Is the warning line between 34 and 39 inches?
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Is the warning line flagged at least every 6 feet?
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Will the warning line with stand at least 16 pounds of outward force?
Full Body Harness
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Have all employees inspected their harness before use?
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Are employees wearing the full body harness correctly? Snug not loose?
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Are all harnesses in good working condition?
Safety Cart
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Are safety carts greater than 6 feet from the roof edge or opening?
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Is the safety cart in good working condition?
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Are employees using the safety cart correctly?
Self Retracting Lifelines and Lanyards
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Are SRL's in good working condition?
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Are lanyards in good working condition?
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Are SRL's and lanyards being used properly?
Personal Protective Equipment
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Are all workers wearing safety glasses?
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If applicable are all workers wearing protective hardhats?
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Are workers handling hot asphalt wearing long sleeves and gloves?
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If applicable are all workers wearing the appropriate footwear?
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Are first aid kits well stocked and available to the workers?
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If applicable are face shields in use?
Fire Safety
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Is there a fire extinguisher on the roof?
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Is there a fire extinguisher available by the kettle?
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Are approved safety cans being used on the jobsite?
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Are bulk propane tanks at least 25 feet away from the kettle?
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Hot work permit in use? (If Required)
Electrical
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Are all cords in good working condition?
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Are electrical cords being used in a dry environment?
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Do all plugs have an electrical ground prong?
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Are working GFCI's in use on all generators?
Equipment
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Seatbelt in use on mobile equipment?
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Back up alarm working?
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Park brake in use when stopped?
Miscellaneous
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Are holes greater than 18" x 18" covered or flagged off?
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Are single service cups or bottled water available on the roof?
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Has the jobsite been inspected for hazards prior to work start?
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Comments/recommendations
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Signature