Title Page

  • Conducted on

  • Prepared by

  • Who is the Client?

  • What is the Job Name &/or Number?

  • Location
  • Crew members onsite?

  • Safety Inspection conducted with what member of the crew?

Housekeeping

  • All trip hazards are identified with channelizers, barricades, and caution tape.

  • No accumulation of trash or debris on job site.

  • Equipment and Trucks are cleaned before leaving jobsite.

  • Was a tool box talk completed this week?

  • What was the topic?

  • Who is the OSHA defined competent person onsite?

Personal Protective Equipment (PPE)

  • Is all required PPE available for employees?

  • Are employees wearing proper PPE? This should include at a minimum work boots, long pants, sleeves, high visibility outer layer.

  • Is there a stocked and current First Aid Kit onsite?

  • Does this project require hard hat, safety glasses or gloves?

  • Are employees wearing required PPE?

  • Does this project require respirators?

  • Are respirators available for employees?

  • Have employees been fit tested?

  • Are employees wearing respirators when required?

Heat Stress

  • Is adequate drinking water available?

  • Are employees taking breaks as appropriate?

  • Is the heaviest work scheduled for the coolest part of the day if possible?

Hazard Communication

  • SDS book is available

  • A minimum number of buckets or containers are onsite and labeled properly.

Material Handling

  • Material handling equipment is used as much as possible.

  • Job rotation used where appropriate and when possible.

  • Employees are bending at the knees and using team lifts.

Fire Prevention

  • Fuels are stored in OSHA approved containers.

  • Proper sized fire extinguishers are available.

  • Has the fire extinguisher been inspected in the last 12 months?

Tools & Equipment

  • Any power tools onsite have been inspected and are in good working condition.

  • Lockout Tagout has been used where appropriate.

  • All Heavy equipment has been inspected and in good working condition.

  • What equipment is onsite?

  • Backup alarms are operable?

  • Where do you report equipment maintenance if it is not an emergency?

Equipment Operation

  • Equipment is being operated in a safe manner and at a safe speed.

  • Heavy equipment operator is wearing a seat belt.

  • Overhead power lines are identified.

  • No riders on equipment unless designed for passengers.

  • 3 point contact rule is being followed. No jumping from vehicles.

Excavations

  • Are we excavating (digging) ?

  • Were utilities located? Can we provide documentation for proof?

  • Trenches deeper than 4 feet are properly sloped or benched.

  • Spoils pile is at least 2 feet from edge of excavation.

  • A proper ladder is provided for entry and exit of excavation if required.

Traffic Control

  • Taffic control devices onsite are appropriate and operating.

  • If required, Flagman is highly visible and paying attention.

Fall Protection

  • Is anyone working higher than 4 feet off the ground? Do we need fall protection?

  • Handrails and barricades are in place.

  • Toe boards are in place where required.

  • Scaffolding is in place where required.

  • All exits are clearly marked.

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.