JOBSITE SAFETY CHECKLIST

• CONDUCTED ON

  Date
• LOCATION
  Address

• CREW

Site Details

• Site / Project Name

• Use this audit to assess the following aspects of this site as Safe, At Risk or Not Applicable. Unsafe response indicate that attention is required to bring items to a satisfactory standard. Notes and photos should be attached where appropriate, particularly to At Risk items.

Work Areas

• Do you wish to examine work areas on this inspection?

  Yes

  No

  N/A

• General Housekeeping

  Safe

  At Risk

  N/A

• Walkways (free of trip hazards and obstructions)

  Safe

  At Risk

  N/A

• Impalement Hazards (none present, or adequately marked)

  Safe

  At Risk

  N/A

• Material Storage/Lay Down

  Safe

  At Risk

  N/A

• Work area is properly protected with barriers and/or barricades

  Safe

  At Risk

  N/A

• Is concrete or masonry work in progress at this location?

  Safe

  At Risk

  N/A

• Is confined space entry in progress at this location?

  Safe

  At Risk

  N/A

• Are there hot works of any type at this location?

  Safe

  At Risk

  N/A

Personal Protective Equipment (PPE)

• Do you wish to examine PPE on this inspection?

  Safe

  At Risk

  N/A

• Hard Hats

  Safe

  At Risk

  N/A

• Safety Glasses, Face Shield, Goggles

  Safe

  At Risk

  N/A

• Respiratory Protection

  Safe

  At Risk

  N/A

• Hearing Protection

  Safe

  At Risk

  N/A

• Appropriate Clothing

  Safe

  At Risk

  N/A

• Leather Gloves

  Safe

  At Risk

  N/A

• Foot Protection (fit for task)

  Safe

  At Risk

  N/A

Fall Protection Equipment

• Do you wish to examine fall protection equipment on this inspection?

  Yes

  No

  N/A

• Fall protection equipment inspected inspected regularly and before use

  Safe

  At Risk

  N/A

• Appropriate for task and used properly by crew where applicable

  Safe

  At Risk

  N/A

• Suitable Anchorage Points

  Safe

  At Risk

  N/A

Ladders

• Do you wish to examine ladders on this inspection?

  Yes

  No

  N/A

• Ladders are well maintained and in satisfactory condition

  Safe

  At Risk

  N/A

• Ladder base, footing and set up is to standard

  Safe

  At Risk

  N/A

• Proper Ladder for Task

  Safe

  At Risk

  N/A

Tools and Equipment

• Do you wish to examine tools and equipment on this safety walk?

  Yes

  No

  N/A

• First Aid kits available and maintained

  Safe

  At Risk

  N/A

• Fire extinguishers in place for general conditions, and<br>inspections complete

  Safe

  At Risk

  N/A

• Tools and Equipment inspections take place and are recorded

  Safe

  At Risk

  N/A

• General condition of tools

  Safe

  At Risk

  N/A

• Correct tools are being used for specific tasks

  Safe

  At Risk

  N/A

• Crew members are trained to be competent in the tools appropriate for their work tasks

  Safe

  At Risk

  N/A

• Guards in place on grinders, saws

  Safe

  At Risk

  N/A

Excavations

• Do you wish to examine excavations on this inspection?

  Yes

  No

  N/A

• Bluestakes Ticket Number

• Excavation inspected by competent person prior to crew entry

  Safe

  At Risk

  N/A

• Access/Egress is safe and frequency of egress is acceptable

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• Utilities are supported, protected, or removed in open excavation.

  Safe

  At Risk

  N/A

• Shoring/Shielding/Sloping is safe

  Safe

  At Risk

  N/A

• Spoil piles are at least 2 feet from edge of excavation

  Safe

  At Risk

  N/A

Electrical Safety

• Do you wish to examine electrical safety on this inspection?

  Yes

  No

  N/A

• Ground fault circuit interrupters in use

  Safe

  At Risk

  N/A

• Extension Cords are not causing trip hazards or used inappropriately

  Safe

  At Risk

  N/A

• Power Tools are undamaged and being used fit for purpose

  Safe

  At Risk

  N/A

• Color coded tape present, quarterly inspection of cords

  Safe

  At Risk

  N/A

People Safety

• Do you wish to check work crew safety knowledge at this inspection?

  Yes

  No

  N/A

• Approach at least one team member and record their responses to the following. Make clear this is not an assessment of the team member themselves, but rather the safety procedures on site.

Crew

• JSA or toolbox talk within the last week?

  Yes

  No

  N/A

• Who is competent person onsite?

• Is the crew member able to describe the correct process to follow in an emergency situation?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Is the worker able to identify hazards they may encounter in their tasks today?

  Yes

  No

  N/A

General Comments

• Any further comments or recommendations arising from this inspection?

• Add any additional relevant photos

  Media

• Have all required corrective actions been added as Actions to this inspection?

  Yes

  No

  N/A

• Please add any corrective actions to the appropriate questions above before completing this report

Sign Off

• Name & Signature of Inspector

  Sign