Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Safety Equipment & Conditions

  • DOL/OSHA Required Poster Posted

  • Emergency Action Plan Posted

  • Safety Department & Project Management Phone Numbers Posted

  • Employee CPR/FA trained on site

  • Fully stocked First Aid Kit Available

  • First Aid Kit in date

  • PPE for rendering First Aid available? Exam gloves, face shield, cpr mask

  • Eye wash stations available within 10 seconds walk of employees performing work that produces flying debris (pouring concrete, cutting wood/rebar)

  • Access to drinking water (cold water in hot weather)

  • Restrooms available and clean

  • PTP filled out correctly and being used

  • CAZ properly barricaded and signage on all sides (signs should include: name of responsible party, phone number and company name, hazard inside of CAZ)

  • Required permits filled out and available (Excavation, hot work, confined space, ladder, concrete pump)

  • Competent person on site and inspecting frequently

HOUSEKEEPING

  • Is there General neatness of the work area?

  • Are projecting nails removed?

  • Are waste containers provided and used?

  • Are passageways and walkways clear

  • Is lighting adequate?

  • Is the lay down yard near and organized? (Rebar caps on verticals)

FIRE PREVENTION

  • Are there adequate fire extinguishers that are accessible and inspected (monthly/annually)

  • Are flammable liquids stored properly

  • Bulk flammable storage and/or bulk fueling tank area have at least a 20lb ABC extinguisher no closer that 25ft and not farther than 75ft

  • Are no smoking signs posted and enforced.

  • Are funnels being used when refilling equipment

  • Is equipment shut down while fueling?

  • Is propane stored at least 25’ from occupied structures?

ELECTRICAL

  • All power cords inspected for frays, bare wires, missing ground pins or other damage?

  • Any cords taken out of service?

  • Are GFCI being used?

  • Are terminal boxes equipped with required covers?

  • Are flexible cords protected from damage (not being run over by equipment, shut in doors etc)

  • Are cords suspended above wet areas or areas with standing water?

  • Are generators inspected and grounded

HAND TOOLS / POWER TOOLS

  • Are hand tools inspected frequently?

  • Are broken handles, mushroom heads present?

  • Are protective guards in place on tools

  • Is the right tool being used for the job

  • Powder actuated tools in use? If so, are operators licensed?

  • Are operators using proper PPE

  • Are tools neatly stored and carried properly?

FALL PROTECTION

  • Are employees working more than 6’ above a lower level protected by guardrails, safety nets, PFAS

  • Are guardrails/safety nets secured properly and located at correct heights?

  • Are employees exposed to fall hazards using PFAS and properly tied off? (5k anchor point, correct lanyard)

  • Are employees using turbos along with rebar chains when positioning?

  • Handrails at inclines (such as excavations)

  • Steps of not more than 9.5”

  • Steps have a proper landing?

  • Steps have a hand rail?

  • Tools/hard hats equipped with lanyard?

  • Barricade around excavation?

LADDERS

  • Ladder permit in use?

  • Job Built ladders meet OSHA spec?

  • Are ladders at least 3’ above landing

  • Are ladders secured at top and bottom?

  • Corral and offset in place to prevent falls?

  • Damaged ladder taken out of service?

  • All ladders equipped with all decals?

  • Step ladders used in the fully open and locked position

SCAFFOLDING

  • Has scaffolding been inspected by a competent person?

  • Is there a green tag present and signed?

  • Is scaffolding erected on sound level footing?

  • Plumb, square with cross bracing?

  • Are guardrails, midrails, toeboards or screens in place?

  • Is planking full, sound and sturdy?

  • Overlap of at least 12” at corners and edges of planking?

  • Working areas free of dirt, snow, ice and grease?

  • Are employees below protected from falling objects?

  • Is fall protection available and in use?

FLOOR AND WALL OPENINGS

  • Are all floor or deck openings planked over or barricaded?

  • Is perimeter protection in place?

  • Are deck planks secured?

  • Are materials stored away from the edge?

  • Is corral in place with offset entrance and toe boards to prevent falls to lower level?

  • Do all corrals, covers and barricades include signage?

TRENCHES, EXCAVATIONS & SHORING

  • Competent person present and inspecting?

  • Are excavations 4’ or greater sloped or benched?

  • Are materials and spoil pile at least 2ft from edge of excavation?

  • Is equipment at least 2ft away from edge of excavation?

  • Are ladders provided every 25’ and secured top and bottom?

  • Have underground utilities been located?

  • Excavation permit completed?

  • Does mobile equipment have spotters?

  • Are swing radius markers in place on equipment?

  • Are Flagger wearing class 3 vests and have traffic wands?

  • What is the soil class? Pentrometer used? What is the pentrometer reading?

  • Are handrails used to enter/exit excavations?

MATERIAL HANDLING

  • Are materials properly stored or stacked

  • Dunnage being used?

  • Tag lines used to guide loads?

  • Are there adequate employees for the operation?

  • Rebar 90D bars covered while in staging area?

  • Material free rigged from from forklift mast?

  • Material secured to forks/mast with strap?

  • Materials properly rigged to forklift?

WELDING & CUTTING

  • Are compressed gas cylinders stored upright and secured?

  • Is there 20ft min separation between fuels and oxygen?

  • Fire extinguishers within 25ft?

  • Hoses and regulators in good condition?

CRANES

  • Crane operator certified for type of crane being used?

  • Daily crane inspection completed?

  • Lift chart present in crane?

  • Chains, rigging hardware and slings inspected and tagged as required?

  • Hand signal charts located in crane?

  • Crane Operator DOT physical in date?

  • Warning whistles being used?

  • Clear communication between signalman and crane operator?

CONCRETE CONSTRUCTION / SILICA

  • Proper PPE being worn (faceshield,apron,chem gloves for pouring concrete) N95/Respirator for cutting/drilling ops

  • Are employees protected from cement dust?

  • Is exposed skin covered?

  • Are walls over 8’ supported properly?

  • Rebar covered by caps?

  • Concrete pump permit complete?

  • Saw cut operations producing acceptable amount of dust?

  • Cutting operations using water/vacuum as deigned?

  • Concrete bucket in good condition?

PERSONAL PROTECTIVE EQUIPMENT

  • Hard hats, Safety glasses, vests and gloves being worn properly?

  • Faceshields being worn when needed? (Any operation producing flying debris)

  • Are respirators being used when required/needed?

  • Hearing protection being worn in environments greater than 90db?

MOBILE EQUIPMENT

  • Mobile Equipment equipped with back-up alarm?

  • Inspection report complete?

  • Operators certified for equipment?

  • Seat belts being used

  • Fire extinguisher on machine and inspected?

  • All machines have a century label on them?

STAIRS

  • Stairs with more than 4 risers equipped with handrail?

  • Metal pan stairs filled with wood until filled with concrete?

  • Proper landing at top of stairs?

  • Stair risers no more than 9.5”

HAZARD COMMUNICATION

  • Is there an SDS available to all employees?

  • SDS inventory on site and accurate?

  • Each original container labeled with product identifier, signal words, hazard statement, pictograms, precautionary statements, name, address, phone number of chemical manufacturer.

  • Is each secondary container (example spray cans) labeled with original labeling or product ID and words, pictures, and/or symbols which provide general information regarding the chemical contained inside.

  • Are materials properly stored?

  • Are employees trained in HAZCOM?

Unsafe Actions Observed

  • Please list all unsafe actions observed and the abatement for each

  • Summary of todays activities and conversations had.

  • Conference with GC

  • If yes above, name and title

NEAR MISSES

  • Near Miss today

  • Describe near Miss and abatement

INCIDENTS TODAY?

  • Any incidents / Injuries Today?

  • Detail todays incident below

UPCOMING HIGH RISK ACTIVITES

  • Are there any high risk activities coming up in the next 4-6 weeks?

  • If so, detail below

TRAINING / TOOL BOX TALK

  • Topic of training

  • Copy of roster sent to GC?

SAFETY PRO COMPLETING REPORT

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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.