Jobsite Safety Inspection Report

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

JOB INFORMATION

• Safety Book

  Yes

  No

  N/A

• Tool box safety talks?

  Yes

  No

  N/A

• MSDS Book?

  Yes

  No

  N/A

• Work areas properly signed and barricaded?

  Yes

  No

  N/A

• Water available?

  Yes

  No

  N/A

HOUSEKEEPING

• Work areas neat?

  Yes

  No

  N/A

• Waste containers provided and used?

  Yes

  No

  N/A

• Passageways and walkways clear?

  Yes

  No

  N/A

• Cords and leads off the floor?

  Yes

  No

  N/A

FIRE PREVENTION

• Adequate fire extinguishers, checked and accessible?

  Yes

  No

  N/A

• Hot Work Permit Filed?

  Yes

  No

  N/A

• "No Smoking" posted and enforced near flammables?

  Yes

  No

  N/A

ELECTRICAL

• Extension wires with bare wires or missing ground prongs taken out of service?

  Yes

  No

  N/A

• Ground fault interrupters being used?

  Yes

  No

  N/A

• Terminal boxes equipped with required covers?

  Yes

  No

  N/A

HAND, POWER & POWDER ACTUATED TOOLS

• Hand tools inspected regularly?

  Yes

  No

  N/A

• Guards in place on machines?

  Yes

  No

  N/A

• Correct tool being used for job at hand?

  Yes

  No

  N/A

• Operators of powder actuated tools licensed?

  Yes

  No

  N/A

FALL PROTECTION

• Safety rails and cables secured properly?

  Yes

  No

  N/A

• Safety harnesses worn properly?

  Yes

  No

  N/A

• Employees exposed to fall hazards tied off?

  Yes

  No

  N/A

• Employees below protected from falling objects?

  Yes

  No

  N/A

LADDERS

• Ladders extended at least 36" above landing?

  Yes

  No

  N/A

• Ladders are secure to prevent slipping, sliding or falling?

  Yes

  No

  N/A

• Ladders with split or missing rungs taken out of service?

  Yes

  No

  N/A

• Stepladders used in fully open position?

  Yes

  No

  N/A

• No step at top two rungs of stepladder?

  Yes

  No

  N/A

SCAFFOLDING

• All scaffolding inspected daily?

  Yes

  No

  N/A

• Erected on sound rigid footing?

  Yes

  No

  N/A

• Tied to structure as required?

  Yes

  No

  N/A

• Guardrails, intermediate rails, toe boards and screens in place?

  Yes

  No

  N/A

• Planking is sound and sturdy?

  Yes

  No

  N/A

• Proper access provided?

  Yes

  No

  N/A

• Employees below protected from falling objects?

  Yes

  No

  N/A

FLOOR & WALL OPENINGS

• All floor openings planked over or barricaded?

  Yes

  No

  N/A

• Perimeter protection in place?

  Yes

  No

  N/A

• Deck planks secure?

  Yes

  No

  N/A

• Materials stored away from edge?

  Yes

  No

  N/A

TRENCHES, EXCAVATION & SHORING

• Competent person identified and present?

  Yes

  No

  N/A

• Excavations are shored and sloped back?

  Yes

  No

  N/A

• Materials are stored at least 2' away from trench?

  Yes

  No

  N/A

• Ladders provided every 25' in trench?

  Yes

  No

  N/A

• Equipment is at a safe distance from edge of trench or excavation?

  Yes

  No

  N/A

MATERIAL HANDLING

• Materials properly stored or stacked?

  Yes

  No

  N/A

• Employees using proper lifting techniques?

  Yes

  No

  N/A

• Proper number of workers for each operation?

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Hard hats being worn?

  Yes

  No

  N/A

• Safety glasses being worn?

  Yes

  No

  N/A

• Respirators used when required? Proper respirator documentation available?

  Yes

  No

  N/A

• Hearing protection being worn when required?

  Yes

  No

  N/A

• Traffic vests or high visibility clothing material being worn?

  Yes

  No

  N/A

SUBCONTRACTOR'S

• Westside Mechanical's Subcontractors working Safe?

  Yes

  No

  N/A

SIGNATURES

• Safety Manager

  Sign

• Superintendent

  Sign

• Rich Bulava

  Sign