Jobsite Safety Inspection

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Foreman

• Job Type

  Select

General

• Is the general work area neat and orderly?

  Yes

  No

  N/A

• Is trash and debris being placed in proper receptacles?

  Yes

  No

  N/A

• Does the Foreman know the MedCor reporting process?

  Yes

  No

  N/A

• Is there a first aid kit available?

  Yes

  No

  N/A

• Is there a fire extinguisher readily available?

  Yes

  No

  N/A

Slip, Trip & Fall Protection

• Are all hoses, cords, cables, metal banding, shovels, rakes etc. placed neatly away from walk ways?

  Yes

  No

  N/A

• Is the inside of the truck kept tidy and organized to prevent tripping hazards?

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• Are hard hats being worn when working below grade or around excavation equipment?

  Yes

  No

  N/A

• Are work boots work by all employees?

  Yes

  No

  N/A

• Are gloves, earplugs, safety glasses, mask(respirator) PPE readily available to all employees?

  Yes

  No

  N/A

• Are all forms of PPE worn by employees in good condition?

  Yes

  No

  N/A

Excavation & Trenching

• Is the crew aware of all potential existing utilities in the work area?

  Yes

  No

  N/A

• Is the crew aware of all overhead electrical lines in he work area?

  Yes

  No

  N/A

• Are all utilities marked?

  Yes

  No

  N/A

• Are excavations more than 5 feet deep protected from cave in by proper shoring or benching?

  Yes

  No

  N/A

• Are spoil piles kept back from the excavation edge by at least 2 feet?

  Yes

  No

  N/A

• Are excavation areas where crews are not actively working protected by barricades, fences or parked machines?

  Yes

  No

  N/A

Hand & Power Tools

• Are all tools stored neatly and protected from damage?

  Yes

  No

  N/A

• Are all power cords and extension cords free from cuts, frays and other damage?

  Yes

  No

  N/A

• Are all guards on tools in place and in working order?

  Yes

  No

  N/A

• Are all hands tools clean and in good repair?

  Yes

  No

  N/A

Heavy Equipment & Excavators

• Are all backup alarms functioning properly?

  Yes

  No

  N/A

• Are all seatbelts functioning and being used?

  Yes

  No

  N/A

Heat & Hydration

• Do all employees have access to cool shaded area to take breaks?

  Yes

  No

  N/A

• Do all employees have access to water?

  Yes

  No

  N/A

Corrective Action

• Do any areas need corrective action?

  Yes

  No

• What corrective action was taken?