• Project / Job Name

  • Foreman

  • Department

  • Branch Office

  • Conducted on

  • Auditor

General Jobsite Safety

  • Health and Safety Manual

  • Claims Packets

  • First Aid Kit

  • Expiration Date of Kit

  • Weekly Toolbox Talk reviewed

  • Reviewed onsite

  • This weeks TBT Topic:

  • Fire Extinguishers available if needed

  • Medcor Programmed into Company Phones

  • If no company phones; stickers and/or poster visible

  • Lean Trucks - Would the foreman feel comfortable giving the area manager / operations manager a ride in his truck?

Specific Jobsite Safety

  • Daily Huddle completed

  • Daily Huddle Documented

  • Stretching Routine completed

  • PPE - Hardhats, Safety Glasses, Work Boots worn by all employees?

  • Additional PPE required or worn by employees:

  • Electrical - cords in good condition?

  • GFCI in use

  • Cords taped for appropriate quarter

  • Fall Protection - in place?

  • Holes covered

  • Guardrails in good condition

  • Harnesses / tie-off points provided and in good condition

  • Ladders - work completed from ladders performed safely?

  • Inspected before use

  • Stickers in good condition?

  • Lifts - work completed using aerial lifts performed safely

  • Pre-use lift inspection performed and documented?

  • Hand Tools - in good condition

  • No Cheaters

  • No Cracked Handles

  • Material Handling - carts in use to transport materials

  • Rigging / slings in good condition

  • Material Storage - Neat and in order? Good Housekeeping?

Loss Prevention / Risk Management


  • Discussed "Never work on Live Systems" and "Trust but verify" with field

  • Sure-off Tester is available

Work Start

  • Signed Agreement in place (contract, work order, signed PO with terms, etc.)

  • Control Valve is shut

  • Main Drain is open

  • Trapped water drained

  • Owner/Occupant property covered or removed from work area

Review w/ crew for work end

  • Clean up work area

  • Test with air before water

  • Turn on water in small increments / check work area for leaks

  • Service Work Ticket?

  • Obtain 2nd Signature

  • Circle "in-service" or "out of service"

  • If system will be left out of service get owner/occupant to sign Deactivation Authorization Notice

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.