Johnson-Peltier Monthly Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Job Name:

• Job # :

• Select date

  Date

Housekeeping

• Clutter

  Safe

  At Risk

  N/A

• Trash Containers

  Safe

  At Risk

  N/A

• Trade Clean Up

  Safe

  At Risk

  N/A

• Temp Lighting

  Safe

  At Risk

  N/A

• Material Lighting

  Safe

  At Risk

  N/A

Personal Protective Equipment

• Hard Hat

  Safe

  At Risk

  N/A

• Eye Protection

  Safe

  At Risk

  N/A

• Gloves

  Safe

  At Risk

  N/A

• Clothing

  Safe

  At Risk

  N/A

• Safety Vest

  Safe

  At Risk

  N/A

• Gas Monitor

  Safe

  At Risk

  N/A

• Safety Harness

  Safe

  At Risk

  N/A

• Other

  Safe

  At Risk

  N/A

Body Movement/Positioning

• Straining

  Safe

  At Risk

  N/A

• Body Movement Awareness

  Safe

  At Risk

  N/A

• Teamwork(Communication)

  Safe

  At Risk

  N/A

• Visibility

  Safe

  At Risk

  N/A

• Positioning/Stability

  Safe

  At Risk

  N/A

• Lifting

  Safe

  At Risk

  N/A

• Firm Base

  Safe

  At Risk

  N/A

• Pinch Points

  Safe

  At Risk

  N/A

• Horseplay

  Safe

  At Risk

  N/A

Vehicle Use

• Safety Belts

  Safe

  At Risk

  N/A

• Trucks on location

  Safe

  At Risk

  N/A

• Traffic Laws

  Safe

  At Risk

  N/A

• Vehicle Condition

  Safe

  At Risk

  N/A

• Forklift Operation

  Safe

  At Risk

  N/A

Electrical

• Lockout Equip. & Use

  Safe

  At Risk

  N/A

• Extension Cords

  Safe

  At Risk

  N/A

• Spider Boxes

  Safe

  At Risk

  N/A

• Energized equipment

  Safe

  At Risk

  N/A

• Temporary Lighting

  Safe

  At Risk

  N/A

• Electric Tools

  Safe

  At Risk

  N/A

Misccellaneous

• Ladders

  Safe

  At Risk

  N/A

• Trenches/Excav.

  Safe

  At Risk

  N/A

• Scaffolding

  Safe

  At Risk

  N/A

• Barricades

  Safe

  At Risk

  N/A

• Tools

  Safe

  At Risk

  N/A

• First Aid

  Safe

  At Risk

  N/A

• Floor, Wall Openings, & Stairways

  Safe

  At Risk

  N/A

• Confined Space

  Safe

  At Risk

  N/A

• Fire Extinguishers

  Safe

  At Risk

  N/A

• Scissor Lifts

  Safe

  At Risk

  N/A

• Postings

  Safe

  At Risk

  N/A

• Comments:

• Routing: General Contractor (copy), Job File (copy), Safety Department (original)

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