Information
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Conducted on
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Prepared by
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Client / Site / Job Number:
Ensure that the Jobsite is safe in accordance with the Johnson Wilson Safety Guide:
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All Sub-Contractors have an AWAIR Program (MN Sites Only)
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Right-to-Know / GHS / SDS
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Lead, Asbestos, Silica Exposures
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Respiratory Protection (Voluntary & Required Use)
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Fall Protection (6' Trigger Height)
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Steel Erection (15' & 30' Trigger Heights, Controlled Decking Area, Controlled Access Below)
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Ladders (Proper Use)
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Stairways (Handrails, Steps, etc.)
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Scaffolding (10' Trigger Height for Fall Protection, fully planked, mud sills, safe access, secured)
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Cranes (Operator License, Inspections, Lifting Calculations, Critical Lifts)
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Hoisting & Rigging, Signalers (Must be Trained/Certified)
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Electrical Wiring & Equipment (Cords, Panels, Covers, Protect from Damage, Overhead Power Lines)
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Forklift Operators (Trained & Certified 3 Years, Inspections, Seatbelts)
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Aerial Work Platforms (PFAS, Guardrails, Secured)
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Excavations (2,4,5 Rules - A,B,C Soil Types)
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First Aid & CPR (EMS Response within 4 minutes)
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Woodworking Machines (Guards in Place, Push Sticks)
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Power Tools (Cords, Guards/Shields, Proper Use)
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Fire Extinguishers (75 feet max travel distance, located on each floor, 3A, 40 B:C rating (5-6lb ABC) minimum size)
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Demolition (Stability Dust Control, Safe Access/Egress, Holes)
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Personal Protective Equipment - Proper Use
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To the Best of Your Knowledge All Other Jobsite Hazards are Controlled
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Please Sign Here When Your Safety Inspection is Complete