Keller Inc. Focused Site Inspection

• Job Number

• Job

• Conducted on

  Date

• Prepared by

• Competent Person

Keller requirements are met, including PPE, site safety plan, housekeeping, hospital map, emergency numbers, daily tool box talks,

• Comments

  Safe

  At Risk

  N/A

1) Fall Hazards---aerial lifts, ladders, roof, scissors lifts and scaffolds. Includes railings and guarding of holes.

• Comments:

  Safe

  At Risk

  N/A

2) Struck By Hazards---vehicles, falling material, suspended loads, etc.

• Comments:

  Safe

  At Risk

  N/A

3) Electrical---GFCI, overhead, underground, tools, guarded from contact, etc.

• Comments:

  Safe

  At Risk

  N/A

4) Caught In-Between---under crane or forklift loads, pinch points, vehicle, material, etc.

• Comments:

  Safe

  At Risk

  N/A

Excavations including soil classification and means of protection, slope, shoring, step back, trench box.

• Comments:

  Safe

  At Risk

  N/A

Additional Comments or Concerns

• Comments:

  Safe

  At Risk

  N/A

• Prepared By:

  Sign

• Competent Person on Site:

  Sign

• Construction Manager:

  Sign

• Safety, Training, & Quality Control Services:

  Sign