Information

  • Document No.

  • Job Site

  • General Contractor

  • Conducted on

  • Prepared by

  • Location
  • Supervisor

  • Competent Person

  • Crew Size

1. Work Environment

  • Drain holes same size as the drain pipe & membrane inside diameter by 1/2”

  • Adequate amenities? (Toilets, potable water, cups, dumpsters, etc)

  • No smoking on the roof?

  • Work area maintained neat and clean?

  • Tripping / puncture hazards addressed properly?

  • Equipment / material properly secured? (During transportation, on the roof, loading the roof)

  • Public protection?

2. Personal Protective Equipment (PPE)

  • Hard hats?

  • Eye and face protection?

  • Hand and foot protection?

  • Protective clothing? (Safety vests, long sleeve shirts, etc)

3. Hazardous Chemicals (Including Fuel and Oil)

  • Safety data sheets accessible on site?

  • Storage location? (Fire, spill, contamination hazards)

  • Chemical containers properly labeled?

  • Condition of chemical containers?

  • Hand sanitizing means available?

  • First aid kit stocked and available?

  • Emergency phone numbers and location available?

  • Exits available and accessible?

  • Approved flammable containers?

  • Fire extinguishers accessible?

  • Fire extinguisher maintenance? (Inspected, charged, and in good condition)

4. Ladders

  • Ladder condition?

  • Ladder angle? (4 to 1)

  • Ladder 3 feet above the landing and secured?

  • Proper use of ladder?

  • Ladder at least 10 feet away from electrical lines?

  • Stairways and ramps condition and use?

5. Scaffolds

  • Scaffold erected by certified company?

  • Scaffold is safe and complete?

  • Scaffold was inspected prior to use?

6. Job Site and Equipment

  • Equipment on site (Skytrak, Boom, Scissor lift, Etc,)

  • Condition of equipment and tools? (Missing or damaged guards, cords, etc)

  • Use of proper tool / equipment for the job?

  • Licensed equipment operator / vehicle driver?

  • Audible back up alarm?

  • Seat belts in use?

  • Following proper operating techniques?

  • Safe and secure loads?

  • Overhead hazards properly addressed?

  • GFCI in use, tested, and working properly?

  • Extension cords inspected using proper color coding?

7. Fall Protection

  • Guard rail / cable rail system set up properly?

  • PFAS / mobile fall protection cart used properly?

  • Openings in floor / wall properly protected?

  • Condition of fall protection equipment?

  • Warning line system set up and maintained properly?

  • Using approved cover removal techniques?

  • Weight of load distributed?

  • Decking strength?

  • Skylights / roof hatches properly protected?

  • Rescue equipment available? (Including rescue plan after an arrested fall)

Corrective Actions

  • Corrective actions taken while on site?

Sign Off

  • Competent Person's Signature

  • Auditor's Signature

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