Title Page
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Conducted on
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Prepared by
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Site Location / Store Number
General
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Job Box on site
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Fire Extinguishers inspected
Housekeeping / Barricading
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Work site neat and orderly
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Barricading / Fencing / Signage in place
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Following CDC guidelines
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What job sites have you traveled to today.
Personal Protective Equipment
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Head Protection being used
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Eye Protection being used
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Hi Vis / Proper clothing being worn
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Other PPE
Fall Protection
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6 Ft. Fall Protection being followed
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Personal Fall Arrest used properly
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Guardrail / Toeboards installed properly/complete
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Warning lines / Barricading installed properly/complete
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Holes covered/labeled
Ladders and Stairs
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Ladders suitable for the job (use, condition, size, type, secured)
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Stairway rails / Handrails installed when required
Hand and Power Tools
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Proper tools for the job
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Guards in place
Electrical
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Electrical cords protected
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Electrical cords in good repair
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Assured grounding program being followed
Excavation and Trenching
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Proper shoring and/or sloping of excavation
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Proper placement of spill piles
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Adequate means of egress
Scaffolds
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Erected on rigid footing
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Scaffold, square and level
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Cross braces are complete
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Toe Guards secure and place
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Complete guard rail system
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Proper access/egress
Cranes and Derricks
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Areas within the swing radius barricaded
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Proper Rigging / Tag Lines
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CCO
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Concrete / Masonary
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Rebar Caps in place
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Silica controls in place
Weather Conditions
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Temperature / Degrees
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Rainy
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Sunny
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Cloudy
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Windy
Site Activities
Subcontractors or Visitors on Site
Equipment Rental and/or Material Deliveries
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Forklift
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Scissors Lift
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Straight Boom
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Skidsteer
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Generator
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Temp Heater
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Other:
Notes/Corrective Action/Follow Up/Other
Request of notifications to be sent (Sub, incident, direction)
Completed by:
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Select date
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