LBC JOBSITE HAZARD ASSESSMENT 2

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

LB WORKFORCE WEARING PROPER PPE

• HARDHATS

  YES

  NO

• EYE PROTECTION

  YES

  NO

• HI-VIZ LB VESTS or LB SHIRTS

  YES

  NO

EMERGENCY ACTION

• FIRE EXTINGUISHER READILY AVAILABLE

  YES

  NO

• FIRST-AID KIT READILY AVAILABLE

  YES

  NO

• FIRST-AID / CPR TRAINED PERSON ONSITE

  YES

  NO

• EMERGENCY ACTION PLAN AVAILABLE

  YES

  NO

PREVENT HEAT ILLNESS

• WATER READILY AVAILABLE

  YES

  NO

PREVENT FALLS

• FALL HAZARDS PRESENT

  YES

  NO

PREVENT STRUCK-BY

• STRUCK BY HAZARDS PRESENT

  YES

  NO

PREVENT CAUGHT-IN / BETWEEN

• CAUGHT-IN / BETWEEN HAZARD PRESENT

  YES

  NO

PREVENT ELECTRICUTIONS

• ELECTRICUTION HAZARD PRESENT

  YES

  NO

HAZARD IDENTIFICATION

• FIND HAZARD

  YES

  NO

• REMOVE HAZARD

  YES

  NO

EQUIPMENT INSPECTION

• FORKLIFT

  YES

  NO

• SCISSOR LIFT

  YES

  NO

• BOOM LIFT

  YES

  NO

FINAL HAZARD RATING (10 - EXTREMELY HAZARDOUS)

• HAZARD RATING

NOTES

HAZARD REVIEW

• FOREMAN HAZARD REVIEW

  Sign

• SAFETY HAZARD REVIEW

  Sign