Information

  • PROJECT NAME

  • PROJECT NUMBER

  • GENERAL CONTRACTOR

  • CONDUCTED ON

  • PREPARED BY

  • Location
  • Number of Personnel on Site

PROJECT MANUALS & POSTINGS

  • Federal & State Posters

  • Anti-Harrassment

  • Safety Manual

  • MSDS

  • Toolbox Talks

  • NOI, Employee Warnings, Termination Slips

  • Weekly Job site Safety Inspections conducted?

FLOORS

  • Slip, Trip, or Fall Hazards

  • Openings covered or enclosed

  • Clean, orderly and free of oil or grease hazards

STAIRS

  • Uniform height & tread depth

  • Grating-type tread on exterior stairs

  • Sturdy railings on all open sides

  • No storage of materials on stairs

  • Proper lighting on stairs

SCAFFOLDS

  • Level and plumb

  • Proper access to scaffolding

  • Fully planked

  • Wheels in locked position when in use

LIGHTING

  • Illumination level sufficient for work being performed

  • All temporary lighting cages closed

  • Temporary lighting on separate branch circuit

  • Temporary lighting utilizes non-conductive supports

  • Temporary lighting supported every 10 feet

PORTABLE TOOLS & EQUIPMENT

  • Electrically grounded

  • Guards and safety fixtures safe and operable

  • Personnel trained on their use of tools

  • Cords in good condition

ELECTRICAL

  • Panels clearly identified and secured

  • Only qualified electricians allowed access

  • Extension cords free of frays and absent of splices

  • Panel schedules updated

LOCK-OUT TAG-OUT SYSTEMS

  • Locks with individual keys given to each electrician

  • Personalized danger tags provided to each person

  • Lock-out system will reduce power to zero-energy state

  • All personnel test to confirm zero energy

PERSONAL PROTECTIVE EQUIPMENT

  • Gloves properly chosen for work performed

  • 100% eye protection in use by personnel

  • Hard hats used by personnel

  • Foot protection properly selected for work performed

  • Hearing protection selected for areas above noise standard (85dB)

LADDERS

  • Serviceable

  • Proper use

  • Not on top two steps

  • Proper height for the task

  • Stepladders in the fully opened and locked position

  • Straight ladders used for access are 3 feet above edge

  • Proper ratio (4:1)

  • 3 points of contact when ascending and descending

FALL PROTECTION

  • 100 % tied off

  • Anchor point capable of supporting 5000 lbs.

  • Utilized while in man-lifts or bucket trucks

EXCAVATION AND TRENCHING

  • All trenches and excavations have been inspected

  • Spoil piles located 2 feet from edge

  • Access & Egress located within 25 feet of personnel

  • At 5 feet, protective system in place (shielding or shoring)

  • All soil treated as type 'C' and slipped at 1 1/2 : 1

  • Excavations over 20 feet designed by Engineer

ADDITIONAL COMMENTS:

  • Additional Comments?

SIGN OFF

  • Individual Conducting Inspection

  • Project Superintendant

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.