Title Page

  • Site location

  • Conducted on

  • Prepared by

  • Tac mat clean and still working

  • If area is under negative air, manometer reads less than zero or area is obviously negative

  • Is the air discharge appropriate for the work being done

  • Is proper PPE being worn

  • Fire extinguishers are tagged with annual inspection date and monthly inspection

  • No pressurized tanks standing unsupported

  • No worksite contamination being tracked throughout the hospital

  • Contractors wearing proper ID

  • Proper fall protection implemented as required

  • Ladders are secured and used properly

  • Egress and exits are maintained free from obstructions

  • Proper paperwork posted (ILSM, ICRA, Hot work permit)

  • Window policy is being followed

  • Chemicals labeled and SDS on site

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