Title Page
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Conducted on
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Week ending
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Community
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Prepared by
1. Community
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Work areas properly signed and barricaded?
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First aid suppplies readily accessible?
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Are portable toilet facilities available at the site?
2. Housekeeping
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General neatness of work area/job sites
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Projecting nails removed of bent over?
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Waste containers provided and used?
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Passageways and walkways clear?
3. Fire Prevention
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Phone no. of fire department posted?
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"No Smoking" signs posted and enforced?
4. Electrical
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Extension cords missing ground prongs or bare wires exposed?
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Ground fault circuit interrupters being used?
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Terminal boxes equipped with required covers?
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Are flexible cords and cables protected from damage?
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Are unused openings in cabinet boxes and fittings closed?
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Are all cabinets, panels, and switches located in wet locations enclosed in weather proof enclosures
5. Hand, Power & Power Actuated Tools
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Hand tools inspected regularly?
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Gaurds in place on machines, such as saws?
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Right tool being used for the job at hand?
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Operators of power actuated tools are licensed?
6. Fall Protection
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Safety rails and cables are secured properly?
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Employees exposed to fal hazards are tied off?
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Employees below protected from falling objects?
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Employees using body belts for positioning devices only?
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Are employees working more than 6' above a lower level protected by gaurdrails, safety nets, personal fall arrest system?
7. Ladders
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Ladders extend at least 36" above the landing?
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Ladders are secured to prevent slippnig, sliding, or falling?
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Ladders with split or mising rungs taken out of service?
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Stepladders used in fully open position?
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No step at top two rungs of stepladder?
8. Scaffolding
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All scaffolding inspected daily?
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Erected on sound rigid footing?
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Tied to structure as required?
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Gaurdrails, intermediate rails, toeboards and screens in place?
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Planking is sound and sturdy?
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Proper access provided?
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Employees below protected from falling objects?
9. Floor & Wall Openings
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All floor or deck openings are planked over or barricaded?
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Perimeter protection is in place?
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Deck planks are secured?
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Materials are stored away from edge?
10. Material Handling
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Materials are properly stored or stacked?
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Employees are using proper lifting methods?
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Proper number of workers for each operation?
11. Concrete Construction
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Employees are protected from cement dust?
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Exposed skin covered?
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Walls over 8' are supported?
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Are all protruding reinforcing rods covered?
12. Personal Protective Equipment
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Hard hats being worn?
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Safety glasses being worn?
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Respirators are used when required?
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Hearing protection being worn when required?
13. Vehicles
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Do vehicles or earth moving equipment with an obstructed view to the rear have backup alarm or used with an observer?
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Do vehicles or earth moving equipment have seat belts and are they used?
14. Stairs
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Are flights of stairs with 4 or more risers equipped with standard stair railings or handrails?
Violations or warnings given this week?
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Violations, lot # and date
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Warnings , lot # and date