Title Page

  • Supervisor(s)

  • Job Site:

  • Conducted on

  • Prepared by

Training documents

  • Competent Person

  • Site Management

  • OSHA Training Documents

  • Equipment Operators

  • Site Orientation

Site Prep

  • EAP Posted

  • Federal/State poster

  • Safety Bulletin Board

  • Muster Area Identified

  • Storm Alert

  • Cooling/Heat Stations

Site Conditions

  • PTP Available

  • Tools In Good Condition

  • Falls Hazards Mitigated

  • Hand protection

  • Safety Glasses

  • Hard Hats

  • High-Vis Reflective Vest

  • Hearing Protection

  • Safety Toed Work Boots

  • House Keeping

  • Emergency Phone Numbers Posted

  • Flammable Storage

  • GFCI In Use

  • Material Storage

  • Hot Work Permit

  • Confined Space Permit

  • Energized Electrical Work

  • Mobile Equipment

  • Material Handling

  • Ladder Use

  • Scaffolding

  • Rigging

  • Qualified Signal Persons

Inspections

  • Daily Equipment Inspection

  • Current Fire Ext Inspection

  • 2 Person High Hazard

  • Daily Crane Inspection

  • No Outdated First Aid Items

Confined Space

  • Competent Person

  • Atmosphere Monitoring

  • CSCP Identified/ Documented

  • Supervisor Trained

  • Entrant Trained

  • Attendant Trained

  • Proof Of Training Available

  • Danger Confined Space Posted At Point Of Entry

  • Gates or Barricades Used

  • Tagged With CS Signage

  • PRCS Plans Developed And Implemented

  • Documented Proof CS Team Understands Plan

  • SDS For exposed Entrants

  • Space Ventilated

  • Rescue / Retrieval Unit In Place

  • Entry Permit Posted

  • Signed By Entry Supervisor

  • Blanking Of System

  • Lock Out System

  • Non-Sparking Tools Being Used

  • Certification On Hand

  • Emergency Procedure Plan

  • Trained Rescue Team Onsite/Offsite Notified of Entry

Lockout /Tagout

  • LOTO Plan Developed

  • Inventory List / Lockout Points

  • Competent Person

  • Employees Trained

  • Assigned Locks

  • Annual Review Of Program

  • List Of Locks Issued

  • Affected Workers Notified

  • Locks / Tags Applied

  • Workers Trained in ERP

  • Energy Source Isolated

  • Testing (TRY)

  • All Notified Of Restored Power

Cranes

  • Annual Inspection

  • Certified Crane Operator

  • Qualified Rigger

  • Qualified Signal Person

  • Periodic Inspection

  • Energized Power Lines Near

  • Start Up Inspection

  • Crane on Firm / Level Ground

  • Crane Radius Barricaded

  • Workers Not Under Load

  • Communication Established

  • Lift Plan in Place

  • Critical Lift

Rigging

  • Inspected By CP

  • Manufactures Tag Legible

  • Load Balanced

  • Rated Weight Capacity

  • Wire Rope Corrosion

  • Kinking, Cushing, Birdcaging

  • Broken Strands In Wrap

  • Hooks Bent Or Twisted

  • Hook Self-Locking

  • Chaffing Of Synthetic Sling

  • Broken Stitches, Cuts, Tears, Or Chemical Burns

  • Excessive Wear

  • Rigging Stored Properly

Trench / Excavation

  • Trench / Excavation Plan

  • Proper Slope / Step

  • Daily Inspection

  • Water Controlled / Removed

  • Documented Inspection

  • Spoils 2' from Edge

  • Over 48" Ladder For Ingress / Egress

  • Multi-Gas Monitor Used

  • Barricaded Area

Mobile Equipment

  • Daily Inspection By CP

  • Backup Alarm

  • Documented Inspection

  • Operator Proof Of Training

  • Flashing Light On Top

  • Spotter In Use

Energized Electrical Work

  • Competent Person

  • Power Cabinets Protected

  • Hazardous Energy Control Plan

  • Individual Red Locks

  • Energized Work Permit

  • Lock Numbers Listed

  • Qualified Personnel

  • Lock User Identified

  • Verifiable Credentials

  • Flexible Cords Inspected

  • Arc Flash Requirements Known

  • GFCI In Use

Material Handling And Storage

  • Competent / Qualified Person

  • Hazards Identified And Controlled (PTP)

  • Trained Equipment Operators

  • Equipment In Use Has Documented Daily Inspections

  • Storage Area Clean And Neat

  • Flammable Storage Area

  • Fire Extinguisher Available

  • SDS for Hazardous Chemicals.

Comments

  • Comments

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.