Information

  • Location
  • Client

  • Site

  • Conducted on

  • Prepared by

  • Personnel

COVID-19

  • Are all employees wearing proper face covering?

  • Instruct employee to put face covering back on, notify their foreman, and retrain.

  • Are employees practicing social distancing?

  • Instruct employees to practice social distancing per Southland COVID-19 plan.

  • Do we have adequate sanitizing supplies readily available on site?

  • Instruct employees to stop and get proper sanitizing supplies. Also notify foreman.

FALL PROTECTION

  • Are guard rails present at all perimeters/shafts?<br>

  • Contact responsible party immediately. Keep a safe distance from hazard and instruct others to avoid hazard.

  • Are ladders inspected and in good condition?<br>

  • Tag ladder out of service and inform foreman and tool room.

  • Is fall protection equipment inspected and in good condition?

  • If repairable, tag out of service and inform foreman and tool room. If not repairable, destroy so it will not be used and dispose. Inform foreman and tool room.

  • Are scissor lifts being inspected and documented?

  • Are PFAS anchor points capable of holding 5000 lbs. per person?

  • Stop personnel immediately. Inform foreman. Coach employees on proper anchor points. Issue infraction(s) if appropriate.

  • Are holes > 2" protected?

  • Inform foreman. Tape area off if appropriate.

PERSONAL PROTECTIVE EQUIPMENT

  • Is all required PPE available for use?

  • Assist foreman with obtaining proper PPE.

  • Is PPE being worn at all times by employees?

  • Inform foreman and issue WRITTEN infraction.

ELECTRICAL

  • Is temporary power out of the way of our work?

  • Inform foreman and assist with coordination with electrical contractor if requested.

  • Are extension cords elevated to avoid tripping hazards?

  • Inform foreman and consider use of zip ties, J-hooks or other no conductive means to elevate cords.

  • If permanent power is being used, are GFCI pigtails being used?

  • Inform foreman and assist with obtaining GFCI pigtails if necessary.

TOOLS

  • Are auxiliary handles present on tools where they are required?

  • Inform foreman. If handle is not readily available, confiscate tool until handle can be replaced. Assist foreman with obtaining replacement handle if requested.

  • Are pipe vises being used for cutting?

  • Inform foreman. Coach employees to use proper cutting techniques.

  • Are cords on tools original from factory?

  • Inform foreman and tool room. Confiscate tool, tag it out of service and return to tool room for repair.

HOUSEKEEPING

  • Is the area free of trash & trip hazards?

  • Inform foreman. Assist with clean-up efforts.

  • Are barricades/tape/signs maintained?

  • Inform foreman. Assist with taping and signs.

  • Is there enough light to see clearly?

  • Inform foreman. General Contactor/Electricians are responsible for providing area lighting. We are responsible for task specific lighting.

MATERIAL HANDLING

  • Are carts being used to move materials?

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  • Are materials being stored on carts?

  • Is the area free of excess materials?

  • Has rigging been inspected?

  • Inspect rigging.

  • Is material handling equipment such as roustabouts or duct jacks inspected?

  • Use equipment checklists to complete inspections.

  • For Genie duct jacks, are Genie extensions the only ones being used?

  • Inform foreman. Confiscate illegal extensions. Note: Vermette jacks allow use of pipes/units rut.

FIRE PREVENTION

  • Are flammable materials being stored in a flammable cabinet?

  • Inform foreman. Assist in moving flammables to proper storage.

  • Has welding equipment been inspected?

  • Inform foreman.

  • Is there a fire watch present for hot work activities?

  • Inform foreman. Ensure fire watch is present for hot work.

  • Are fire extinguishers inspected?

  • Inform foreman. Assist with inspecting and/or tagging extinguishers.

  • Are gas cylinders secured from falling?<br>

  • Inform foreman. Assist in securing cylinders.

  • Did you observe any safe behaviors durring you inspection?

  • What was or were the safe behaviors exhibited?

Were there any good observations or concerns that haven't been addressed?

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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.