Yes= Safe and Compliant; No= Deficiency or Non-Compliance; N/A= Not applicable



Pre-job planning documents at worksite are up to date and cover activities


Drinking Water/ Sanitation Requirements/ First Aid Kit

Electrical (proper grounding and GFCI)

Lock and Tag

Hand and Power Tools (guards in place, good cords/ plugs, etc.)

Walking/ working surfaces (including ladders, floor openings, aisle ways, and stairs)

Proper PPE

Vehicles (Parking/ Fire Extinguisher)

Heavy Equipment/ Crane & Rigging equipment

Excavation (inspection by competent person)

Fire Extinguishers

Permits (hot work, excavation, fall protection, etc.)

Chemical/Storage SDSs on site with containers labeled

Scaffold System (competent person)

Radiological Work

General area barricading/ Warning signs

Weekly Focus/ Safety Tailgate

Comments/Corrective Action

• Note all deficiencies or non-compliance in comment section

• Note all items corrected on the spot and also any that need follow up resolution. (Consider initiating a Condition Report)

• DOCUMENT safety and health inspection results, including results that identify existing and potential safety and health hazards and non-compliances, as well as general observations of unsafe acts or behaviors.

• COMMUNICATE results of the safety and health inspection performance to Project Management.

Work Performed:


Craft Person(s) if applicable:


Follow up resolution required?

Safety Signature

Work Week Completion

Week End Sign off
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.