Office Inspection.

• Document No.

• Conducted on

  Date

• Job Type

  Select Water Fire Mold Contents Reconstruction Office

  • Water
  • Fire
  • Mold
  • Contents
  • Reconstruction
  • Office

• Client / Site

• Prepared by

• Location
  Address

• Employees on site:

  Select Abbey Heidecker Adam Walz Antonio Portillo Bo Nelson Brandon Murray Caitlin Shutrop Cameron Nidever Chris Notermann Cody Burke Demetrius Atchison Ed Ullman Hanna Anderson Harley Bauer Hunter South Izaiah Reynolds Jamey Grimsley Jaxon Hickman Jeremy Lund Jessica Mox Joe Hickman Joel Bondhus Jordan Rosendahl Kayla Darveaux Kayli Luna Keith Nyquist Ken Kako Kou Vue Krystal Fair Laura Cash Mark Giroux Mathew Anderson Matt Running Mike Hornung Mikayla Hackbarth Miranda McKenzie Nate Johnson Nic Madzey Nicole Kranz Robert Erlien Ryan Andresen Savannah Minerich Shanda Daluge Shaun Hickman Shayna Floyd Steve Peterson Theresa Parthum Todd Thrall Tom Wasilk Other

  • Abbey Heidecker
  • Adam Walz
  • Antonio Portillo
  • Bo Nelson
  • Brandon Murray
  • Caitlin Shutrop
  • Cameron Nidever
  • Chris Notermann
  • Cody Burke
  • Demetrius Atchison
  • Ed Ullman
  • Hanna Anderson
  • Harley Bauer
  • Hunter South
  • Izaiah Reynolds
  • Jamey Grimsley
  • Jaxon Hickman
  • Jeremy Lund
  • Jessica Mox
  • Joe Hickman
  • Joel Bondhus
  • Jordan Rosendahl
  • Kayla Darveaux
  • Kayli Luna
  • Keith Nyquist
  • Ken Kako
  • Kou Vue
  • Krystal Fair
  • Laura Cash
  • Mark Giroux
  • Mathew Anderson
  • Matt Running
  • Mike Hornung
  • Mikayla Hackbarth
  • Miranda McKenzie
  • Nate Johnson
  • Nic Madzey
  • Nicole Kranz
  • Robert Erlien
  • Ryan Andresen
  • Savannah Minerich
  • Shanda Daluge
  • Shaun Hickman
  • Shayna Floyd
  • Steve Peterson
  • Theresa Parthum
  • Todd Thrall
  • Tom Wasilk
  • Other

• Employee name:

General

• Select site weather conditions at time of this inspection (select all that apply)

  Select Clear Sky Cloudy Raining Windy Hazy Snow / Hail OTHER

  • Clear Sky
  • Cloudy
  • Raining
  • Windy
  • Hazy
  • Snow / Hail
  • OTHER

• Describe weather conditions on site today

• Minimum temperature today?

• Maximum temperature today?

• Current activities being undertaken on site (select all that apply)

  Select General Abatement Demolition Flooring Removal Drywall Removal CeilingTeardown Insulation Removal Electrical Plumbing Roofing Painting Drywall Trim Cleaning Post Con OTHER

  • General
  • Abatement
  • Demolition
  • Flooring Removal
  • Drywall Removal
  • CeilingTeardown
  • Insulation Removal
  • Electrical
  • Plumbing
  • Roofing
  • Painting
  • Drywall
  • Trim
  • Cleaning
  • Post Con
  • OTHER

• Describe activities being undertaken on site

Site Safety Inspection

Parking Lot

• What is the condition of the parking lot?

  Good

  Fair

  Poor

  N/A

• What is the condition of the lines?

  Good

  Fair

  Poor

  N/A

• What is the condition of the sidewalk?

  Good

  Fair

  Poor

  N/A

• What is the condition of the loading docks?

  Good

  Fair

  Poor

  N/A

Outside of the building

• What is the condition of the downspouts?

  Good

  Fair

  Poor

  N/A

• What is the condition of the siding?

  Good

  Fair

  Poor

  N/A

• What is the condition of the pedestrian doors?

  Good

  Fair

  Poor

  N/A

• What is the condition of the garage doors?

  Good

  Fair

  Poor

  N/A

• What is the condition of the windows?

  Good

  Fair

  Poor

  N/A

Fire Prevention

• Is a Fire Extinguisher present?

  Yes

  No

  N/A

• Is there a tag on the fire extinguisher?

  Yes

  No

  N/A

• Is the fire extinguisher in good condition?

  Yes

  No

  N/A

• Is the fire extinguisher properly charged?

  Yes

  No

  N/A

• Is the fire extinguisher clear of obstructions?

  Yes

  No

  N/A

• Are smoke detectors working?

  Yes

  No

  N/A

• Are carbon monoxide detectors working?

  Yes

  No

  N/A

First Aid

• Is there a First Aid kit present?

  Yes

  No

  N/A

• Are the first aid kits properly stocked?

  Yes

  No

  N/A

• No first aid contents past their expiry date?

  Yes

  No

  N/A

• Are the first aid supplies easily accessible?

  Yes

  No

  N/A

• Employees aware of location of first aid kit?

  Yes

  No

  N/A

Medical Facility

• Is cell service in the area good to be able to call 911?

  Yes

  No

  N/A

• Do employees know the location of the closest Medical facility?

  Yes

  No

  N/A

• Is the employee trainined in First Aid?

  Yes

  No

  N/A

Site Security

• Is site security to be inspected in this audit?

  Yes

  No

  N/A

• Is the EAP (Emergency Action Plan) posted?

  Yes

  No

  N/A

• Are entry and exits clear and free of obstructions?

  Yes

  No

  N/A

• Are the walkways clear?

  Yes

  No

  N/A

• Is there adequate lighting?

  Yes

  No

  N/A

• Are the appropriate doors locked/unlocked?

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• Is Personal Protective Equipment to be inspected in this audit?

  Yes

  No

  N/A

• Is the appropriate PPE being used?

  Yes

  No

  N/A

• Is eye protection worn (blue light filter)?

  Yes

  No

  N/A

• Are nitrile gloves being worn?

  Yes

  No

  N/A

• Is respiratory protection worn where dust, mist or fumes are present?

  Yes

  No

  N/A

• Is footwear in good condition and of correct type?<br>

  Yes

  No

  N/A

• Is additional PPE used where required?

  Yes

  No

  N/A

• Are staff aware of correct PPE for tasks they are trained to perform?

  Yes

  No

  N/A

Trip and Fall Safety

• Trip and fall safety to be inspected in this audit?

  Yes

  No

  N/A

• Are floor surfaces even and uncluttered?

  Yes

  No

  N/A

• Are entry and walkways kept clear?

  Yes

  No

  N/A

• Are floor surfaces free of liquid spills?

  Yes

  No

  N/A

• Are walkways adequately and clearly marked?

  Yes

  No

  N/A

• Is the ice taken care of?

  Yes

  No

  N/A

• Are pedestrian walk railings in good condition?

  Yes

  No

  N/A

• Are rugs in good condition?

  Yes

  No

  N/A

• Are all floor openings fully barricaded or are protected with a secured cover and labelled?

  Yes

  No

  N/A

Ladders

• Ladders to be inspected in this audit?

  Yes

  No

  N/A

• Is the appropriate sized ladder being used?

  Yes

  No

  N/A

• Are ladders clean and in good condition?

  Yes

  No

  N/A

• If used for electrical work are ladders non conductive? (wood or fibre glass.)

  Yes

  No

  N/A

• Are ladders being used according to instructions?

  Yes

  No

  N/A

• For extension ladders: are ropes, pulleys and treads in a good state of repair?

  Yes

  No

  N/A

• Are ladders not used to access heights when higher order controls should be used?

  Yes

  No

  N/A

Bathrooms

• Bathroom situation to be inspected in this audit?

  Yes

  No

  N/A

• Is the area clean?

  Yes

  No

  N/A

• Is the floor clean and free of water?

  Yes

  No

  N/A

• Are wet floor signs present?

  Yes

  No

  N/A

• Is it properly stocked (paper towels, soap, toilet paper, etc.)

  Yes

  No

  N/A

Electrical Safety

• Electrical safety to be inspected this audit?

  Yes

  No

  N/A

• Are appropriate extension cords being used?

  Yes

  No

  N/A

• Personal heaters unplugged at the end of the day?

  Yes

  No

  N/A

• There are no outlets are overloaded / No double adapters in use?

  Yes

  No

  N/A

• There are no broken plugs, sockets or switches?

  Yes

  No

  N/A

• No frayed or damaged leads?

  Yes

  No

  N/A

• Water sources away from outlets?

  Yes

  No

  N/A

• Service panels are unobstructed?

  Yes

  No

  N/A

Housekeeping

• Is site housekeeping to be inspected in this audit?

  Yes

  No

  N/A

• Is the rubbish and debris laying around?

  Yes

  No

  N/A

• Are chemicals stored properly?

  Yes

  No

  N/A

• Does the area look professional?

  Yes

  No

  N/A

• Does the area have adequate lighting?

  Yes

  No

  N/A

• Are fire extinguishers clear 3' around?

  Yes

  No

  N/A

• Are walkways and exits clear of debris/tools?

  Yes

  No

  N/A

• Are rugs in good condition?

  Yes

  No

  N/A

• Are emergency exit signs working properly?

  Yes

  No

  N/A
Office Work Area

• Office desk work area to be inspected in this audit?

  Yes

  No

  N/A

• Who's Work Area:

  Select Abbey Heidecker Adam Walz Antonio Portillo Bo Nelson Brandon Murray Caitlin Shutrop Cameron Nidever Chris Notermann Cody Burke Demetrius Atchison Ed Ullman Hanna Anderson Harley Bauer Hunter South Izaiah Reynolds Jamey Grimsley Jaxon Hickman Jeremy Lund Jessica Mox Joe Hickman Joel Bondhus Jordan Rosendahl Kayla Darveaux Kayli Luna Keith Nyquist Ken Kako Kou Vue Krystal Fair Laura Cash Mark Giroux Mathew Anderson Matt Running Mike Hornung Mikayla Hackbarth Miranda McKenzie Nate Johnson Nic Madzey Nicole Kranz Robert Erlien Ryan Andresen Savannah Minerich Shanda Daluge Shaun Hickman Shayna Floyd Steve Peterson Theresa Parthum Todd Thrall Tom Wasilk Other

  • Abbey Heidecker
  • Adam Walz
  • Antonio Portillo
  • Bo Nelson
  • Brandon Murray
  • Caitlin Shutrop
  • Cameron Nidever
  • Chris Notermann
  • Cody Burke
  • Demetrius Atchison
  • Ed Ullman
  • Hanna Anderson
  • Harley Bauer
  • Hunter South
  • Izaiah Reynolds
  • Jamey Grimsley
  • Jaxon Hickman
  • Jeremy Lund
  • Jessica Mox
  • Joe Hickman
  • Joel Bondhus
  • Jordan Rosendahl
  • Kayla Darveaux
  • Kayli Luna
  • Keith Nyquist
  • Ken Kako
  • Kou Vue
  • Krystal Fair
  • Laura Cash
  • Mark Giroux
  • Mathew Anderson
  • Matt Running
  • Mike Hornung
  • Mikayla Hackbarth
  • Miranda McKenzie
  • Nate Johnson
  • Nic Madzey
  • Nicole Kranz
  • Robert Erlien
  • Ryan Andresen
  • Savannah Minerich
  • Shanda Daluge
  • Shaun Hickman
  • Shayna Floyd
  • Steve Peterson
  • Theresa Parthum
  • Todd Thrall
  • Tom Wasilk
  • Other

• Are lights off if the space is not occupied?

  Yes

  No

  N/A

• Are work surfaces neat and orderly?

  Yes

  No

  N/A

• Are computers working properly?

  Yes

  No

  N/A

• Are shelves secured?

  Yes

  No

  N/A

• Are drawers closed?

  Yes

  No

  N/A

• Are outlets overloaded?

  Yes

  No

  N/A

• Are there sharp edges?

  Yes

  No

  N/A

• Are wires stored properly (out of the way)?

  Yes

  No

  N/A

• Is the chair in good condition?

  Yes

  No

  N/A

• Is there any other broken furniture?

  Yes

  No

  N/A

• Easy access to exits?

  Yes

  No

  N/A

• Is furniture arranged in a non-hazardous way?

  Yes

  No

  N/A

• Are all ceiling tiles in place?

  Yes

  No

  N/A

• Work has ID badge with them?

  Yes

  No

  N/A

General Comments

• Any further comments or recommendations arising from this inspection?

• Add any additional relevant photos

  Media

• Have all required corrective actions been added as Actions to this inspection?

  Yes

  No

  N/A

• Please add any corrective actions to the appropriate questions above before completing this report

Sign Off

• Name & Signature of Inspector

  Sign

• Completed:

  Date