Information

  • Site conducted

  • Company Name

  • Location

  • Report Date (YYYYMMDD)

  • Manager

  • Location

PRE-INSPECTION

  • Who did the inspector first contact at the jobsite? (Name and Position)

  • Did Compliance Officer show his/her credentials?

  • Attach copies of the Compliance Officer's credentials to this report.

  • Give a brief explanation why no credentials are attached.

  • Credentials
  • Compliance Officer's credentials

  • Inspector's Name. (List all inspectors, if more than one)

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  • Was the Safety Manager contacted?<br>(Note it’s acceptable to have them wait a reasonable amount of time to get correct personnel max 1 hour)

  • Name of Safety Manager that was contacted.

  • Beginning Time for Contacting Personnel

OPENING CONFERENCE

  • List who was present at the Opening Conference.

  • Person
  • Full Name - Company Name - Position

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  • Purpose of visit (attach a copy of written complaint, if applicable)

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  • Was there a complaint filed?

  • Did the office get a copy of the complaint? (If so, attach the copy to this report. If not, ask the Inspector for a copy)

  • Photo of complaint

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  • Was there a search warrant served? (Attach the search warrant to this report)

  • Photo of search warrant

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  • Did the Compliance Officer request to review records?

  • List what was requested and what was reviewed. If items were requested and were not reviewed, explain why.

  • Request
  • Requested:

  • Reviewed?

  • Comments:

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  • Were employees selected to be interviewed with the Compliance Officer during opening conference?

  • How many employees were interviewed?

  • List employees selected, employee companies, and craft represented.

  • Employee
  • Employee Name - Company Name - Trade

THE INSPECTION

  • List who was present during the Inspection Process.

  • Person
  • Employee Name - Company Name - Position

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  • Were pictures taken? (If so, attach the photograph log to this report)

  • Photo
  • Inspection Photo

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  • Were any portions of the job-site shut down?

  • List areas shut down, why they were shut down, and for how long.

  • Photo
  • Add media

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  • Were "red tags" used?

  • Describe what was "red tagged", why, and for how long.

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  • List any employees that were talked to by the Compliance Officer and what Company they worked for.

  • Person
  • Employee Name - Company Name

  • NOTE: YOU ARE NOT ALLOWED TO ASK THE EMPLOYEE WHAT THEY DISCUSSED WITH THE COMPLIANCE OFFICER.

  • Other comments that should be noted as being discussed during the inspection.

  • Were the interviews videotaped or tape recorded?

CLOSING CONFERENCE

  • List who was present during the Closing Conference.

  • Person
  • Employee Name - Company Name - Position

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  • Were alleged violations of standards discussed?

  • List alleged violations.

  • Alleged Violation
  • Alleged violation:

  • Type?

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  • Did the Compliance Officer give any indication of future OSHA inspections (required or otherwise)?

  • List comments from CO.

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  • Additional Comments:

  • Signature of Safety Manager

  • Signature of Superintendent or Project Manager

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.