Pete King Corp Project Safety Evaluation Form

• Site conducted

  Select

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• Yes

  No

  N/A
• Location
  Address

• Project Name

• Date

  Date

• General Contractor

• Time In/Out

  Date

PROJECT SAFETY REVIEW

• PPE (Hard Hat, Safety Glasses, Boots, Gloves, Hi-Vis Vest or Shirt, etc)

  Yes

  No

  N/A

• Fire protection / Fire extinguishers at welders, chop saws, spray trucks

  Yes

  No

  N/A

• Verified all working areas and conditions are safe

  Yes

  No

  N/A

• Right tools / Used correctly / Safe conditions

  Yes

  No

  N/A

• Hazard Communication / Safety Data Sheets

  Yes

  No

  N/A

• Competent person / Qualified person

  Yes

  No

  N/A

• Fall Protection/Elevated Work

  Yes

  No

  N/A

• Site specific emergency action plan / evac plan

  Yes

  No

  N/A

• Inspect Scaffold / Planks / Rails / Bracing

  Yes

  No

  N/A

• Aerial lifts / Booms / Fall Protection / Cert Cards

  Yes

  No

  N/A

• Task Hazard Analysis (THA)

  Yes

  No

  N/A

• Cords / Plugs / Grounding

  Yes

  No

  N/A

• Guardrails / Stairs / Floor Holes

  Yes

  No

  N/A

• Housekeeping

  Yes

  No

  N/A

Evaluation

• Observations

• Violations

• Action Taken / Needed

• Safety Inspector

• PKC Superintendent

• Foremen on site