Information

  • Job Number

  • Job Name

  • Superintendent

  • Project Manager

  • Conducted on

  • Location

Current Status of Project (check all that apply)

  • Site Clearing & Grubbing

  • Interior Finishes

  • Structural Frame

  • Overhead Mechanical/Electrical

  • Foundations

  • Remodeling

  • Excavations

  • Demolition

  • Exterior Enclosure

  • Close-out

  • Other:

Office Procedures

  • Are safety and health posters posted?

  • Action Taken:

  • Are emergency telephone numbers listed?

  • Action Taken:

  • Are first aid kits and supplies on the job?

  • Action Taken:

  • Has each member of the project staff completed an approved First Aid course and maintained a card?

  • Action Taken:

  • Did OSHA visit the site this month?

  • Inspection Results:

  • Were there any reported incidents this month?

  • Brief Description:

  • Is the OSHA 300A form posted, through the months of February, March, and April, in or around the jobsite trailer?

  • Action Taken:

  • Is the Haz-Com program and the SDS Sheets in place?

  • Action Taken:

Site Security & Warning Signs

  • Is the trailer area secured with a fence and lockable gates?

  • Action Taken:

  • Are all necessary safety and warning signs posted for employees and the general public?

  • Action Taken:

  • Are “No Smoking”, “Danger-Flammable” signs posted around all fuel tanks?

  • Action Taken:

  • Are only approved containers (gas cans, etc.) being used to store flammable liquids?

  • Action Taken:

  • Is overhead protection installed at entrances where any overhead work is proceeding?

  • Action Taken:

  • Is all work outside of site secured at the end of the day?

  • Action Taken:

  • Are barricades with warning lights put in traffic areas?

  • Action Taken:

  • Is all mobile equipment locked at end of day?

  • Action Taken:

Company Employee's Safety Responsibilities

  • Are perimeter guardrails installed properly for protection of employees?

  • Action Taken:

  • Are all open shafts or floor openings protected by guardrails or properly covered and marked with the word “HOLE” ?

  • Action Taken:

  • Are scaffolding properly constructed and secured with appropriate, planks, ladders/access, and fall protection?

  • Action Taken:

  • Are workers hooked off with harnesses & lanyards when using aerial lifts?

  • Action Taken:

  • Is all heavy equipment checked at the start of the day, and are operating rules posted in the operator’s stations?

  • Action Taken:

  • Are temporary ladders properly installed to all levels and secured at the top?

  • Action Taken:

  • Are hoist entrances guarded by barricades?

  • Action Taken:

  • Are Company employees wearing hard hats, safety glasses, and all required personal protection equipment (PPE’s)?

  • Action Taken:

  • Have fire protection programs and emergency evacuation procedures for construction employees been discussed in a weekly meeting?

  • Action Taken:

  • Are fire extinguishers installed throughout the project?

  • Action Taken:

  • Are all new Company employees instructed in safety procedures before starting work?

  • Action Taken:

  • Are Weekly Tool Box meetings being held for all field employees?

  • Action Taken:

  • Are adequate toilet facilities installed and kept sanitary?

  • Action Taken:

  • Are trash containers provided?

  • Action Taken:

  • Is drinking water provided for Company employees?

  • Action Taken:

  • Is traffic control being used to protect crossing traffic and pedestrians?

  • Action Taken:

General Contractor Safety Responsibilities

  • This section concerns all subcontractor's employees on your jobsite.

  • Are all subcontractors’ employees following all Company safety guidelines as stipulated in their contracts?

  • Action Taken:

  • Comments, recommendations or actions you will take to correct the above violations or any safety violations noted

Signature

  • Select date

  • Signature

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