Information
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Job Number
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Job Name
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Superintendent
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Project Manager
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Conducted on
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Location
Current Status of Project (check all that apply)
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Site Clearing & Grubbing
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Interior Finishes
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Structural Frame
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Overhead Mechanical/Electrical
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Foundations
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Remodeling
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Excavations
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Demolition
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Exterior Enclosure
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Close-out
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Other:
Office Procedures
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Are safety and health posters posted?
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Action Taken:
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Are emergency telephone numbers listed?
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Action Taken:
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Are first aid kits and supplies on the job?
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Action Taken:
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Has each member of the project staff completed an approved First Aid course and maintained a card?
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Action Taken:
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Did OSHA visit the site this month?
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Inspection Results:
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Were there any reported incidents this month?
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Brief Description:
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Is the OSHA 300A form posted, through the months of February, March, and April, in or around the jobsite trailer?
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Action Taken:
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Is the Haz-Com program and the SDS Sheets in place?
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Action Taken:
Site Security & Warning Signs
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Is the trailer area secured with a fence and lockable gates?
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Action Taken:
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Are all necessary safety and warning signs posted for employees and the general public?
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Action Taken:
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Are “No Smoking”, “Danger-Flammable” signs posted around all fuel tanks?
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Action Taken:
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Are only approved containers (gas cans, etc.) being used to store flammable liquids?
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Action Taken:
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Is overhead protection installed at entrances where any overhead work is proceeding?
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Action Taken:
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Is all work outside of site secured at the end of the day?
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Action Taken:
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Are barricades with warning lights put in traffic areas?
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Action Taken:
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Is all mobile equipment locked at end of day?
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Action Taken:
Company Employee's Safety Responsibilities
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Are perimeter guardrails installed properly for protection of employees?
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Action Taken:
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Are all open shafts or floor openings protected by guardrails or properly covered and marked with the word “HOLE” ?
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Action Taken:
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Are scaffolding properly constructed and secured with appropriate, planks, ladders/access, and fall protection?
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Action Taken:
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Are workers hooked off with harnesses & lanyards when using aerial lifts?
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Action Taken:
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Is all heavy equipment checked at the start of the day, and are operating rules posted in the operator’s stations?
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Action Taken:
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Are temporary ladders properly installed to all levels and secured at the top?
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Action Taken:
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Are hoist entrances guarded by barricades?
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Action Taken:
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Are Company employees wearing hard hats, safety glasses, and all required personal protection equipment (PPE’s)?
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Action Taken:
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Have fire protection programs and emergency evacuation procedures for construction employees been discussed in a weekly meeting?
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Action Taken:
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Are fire extinguishers installed throughout the project?
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Action Taken:
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Are all new Company employees instructed in safety procedures before starting work?
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Action Taken:
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Are Weekly Tool Box meetings being held for all field employees?
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Action Taken:
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Are adequate toilet facilities installed and kept sanitary?
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Action Taken:
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Are trash containers provided?
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Action Taken:
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Is drinking water provided for Company employees?
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Action Taken:
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Is traffic control being used to protect crossing traffic and pedestrians?
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Action Taken:
General Contractor Safety Responsibilities
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This section concerns all subcontractor's employees on your jobsite.
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Are all subcontractors’ employees following all Company safety guidelines as stipulated in their contracts?
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Action Taken:
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Comments, recommendations or actions you will take to correct the above violations or any safety violations noted
Signature
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Select date
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Signature