Soft Tissue Injury Mitigation Program

Material Handling Plan in Place no Lifting over 55 Lbs

Material Moving Equipment on site and in use (i.e. carts, dolleys, hoists, fork lifts, etc.)

Proper Lifting procedures, addressed on site specific plan and enacted on the field?

Repetitive motion injuries addressed and plan in place to mitigate them?

Team members trained on STOMP procedures.


Fall Protection and Ladders

Fall protection in use, in good condition, inspected, and within expiration date

Ropes and rope grabs inspected and anchored correctly

Anchors are in sound condition and secured to a proper point. Capable of supporting at least 5000 pounds per worker

Retractable lanyards are used in boom lifts/scissor lifts

Floor holes (over 2 inches) and wall openings properly protected, securely covered and marked

Ladders in good condition; tied back; extended 3ft. beyond the landing point. Ladder angle at 4:1 ratio

Step ladders inspected and spreader bars extended and locked in place while in use

Extension ladders should be used only for access no work performed from ladders ?

Electrical Safety Procedures

Is Energized work being performed?

Is the qualified person trained in hot work procedures

Is the proper PPE available and inspected

is there a back up person trained in the procedures available

LOTO Procedures in place?

Affected team members trained?

LOTO equipment on site and being used?

Electrical equipment connected properly, grounded and in good condition. GFCI in good condition.


Tools and Equipment

Tools and equipment in good condition and properly guarded

All mobile equipment inspected and documented daily by competent person and operator has been trained in operation.

Seatbelts in use by all operators and passengers

Back-up alarms are functional


Safe access to work area and good housekeeping

Barricades/warning signs in place

Fire extinguisher: good condition, current inspection
tag, 50 ft. rule

First aid; kit and certified employees onsite. Eye
wash available

Paperwork and other Postings

Employees have received Safety Orientation and are familiar with JBI Safety Procedures

OSHA posters and emergency phone numbers posted

Job logs, Job Safety Check Sheets being performed and JHA completed

Daily Huddle conducted at the beginning of each shift and documented

Site specific safety plan being used and updated as job progresses.

Employees have received a site specific safety orientation and signed the site specific safety plan.

Task training performed and employee suitability
verified prior to task assignment

Address behavioral issues positive and negative – Other general comments – PPE worn – Supervisor set proper example – accidents / near misses reported

Project Manager Signature
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.