Information
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Document No.
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PMH1 Safety Inspection
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Operation Name
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Conducted on
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Prepared by:
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Location
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Select date
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Is the housekeeping (garbage, electrical cords, cleanliness, ladders, debris, material storage, etc) in good condition?
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Is there an eyewash station and muster points identified within the operation?
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Electrical - Proper grounding, LOTO, GFCI, cords in good condition?
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All access (walking/working) surfaces free of holes, debris and is slippery conditions?
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All personal protective equipment (respirators, harnesses, common PPE etc.) being worn and worn properly?
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All electrical tools have their guards in place, are in good condition and stored properly?
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Cranes - Rigging equipment such as slings and shackles properly inspected and stored?
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Excavation - Properly sloped or shored, GDP permits in place and reviewed/signed off and barricades in place?
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Flammable sand combustibles stored properly, fire extinguishers, welding and cutting equipment all in place?
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Scaffold system fully assembled, tagged properly, inspections complete?
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All barricaded areas properly signed/tagged with appropriate contact information?
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Is there a Job Hazard Analysis created for the operation/task?
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Supervisor name (type): Supervisor Signature:
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Safety name (type): Safety Rep Signature: