Title Page
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Job Number
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Job Name
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Contractor (If Different from job name)
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Date of walk through
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Prepared by
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Personnel
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Personnel present:
- Tom Burns
- William Nichols
- Bill Childress
- Daniel Kennedy
- Brett Brashear
- Grant Brock
- Kevin Pardue
- Nick Warndorf
- Sales Rep (Listed Below)
- Foreman (Listed Below)
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Sales Rep:
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Location
Safety:
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Special Training?
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What kind of Training or Certification?
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Type of Training
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Safety Plan?
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What is the proposed Safety Plan?
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Describe the Safety Plan
- Flags & Stands
- 3/8" Cable
- Fire Extinguesher
- Crash Cart
- Safety Monitor
- 2 Way Radios
- Hard Hats
- Harness
- Butterfly Ancors
Accessibility:
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Size of Ladder required?
- "A" Frame
- 12'
- 32'
- 40'
- 60'
- OTHER
Special Equipment?
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Which Equipment is needed? (Check all that apply) Use the "Notes" tab for additional equipment.
- Dump Truck
- Dumpster
- Generator
- Robot
- ISO Buggy
- Wheel barrow
- Ramp Materials
- Porta John
- Rhino
- Pace Cart
- Lull/Lift
- Crane
- Plywood
- A/C Jacks
- OTHER