Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Vendor

  • CBRE Work Order Number

  • MMC Number

  • Reviewed SOW details and supporting documents

  • All Instructions are fully understood

PPE REQUIRED

  • Proper Gloves

  • Hearing Protection

  • Face Shield

  • Goggles

  • Safety Glasses

  • Arc Flash Protection Needed

  • Fall Protection Required

HAZZARDS IDENTIFIED

  • Heat Stress Apparent

  • Elevated Work/Overhead Work Apparent

  • Sharp Edges Apparent (Cuts)

  • Slips Trips and Falls Apparent

  • Inhalation of Hazzordous Chemicals Apparent

  • Electrified Equipment Apparent

  • Spills/Leaks Apparent

  • Burns (Thermal or Chemical) Aparent

  • Insects Apparent

  • Fire Life Safety Put on Test

  • Weather OK for Work

  • Hot Work Permit

GENERAL SAFETY

  • Eye Wash Available Near

  • Tool Inspection

  • Signs/Barricades/Signals in place if Needed

  • LOTO Completed if Needed

  • Aware of Fire Estinguisher Locations

  • GFCI Outlets Available

  • Ladder Tags Current

  • Confined Space Work

  • Signature

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