Information
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Company
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Project Name
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Project Number
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Conducted on
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Prepared by
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Location
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Project Personnel
Housekeeping
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Material Properly Stacked & all trash properly disposed of
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Site clean, free of debris & trip hazards
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Date of Correction
Fuels & Compressed Gas Cylinders
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Temporary fuel tanks protected with proper signage and fire protection
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Fuels in approved containers for flammable liquids and properly labeled
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Cylinders upright and secured with caps in place
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Date of corrective action
Fire Protection
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Fire Extinguisher have been inspected and are in good working condition
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Extinguishers fully charged
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Proper signage (flammable, no smoking, etc.)
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Date of corrective action
Tools
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Power tools properly guarded
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All cords in good operating condition
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Safety glasses and hearing protection utilized when required
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Date of corrective action
Electrical
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Sufficient lighting in all areas
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No broken or burnt out bulbs
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Proper guarding on temporary lighting
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GFCI protected outlets utilized
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Electrical panels protected, no knockouts or circuits missing
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Circuits properly labeled
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Date of corrective action
Scaffolds
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Scaffold set on adequate base, level, bearing and plumb
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Required bracing installed
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Scaffolds fully planked and in good condition
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Guardrails and toe boards in place
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Mobile scaffolds locked or rollers blocked
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Area of access/egress protected
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Date of corrective action
Ladders/Stairways
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All ladders OSHA approved and in good condition
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Ladders secured, properly extended and stable
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Temporary stair pans filled
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Proper barricades and signage on stairways under construction
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Handrail system in place
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Select date
Floor & Wall openings
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Floor openings guarded with a guardrail system or solid cover appropriately marked
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Window and door openings properly protected from fall hazards
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Select date
Fall Protection
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Wire rope cabling installed on perimeter having no more than 2 ''deflection
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Wire rope perimeter protection system flagged at no more than 6' intervals
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Wood guardrails installed with upright supports every 8'
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Top rails at 42'', mid rails at 21'', toe boards at least 4''
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Personal fall arrest systems inspected & properly used
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Site specific fall protection plans reviewed and secured on the project
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Guardrail systems in place on lifts
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Date of corrective action
Excavations
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Area around trench/excavation is barricaded or protected
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Sloped or shored per OSHA 29 CFR 1926 Subpart P
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Excavations over 20' have an engineered protection system in place
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Spoil piles back at least 2'
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Ladder access within 25' of working areas
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Date of corrective action
Miscellaneous
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Any and all rebar capped
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Working platforms double planked and not to exceed 6'
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CO monitor used as needed
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Functional back-up alarms on heavy equipment
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Proper PPE in use by all project personnel
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Signs used to control public liability hazards
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First Aid supplies available
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Proper postings displayed on the project
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SDS and HAZCOM programs from all trades
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Safety training certs secured when applicable
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Superintendent or Foreman conducting weekly safety meetings/inspections
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Date of corrective action
Sign Off
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On site representative
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Auditor's signature