Information

  • Company

  • Project Name

  • Project Number

  • Conducted on

  • Prepared by

  • Location
  • Project Personnel

Housekeeping

  • Material Properly Stacked & all trash properly disposed of

  • Site clean, free of debris & trip hazards

  • Date of Correction

Fuels & Compressed Gas Cylinders

  • Temporary fuel tanks protected with proper signage and fire protection

  • Fuels in approved containers for flammable liquids and properly labeled

  • Cylinders upright and secured with caps in place

  • Date of corrective action

Fire Protection

  • Fire Extinguisher have been inspected and are in good working condition

  • Extinguishers fully charged

  • Proper signage (flammable, no smoking, etc.)

  • Date of corrective action

Tools

  • Power tools properly guarded

  • All cords in good operating condition

  • Safety glasses and hearing protection utilized when required

  • Date of corrective action

Electrical

  • Sufficient lighting in all areas

  • No broken or burnt out bulbs

  • Proper guarding on temporary lighting

  • GFCI protected outlets utilized

  • Electrical panels protected, no knockouts or circuits missing

  • Circuits properly labeled

  • Date of corrective action

Scaffolds

  • Scaffold set on adequate base, level, bearing and plumb

  • Required bracing installed

  • Scaffolds fully planked and in good condition

  • Guardrails and toe boards in place

  • Mobile scaffolds locked or rollers blocked

  • Area of access/egress protected

  • Date of corrective action

Ladders/Stairways

  • All ladders OSHA approved and in good condition

  • Ladders secured, properly extended and stable

  • Temporary stair pans filled

  • Proper barricades and signage on stairways under construction

  • Handrail system in place

  • Select date

Floor & Wall openings

  • Floor openings guarded with a guardrail system or solid cover appropriately marked

  • Window and door openings properly protected from fall hazards

  • Select date

Fall Protection

  • Wire rope cabling installed on perimeter having no more than 2 ''deflection

  • Wire rope perimeter protection system flagged at no more than 6' intervals

  • Wood guardrails installed with upright supports every 8'

  • Top rails at 42'', mid rails at 21'', toe boards at least 4''

  • Personal fall arrest systems inspected & properly used

  • Site specific fall protection plans reviewed and secured on the project

  • Guardrail systems in place on lifts

  • Date of corrective action

Excavations

  • Area around trench/excavation is barricaded or protected

  • Sloped or shored per OSHA 29 CFR 1926 Subpart P

  • Excavations over 20' have an engineered protection system in place

  • Spoil piles back at least 2'

  • Ladder access within 25' of working areas

  • Date of corrective action

Miscellaneous

  • Any and all rebar capped

  • Working platforms double planked and not to exceed 6'

  • CO monitor used as needed

  • Functional back-up alarms on heavy equipment

  • Proper PPE in use by all project personnel

  • Signs used to control public liability hazards

  • First Aid supplies available

  • Proper postings displayed on the project

  • SDS and HAZCOM programs from all trades

  • Safety training certs secured when applicable

  • Superintendent or Foreman conducting weekly safety meetings/inspections

  • Date of corrective action

Sign Off

  • On site representative

  • Auditor's signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.