PSU Lansdscape Safety Inspection

• Inspection Type

• Division

  Select 1 2 3 4 7 8 9 10 11 12 Tree Co 16

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  • Tree Co
  • 16

• Conducted on

  Date

• Prepared by

• Location
  Address

• Work area

PPE

• Safety Glasses in use

  Safe

  At Risk

  N/A

• Safety Boots in good condition

  Safe

  At Risk

  N/A

• Long pants worn while trimming

  Safe

  At Risk

  N/A

• High Viz shirt or vest worn

  Safe

  At Risk

  N/A

• Hearing Protection while using equipment

  Safe

  At Risk

  N/A

• Sun shade or hat used

  Safe

  At Risk

  N/A

• Additional PPE used when necessary

  Safe

  At Risk

  N/A

Pesticide and Fertilizer Application

• Are you applying pesticides? or Fertilizer

  Yes

  No

  N/A

• SDS's available

  Yes

  No

  N/A

• Pesticide Safety Products (Soap, paper towels, tyvek)

  Yes

  No

  N/A

• Chemicals Labeled

  Yes

  No

  N/A

• Pesticide PPE

  Yes

  No

  N/A

• Yes

  No

  N/A

Vehicle

• Is a vehicle or trailer on jobsite

  Yes

  No

  N/A

• Weekly Inspection completed accurately

  Safe

  At Risk

  N/A

• F/A kit onboard and stocked

  Safe

  At Risk

  N/A

• Cones around truck

  Safe

  At Risk

  N/A

• Wheel chocks used

  Safe

  At Risk

  N/A

• Employees using 3 points of contact to enter/exit

  Safe

  At Risk

  N/A

• Not overfilled?

  Safe

  At Risk

  N/A

• Heat Illness Prevention Program

  Safe

  At Risk

  N/A

• Tires, Lights, License Plate, Mirrors in serviceable condition

  Yes

  No

  N/A

• Tools in serviceable condition/ Secured

  Yes

  No

  N/A

• Fuel/ Fertilizer stored properly

  Yes

  No

  N/A

• Trailer lights working

  Safe

  At Risk

  N/A

• Equipment secure on trailer?

  Safe

  At Risk

  N/A

Behavior

• 3 Points of contact while ascending/descending ladders or stairs?

  Safe

  At Risk

  N/A

• Using proper Lifting / Twisting technique?

  Safe

  At Risk

  N/A

• Protected from Line of fire? Caught-in, Struck by, Energy Release

  Safe

  At Risk

  N/A

• Workers keeping hands out of danger zone?

  Safe

  At Risk

  N/A

• Workers staying focused...Eyes on path?

  Safe

  At Risk

  N/A

Final

• Additional Findings/Comments

• Inspector Signature

  Sign