Title Page

  • Job Site Name

  • Customer

  • Location
  • Conducted on

  • Prepared by

  • Crew Foreman

  • General Foreman

Safety and Personal Protective Equipment Compliance

  • Employee Name

  • Hearing Protection

  • Eye Protection

  • Chainsaw Protection

  • Reflective Vest

  • Head Protection

  • Lanyard(s)

  • Fall Protection

  • Rubber Gloves

  • Long Sleeve Shirt

General

  • First Aid Kit

  • Spill Kit

  • Material Safety Data Sheets / Safety Data Sheets

  • Equipment Inspection

  • Daily Job Briefing

  • Tailgate Safety

  • Traffic / Site Control

Vehicles

  • Vehicle #

  • DOT Log Book

  • Outrigger Pads

  • Dielectric Date

  • Signs

  • Cones

  • Flagman/Spotter

  • Fire Extinguisher

  • Pre/Post Trip Inspections

  • Triangles

Comments

  • Inspector Name

  • Inspector Signature

  • Crew Foreman Name

  • Crew Foreman 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.