Title Page

  • Client / Site

  • Conducted on

  • Prepared by

  • Personnel

Safety Snapshot

Leadership (General Manager, Production Manager, etc)

  • General comments regarding leadership (Please identify any coaching and/or training opportunities, positive findings, etc)

  • Please include any photos or other documentation necessary.

Processes

  • Review one process (clean up, etc) and identify any opportunities for coaching and/or training.

  • Please include any photos or other documentation necessary.

Systems

  • Safety Systems (SBO's, SQBA's, JTA's, etc) are an integral part of our safety culture. Please provide your impression of these systems.

  • Please include any photos or other documentation necessary.

Safety Committee

  • Is the local Safety Committee effective?

  • Please include any photos or other documentation necessary.

Behaviors

  • Please include items from the SQBA in this section.

  • Please include any photos or other documentation necessary.

Work Environment (Regulatory Compliance/Rinker Policy/Best Practice)

Regulatory Compliance

  • Are fire extinguishers current on inspections (annual by 3rd party and monthly in-house)?

  • Are LO/TO/TO instructions clearly posted for each piece of equipment and up to date?

  • Are monthly and annual crane inspections documented?

  • Are identified deficiencies corrected?

  • Are JTA's being completed per task requirement and are they available to EE's?

  • Please enter any identified housekeeping issues

  • Please utilize this section to identify any other items of concern

Rinker Policy

  • Are all air hoses equipped with check valves and/or anit-whip devices?

  • Is New Employee Induction being completed and followed up with (30 day, 60 day, 90 day, etc) completed?

  • Is visitor and vendor induction completed?

  • Please identify any Critical Safety Rule concerns.

  • Use this area for any pictures or other media regarding Critical Safety Rule concerns.

Environmental

  • Please identify any environmental concerns. These may include: lack of secondary containment, oil spills in the yard

  • Use this area for any pictures or other media regarding Environmental Concerns

OSHA Logs

  • Does the facility have the last 5 years of OSHA Logs available for review?

Best Practice

  • Please identify any best practices observed during your site visit that can/should be shared with other facilities.

  • Please include any photos or other documentation necessary.

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.