Adolfson & Peterson RLT Observations

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Engagement ? Trigger Questions to ask

• How long have you worked for Adolfson & Peterson Construction?

• How long have you been in the trades?

• What is your trade? (Carpenter, Laborer, Finisher, Operator)

• Are you comfortable speaking up when you see an unsafe act or condition? If not Why?

  Yes

  No

  N/A

• Something Personal - Where are you from? Where do you live? Married? Children? what are your plans for the weekend?

• What do you like about working for AP?

• How long have you worked on this project?

• Has the Stop Work Authority process been explained to you

  Yes

  No

  N/A

• Name of person talked with

Job site review

• Housekeeping?

  Green

  Yellow

  Red

• Walkways Clear? (3 ft. width)

  Green

  Yellow

  Red

• Pre-task plans available, adequate, known and understood?

  Green

  Yellow

  Red

• Foreman available?

  Green

  Yellow

  Red

• PPE being worn?

  Green

  Yellow

  Red

• Material storage adequate?

  Green

  Yellow

  Red

• Good communication between crews and across trades?

  Green

  Yellow

  Red

• Pace of work appropriate?

  Green

  Yellow

  Red

• General attitude of workplace and /or worker?

  Green

  Yellow

  Red