Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

CCIP Enrollment Submittals

  • Contract Signed and Returned?

  • Subcontractors affidavit?

  • Insurance Certificates on File?

  • SDI Enrollment?

  • Shop Drawings Approved?

  • Safety Manual/Plan turned in?

  • Hazard Communication Program/MSDS turned in?

  • Training Certificates turned in?

General Items

Contract Requirements

  • Contract Signed and Returned?

  • Insurance Certificates Issued?

Project Scope of Work Review

  • Establish property corners and boundaries

  • Provide benchmarks as needed

  • Layout site for rough grading

  • Verify finish grade

  • Layout site utilities and provide offset stakes as required

  • Provide offset stakes for curbs and walks

  • Layout building corners and establish gridlines as necessary

  • Verify anchor bolt locations before the start of steel erection

  • Provide as-built drawings

General Safety Expectations

  • The use or possession of intoxicating beverages, drugs, firearms, or other weapons on the job is forbidden. Employees under the influence of alcohol or drugs are not permitted on the job.

  • S. M. Wilson & Co. may require an employee to be tested if it is reasonably suspected that the employee has violated the Drug & Alcohol Policy

  • Refusal to submit to the drug/alcohol test or testing positive for illegal drugs or alcohol will result in the employee being terminated from the project.

  • Hard hats are to be worn by all employees 100% of the time.

  • Safety Glasses are to be worn by all employees 100% of the time.

  • Appropriate personal protective equipment is to be worn when hazards exist.

  • Indicate all that will be required:

  • Sturdy, heavy-duty work boots or leather shoes are required.

  • Long pants and shirts with sleeves are required at all times.

  • Report all accidents and injuries immediately to S. M. Wilson. Provide detailed incident report within a 24 hour period.

  • Any employee involved in an accident or incident that results in an injury or property damage will be required to submit a post incident drug test.

  • Maintain a clean workspace.

  • Daily Job-site Safety Analysis.

  • Weekly Safety Meeting - Tool Box Talks

  • Weekly Safety Audit Reports

  • Site Specific Safety Issues:

  • Landscaping Safety:

  • Equipment (Laser):

  • Traffic Control:

  • High Visibility Vest to be worn:

Sequence/Schedule

  • Start Date

  • Completion Date

  • Other Issues

Logistics

  • Storage/Laydown

  • Trailer Needs

  • Parking

  • Break Areas, Smoking, Sanitation

  • Site Access

  • Other issues

  • Name and Number of Foreman (Competent Person):

  • Name and Number of Designated Safety Representative

  • Name and Number of 24 hour Emergency Contact

  • Attendees

  • Add 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.