Title Page
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Inspected by
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Conducted on
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Location
Site Control
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Permits/JSA's Posted & Correct
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Environmental plans/measures
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Toolbox talk last date
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Safety inductions for all on site
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Safety notice board current
Site Facilities
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Offices clean, adequate & good lighting
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Smoke sheds – clean, potable water
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Tool/equipment sheds adequate
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Toilets – clean, washing water
General Site Tidiness and Accessways
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Clear, safe access to work areas
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Stairways and accessways clear
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Hoardings/fence and gates secure/Barricades
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Loose materials secure from wind
Personal Protective Equipment
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Signage displayed and legible
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Hardhats being worn
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Correct footwear being worn
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Glasses/ear muffs/vests/masks used
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Hazard evaluations been performed and certified
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Protective equipment adequate for exposure
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Employees issued with PPE where needed
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PPE being used and are in good condition
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Inspections being conducted before and after use of PPE
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Adequate maintenance and sanitary storage available and used
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Adequate fall protection provided
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Eye protection available
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Face protection (glasses, goggles, shields) available and are in good condition
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Hearing protection available
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Respirators and masks provided
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Respirators used to protect against harmful dust, asbestos, sand blasting, and welding (lead, paint, and galvanized zinc or cadmium)
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Head protection available
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Hand and foot protection available
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Physical exams performed as required
Fire Extinguishers and Fire Protection
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Fire extinguishers fully charged, operable, and kept in designated places at all times
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Portable fires extinguishers inspected monthly
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Employees are expected to use fire extinguishers, they've been trained in the general principles of fire extinguisher use and hazards involved with the incipient stage of firefighting
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Fire alarm system tested annually
Emergency Evacuation
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Written emergency and fire prevention plans made available to building occupants for review
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Occupants been trained in emergency evacuation of the building
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Emergency drills conducted on a routine basis
Cranes/Hoist/Lifting Equipment
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Proper lift assessment plan done
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Crane certification current
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Slings/chains certified
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Operator procedures in place
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Inspections being done
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Man cage available
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Emergency plan in place
Compressed Air Equipment
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In good condition
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Appropriate guards fitted
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Trained user
Excavations
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Correctly shored
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Access controlled
Hot Works
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Hot work permits being issued
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Fire extinguishers on hand
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Operators using PPE
Electrical Equipment/Plant
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Main board lockable/weatherproof
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Current tagged and damage-free leads
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Current tagged plant
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Current tagged lifeguards
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Leads safely placed
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Electrical equipment/plant – good condition
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Electrical equipment/plant – appropriate guards on plant
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Adequate temporary lighting
Scaffolding – Planks Secured
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Notifiable weekly Scaftag/current
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Handrails/mid-rails
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Toe boards
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Platforms
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Ladders/stairs
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Base sound
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Work platforms clear
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Platforms trip free
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Planks tied down
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Headroom clear
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Ties/bracing adequate
Ladders
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Good condition
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Secured top and bottom
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Stays to step ladders
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Working 2 steps down
Completion
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Additional recommendation
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Full Name & Signature of Inspector
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Supervision/Leadman Signature
