Title Page

  • Client

  • Project

  • Conducted on

  • Location
  • Prepared by

DEMOLITION

  • Pre-planned and each task supervised

  • Adjacent structures and public protected

EXCAVATION

  • Utilities located and marked

  • Daily reports submitted by COMPETENT person

  • Perimeter warnings clearly posted

ILLUMINATION

  • Adequate light levels maintained per use of space

  • Temporary lights are safely installed and guarded

TRAFFIC CONTROLS

  • Emergency access roads are managed

  • Signage and flag persons are as required

  • Speed limits and controls are obeyed

BARRICADES, FENCES & GATES

  • Perimeter security is intact and appropriate

  • Exterior signage is clear and appropriate

  • Shafts, floor holes, and slab edges guarded

HEAVY EQUIPMENT & VEHICLES

  • Proper maintenance

  • Trained and qualified operators and signal people

  • Safety features in place and functioning

  • Safe hauling of people and materials

CRANES & RIGGING

  • Proper certifications and maintenance

  • Proper set ups for conditions and operations

  • Trained and qualified operators and signal people

  • Safety features in place and functioning

  • Rigging checked and properly used

  • Counterweight & swing dangers marked

  • Proper clearances from electric and object contact

HOISTS (PERSONNEL & MATERIAL)

  • Proper use, maintenance and signage

  • Trained operators

WORKER’S SAFETY TRAINING

  • Weekly “Tool Box” training conducted

  • New worker safety orientations completed

  • Individual safety training for new tasks conducted

PERSONAL PROTECTIVE EQUIPMENT

  • 100% use of hard hats and eye protection

  • Fall arrest or restraint equipment used properly

  • Hearing, feet, hands, faces, arms and other parts

SANITATION

  • Number and condition of toilet facilities

  • Adequate, proper arrangement for drinking water

  • Sources of non-potable water clearly marked

EMERGENCY ACTION PLAN

  • Emergency numbers available

  • First aid certifications and logs are up to date

  • Current plan is appropriate for site conditions

FIRE PROTECTION

  • Fire extinguishers inspected, in required locations

  • Fire monitors trained and posted as necessary

  • Hydrants, permanent systems in best possible order

  • Proper signage posted at hazardous locations

  • Proper quantities of flammables and combustibles

HAZARD COMMUNICATION PROGRAM

  • Safety Data Sheets (SDS) current and available for all items

  • Written program, inventory, training records current

  • All containers are clearly marked and labeled

HAZARDOUS MATERIALS / WASTE

  • Proper handling and use (ventilation, PPE, etc.)

  • Proper spill control and disposal plan

  • Appropriate warning signs and systems in place

WEATHER PROTECTION

  • Weather related shut down plan is adequate

  • Temporary bracing and tie-offs are adequate

  • Workers are trained for current climate issues

SCAFFOLDS and AERIAL LIFT PLATFORMS

  • All users and operators are trained

  • Foundations and suspension structures are proper

  • Frame parts, sizes and braces are proper

  • Access and work platforms are proper and safe

  • Overhead hazards are addressed

  • Fall protection arrangements are appropriate

LADDERS

  • Proper types, sizes, and conditions

  • Safely located, placed, secured and used

  • Ladders removed at end of shifts (when required)

  • Ladder inspections are conducted responsibly

STAIRS, RAMPS, and LANDINGS

  • Proper designs, materials and construction

  • Handrail, guard rails, and toe boards as required

  • Clean, dry, cleated, and pans filled as required

HAND, POWER, and POWDER-ACTUATED TOOLS

  • Hand tools (handles, teeth, and hammer heads)

  • Power tools and cords inspected for safe use

  • Correct guards, blades, disks and accessories

  • Proper pressures and safeguards for pneumatics

  • Operators of Powder-Actuated tools are trained

  • Unfired shots and loads are disposed of properly

ELECTRICAL

  • GFCI or Assured Equip. Grounding Program used

  • Sources of service are locked out from casual access

  • Types of cords and conductor sizes are appropriate

  • Panels and devices are properly marked

COMPRESSORS, GENERATORS, WELDERS

  • Exhaust (thermal and atmospheric) issues addressed

  • Safety features and safeguard requirements verified

WELDING & BURNING

  • Proper permits in place

  • Condition of cables, hoses, guages, torches, etc.

  • Cylinders properly stored, separated, and secured

  • Proper fire protection and monitoring in place

  • Flash-back arrestors and flash burn screens used

  • Proper PPE and training for users and helpers

FLAMMABLES & COMBUSTIBLES

  • Safe storage distances from fences and buildings

  • Extinguishers, proper signs and container labels

  • Secondary containment arranged as required

  • Proper portable containers and safety features

  • Bonding, grounding, ventilation and protection

CONFINED SPACES

  • All identified by proper signage

  • Written plan and documented training

  • Proper permits in place and enforced

  • Adequate rescue measures available

  • Testing equipment calibrated and properly used

HOUSEKEEPING

  • Storage of materials is stable and accessible

  • Access (extinguishers, valves, showers, switches)

  • Physical hazard controls (slips, trips, punctures)

  • Adequate number and locations for trash containers

  • Proper management of cords, hoses, and cables

  • Dust, sand and particulate mopped or swept out

OTHER:

  • OTHER:

Confirmation

  • General Comments/Summary

  • Inspectors Signature:

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