Information
-
SR# or Job Name
-
Conducted on
-
Prepared by
-
Was the building constructed prior to 1980?
-
Is there asbestos in the area you will be working?
-
Has the asbestos been disturbed or will you disturb it during your work?
-
Stop work and call your supervisor or manager
-
Are there any fall protection hazards including guard rails, floor holes, or stairwells in the area you will be working?
-
Call your supervisor or manager to discuss
-
Are there any slip, trip, or fall hazards apparent?
-
Be cautious in these areas
-
Is there any special PPE required for this job?
-
Are you unable to perform this work because a lack of PPE or training?
-
Stop work and call your supervisor or manager.
-
Are you required to work in a confined space?
-
Are you unable to perform this work because a lack of PPE or training?
-
Stop work and call your supervisor or manager.
-
Are there any special site or customer emergency procedures for this job site?
-
Are you unable to perform this work because a lack of job site training?
-
Stop work and call your supervisor or manager.
-
Are there any other hazards or safety concerns at this job site?
-
Call you supervisor or manager to discuss.
-
Add pictures as necessary
-
Add media
