Site Safety Evaluation

• Conducted on

  Date

• Job Name

• Job Number

• Location
  Address

• Project Manager:

• Superintendent:

Safety & Health General

• IIPP & MSDS on Site

  Safe

  At Risk

  N/A

• Orientation/Code of Safe Practices

  Safe

  At Risk

  N/A

• Toolbox Meetings / Pre-Job Safety

  Safe

  At Risk

  N/A

• Posting (OSHA) Government

  Safe

  At Risk

  N/A

• Emergency Numbers / First Aid

  Safe

  At Risk

  N/A

Environment

• Housekeeping / Ventilation / Illumination

  Safe

  At Risk

  N/A

• Excavations - Barricades / Shored

  Safe

  At Risk

  N/A

• Floor / Roof Openings Guarded / Covered-Marked

  Safe

  At Risk

  N/A

• Access and Egress

  Safe

  At Risk

  N/A

• Rebar Capped

  Safe

  At Risk

  N/A

• Parking / Material Storage

  Safe

  At Risk

  N/A

• Traffic / Heavy Equipment

  Safe

  At Risk

  N/A

• Signage / Public Safety

  Safe

  At Risk

  N/A

• Fire Extinguishers

  Safe

  At Risk

  N/A

• Flammable Materials Storage

  Safe

  At Risk

  N/A

Electrical Safety

• Cords, Plugs & Receptacles

  Safe

  At Risk

  N/A

• GFI Boxes & Grounding

  Safe

  At Risk

  N/A

• Overhead Lines

  Safe

  At Risk

  N/A

Personnel Hoists & Cranes

• Inspections & Maintenance

  Safe

  At Risk

  N/A

• Crane Set Up & Swing Protection

  Safe

  At Risk

  N/A

• Rigging & Loads Secured

  Safe

  At Risk

  N/A

Personal Protection Equipment (PPE)

• Hard Hats

  Safe

  At Risk

  N/A

• Eye & Face Protection

  Safe

  At Risk

  N/A

• Ear Protection

  Safe

  At Risk

  N/A

• Gloves / Clothing

  Safe

  At Risk

  N/A

• Footwear

  Safe

  At Risk

  N/A

• Respirators

  Safe

  At Risk

  N/A

Hand & Power Tools

• Guarded

  Safe

  At Risk

  N/A

• Grounded Properly

  Safe

  At Risk

  N/A

• Working Properly

  Safe

  At Risk

  N/A

• Air Hoses

  Safe

  At Risk

  N/A

Ladders

• Ladder Condition

  Safe

  At Risk

  N/A

• 3' Above Landing - Extension

  Safe

  At Risk

  N/A

• Braced & Tied

  Safe

  At Risk

  N/A

• Step Ladder Set Up

  Safe

  At Risk

  N/A

• Correct Height

  Safe

  At Risk

  N/A

• Proper Use

  Safe

  At Risk

  N/A

Scissors Lifts / Zoom Booms / Lift Trucks

• Controls Operative

  Safe

  At Risk

  N/A

• Gates / Chains <br>

  Safe

  At Risk

  N/A

• Harness & Lanyards (JLG's)

  Safe

  At Risk

  N/A

• Operator Certification

  Safe

  At Risk

  N/A

• Visual Inspection

  Safe

  At Risk

  N/A

• Fluid Levels (Oil, Water)

  Safe

  At Risk

  N/A

• Brakes / Lights

  Safe

  At Risk

  N/A

• Gauges - Operative

  Safe

  At Risk

  N/A

Welding & Cutting

• Cylinders - Use & Storage

  Safe

  At Risk

  N/A

• Torches, Hoses, Gauges, etc.

  Safe

  At Risk

  N/A

• Weld Leads, Holders & Grounds

  Safe

  At Risk

  N/A

• Fire Protection

  Safe

  At Risk

  N/A

• Eye Protection / Clothing

  Safe

  At Risk

  N/A

Subcontractor Action Items

• Include Action Items For Subcontractor

  Yes

  No

  N/A

• How many subcontractors require action items?

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

• Subcontractor Name

• Subcontractor Trade

• Subcontractor Action Items

Additional Information

• Comments:

• Number of Inspectors

• Conducted By:

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• ALL Devcon personnel and subcontractor employees are responsible to conduct work activities in a safe and healthful manner for their health and well-being as well as their co-workers. The purpose of the Site Safety Evaluation is to increase your awareness of the need for safe work habits and a positive attitude toward loss prevention.