Subcontractor Safety Non-Compliance

• Document No.

• Company

  Lincoln Builders - Baton Rouge

  Lincoln Builders - Ruston

  Lincoln Builders - Texas

  Trinity Drywall Systems LLC

• Project

• Conducted on

  Date

• Prepared by

• Location
  Address

• Superintendent/Foreman

• Job Name

• Date/Time

  Date

• Employee Name

• Job Title

  Superintendent

  Carpenter

  Equipment Operator

  Labor

  Other

• Date of Hire

• Has this employee had prior non-compliance issues? If Yes, list date(s) below

  Yes

  No

  N/A

Type of At-Risk Behavior and Observation

• PPE

  Safe

  At Risk

  N/A

• Fall Protection

  Safe

  At Risk

  N/A

• Scaffolds

  Safe

  At Risk

  N/A

• Ladders

  Safe

  At Risk

  N/A

• Tools

  Safe

  At Risk

  N/A

• Equipment

  Safe

  At Risk

  N/A

• Material Handling

  Safe

  At Risk

  N/A

• Electrical

  Safe

  At Risk

  N/A

• Horseplay

  Safe

  At Risk

  N/A

Severity and Solutions

• Risk Level

  Extreme-Imminent Danger/Death

  Major-Serious Injury

  Serious

  Minor

• Severity Level

• Has This Employee Had Previous At-Risk Observations;if so, how many?

  Yes

  No

  N/A

• Recommended Action

  First Offense-Verbal Warning,Retrain

  Second Offense-Written Warning,3 Day Suspension

  Third Offense-Discharge

Documentation

• Pictures

  Media

• Diagrams/Drawings

  Drawing

Signatures

• Employee

  Sign

• Supervisor

  Sign

• General Superintendent

  Sign

• Safety Director

  Sign