Information

  • Conducted on

  • Project Name

  • Project Number

  • Prepared by

  • Location
  • Comments

  • FOR INTERNAL USE ONLY

GENERAL ITEMS

  • Were there any incidents or accidents today that involved an injury or greater than $500 in property damage?<br>If yes, be sure to attach a completed Incident/Accident Report.

  • Provide brief description here.

  • Provide photos if possible.

  • Were any "close calls" or serious safety risks witnessed today?<br>If yes, please attach a completed Incident/Accident Report.

  • Provide brief description here.

  • Provide photos if possible.

  • Were any verbal or written warnings issued today?<br>If yes, provide specifics or attach written documentation.

  • Provide brief description here.

  • Provide photos if possible.

  • Were all deficiencies found during your inspection corrected immediately?

  • Which deficiencies were not corrected?

  • Why weren't they corrected immediately and what is being done to correct them?

  • When will they be corrected?

ADMIN ITEMS

  • INSPECTION ITEMS INCLUDE STELLAR J AND ALL SUBCONTRACTORS.

  • Are all required safety signage/posters/bulletins posted?

  • Is Site Specific Safety Plan available on site (including all 4 volumes)?<br>

  • Is the site Fall Protection Work Plan up to date for current work and posted where employees can review it?

  • Is the site current on toolbox safety meetings and are the sign-in sheets available?

  • Have all employees and subcontractors received a Site Specific Orientation (completed form in file and stickers on hard hat)?

  • Are adequate PPE supplies available on site?

  • Are adequate first aid supplies available on site?

  • Do you have at least one first aid/CPR trained employee on site?

  • Are adequate Lock Out/Tag Out supplies available on site?

SITE INSPECTION ITEMS

  • INSPECTION ITEMS INCLUDE STELLAR J AND ALL SUBCONTRACTORS.

  • How is the site housekeeping (10 being perfect)?

  • Provide a photo that is representative of the overall site housekeeping.

  • Are all employees and subcontractors using PPE as required?

  • Are all ladders being used and stored properly (including subs)?

  • Are all equipment operators (including subs) operating safely, including using their seat belts properly?

  • Are all scaffolds installed properly and inspected by a competent person before each shift?

  • Who is the competent person for the scaffolding?

  • How is the site material handling (including subs)?

  • Is all heavy equipment in serviceable condition (backup alarms, guards in place, glass in good condition, etc.)?

  • Are proper backing/spotters being used?

  • Is Lock Out/Tag Out policy being implemented properly?

  • Are all excavations and trenches benched or shored properly?

  • Who is your competent person for excavations?

  • Is all lift equipment being operated properly, have weight limit markings, and an operator's manual?

  • Are all barricades and guard rails in place and in good condition?

  • Are all fire hazards properly protected (including fire extinguishers and flammables storage)?

  • Is all rigging being stored properly, marked properly and used properly?

  • Are all electrical cords in good condition, up to date and are GFCI's being used on all cords?

  • Is the confined space policy being followed properly? Are all confined spaces properly marked?

  • Are all tools/machinery in good condition and complete with all factory guards?

  • Are proper hand wash and toilet facilities available?

  • Add signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.