Information
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Conducted on
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Project Name
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Project Number
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Prepared by
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Location
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Comments
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FOR INTERNAL USE ONLY
GENERAL ITEMS
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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.
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Provide brief description here.
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Provide photos if possible.
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Were any "close calls" or serious safety risks witnessed today?<br>If yes, please attach a completed Incident/Accident Report.
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Provide brief description here.
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Provide photos if possible.
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Were any verbal or written warnings issued today?<br>If yes, provide specifics or attach written documentation.
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Provide brief description here.
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Provide photos if possible.
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Were all deficiencies found during your inspection corrected immediately?
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Which deficiencies were not corrected?
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Why weren't they corrected immediately and what is being done to correct them?
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When will they be corrected?
ADMIN ITEMS
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INSPECTION ITEMS INCLUDE STELLAR J AND ALL SUBCONTRACTORS.
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Are all required safety signage/posters/bulletins posted?
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Is Site Specific Safety Plan available on site (including all 4 volumes)?<br>
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Is the site Fall Protection Work Plan up to date for current work and posted where employees can review it?
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Is the site current on toolbox safety meetings and are the sign-in sheets available?
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Have all employees and subcontractors received a Site Specific Orientation (completed form in file and stickers on hard hat)?
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Are adequate PPE supplies available on site?
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Are adequate first aid supplies available on site?
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Do you have at least one first aid/CPR trained employee on site?
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Are adequate Lock Out/Tag Out supplies available on site?
SITE INSPECTION ITEMS
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INSPECTION ITEMS INCLUDE STELLAR J AND ALL SUBCONTRACTORS.
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Provide a photo that is representative of the overall site housekeeping.
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Are all employees and subcontractors using PPE as required?
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Are all ladders being used and stored properly (including subs)?
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Are all equipment operators (including subs) operating safely, including using their seat belts properly?
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Are all scaffolds installed properly and inspected by a competent person before each shift?
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Who is the competent person for the scaffolding?
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How is the site material handling (including subs)?
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Is all heavy equipment in serviceable condition (backup alarms, guards in place, glass in good condition, etc.)?
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Are proper backing/spotters being used?
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Is Lock Out/Tag Out policy being implemented properly?
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Are all excavations and trenches benched or shored properly?
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Who is your competent person for excavations?
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Is all lift equipment being operated properly, have weight limit markings, and an operator's manual?
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Are all barricades and guard rails in place and in good condition?
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Are all fire hazards properly protected (including fire extinguishers and flammables storage)?
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Is all rigging being stored properly, marked properly and used properly?
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Are all electrical cords in good condition, up to date and are GFCI's being used on all cords?
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Is the confined space policy being followed properly? Are all confined spaces properly marked?
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Are all tools/machinery in good condition and complete with all factory guards?
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Are proper hand wash and toilet facilities available?
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