Information
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Sussex Development Corporation
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Week Ending
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Prepared By
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Date Conducted
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Location
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Additional Information
Focus Four Hazards (These cause 90% of all fatalities)
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1.1. Fall Hazards
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1.2. Caught-in or -Between Hazards
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1.3. Struck by Hazards
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1.4. Electrical Hazards
1. Other Risks (These cause the most injuries)
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1.1. Blasting / Explosives
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1.2. Concrete Construction
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1.3. Cranes & Elevators
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1.4. Demolition
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1.5. Electrical
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1.6. Excavations
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1.7. Fire Protection
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1.8. First Aid
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1.9. Flamables
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1.10. Floor and Wall Openings
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1.11. Gasses, Fumes, Dusts
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1.12. General Safety
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1.13. Hazard Communication
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1.14. Housekeeping
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1.15. Illumination
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1.16. Lockout/ Tagout
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1.17. Maintenance
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1.18. Motor Vehicles
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1.19. Noise Exposure
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1.20. Personal Protection
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1.21. Safety Training
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1.22. Sanitation
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1.23. Scaffolding
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1.24. Signs, Signals, Barricades
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1.25. Stairways and Ladders
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1.26. Steel Erection
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1.27. Tools
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1.28. Welding and Cutting
Sign Off
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Superintendent/ Auditor
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Auditor's signature- (If other than superintendent)