1.0 Work at Heights Including Scaffold, Ladders, and Gangplanks

1.1 Guardrails/rigid barricades in place and adequate?

1.2 Hole covers in place and adequate?

1.3 Scaffolding - tagged, signed off, contact name and number available?

1.4 100% tie off being followed?

1.5 Ladders- good condition, secured, correct angle, extend past landing?

1.6 Gangplanks - secured at one end, correct angle, proper guardrails?

1.7 Other:

1.8 Ohter:

2.0 Emergency Equipment/Supplies Available

2.01 First Aid Kit available and properly stocked?

2.2 Eye wash station sealed and readily available?

2.3 Fire extinguisher available and ready for use?

2.4 Other:

2.5 Other:

3.0 Motorized Heavy Equipment

3.1 Pedestrian and vehicle traffic separated?

3.2 Flagger in place?

3.3 Highly-visibility clothing used?

3.4 No approach of equipment until acknowledged by operator?

3.5 Swing radius barricades or appropriate?

3.6 Other:

3.7 Other:

4.0 Material Handling

4.1 Personnel are clear of line of fire when loads are moved?

4.2 Loads are stable prior to unstrapping?

4.3 Loads are secured before transit?

4.4 Materials are stored properly as required?

4.5 Other:

4.6 Other:

5.0 Confined Space Entry

5.1 Permit requirements followed and signed permit available?

5.2 Forced ventilation in place?

5.3 Atmospheric testing done?

5.4 Attendant(s) in place?

5.5 Other:

5.6 Other:

6.0 Cranes and Rigging

6.1 Crane and suspended load area is clear of unauthorized?

6.2 Swing radius barricaded?

6.3 Tag lines in use?

6.4 Daily rigging inspection documented in team book?

6.5 Other:

6.6 Other:

7.0 Trenching and Excavations

7.1 Competent person available and daily inspection in team book?

7.2 Benched, sloped, shored properly when deeper than 5 feet?

7.3 Spoil dirt, equipment and material storage at least 2 feet back?

7.4 No water accumulation in excavations?

7.5 Access and egress provided every 25 feet?

7.6 Other:

7.7 Other:

8.0 Electrical Work

8.1 Working on live equiment to be avoided unless not possible?

8.2 Proper PPE in place such as flame resistant clothing and voltage rated gloves as needed for live work?

8.3 Work area properly barricated?

8.4 Live work permits in place?

8.5 All equipment, tools, and materials kep minimum of 20 feet?

8.6 Other:

8.7 Other:

9.0 Hazardous Energy Control/Line

9.1 Identify and isolate potential energy sources and stored?

9.2 Lockout, tag, verify zero energy prior to working on systems or equipment?

9.3 Other

9.4 Other

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.