Title Page
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Company Name
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Job Site Name
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Foreman
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Conducted on
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Prepared by
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Location
Cranes, Forklifts, Rigging, and Material Handling
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Is the crane operator NCCCO certified for the crane being operated or is the forklift operator trained?<br>
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Has the fall zone been barricaded or controlled?
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Is the crane/forklift maintaining 20 feet of clearance from overhead power lines?
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Is the ground condition ok and are outrigger pads being used?
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Are qualified riggers and signal persons being used?
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Is proper fall protection in place while performing material handling operations?
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Are trash boxes, hoisting parachutes, and rigging maintained?
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Has the documented monthly inspection been completed for the crane?<br>
Tanker and Kettle Operations
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Is the tanker or kettle properly barricaded to prevent unauthorized access?
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Is a fully charged fire extinguisher located near the tanker or kettle?
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Is proper PPE worn while working with hot asphalt?<br>
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Is the hot pipe properly set up and secured?
Ladders and Access
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Is the ladder properly set up and secured?
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Are proper steps in place where elevation changes exceed 19 inches?<br>
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If using a roof hatch, is the hatch area properly protected?
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Is the general ladder condition ok?
Fall Protection
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Are the guardrails properly set up?
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Are warning line systems properly set up?<br>
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Are safety monitors properly used?
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Are all roof openings properly protected?
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Are personal fall arrest systems properly used?
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Is overhead protection in place?
Fire Safety
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Is smoking prohibited in the vicinity of flammable operations and is no smoking signage in place?
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Is an inspected and properly working fire extinguisher within 50 feet of flammables or 100 feet of general work?
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Are compressed gas cylinders and other flammables properly stored?
Hazard Communication / GHS
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Are safety data sheets available?
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Are all employees trained in GHS?
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Are all product containers properly labeled?
Personal Protective Equipment
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Is proper PPE being worn by all employees on site?
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Are there any other PPE issues (respiratory, hearing, body protection)
Electrical Safety
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Are all cords and tools undamaged and properly grounded <br>
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Are incoming power lines protected?
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Is GFCI being used?
General Safety and Health Provisions
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Is housekeeping sufficient?<br>
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Are properly stocked first aid kits available onsite?
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Are on-site rest rooms available
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Is drinking water available?
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Are there any silica, asbestos, or lead issues?<br>
Power and Hand Tools
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Are the proper tools being used for the job?
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Is proper guarding in place on tools and equipment?
Scaffolding
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Has scaffolding been properly assembled and secured and is a competent person on site?
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Have daily inspections been completed by a competent person and is the scaffolding properly tagged?
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Does the scaffolding have proper access?
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Are employees properly trained on aerial work platforms?<br>
DOT Compliance
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Are commercial drivers properly qualified?
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Have pre-trip and post-trip inspections been completed and any defects repaired?
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Does the vehicle have proper markings and/or placarding?
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Is there a fire extinguisher in the cab of a vehicle?
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Does the commercial vehicle have a valid DOT inspection?
Foreman Review
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Foreman Name: