Title Page

  • Conducted on

  • Prepared by

  • Branch Location/Job Name/Employee
  • Client / Site

  • Mechanics Name

Safety Documentation:

  • Does Employee have a safety manual?

  • Is the Daily Jobsite Inspection Checklist documented?

  • Has a Job Hazard Analysis been completed and discussed with all Employees on site?

  • Are the applicable F.P.P.checked off and incorporated into the JHA<br> Personal Protective Equipment<br> Lock-Out/Tag-Out/Try-Out<br> Jumpers<br> Live Electrical Troubleshooting<br> Mechanical Stored Energy<br> Cartop and Pit Access<br> Barricades<br> Fall Protection<br> False Cars and Running Platforms<br> Hoisting and Rigging<br>

  • Are the applicable 5 Behavioral Safety Traps checked off and incorporated into the JHA<br> Lack of Awareness<br> Diminishing the Risk<br> Lack of Concentration<br> Unintentional Pressure<br> Fear Factor<br>

  • Has the Running Platform checklist been properly documented?

Clothing & Personnel Equipment:

  • Are Employees wearing proper footwear?

  • Is all required PPE being worn?

  • Do employees have their safety bag and additional PPE on site?

  • Does employee have Arc rated gloves and sleeves available for immediate use?

Electrical Safety:

  • Are all power cords in use plugged into GFCI?

  • Are all cords serviceable and grounded?

  • Are all jumpers on controllers installed according to TKE policy?

  • Is there a jumper log on each controller in plain view & filled out properly?

  • Are meter and leads properly rated per TKE Policy (Category III, 1000V)?

Lockout/Tagout:

  • Are energy sources locked & tagged out as required by TKE lockout policy?

  • Are all damaged & defective tools, power cords, ladders & hoisting equipment tagged "Out of Service"?

Fall Protection:

  • Are all guardrails of proper construction, in place as required & in good repair?

  • Are employees tied off as required by TKE policy?

  • Is all fall protection equipment serviceable and worn correctly?

  • Have employees discussed the fall protection plan for the jobsite?

  • In the event of an employee falling into their PFAS, has a rescue plan been discussed?

Fire Protection:

  • Are work areas clean of unnecessary combustible materials?

  • Are fire extinguishers of proper size & type, charged, tagged & certified within the last year?

First Aid:

  • Are adequate first aid supplies on hand?

Hand & Power Tools:

  • Are power tools in good condition & do they have guards if required?

  • Are chisels, hammer handles, screwdriver tips and al other hand tools in good condition?

Hazard Communication:

  • Are SDS's available on site for all chemicals and cleaners?

  • Are all containers and chemicals clearly marked with contents?

  • Does the age of the building / equipment and work to be performed necessitate asbestos testing?

Hoisting Equipment:

  • Are all hoisting devices on site marked with rated capacity?

  • Have all employees on site received proper training for the equipment to be used?

  • Is all hoisting equipment & rigging in good condition? (clamps, hoists, hooks, shackles & slings)

  • Have all chain falls & chain hoists been certified within the last year?

  • Do we know the capacities of any building components used for hoisting?

  • Is the weight of the material to be lifted been verified?

Material Handling:

  • Do employees use proper lifting technique? (back vertical & lifting with legs)

  • Is all material handling equipment in good condition? (wheels, handles, pins, etc.)

  • Is the weight of the material to be moved been verified?

Illumination:

  • Are work areas illuminated enough to work safely?

Ladders:

  • Are ladders in good condition & with non-metal side rails?

  • Are ladders being used properly & for all access over 19" when stairs or ramp are not provided?

Slips and Trips:

  • Are work areas and walkways clear of debris, spills and unnecessary tools & materials?

Welding, Cutting & Compressed Gasses:

  • Are regulators, hoses and torch in good condition?

  • Are Oxygen and Acetylene bottles properly stored?

  • Are arc welder leads in good condition with no splices within 10' of the end?

  • Are there any OTHER UNSAFE CONDITIONS, equipment or actions? If yes, explain below. N/A if there are none

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.