Title Page
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Conducted on
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Prepared by
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Branch Location/Job Name/Employee
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Client / Site
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Mechanics Name
Safety Documentation:
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Does Employee have a safety manual?
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Is the Daily Jobsite Inspection Checklist documented?
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Has a Job Hazard Analysis been completed and discussed with all Employees on site?
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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>
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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>
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Has the Running Platform checklist been properly documented?
Clothing & Personnel Equipment:
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Are Employees wearing proper footwear?
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Is all required PPE being worn?
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Do employees have their safety bag and additional PPE on site?
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Does employee have Arc rated gloves and sleeves available for immediate use?
Electrical Safety:
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Are all power cords in use plugged into GFCI?
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Are all cords serviceable and grounded?
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Are all jumpers on controllers installed according to TKE policy?
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Is there a jumper log on each controller in plain view & filled out properly?
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Are meter and leads properly rated per TKE Policy (Category III, 1000V)?
Lockout/Tagout:
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Are energy sources locked & tagged out as required by TKE lockout policy?
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Are all damaged & defective tools, power cords, ladders & hoisting equipment tagged "Out of Service"?
Fall Protection:
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Are all guardrails of proper construction, in place as required & in good repair?
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Are employees tied off as required by TKE policy?
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Is all fall protection equipment serviceable and worn correctly?
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Have employees discussed the fall protection plan for the jobsite?
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In the event of an employee falling into their PFAS, has a rescue plan been discussed?
Fire Protection:
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Are work areas clean of unnecessary combustible materials?
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Are fire extinguishers of proper size & type, charged, tagged & certified within the last year?
First Aid:
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Are adequate first aid supplies on hand?
Hand & Power Tools:
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Are power tools in good condition & do they have guards if required?
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Are chisels, hammer handles, screwdriver tips and al other hand tools in good condition?
Hazard Communication:
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Are SDS's available on site for all chemicals and cleaners?
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Are all containers and chemicals clearly marked with contents?
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Does the age of the building / equipment and work to be performed necessitate asbestos testing?
Hoisting Equipment:
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Are all hoisting devices on site marked with rated capacity?
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Have all employees on site received proper training for the equipment to be used?
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Is all hoisting equipment & rigging in good condition? (clamps, hoists, hooks, shackles & slings)
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Have all chain falls & chain hoists been certified within the last year?
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Do we know the capacities of any building components used for hoisting?
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Is the weight of the material to be lifted been verified?
Material Handling:
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Do employees use proper lifting technique? (back vertical & lifting with legs)
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Is all material handling equipment in good condition? (wheels, handles, pins, etc.)
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Is the weight of the material to be moved been verified?
Illumination:
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Are work areas illuminated enough to work safely?
Ladders:
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Are ladders in good condition & with non-metal side rails?
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Are ladders being used properly & for all access over 19" when stairs or ramp are not provided?
Slips and Trips:
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Are work areas and walkways clear of debris, spills and unnecessary tools & materials?
Welding, Cutting & Compressed Gasses:
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Are regulators, hoses and torch in good condition?
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Are Oxygen and Acetylene bottles properly stored?
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Are arc welder leads in good condition with no splices within 10' of the end?
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Are there any OTHER UNSAFE CONDITIONS, equipment or actions? If yes, explain below. N/A if there are none