Information
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potential OSHA violations.
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
OVERALL SITE
OVERALL SITE
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Safety meetings ? Toolbox talks up to date?
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Phone numbers & directions for nearest medical center posted or handouts [maps] available?
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Fire, police & site emergency contacts posted and visible or handouts used?
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First aid kits available / access to trained first aiders?
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insurance, federal, state and other required information posted?
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SDS sheets & emergency procedures readily accessible on site?
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Laser in use warning signs posted as needed?
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Proper PPE used at all times [hard hats, protective eye & hearing protection, proper shoes and clothing worn at all times]?
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Proper fall protection used when needed [no exceptions]
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general neatness of work areas?
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Waste containers provided & used at all times / containers properly loaded and covered when needed?
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No projecting nails or other tripping hazards, All rebar has proper caps or protection?
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Proper material storage proceidures used?
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Proper & adequate amenities? [ toilets, wash areas and lunch areas]
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Hot / cold weather provisions in place [cool drinking water provided etc.]
Site # 1
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
Site # 2
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
Site # 3
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
Site # 4
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
Site # 5
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
Site # 6
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
Site # 7
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
Site # 8
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
Site # 9
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
Site # 10
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
Site # 11
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
Site # 12
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
Site # 13
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
Site # 14
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
Site # 15
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Address or lot #
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New items or concerns
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repeat items?
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repeat items
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Corrected items?
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corrected items
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general notes
General site items
Signature
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