Information

  • Project Name

  • Project Manager

  • Construction Manager

  • Project Superintendent

  • Conducted on

  • Prepared by:

  • Scope of Work:

Hazard Assessment

  • Crane / Hoisting Operations

  • Third Party Inspection on file?

  • Is Lift Plan available?

  • Unauthorized personnel removed from hoisting radius?

  • Scaffolding

  • Daily Inspection Documented?

  • Scaffold Design Meets OSHA Criteria (access, fully decked, fall protection, toe boards)

  • Scaffold Free of Accumulated Debris

  • Permit Required Confined Spaces

  • Permit Completed and Visible

  • Fresh Air Ventilation

  • UCONN Fire Department Notified of PRCS Entry Location.

  • Working from Heights

  • Perimeter Edge Protection

  • Holes / Openings / Skylight Protection

  • Personal Fall Arrest / Restraint Systems

  • Hot Work

  • Hot Work Permit Posted

  • Fire Extinguishers Available?

  • Flammable / Combustible Material Storage

  • Environmental Abatement

  • Asbestos

  • Lead

  • PCB's

  • Mold

Safe Work Practices

  • Unsafe Conditions and/or Behaviors

  • Observation & Corrective Action
  • Positive Findings

  • Note / Observation
  • Student / Faculty Protection

  • Notes / Observationa

Signatures

  • HC&A Representative

Pictures

  • Add media

  • Add media

  • Add media

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.