Job Site Details

  • WaterOne Division

  • Date/Time

  • Location

  • Work Group

  • Foreman/Manager

  • Work Activity

  • Prepared by

Traffic Control

  • Traffic Control set up properly and visible?

  • Are walkways clear for pedestrians if needed?


  • Walkways and Passageways clear?

  • Material stored safely and properly?

Personal Protective Equipment

  • Hard Hats worn when required?

  • Safety Glasses, Goggles, Face Shield worn when required? Are

  • Hearing Protection worn when required?

  • Respirators worn when required (dust, fumes, etc)?

  • High Visibility Clothing worn at all times (vests/jackets)?

  • Gloves in use handling material?

  • Safety Toed Shoes worn at all times?


  • Have utilities been located & protected?

  • Adequately sloped or shored if below 5' in depth?

  • Means of egress every 25 feet?

  • Spoil pile & equipment back at least 2 feet from edge?

  • Water being pumped out if present?

Hand & Power Tools

  • Power tools free from damage (switches, cords, guards, etc)?

  • Hand tools free from damage (shaft, head, splinters, etc)?


  • Are ladders in good working condition w/o damages?

  • Do ladders extend 36" above landing?

Power Industrial Equipment & Vehicles

  • Back-up alarms working on equipment?

  • Operators wearing seat belts?

  • Are overhead power lines located greater than 10 feet of equipment?

Fire Protection

  • Are NFPA containers used for fuel storage?

  • Fire extinguishers located on-site (within vehicles)?

  • Container Labeling

Cranes & Rigging

  • Are employees communicating with operator properly?

  • Slings in good condition?

  • Is material rigging conducted safely?

Fall Protection

  • Are employees protected from heights greater than 4 feet?

  • Is fall prevention installed and in safe condition (handrail)?

  • Is fall protection (harness/lanyard/retractable/etc) being utilized safely?

Observation Summary

  • Observation Notes

  • Pictures

  • Inspection Completed By:

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