Title Page
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Weekly Jobsite Inspection
I-5 North Coast Corridor Project -
Prepared by
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Conducted on
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Segment:
- Segment 1
- Segment 2
- Segment 3
- Segment 4
- Segment 6
- Segment 7
- Segment 8
- Early Work
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Location Description:
Checklist
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Inspect your area for each of the following and select the appropriate response. For all items that are unsatisfactory, specify a corrective action. Each Section should have at least 1 photo
HOUSEKEEPING
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NAILS REMOVED FROM LUMBER
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Corrective Actions:
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DEBRIS IS IN CONTAINERS
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Corrective Actions:
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SCRAP WOOD BUNDLED
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Corrective Actions:
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REBAR COVERED PROPERLY
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Corrective Actions:
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MATERIAL STORED PROPERLY
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Corrective Actions:
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WASH OUT AREA CLEANED
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Corrective Actions:
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HAZ-MAT IN CONTAINMENT
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Corrective Actions:
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PERSONAL PROTECTIVE EQUIPMENT:
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HARD HATS USED
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Corrective Actions:
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EAR PROTECTION USED
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Corrective Actions:
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EYE PROTECTION USED
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Corrective Actions:
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FACE SHIELDS USED
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Corrective Actions:
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CORRECT GLOVES USED
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Corrective Actions:
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CORRECT FOOTWEAR
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Corrective Actions:
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RESPIRATORS
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Corrective Actions:
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ACCESS / EGRESS:
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WALKWAYS IDENTIFIABLE
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Corrective Actions:
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WALKWAYS CLEAR OF DEBRIS
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Corrective Actions:
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RAMPS PROPERLY CONSTRUCTED
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Corrective Actions:
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LADDERS TIED OFF
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Corrective Actions:
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JOB LADDERS BUILT PROPERLY
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Corrective Actions:
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TRAFFIC CONTROL:
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TRAFFIC PLAN IN PLACE:
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Corrective Actions:
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PEDESTRIAN CONTROLS IN PLACE:
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Corrective Actions:
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SIGNAGE IN PLACE:
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Corrective Actions:
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CRASH CUSHIONS MAINTAINED
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Corrective Actions:
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REFLECTIVE MARKERS CLEANED
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Corrective Actions:
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STREET CLEANING
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Corrective Actions:
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TRUCK WASH STATION
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Corrective Actions:
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EMERGENCY PREPAREDNESS:
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EMERGENCY PLAN POSTED
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Corrective Actions:
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1ST AID KIT PRESENT
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Corrective Actions:
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1ST AIDE KIT MAINTAINED
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Corrective Actions:
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CRISIS COMMUNICATION SYSTEM POSTED
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Corrective Actions:
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FIRE PREVENTION/CONTROL
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FIRE EXTINGUISHERS PRESENT
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Corrective Actions:
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FIRE EXTINGUISHERS CHARGED
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Corrective Actions:
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FIRE EXTINGUISHER MONTHLY INSPECTION INITIALED
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Corrective Actions:
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DEBRIS IN CONTAINERS
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Corrective Actions:
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FLAMMABLE STORED PROPERLY
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Corrective Actions:
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TRENCHING / EXCAVATION:
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SHORING USED FOR EXCAVATIONS OVER 5’ DEEP
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Corrective Actions:
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SLOPES PER TABLES OR ENGINEER
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Corrective Actions:
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UTILITIES LOCATED AND DIG ALERT IS CURRENT
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Corrective Actions:
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ACCESS / EGRESS
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Corrective Actions:
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CONFINED SPACE PERMIT FILLED OUT
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Corrective Actions:
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SPOIL BACK 2 FEET
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Corrective Actions:
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PRE & DAILY INPECTIONS UP DO DATE
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Corrective Actions:
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WELDING SAFETY:
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FIRE EXTINGUISHERS PRESENT
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Corrective Actions:
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LEADS IN GOOD CONDITION
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Corrective Actions:
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WHIPS FREE OF DEFECTS
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Corrective Actions:
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FLASH GUARDS USED
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Corrective Actions:
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CHECK VALVES USED
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Corrective Actions:
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HOT WORK PERMIT
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Corrective Actions:
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FALL PREVENTION AND PROTECTION:
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GUARD RAILS IN PLACE
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Corrective Actions:
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GUARD RAILS MAINTAINED
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Corrective Actions:
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NETS MAINTAINED
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Corrective Actions:
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HARNESS USED WHERE REQUIRED
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Corrective Actions:
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HARNESSES IN GOOD CONDITION
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Corrective Actions:
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RETRACTABLES USED
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Corrective Actions:
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FALL EQUIPMENT INSPECTED
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Corrective Actions:
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CRANES & RIGGING
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CERTIFICATIONS IN CRANE
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Corrective Actions:
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PROPER LOAD CHART IN CRANE
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Corrective Actions:
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DAILY INSPECTIONS COMPLETE
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Corrective Actions:
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SWING RADIUS UP
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Corrective Actions:
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RIGGING IN GOOD CONDITION
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Corrective Actions:
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TAG LINES USED
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Corrective Actions:
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FALL PREVENTION USED WHERE REQUIRED
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Corrective Actions:
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TOOLS & EQUIPMENT:
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EQUIPMENT INSPECTED
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Corrective Actions:
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EQUIPMENT PROPERLY PARKED
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Corrective Actions:
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ALL TOOLS INSPECTED DAILY
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Corrective Actions:
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GUARDS IN PLACE
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Corrective Actions:
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ELECTRICAL IN GOOD CONDITION
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Corrective Actions:
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EXTENSION CORDS IN GOOD WORKING CONDITION
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Corrective Actions:
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AIR LINES PINNED OR CHECKED
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Corrective Actions:
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GENERAL
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SAFETY HANDBOOK PRESENT
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Corrective Actions:
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SAFETY MEETINGS UP TO DATE
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Corrective Actions:
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CWP COMPLETE FOR OPERATION
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Corrective Actions:
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REQUIRED POSTINGS UP
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Corrective Actions:
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VEHICLES PROPERLY PARKED
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Corrective Actions:
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Any Other Comments
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Comments, Questions, Concerns, Best Practices, etc:
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Acceptance
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Accepted By:
Person
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Signature:
