Weekly Supervisor Checklist

• Document No.

• Area Audited/Zone

• Conducted on

  Date

• Prepared by

• Supervisor

Fire Extinguishers

• Full

  Yes

  No

  N/A

• Good Physical Condition

  Yes

  No

  N/A

• Tag

  Yes

  No

  N/A

• Punched

  Yes

  No

  N/A

• Comments

• Yes

  No

  N/A

• Access

  Yes

  No

  N/A

• Egress

  Yes

  No

  N/A

• Clean

  Yes

  No

  N/A

• Fire Extinguishers

  Yes

  No

  N/A

• Yes

  No

  N/A

• No Refuse

  Yes

  No

  N/A

• Comments

Washrooms

• Working Toilets

  Yes

  No

  N/A

• Clean<br>

  Yes

  No

  N/A

• Paper Supplies

  Yes

  No

  N/A

• Sink,Soap,ect...

  Yes

  No

  N/A

• Water Reservoir <br>

  Yes

  No

  N/A

• Comments

First Aid Kits: Content and Availability

• Gloves

  Yes

  No

  N/A

• Bandages

  Yes

  No

  N/A

• Gauze Bandages

  Yes

  No

  N/A

• Safety Pins

  Yes

  No

  N/A

• Triangular Bandages

  Yes

  No

  N/A

• Sterile Gauze Pads

  Yes

  No

  N/A

• Eye Wash Station, Clean, and within its expiration date

  Yes

  No

  N/A

• Adequate Signage

  Yes

  No

  N/A

• Available and Accessible <br>

  Yes

  No

  N/A

• Comment

Communication

• 2-Way Radios <br>

  Yes

  No

  N/A

• Phones <br>

  Yes

  No

  N/A

Roadways

• Potholes <br>

  Yes

  No

  N/A

• Cracks <br>

  Yes

  No

  N/A

• Washouts <br>

  Yes

  No

  N/A

• Guardrails <br>

  Yes

  No

  N/A

• Signs <br>

  Yes

  No

  N/A

• Comments

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