Title Page

  • Conducted on

  • Prepared by

  • Location

Safety Management

  • Safety PreCons

  • Orientations

  • JSA

  • JSA Quality

  • WHAT

  • Quality of WHAT

  • Designated Operator Qualification Listing

  • Toolbox Talks

  • Silica Prevention Plan

  • SDS

PPE

  • Safety Glasses

  • Hard Hats

  • High Visability

  • Gloves

  • Specialized PPE

Fall Protection

  • Zero Fall Hazards

  • JSA for All Fall Hazards

  • Tie-Off Correct

Fire Protection

  • Extinguishers in Place

  • Extinguishers Inspected

  • Fuel Storage

Access Equipment

  • Ladder Type

  • Step Ladders Correct

  • Extension Ladders Secured

  • Stairs

  • Aerial Lifts

Electrical

  • Pre-Energization Plan

  • GFCI Testing Log

  • Temporary Panels

  • Extension Cords

  • Temporary Lighting

  • Lockout / Tagout

Excavations

  • Competent Person

  • Cave-In Protection

  • Daily Dig Permit

  • Excel Spreadsheet

Scaffold

  • Competent Person

  • Base

  • Cross Braces

  • Planks

  • Fall Protection / Guardrails

  • Access

  • Scaffold Tag

Nothing Hits The Floor

  • Cut Stations

  • Trash Cans

  • Cords Elevated

  • Material Storage

  • Loose Debris

  • Fall Protection

Equipment

  • Inspections

  • Back-up Alarms

  • Barricades

  • Operator Training

  • Company Vehicles How's My Driving Sticker, Cargo Net

Welding and Cutting

  • Flash Screens

  • Welding Blankets and Spark Control - Combustibles Moved or Protected

  • Following Requirements of Hot Work Permit

  • Grinders have guards and handles in place

  • No quick connects on oxy, acetylene, or inert gas hoses

Lifting Techniques

  • Are employees complying with 50 lb lifting limitation

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.