• Project Name

  • Location
  • Conducted on

  • Prepared by

Company: Absolute Completions

  • Date

  • Project name:

  • Site location

Instructions: To be completed by supervisor prior to work beginning each day when off site. Email to


  • First Aider's identified and First Aid kit Available

  • Drinking water, Restroom facilities and Eye Wash Station available?

  • Muster location and Emergency procedures known?

  • MSDS available on site?


  • Weather Conditions

  • Extreme temperatures

  • Noise

  • Lighting

  • Wet / Slippery Surfaces

  • Work Area is Clean

  • Others Working in Area

  • Work being performed overhead? Potential Falling Objects?

  • Craning / Hoisting operations in progress

  • Power lines overhead?

  • Floor openings covered and marked?

  • Moving Vehicles / Equipment in the area

  • Corrective action required by General Contractor or other trades?

  • Photos of site conditions

Your working Conditions under your direct control

  • Are you working at heights or above a hazard (your feet 9' above the ground)?

  • Control: Fall protection plan and fall arrest training is required in order to proceed.

  • Are you avoiding over extension, prolonged motion, awkward body position, heavy lifting, tight area?

  • Control: Remember to stretch and return to your normal body posture to avoid injury.

  • Do you have only one emergency escape route? (working in Restricted / Confined Space Potential)

  • Control: Ensure you have more then one escape route for emergencies, and if this is not possible you may need to have a confided entry permit and training.

  • Working near energized / operating equipment?

  • Control: ensure operator is aware you are in the area and ask for an orientation from competent worker responsible for energized / operating equipment. Lockout procedure may be needed.

  • Tool Condition

  • Equipment Condition

  • PPE Condition

  • Training Required

  • Control: Ask for help and training from supervisor

  • Working Alone

  • Control: Working alone procedure must be used. Establish check in / call in frequency with supervisor and notify when completed.

  • Dust/ Gas/ Fumes/ Mist

  • Control: use exhaust / air exchange equipment and or respiratory protection

  • Flammables/ Explosives in Area

  • Control: reschedule work if possible or avoid sources of ignition.

  • Chemical Handling

  • Control: refer to MSDS for proper handling instructions, control measures and PPE required.

  • Other site hazards

  • Hazard
  • Task

  • Hazard

  • Control:

  • Enter any corrective actions necessary

  • Photos of Absolute hazards, if needed


  • Add signature

  • Add signature

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.