Title Page
Items to Review
People
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Unsafe Acts
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Unsafe Work Procedure
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Improper tool use
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Improper Equipment use
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Not Using PPe
Equipment
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Ladders/Scaffolds
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Power Tools
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Adequate Supply of PPE
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Fire Extinguisher
Materials
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Housekeeping
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Controlled Products
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MSDS Sheets
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Storage & Stacking
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Rough Edges
Environment
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Noise
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Ventilation
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Lighting
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Ice/Snow/Temperature
Wostco Site Inspection
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Job site insepected
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Date Completed
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Site Supervisor
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Inspection completed by:
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Worker Safety Rep:
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Hazards Present
Hazard
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Hazard
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Severity Ranking
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1 = Immediate Danger (Death, Disaster)
2 = Serious (Major Injury or Damage)
3 = Minor (Non-Serious Injury or Damage)
4 = Negligible (first aid or less)
5 = Not Applicable -
Probability
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A = Probable (Immediate or Soon)
B = Reasonably Probable (Eventually)
C = Remote (Could Happen at Some Point)
D = Extremely Remote (Not likely to Happen) -
Hazards Control
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Action Completed By:
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Date Completed
Committee
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committee Signature