Job_Site_Checklist 91019

Project Name

Address

Weather

Date:

Date

Documentation

Rows	Yes	No	N/A
a.Notification of project NOP (Updated)
b.Acknowledgment
c.Emergency phone numbers, nearest Hospital and Emergency Response

Administrative

Rows	Yes	No	N/A
a. SDS readily accessible
b. Hazard communication information " shared
c. Fire extinguishers accessible and inspected "
d. Record Keeping: SWP and job site forms readily accessible and current
e. Employees appropriately trained

Job Site

Rows	Yes	No	NA
a.First aid kits available and stocked
b.General housekeeping – area free from debris
c.Compactor/trash Disposal procedures in place
d.Storage areas maintained in orderly manner
e.Potable water available
f.Warning signs, tags, barricade tape in place
g.Walking/Working Surfaces

Temporary Electrical Wiring

Rows	Yes	No	NA
a.Extension cords inspected & free of defects
b.Ground fault circuit interrupters (GFCI) in use
c.All equipment properly grounded
d.Temporary wiring clear of employee & vehicular traffic

Ergonomics

Rows	Yes	No	NA
a.Proper lifting techniques being employed
a.Hard Hats
b.Eye protection
c.Appropriate approved work shoes
d.Hearing protection
e.Gloves
f.Respiratory Protection
a.Adequate lighting
b.Medical Services reasonable accessible
c.Administrative and/or Engineering Controls in place to reduce noise levels
d.Protection from ionizing and/or nonionizing radiation
e.Emergency Action Plan and Fire Prevention

Equipment including PPE, Ladders, Scaffolds & Tools

Rows	Yes	NO	NA
a.Inspected before use
b.Defective items tagged and removed from service
c.Powered Equipment operators trained and authorized

Ladders

Rows	Yes	No	NA
a.Side rails extend at least 3’ above upper landing surface
b.Ladders tied-off to prevent displacement

Scaffolds

Rows	Yes	No	NA
a.Guard rails
b.Full planking
c.Bracing
d.Ladder access
e.Toe boards
f. Tag updated

Fall Protection

Rows	Yes	No	NA
a.Personnel trained in fall protection
b.Conventional Fall Protection System Used
1.Guardrail System
2.Personal Fall Arrest System
3.Warning Line System
4.Controlled Access Zone System
5.Safety Monitoring System: Monitor must be competent to recognize fall hazards & know responsibilities of the position
c.Fall Protection Plan use

Biohazard/virus

Rows	Yes	No	NA
a. Covid-19 daily screening workers, visitors and contractors
b. Electronic Display Digital Infrared Forehead
c. Covid 19 Policy in place
d. Practice of social distancing, donning of face masks and hand sanitizer available

Unsafe work practices will be corrected immediately upon discovery and if total job site safety cannot be restored, job will be shut down until corrections are made. The below listed persons were working in an unsafe manner & enforcement documentation is or will be prepared at the earliest opportunity consistent with safety.

Describe unsafe condition 1

Corrective action 1

Target Date

Date

Location of unsafe condition 1

Person responsible 1

Describe unsafe condition 2

Corrective action 2

Target Date 2

Date

Location of unsafe condition 2

Person responsible 2

Describe unsafe condition 3

Corrective action 3

Target Date 3

Date

Location of unsafe condition 3

Person responsible 3

Describe unsafe condition 4

Corrective action 4

Target Date 4

Date

Location of unsafe condition 4

Person responsible 4

Unsafe photo 1

unsafe photo 2

Unsafe photo 3

Unsafe photo 4

Observations/Comments

I certify, this date, that I have performed a hazard assessment of our job sites and our methods of operations. This hazard assessment was accomplished to determine if hazards are present, or are likely to be present, which necessitate the use of personal protective equipment PPE Identified hazards which cannot be eliminated through engineering controls or changes in procedures will be addressed by the use of selected PPE. All affected employees will be informed of the required PPE for specific work locations or specific types of work to be performed and will receive initial training or retraining, if necessary, before being allowed to perform work requiring PPE. If conditions or procedures change, a reassessment will be made.

Inspection Completed and submitted by:

Signature

Reviewed by supervisor of work

Date of inspection

Date

Signature

Reviewed by Manager

Date

Signature

Job Site Inspection