Demolition Checklist

HSE CHECKLIST FOR DEMOLITION OPERATIONS
This checklist is to be completed initially and weekly thereafter

Demolition Procedure HSEOP-20-01
Project*
Location of Structure to be Demolished*
Controlling Contractor*
Demolition Subcontractor*
Person Completing Checklist*
Your Phone Number*
Please enter a valid phone number so we can text you when the form has been approved.Format: (000) 000-0000.
Email (copy of final approval will be sent here)*
example@example.com
Date Checklist Completed*

MonthDayYear
Date
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/a
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
Comments:
Signature of Competent Person*

Clear
Signature of District HSE Manager or Representative*

Clear
Should be Empty: