Coordinator Site Inspection Form
Please complete this inspection on each site visit.
If any items listed below are deficient, please note the issue and any immediate action taken.
List any recommended actions for deficiencies or action items found.
Provide accurate project update with estimated stations of pipe, grading, sidewalk, paving, etc.
Date:
*
-
Day
-
Month
Year
Date
Time Onsite:
*
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Total 0.0
Duration of Site Visit (Hours):
*
Project:
*
Coordinator Name:
*
Please Select
Chris Mulrooney
Graham Mulrooney
Josh Hartson
Coordinator Email:
*
example@example.com
Site Supervisor:
*
Please Select
Connor Mulrooney
Ken Babcock
Nick Mann
*
Pass
Fail
N/A
Notes - Description of Deficiency and Immediate Action Taken
Trench Safety
Site Trailer
Dust Protection
Construction Site Signage
Overhead Hydro Signage
Erosion Control Protection
Public Access and Egress
Construction Layout Stations and Offsets
Fall Protection/ Confined Space
Site Fencing
Eye and Ear Protection
Guardrails/ Trench Boxes
Swamper/Spotters with Equipment
Pedestrian Bridges Being Used
Utility Locates up to Date
Utilities Painted and Flagged
Worker PPE
Pedestrian Protection Measures
As-Built Records – Drawings/ GPS
Site QA/QC
Tools – Power and Hand (Status)
Traffic Control Compliance
Washroom Facility
Equipment (Status)
Project Update (Comments):
*
Reason for Site Visit (Comments):
*
Action Items or Lagging Items:
*
Pictures:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Coordinator Signature:
*
Submit
Should be Empty: