Rooftop General Safety Inspection
Job Site
Foreman/Lead
First Name
Last Name
Machine #1 Type
Machine #1 Operator
First Name
Last Name
Machine #2 Type
Machine #2 Operator
First Name
Last Name
Machine #3 Type
Machine #3 Operator
First Name
Last Name
Job Safety Briefing performed for the crew?
Acceptable
Marginal
Unacceptable
N/A
N/O
Job Hazard Analysis performed?
Acceptable
Marginal
Unacceptable
N/A
N/O
Energized work being done?
Acceptable
Marginal
Unacceptable
N/A
N/O
Permits needed?
Acceptable
Marginal
Unacceptable
N/A
N/O
Was a Job Safety Briefing given to the inspector?
Acceptable
Marginal
Unacceptable
N/A
N/O
Was a signature asked for on the appropriate form after the briefing?
Acceptable
Marginal
Unacceptable
N/A
N/O
Ask someone what's the scope of work and hazards. Does it match the JHA?
Acceptable
Marginal
Unacceptable
N/A
N/O
Daily Scaffolding form submitted?
Acceptable
Marginal
Unacceptable
N/A
N/O
Was the scaffolding tag signed and dated for that day?
Acceptable
Marginal
Unacceptable
N/A
N/O
All safety cones secured?
Acceptable
Marginal
Unacceptable
N/A
N/O
Walkways clear of obstructions for evacuation?
Acceptable
Marginal
Unacceptable
N/A
N/O
All carts not in use secured from movement?
Acceptable
Marginal
Unacceptable
N/A
N/O
Pallets and contents secured from movement?
Acceptable
Marginal
Unacceptable
N/A
N/O
Rachet straps are tight?
Acceptable
Marginal
Unacceptable
N/A
N/O
Everyone wearing PPE (i.e. safety-rated glasses, high-vis, safety-rated boots, hard hat with chin strap, and hazard appropriate gloves)?
Acceptable
Marginal
Unacceptable
N/A
N/O
Fall protection/fall prevention used as appropriate?
Acceptable
Marginal
Unacceptable
N/A
N/O
Cool water on site for crew?
Acceptable
Marginal
Unacceptable
N/A
N/O
Crew dressed for weather conditions (hot, cold, wet)?
Acceptable
Marginal
Unacceptable
N/A
N/O
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