Conduit Installation Safety Site Inspection
Site
Date/Time
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
24-Hour Time Minutes
Safety Inspector
First Name
Last Name
Foreman/Lead
First Name
Last Name
Machine #1 Operator
First Name
Last Name
Machine #1
Machine #2 Operator
First Name
Last Name
Machine #2
Machine #3 Operator
First Name
Last Name
Machine #3
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
Does the JHA Process Form match the work?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Is the JHA Form complete and with hazards and mitigation?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Cut-resistant gloves worn?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Other PPE worn properly?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
PVC conduit cement/primer properly used?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
PVC conduit heat binding properly used?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Pipe bending properly conducted? (No bracing against the roof membrane, no bouncing on lever, etc.)
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Pipe bending ergonomics correct?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Pipe threading properly conducted? (In proper vise, tools, cutting fluid)
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Conduit cutting tools properly used? (band saw, wheel cutter, etc.)
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Conduit processing protects the roof membrane?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Conduit properly secured?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Expansions properly installed?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Rollers properly installed?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Couplers properly installed?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Collars/penetrations properly installed?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Grounding properly installed?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Submit
Should be Empty: