Crimping and Landing 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
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
Crimper matches the wire and the lug?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Wire matches the drawing?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Lug matches the drawing and the landing area?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Crimper Operator has competency?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Wire properly prepared (exposed, not knicked)
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Crimp properly applied?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Wire minimum bend radius OK?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Heat shrink properly applied?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Label properly applied?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Cuttings collected for disposal?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Fastener properly torqued?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Torque wrench calibration checked?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Torque mark properly applied?
*
Acceptable
Marginal
Unacceptable
N/A
N/O
Submit
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