Site Safety Inspection
Date of Inspection
-
Month
-
Day
Year
Date
Person Conducting Inspection
First Name
Last Name
Description of site being inspected
Ex. Confined Space work in Digester 1
Take picture of job site
Walking/Working Surfaces
Project work areas clean, free of excess trash, & level walking surface
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Floor openings, wall openings and leading edges guarded
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Material or equipment properly stored
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Electrical cords, hoses, welding leads, etc. elevated to prevent trip hazards
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Scrap wood and metal free of protruding puncture hazards & rebar capped
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Rebar and other protruding impalement hazards capped
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Trash receptacles provided for work areas
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Barricades of proper material and color
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Other
Personal Protective Equipment
Hard hats worn and maintained as required
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Hearing protection requirement evaluated and worn
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Eye and face protection evaluated and worn in a proper manner
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Proper foot protection worn for job performed
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Electrical protection evaluated, rated and worn
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Respirators, gloves, chemical resistant garments utilized as required
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Other
Fall Protection & Fall Rescue
Body harness required and worn in a proper manner
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Lanyards & lifelines adequately secured to suitable anchorage
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Trained tower rescue personnel positioned adequately
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Fall protection equipment used only for fall protection
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Fall protection maintained and inspected
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Other
Excavations
Sloped and shored properly
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Access and egress provided every 25 ft.
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Daily documented inspections conducted
Excellent
Good
Fair
Needs Improvement
N/A
Type a question
Other
Cranes, Hoisting & Lifting Equipment
Chain-falls, slings, come-a-longs, chokers in good condition with current inspection
Excellent
Good
Fair
Needs Improvement
N/A
Comment
1.5 x boom length non-worker safe distance parameter being used
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Crane daily inspection complete and accurate
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Proper rigging techniques, tag lines, spotters, barricades & crane stability confirmed
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Other
Vehicles / Mobile Equipment
Lights, brakes, horns, alarms working properly
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Seat belts provided and used
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Other
Tools and Equipment
Electrical cords in good condition
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Tools are maintained in a safe condition
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Tools are properly carried and stored
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Pneumatic / hydraulic hose connections properly secured
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Proper tools used for the job performed
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Tethered properly for overhead job tasks
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Other
Hazardous Material & Hazardous Energy Control
Hazardous Materials separated, contained & stored properly
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Containers labeled as to content
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Fire extinguishers properly located, inspected & rated for intended use
Excellent
Good
Fair
Needs Improvement
N/A
Comment
LO/TO used to control energy sources
Excellent
Good
Fair
Needs Improvement
N/A
Comment
LO/TO program being utilized as required
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Hot work permits used properly
Excellent
Good
Fair
Needs Improvement
N/A
Comment
JHA defines job task/s, hazard/s and control methods being used
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Other
JHA & Permits
Applicable permits posted
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Do all crews and visitors participate in the JHA process
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Procedures being followed i.e., excavation, confined space, critical lift. etc.
Excellent
Good
Fair
Needs Improvement
N/A
Comment
Submit
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