Date Project / Location Contractor Supervisor Project Safety Rep Safety Permits & Documentation Safe Work Permit issued for job scope +-na JSA complete & understood by crew +-na Contractors properly signed in/out +-na Required legal & safety posters/signs +-na Pre Job Safety Meeting Signed +-na SAPs signed & understood by crew +-na STAC complete, hazards understood +-na General Site Conditions Fire Extinguishers present & insepcted +-na Materials properly stored on cribbing trip hazards avoided cords managed +-na Emergency equip./exits/walkways clear +-na Good Housekeeping, debris cleaned up trash cans emptied tools put away +-na No sharp edges or fasteners exposed +-na Flammables & chemical agents stored in approved labeled containers +-na Barricades & tags in place as required +-na Floor & wall openings properly guarded or covered & marked +-na Precautions to avoid dropped objects +-na Slip hazards ice & snow removed +-na Material Handling / Ergonomics Material handling devices inspected and properly used +-na Proper manual lifting techniques used +-na Contractors using hand on stair rails +-na Contractors keeping clear of Line of Fire +-na Electrical All cords & tools protected by GFCI +-na All cords & plug ends in good condition +-na Adequate lighting, guards on lights +-na Cords protected form cuts & water +-na 10-Feet min. clearance from power lines +-na Powered Ind. Trucks/Heavy Equipment Operator permit/traingin up to date +-na Equipment inspection/maint. Complete +-na Seatbealts in use +-na Proper rigging/load secured & balanced +-na Vehicle/crane spotter used as required +-na Equipment operated in safe manner +-na Aerial Lifts Operator permit/training up to date +-na Equip. Inspection/maint. Complete +-na Gate/Chain latched when in use +-na Vehicle spotter used as required +-na Equipment operated in safe manner +-na Hot Work Air Monitoring conducted where required +-na Fire Watch assigned/on duty as requried +-na Flammables moved 50-ft/combustables moved 35-ft or covered with fire blanket +-na Welding machine properly grounded +-na Cylinders restrained, fuel & oxygen seperated by 20-ft or fire wall+-na Unused cylinders capped +-na Leads, hoses, regulators in good condition +-na Scaffold Inspection completed & tag updated +-na Erected properly on level firm surface +-na Scafold plumb & properly braced +-na Walking/Working surfaces fully planked +-na Ladder & components in safe condition+-na Top rail, midrail & toe baords in use +-na Wheels locked & in good condition +-na Facilities Adequate restroom facilities available +-na Fresh drinking water available +-na Personal Protective Equipment Safety glasses with shields/sheilds worn +-na Monogoggles properly worn &/or on person +-na Faceshield for grinding chipping LEO +-na Hardhat worn as required +-na Proper gloves worn for task +-na Long sleeves worn where required +-na Steel toe boots worn +-na Hearing protection worn as required +-na Welding jacket worn for hot work +-na Proper welding helmet/sheild worn +-na Harness & lanyard properly worn +-na Suitable anchor point used +-na Proper outer protective clothing and boots worn where required +-na High visibility vest for spotter & as required +-na Respiratory protection worn as required +-na PPE inspected & in safe condition +-na Tools Guards in place & in good condition +-na T-Handle used on grinder & hammer drill +-na Tool used in safe manner +-na Ladders Ladder inspected & properly sloped +-na Proper ladder selected for task +-na Ladder used safely 3 points of contact +-na Excavations/concrete work Excavation is inspected & properly sloped +-na Soil piles kept minimum 2-ft from edge +-na Access ladder within 25-ft of workers +-na Rod caps on all upright resteel +-na Other Safety Driving +-na Auditor Crew Size Contractor Safety Positives Corrected Items