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Jobsite Inspection Checklist

Site/Contractor Name: Date:

Location: No ofEmployees:Conducted By:

S Satisfactory NS Not Satisfactory NA Not Applicable

Item Inspected S NS NA Requires Immediate Action

1. SITE ACCESS

Clean le!el "round

#de$uate ramps

#de$uate stairs

#de$uate ladders

%ther

2. HOUSEEE!IN"

Clear &alk&ays

Clear &ork areas

Clear access and landin"

%ther3. !ERSONA# !ROTECTI$E E%UI!&ENT

'ead protection

(oot protection

Eye protection

'earin" protection

)espiratory protection

(all protection *plan rescue+

%ther

4. #A''ERS

Secured

,roper an"le *e-tension ladders+

,roper si.e and type

Safe usable condition

,roperly used

,roper 'andrail and landin"s

Nonslip bases

%ther

5. SCA((O#'S

,roperly erected *all parts used+

,roperly secured

,roperly planked,roper "uardrails toeboards

,roper access to platform

#cceptable loadin"

%ther

6. !O)ER TOO#S* E%UI!&ENT

0eneral condition

,roper "uards cords ,,E

1a""in" as DE(EC1I2E

%ther

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7. STAIR)E##S + RA&!S

,roper filler blocks in metal stairs

,roper cleats on ramps

#de$uate li"htin" in stair&ells

,roper handrails or "uardrails

%ther

8. TRA((IC CONTRO#

1rained traffic controllers,roperly located

Clean re"ulation si"n

,roperly dressed *includin" !est+

%ther

9. !U,#IC )A- !ROTECTION

,roperly located *&ithin 345 m+

Entrances clearly marked

Co!ered &here re$uired

6in4 hei"ht &idth re$uirement

,roper rail on street side

,roper li"htin" &here re$uired

%ther

10. (A## !ROTECTION

CS# appro!ed

,roperly &orn

Safe usable condition

7nprotected openin"s and ed"es

8orkin" from: Ladders

Scaffolds

S&in"sta"es

%ther

11. "UAR'RAI#S* ,ARRICA'ES

Located &here re$uired

,roperly constructed

#de$uately secured

%ther

12. "AS C-#IN'ERS

,roperly located

,roperly secured

,roperly mo!ed or lifted

,roperly hooked up

%ther

13. CON(INE' S!ACES

,roper access

#ir testin" before entry

)escue e$uipment readily a!ailable

Safety harness lifeline properlyanchored 9 used

Second person for rescue

%ut"oin" air monitored

Entry permit &here re$uired

%ther

14. (IRST AI' RE%UIR&ENTS

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#de$uate $ualified first aiders on obsite

(irst aid kits: #de$uate number

#de$uate contents

%ther

15. (IRE !ROTECTION

6aster emer"ency plan

E-tin"uishers &here re$uired

(ully char"ed

#de$uately identified%ther

16. CRANES* HOISTS* ETC.

Safe setup of e$uipment

6aintenance lo" a!ailable

Competent operator

Condition of slin"s hard&are

Safety catches on all hooks

,roper use of ta" lines

,roper liftin" containers

Competent si"naller

%ther

17. )E#'IN"

)ods 9 cylinders properly labeled

6SDSs readily a!ailable

,roperly secured "round cables

,roper eye protection &orn

,roper screens and e-haust

0as cylinders upri"ht and secured

(ire e-tin"uisher readily a!ailable

%ther

18.E#E$ATIN" )OR !#AT(OR&8orker trainin"

,roperly used

Safe usable condition

#cceptable loadin"

6anufacturer;s operatin" manual

%ther

19. TRENCHES + E/CA$ATIONS

,roperly sloped &here re$uired

E-ca!ated soil properly placed

#ppropriate shorin" used

,roper access to trench

,roper stora"e of materials in and abo!e

%ther

20. E/TENSION COR'S

%utdoortype rated o!er

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Surface cables buried or protected

%ther

22. &ATERIA#S STORA"E

,roperly located

Safely piled stacked bundled

,roperly mo!ed or lifted

,roperly labeled *8'6IS+

%ther

23. (OR&)OR0uardrails and fallarrest system

Desi"n dra&in"s kept on proect

Inspection statement by en"ineer orcompetent &orker

%ther

24. SUS!EN'E' SCA((O#'S

,roperly attached and capable of at least3 times ma-imum load

%utri""er beam tied to fi-ed support &ithade$uate counter&ei"ht

#ll mechanical/electrical de!ices in "ood&orkin" condition

Independent lifelines for each &orker*e-tend to "round+

En"ineer;s dra&in" on site if re$uired

25. SI"NS + !RINT &ATERIA#

%'9S #ct and re"ulations

8SIB (orm >? poster

6SDSs

8arnin" si"ns

Emer"ency phone list

)eport forms

%ther

26. )ORER E'UCATION

8'6IS trainin"

Company safety policy 9 pro"ram

Inury reportin"

'a.ard reportin"

%'9S #ct and )e"ulations

,ersonal '9S responsibilities

%ther

27. H-"IENE

8ashroom facilities a!ailable

Cleanliness of facilities

Inury/ha.ard reportin"

,ersonal responsibilities

Safety policies and procedures

%ther