The Complete Safety
Checklist eBook
An index of checklists for safety experts to use as part of safety inspection programs
DISCLAIMER: This workbook has been developed by Predictive Solutions Corporation.
If there is any conflict between the information in this eBook and the regulation/policies
of governing safety bodies, those of the safety bodies shall take precedence.                www.predictivesolutions.com
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Table of Contents
01   Industry Checklist
     General Industry                                               06
     General Construction Safety                                    19
     Construction Safety                                            27
     Construction Safety Comprehensive                              36
     Construction & Civil Safety                                    52
     Civil Safety                                                   63
     Fab Shop Checklist                                             67
     Lab Checklist                                                  68
     Marine Checklist                                               73
     Manufacturing Safety Checklist                                 77
     Stormwater Checklist                                           81
     Traffic-Workzone Checklist                                     85
     Underground Plumbing Checklist                                 87
02   Focused Inspection Checklists
     Behavior-Based Safety                                           89
     Fall Protection Audit                                           91
     Body Positioning                                                94
     Concrete Post Pour                                              95
     Guardrails                                                      96
     Hand Safety                                                     97
     Moisture Control                                                98
     Office Safety                                                   99
     Sample 5S                                                      102
     Vehicles                                                       104
03   Leadership Checklists
     Management Audit                                               106
     MSHA Checklist                                                 109
04   Quality Checklists
     Concrete                                                       114
     Plumbing                                                       116
05   SafetyNet
     What Is SafetyNet?                                             117
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Introduction
Safety inspection checklists are a key component to a robust workplace safety program. For one, many
regulatory agencies around the world, including the Occupational Health and Safety Administration in the
U.S., require worksites to be regularly inspected for safety. But more importantly, their use has proven to be
critical in identifying safety hazards that can then be eliminated to prevent workplace injuries and fatalities
before they occur.
There is a lot of research generally that shows why safety checklists are needed. For example, in his
landmark book “The Checklist Manifesto,” Atul Gawande cited a research study that used a checklist to
observe doctors performing central line implantations at Johns Hopkins Hospital. Alarmingly, they found
that about one-third of the doctors failed to execute any of five basic steps, one of which was to simply
wash their hands to help reduce the chance of infection in their patients. Based on these findings, the
hospital implemented a simple pre-implantation checklist to cover these preventive items which helped
reduce the hospital’s infection rate related to central line implantations from 11 percent to zero.
Why would highly trained doctors skip such simple but critical steps to prevent infections? For the same
reasons that highly trained workers skip simple but critical safety steps: overconfidence sometimes coupled
with a lack of previous adverse effects (“I’ve done this a million times”), tiredness, laziness, rushing to finish
a job, etc. Doctors don’t want to infect patients, and workers don’t want to get hurt, but both groups do
both of these things far too often.
One simple workplace injury prevention method is to institute a worksite inspection program based on safety
checklists, very similar to the methodology implemented at Johns Hopkins. Safety inspection checklists can
be used to observe the conditions of the worksite, or the behaviors of workers within the worksite, or both.
Regardless of their type, savvy safety professionals have believed for years that more safety inspections
lead to fewer injuries. This was supported in research conducted by Predictive Solutions Corporation and
Carnegie Mellon University and published in their white paper, “Predictive Analytics in Workplace Safety:
Four ‘Safety Truths’ that Reduce Workplace Injuries.”
After analyzing thousands of worksites and millions of safety inspections across its customer base, Predictive
Solutions found that in nearly every case, as inspections increased, incident rates fell, as shown in the
following customer examples. The green actual and trend lines show inspections increasing while the red
actual and trend lines show safety incidents decreasing.
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                                                                                                                                   TIME                                  TIME
                                                                                                                                                                                   Inspections
                                                                                                                                               Inspections
                     Inspections
                                                                                                    Inspections
                                           Incidents
                                                                                                                                                             Incidents
Incidents
                                                                                                                  Incidents
            TIME                                                                        TIME                                       TIME                                  TIME
This makes perfect sense. The more times a company observes its workers or its worksites, the more
opportunities it has to correct unsafe observations before they turn into actual injuries. Rather than being
                                                                                                    Inspections
                     Inspections
                                           Incidents
Incidents
reactive and waiting for injuries to occur, companies can be proactive and prevent them from occurring in
the first place. As Karl E. Weick and Kathleen M. Sutcliffe noted in their book “Managing the Unexpected,”
companiesTIMEcan develop “skills to detect
                                        TIME
                                            and contain these errors at their early stages.”
Another finding of this research that was less intuitive was that having more employees engaged in
the safety inspection process from outside the safety function also correlated with fewer injuries. In
the following graphic, as the percent of safety professional inspectors goes down, so does a worksite's
number of safety incidents.
                                                                                        100%
                                                                                        90%
                                                       Safety Professional Inspectors
                                                                                        80%
                                                                                        70%
                                                               Percentage of
                                                                                        60%
                                                                                        50%
                                                                                        40%
                                                                                        30%
                                                                                        20%
                                                                                        10%
                                                                                         0%
                                                                                               0   20             40          60          80
                                                                                                   Count of Incidents
The conclusion is twofold. In one sense, a company is benefiting from the wisdom of crowds theory, which
suggests that a large group of people are often more accurate in assessments than any one individual
– often times, even when that individual is an expert in that given field. In another sense, this is the
manifestation of transferring the responsibility for safety to everyone at the worksite’s, rather than just the
safety professionals. When everyone is engaged in safety, they take personal ownership of their and their
co-workers' safety and improve the overall safety culture.
In this eBook, you’ll find various checklists to aid you and your team in conducting safety inspections. Don’t
investigate injuries; prevent them!
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01 Industry Checklists
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General Industry Checklist
 General Industry Checklist
    Inspection                                                                           Inspection
         Type:                                                                                Date:
       Project:                                                                       Inspected By:
                                                                                         Reviewed
                                                                                             With:
 Category : Sub-Category
           Administration                       Safe                 Unsafe                           Comments/Observations:
OSHA records current
Safety manual
SDS on file
Safety meetings
State / Fed posters (Eng/Sp)
Facility Safety Assessments on file
Visitor PPE available
Visitor sign-in form
  Body Positioning/Ergonomics                   Safe                 Unsafe                           Comments/Observations:
Access Points / Ladders
Line of Fire
Proper Lifting techniques
Work Place design adequate
Rotation available
Ergonomic mats available
    Bloodborne Pathogens                      Safe                   Unsafe                           Comments/Observations:
Exposure plan in place
Universal precautions in place
PPE utilized as necessary
Hepatitis B vaccination made
available to employees
Post exposure follow up made
available
Training provided to employees
Medical records kept for duration
of employment + 30 years
                                                                        Page 1 of 13
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    Bloodborne Pathogens                      Safe                   Unsafe            Comments/Observations:
Training records kept 3 years
Bloodborne Pathogen kits
available/accessible
           Confined Space                       Safe                 At Risk           Comments/Observations:
Area secured
Signage Present
Competent Person
Attendant Present
Authorized Entrant
Entry Supervisor Present
Employees Trained
Permit Completed
Entry kit on site
Equipment Inspected
Fire Protection Equipment
Air Monitoring conducted
Rescue plan/emerg #'s/map
Respiratory equipment available
Ventilation Equipment available
Purging, Inerting, Flushing Required
Blocking / Blanking
Lockout / Tagout Utilized
Training Documentation
        Hoisting Equipment                      Safe                 Unsafe            Comments/Observations:
Annual inspection current
Operator training current
Daily inspections current
Load rating posted
Loads properly secured
Notification device functional
Operator appears competent
Rig insp/rated/rated
Safety latches used
Weight of load verified
                                                                        Page 2 of 13
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              Electrical                         Safe                 Unsafe            Comments/Observations:
Cords in good condition
Cords protected from traffic
Elect Hot Work Procedures
Electrical room protected
Energized parts protected
Electrical panels are labeled
Electrical panel doors in place
Electrical panels are free from debris
and obstructions
Electrical panels protected
Qualified electrical personnel on staff
Adequate PPE available based on
panel rating
GFCI's used
Conduits visually inspected
All outlets properly covered
Proper use temp pwr bxs
Signage present
          Lockout/ Tagout                        Safe                 Unsafe            Comments/Observations:
Written LO/TO procedures posted on
each machine
Proper use of locks for LOTO
Proper use of tag for LOTO
All sources of energy have been
isolated
All energy sources have proper shut
off device
Start button tested to verify shut off
Training for affected employees
conducted
Training for authorized employees
conducted
Adequate number of locks issued to
authorized employees
       Emergency Response                        Safe                 Unsafe            Comments/Observations:
Emergency Action plan on file
Employee notification system in
place
Emergency plan communicated to
employees
Incident command system in place
                                                                         Page 3 of 13
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       Emergency Response                        Safe                 Unsafe            Comments/Observations:
Employees with duties trained
Personnel trained First Aid, CPR, &
AED
Refresher training conducted
annually
Exit markings/lighting adequate
Number of exit routes adequate
Means of egress free of obstructions
Exit routes meet height and width
requirements
Evacuation drill conducted
Spills kits available/accessible
   Facility Protection                           Safe                 At Risk           Comments/Observations:
Perimeter fences installed
Public protection signage
Designated employee parking
Designated visitor parking
Adequate lighting
Barricades installed properly
Street closures identified
Traffic control plan
Security system in place
           Fire Protection                       Safe                 Unsafe            Comments/Observations:
Portable fire extinguisher provided
Portable fire extinguisher mounted
adequate height
Fire extinguisher type appropriate for
hazard
Fire extinguisher training for
employees
Fire extinguishers visually inspected
monthly
Fire extinguisher tested annually by
3rd party
Combustible liquids stored
adequately
Cabinets grounded properly
Cabinets labeled properly - NFPA
Fire extinguishing system inspected
annually
Sprinkler heads free from
obstructions/paint
                                                                         Page 4 of 13
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       Hand And Power Tools                      Safe                 Unsafe            Comments/Observations:
Blade/Bit in good condition
Cord in good condition
Tool in good condition
All guards in place
GFCIs used
Ground prong in place
Guards in place
Proper tool for the job
Tools being used properly
      Hazard Communications                      Safe                 Unsafe            Comments/Observations:
Written program on file
Chemicals Properly Stored
Containers labeled
Secondary containers labeled
Inventory list
SDS' available/current
Proper Signage in use
Employees trained
             Heat Stress                         Safe                 At Risk           Comments/Observations:
Potable drinking water available
Water kept cool/ice
Drinking water cups available
Monitoring of employees
Breaks taken when necessary
Adequate clothing worn
Employees trained
            Housekeeping                         Safe                 Unsafe            Comments/Observations:
Clear access to bldg/site
Impalement protection available
Proper material storage
Waste containers available
Waste containers are emptied
regularly
Waste containers have tight fitting
covers
                                                                         Page 5 of 13
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           Housekeeping                           Safe                 Unsafe            Comments/Observations:
Areas free of rodents, insects, and
vermin
Signage in use in wet areas
Slip, trip, fall hazards
protected/removed
Walkways clear
Non potable water sources marked
Toilet facilities adequate & accessible
           Ladders / Stairs                       Safe                 Unsafe            Comments/Observations:
Extension ladders 3' above landing
Clear of debris/materials
Extension ladder 4:1 pitch
Inspected for defects
Landings and treads in good
condition
Proper use of ladder
Safe work dist from hazard
Slip trip exposure eliminated
Portable ladders adequate rating
Fixed ladders in good condition
       Machine Guarding                         Safe                   Unsafe            Comments/Observations:
One or more method of guarding
in place to protect employees in
place
Point of operation properly
protected
Grinding wheels properly
guarded
Tool rest on grinders properly set
Pulleys within 7 feet of floor level
properly guarded
Horizontal and vertical belts
properly guarded
Sprocket wheels and chains
properly guarded
All gears properly guarded
Table saws properly guarded
All portions of bandsaw blades
properly guarded
Self feed rip saws have anti kick
back fingers
Vertical and horizontal shafting
guarded
Radial saws properly guarded
                                                                          Page 6 of 13
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       Machine Guarding                        Safe                   Unsafe            Comments/Observations:
Emergency stop buttons
functional
Written die setting procedures in
place for all presses
Safety blocks used when dies in
the press are repaired or
replaced
All fan blades properly guarded
Proper signage posted
Employees trained to inspect
machine prior to use
Process in place to replace all
guarding after maintenance or
repairs are complete
  Material Handling & Storage                  Safe                   Unsafe            Comments/Observations:
Aisles and passageways in good
repair, kept clear, properly
marked
Materials securely stacked
Good housekeeping in storage
areas
All forklift/power industrial trucks
in good condition
Only trained and authorized
personnel allowed to operate
FL/PIT
Slings, fastenings, and
attachments inspected before
use
Use of makeshift devices
prohibited
              Medical                          Safe                   Unsafe            Comments/Observations:
First Aid cabinet readily available
Personnel trained First Aid, CPR
& AED
AED Available
AED Inspected
Emergency numbers posted
Eye wash station available
Eye wash station inspected
monthly
Map to medical facility
Means of communication
functional
                                                                         Page 7 of 13
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             Medical                           Safe                   Unsafe            Comments/Observations:
                                               Safe                   Unsafe            Comments/Observations:
   Noise/Hearing Protection
Noise assessment conducted
and documented by work area
Written hearing conservation
program in place
Engineering and Administrative
controls in place to reduce noise
levels
Hearing protection is available for
employees
More than one type of hearing
protection is available for
employees
Hearing protection training is
provided for all employees
Hearing protection postings
Signage where hearing
protection is required is posted
Audiograms are conducted
annually for all affected
employees
Audiogram results have been
issued to employees
Audiograms resulting in a
threshold shift have been listed
on the OSHA log
Occupational & Enviro Exposures                  Safe                 At Risk           Comments/Observations:
Containers labeled
Haz material properly stored
Spill containment adequate
Adequate ventilation
Atmospheric exposures
Ionizing radiation exposure
Signage for Laser Use
Signage for Lead, Asbestos
                P.P.E.                           Safe                 Unsafe            Comments/Observations:
Hazard assessment documented
Training provided for all employees
Eye protection adequate
Foot protection adequate
                                                                         Page 8 of 13
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               P.P.E.                            Safe                 Unsafe            Comments/Observations:
Face protection adequate
Body protection adequate
Hand protection adequate
Heat protection PPE adequate
Cold protection PPE adequate
PPE in good condition
    Powered Industrial Trucks                    Safe                 Unsafe            Comments/Observations:
Motor Off Checks
Leaks – Hydraulic Oil, Battery
Tires – Condition and Pressure
Forks, Top Clip Retaining Pin and
Heel -- Condition
Load Backrest Extension – Attached
Hydraulic Hoses, Mast Chains,
Cables & Stops – Check Visually
Finger Guards – Attached
Overhead Guard – Attached
Safety Warnings
Battery – Water/Electrolyte Level and
Charge
Hydraulic Fluid Level – Dipstick
Transmission Fluid Level – Dipstick
Operator's Manual in Container
Capacity Plate Attached –
Information Matches Model, Serial
Number and Attachments
Sitdown Truck - Seat Belt –
Functioning Smoothly
Man-up Truck – Fall
protection/Restraining means -
Functioning
Brake Fluid – Check level
Motor On Checks
Accelerator Linkage – Functioning
Smoothly
Parking Brake – Functioning
Smoothly
Service Brake – Functioning
Smoothly
Steering Operation – Functioning
Smoothly
Drive Control – Forward/Reverse –
Functioning Smoothly
Tilt Control – Forward and Back –
Functioning Smoothly
Hoist and Lowering Control –
Functioning Smoothly
                                                                         Page 9 of 13
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    Powered Industrial Trucks                      Safe                 Unsafe            Comments/Observations:
Horn – Functioning
Lights & Alarms (where present) –
Functioning
Hour Meter – Functioning
Instrument Monitors – Functioning
Training documents on file
       Motorized Equipment                        Safe                At Risk             Comments/Observations:
Daily inspections
Deficiencies Corrected/Repaired
Operator manual in cab
Backup alarm functional
Strobe lights installed/functional
Horn functional
Tire condition
Step/platforms condition
Seat belt functional
Emergency shut off functional
Glass free of obstructions
Glass free from cracks
Cab floor free from trash
Parking break functional
Moving parts guarded
Workface illuminated (night)
Equipment cribbed/blocked
Parking Brake set
Wheels chocked
Clearance overhead hazards
Tools/materials secured
Tie down requirements met
Flagman used if applicable
Seat belts used
Operator Appears Competent
Equipment used safely
Training docs available
                                                                          Page 10 of 13
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       Respiratory Protection                      Safe                 Unsafe            Comments/Observations:
Assessment conducted/documented
Written program plant specific
Appendix D on file for volunteer use
Medical evaluations conducted
Fit test conducted initial/annual
Training for employees documented
Respirators are NOISH approved
Respirators are adequate for the
hazard
Respirators equipped with End of
Service Life Indicator (ESLI)
Employees trained on changing
cartridges
Respirators in good condition
Employees trained in use-inspection
of respirator
Employee trained annually
Re-evaluation of the program
         Scissor / Arial Lifts                     Safe                 At Risk           Comments/Observations:
Daily Inspection Performed
Operators manual stored lift
Operator certified
Strobe light functional
Backup alarm functional
Control panel- all switches clearly
visible
Safety indicator lights functional
Motion alarms functional
Guardrails condition
Platform extension functional
Emergency stop button functional
Tire condition
Braking devices operational
Gate or chain secured
Fall Protection: Harness & Lanyard
Proper Anchor Point
Nothing used to increase height
Work surface surf/free holes
Overhead obstructions
                                                                          Page 11 of 13
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        Scissor / Arial Lifts                     Safe                 At Risk           Comments/Observations:
Equipment loaded properly
Electrical hazards identified and
controlled
Area barricaded
             Ventilation                          Safe                 Unsafe            Comments/Observations:
Air assessment
conducted/documented
Ventilation adequate for the hazard
Hoods or enclosures adequate
Hoods or enclosures in good working
condition
Means of control adequate
Clean air flow provided
Respiratory protection provided when
necessary
         Welding / Cutting                        Safe                 Unsafe            Comments/Observations:
All fire hazards removed from area
Confined spaces adequately
ventilated
Hot Work Permit completed
First Aid equipment available
Fire ext present
Cylinders upright/cap/secured
Cylinders adequately marked
Fire Watch – 30 min
Flash arrest on torches
Flash protection available
Gauges working properly
Leads in good condition
Prop PPE in use
PPE in good condition
Proper ventilation
Torch hoses good cond
Cylinders properly stored
Cylinder valves closed when empty
  Walking and Working Surface                     Safe                 Unsafe            Comments/Observations:
Floor dry and clean
Permanent aisles marked and clear
                                                                         Page 12 of 13
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   Walking and Working Surface                 Safe                 Unsafe            Comments/Observations:
Load limit weights posted in storage
areas
Adequate lighting provided
Covers and guardrails in place where
required
Hatchway and floor opening guarded
Floor holes guarded
Covers and guardrails provided to
prevent incidents
Fixed stairways at least 22 inches
wide
Railing on stairway
Scaffolding load capacity verified
Scaffold planks extend over at least
6”
Scaffolds properly braced
Damaged scaffold parts removed
from service
                                                                      Page 13 of 13
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General Construction Safety Checklist
 General Construction Safety Checklist
    Inspection                                                                      Inspection
         Type:                                                                           Date:
       Project:                                                                  Inspected By:
                                                                                     Reviewed
                                                                                         With:
 Category : Sub-Category
           Administration                     Safe                 Unsafe                        Comments/Observations:
Document pre-const mtgs
Drug Testing program
Freq/reg safety inspections
Incentive/Recognition Program
JHA submitted each trade
MSDS manual
New Empl Orientations held
OSHA 10/30 hour card
OSHA Posters / OSHA 300 Log
Safety manual
Safety meetings
State / Fed posters (Eng/Sp)
Toolbox Meetings
Visitor PPE available
Visitor sign-in form
        Concrete & Masonry                    Safe                 Unsafe                        Comments/Observations:
Adequate bracing
Formwork drawings onsite
Limited access zone
Rebar caps/impalement prot.
Rotating parts guarded
Washout pits/boxes
          Confined Space                      Safe                 Unsafe                        Comments/Observations:
Atmospheric conditions
                                                                       Page 1 of 9
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           Confined Space                    Safe                 Unsafe            Comments/Observations:
Electrical / fire prevention
Harness / extraction equip
Permit required
Regular insp / air monitor
Respiratory equipment
Stand-by person/rescue equip
Training documentation
Ventilation
 Cranes And Hoisting Equipment               Safe                 Unsafe            Comments/Observations:
3rd party insp current
Anti Two Block device
Boom angle indicator
Cert or verify training
Crane supported and level
Daily inspections current
Dist power lines/de-ener
Fire extinguisher in crane
Flagman identified
Gates and signals
Lift plan on file
Load chart posted
Loads properly secured
Means of communication
Operator appears competent
Operator manual in crane
Outriggers extend/cribbing
Rig inspected/rated
Safety latches used
Swing radius barricaded
Tag lines used
Weight of load verified
                Electrical                   Safe                 Unsafe            Comments/Observations:
Blanks and plugs installed
Circuits labeled
Cords in good condition
Cords protected from traffic
                                                                      Page 2 of 9
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              Electrical                      Safe                 Unsafe            Comments/Observations:
Elect Hot Work Procedures
Electrical room protected
Energized parts protected
Equipment firmly mounted
Ext eqp in weatherproof encl
Generators grounded
GFCI's used
LO/TO procedures
NFPA 70 E for Energized work
Proper use temp pwr bxs
Quarterly cord insp current
Signage present
Temp lights installed/guarded
           Environmental                      Safe                 Unsafe            Comments/Observations:
Adequate ventilation
Atmospheric contaminants
Containers labeled
Dust control measures
Erosion ctrl measures maint/adeq
Haz material properly stored
Noise control measures
Regular air sampling
Spill containment adequate
SWPPPlan followed
SWPPPlan on file
            Excavations                       Safe                 Unsafe            Comments/Observations:
1-call/as-builts used
Access with 25'
Competent person present
Daily inspections doc
Excav > 20' engineered
Manuf. data on shoring
Perimeter prot/barricade
Sloped, benched, or shored
Spoil 2' from edge
Surface encumbrances
                                                                       Page 3 of 9
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             Excavations                      Safe                 Unsafe            Comments/Observations:
Surface traffic exposure
Water entering excavation
            Fall Protection                   Safe                 Unsafe            Comments/Observations:
Ext/int guardrails
Fall protection at 6'
Fall protection plan
Fall rescue plan & equip avl
Floor/wall opening protected
Flr covrs adeq,secure,label
Proper anchorage points
Roof edge protected
Safety harness and lanyard
Stair/ramp/walkway prot
           Fire Protection                    Safe                 Unsafe            Comments/Observations:
Emergency vehicle access
Ext charged and inspected
Fire suppression equip avail
Fire watch when applicable
Hot work permits
Interior structure 1-hr rated
LPG storage & use
Prop signs in store areas
Proper fuel containers used
Temp heaters
       Hand And Power Tools                   Safe                 Unsafe            Comments/Observations:
Cord in good condition
Ground prong in place
Guards in place
Information label on tool
Laser in use signage
Powder actuated equipment
Proper tool for the job
Secure air hose couplings
Strain relief functioning
                                                                       Page 4 of 9
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       Hand And Power Tools                    Safe                 Unsafe            Comments/Observations:
Tool in good condition
      Hazard Communications                    Safe                 Unsafe            Comments/Observations:
Copy of program
Employees trained
Inventory list
MSDS' (site specific)
Proper labels on containers
Readily available
            Housekeeping                       Safe                 Unsafe            Comments/Observations:
Clear access to bldg/site
Designated employee parking
Impalement protection
Portable toilets avail/clean/maint
Proper material storage
Proper use of "CAZ" id
Roadway around proj clear
Sanitary cleaner available
Slip, trip, fall hazards
Trash in protected cont
Walkways clear
Work areas clear of debris
           Ladders / Stairs                    Safe                 Unsafe            Comments/Observations:
3' above landing
Access break >19"
Clear of debris/materials
Extension ladder 4:1 pitch
Inspected for defects
Job-blt ldrs const properly
Ladders in good condition
Ladders secured
Landings and treads filled
Proper use of ladder
Rails at stairs/landings
Safe work dist from hazard
                                                                        Page 5 of 9
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              Ladders / Stairs                  Safe                 Unsafe            Comments/Observations:
Slip/trip exposure elim
Stairs illuminated
         Medical / Emergency                    Safe                 Unsafe            Comments/Observations:
1st aid kit
1st Aid/CPR on site
Coordination w/EMS
Emergency numbers posted
Emergency supplies
Emrg Action Plan posted/shared
Eye wash
Light Duty Program in place
Map to medical facility
Occupational Clinic established
Team contact numbers
         Motorized Equipment                    Safe                 Unsafe            Comments/Observations:
Back up alarm functioning
Flagman used if applicable
Glass free of obstructions
Horn functioning
Operator appears competent
ROPS
Seat belts used
State lic. operator if appl.
Training docs available
                  P.P.E.                        Safe                 Unsafe            Comments/Observations:
Face shields
Gloves
Hard Hats
Hearing protection
High visibility vest
Metatarsal protection
Respirators
Safety Glasses
V rated or F.R. Clothing worn
                                                                         Page 6 of 9
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                 P.P.E.                         Safe                 Unsafe            Comments/Observations:
Work Boots
               Scaffolds                        Safe                 Unsafe            Comments/Observations:
Bracing and pins in place
Climbing mast scaffold
Compatible components used
Competent person present
Daily tag inspect. system
Guardrails in place @ 6'
Platforms fully planked
Prop secured to structure
Proper access to platforms
Proper loading of materials
Safe work distances
Scaffold-grade plank used
Sills,plates,jacks installed
Surface in safe condition
Swing scaffolds
Wheels locked/secured
         Scissor / Arial Lifts                  Safe                 Unsafe            Comments/Observations:
Equipment loaded properly
Gate or chain secured
Harness while in lifts
Nothing to increase height
Operating on flat surface
Operator training
Safe work distances
Surface free of holes
       Site / Public Protection                 Safe                 Unsafe            Comments/Observations:
Adequate lighting
Barricades installed properly
Company rep present
Excavations protected
Falling object protection
Perimeter fences
                                                                         Page 7 of 9
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       Site / Public Protection                 Safe                 Unsafe            Comments/Observations:
Public protection signage
Security system in place
Street closure identified
Traffic Control plan
              Steel Erection                    Safe                 Unsafe            Comments/Observations:
2 bolts per connection
Adequate site conditions
Anchor bolts certification
Anchorage points meet req
CDZ training / utilized
Concrete @ 75%
Decking secured
EE above 30' protected
EE btwn 15-30' fall prot pres
Erector notif of modification
Fall pro training provided
Falling object protection
Mult lift proced utilized
Mult lift/rig/con training
Proper anch of columns/beam
Proper erection plan
Site layout / sequence plan
Struct flooring requirements
Written approv conc strength
          Welding / Cutting                     Safe                 Unsafe            Comments/Observations:
Bottles upright/cap/secured
Cylinder ID
Fire ext present
Flash arrest on torches
Flash protection available
Gauges working properly
Leads in good condition
Proper Storage of cylinders
Prop PPE in use
Torch hoses good cond
Weld machine ventilated
                                                                         Page 8 of 9
          Welding / Cutting                     Safe                 Unsafe            Comments/Observations:
Welding boots on device
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Construction Safety Checklist
Construction Safety Checklist
    Inspection                                                                     Inspection
         Type:                                                                          Date:
       Project:                                                                 Inspected By:
                                                                                     Reviewed
                                                                                         With:
Category : Sub-Category
           Administration                     Safe                 Unsafe                        Comments/Observations:
Document pre-const mtgs
Freq/reg safety inspections
JHA submitted each trade
eMSDS Manual on computer
Toolbox Meetings
OSHA Posters / OSHA 300 Log
Safety manual f(online or hard copy)
Safety meetings
State / Fed posters (Eng/Sp)
Visitor PPE available
Visitor sign-in form
   Concrete & Masonry 1926.700
                                              Safe                 Unsafe                        Comments/Observations:
            Subpart Q
Adequate bracing
Formwork drawings onsite
Limited access zone
Rebar caps/impalement prot.
Rotating parts guarded
PPE Available & Adequate
Wall bracing as needed/required
Washout pits/boxes
     Confined Space 1910.146                  Safe                 Unsafe                        Comments/Observations:
Designated competent person
Atmospheric conditions
Harness / extraction equip
Permit required
Regular insp / air monitor
                                                                       Page 1 of 9
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      Confined Space 1910.146                  Safe                 Unsafe            Comments/Observations:
Respiratory equipment
Stand-by person/rescue equip
Training documentation
Ventilation
 Cranes And Hoisting Equipment
                                               Safe                 Unsafe            Comments/Observations:
     1926.1400 Subpart CC
3rd party annual inspection current
Medical card current
Anti Two Block device
Boom angle indicator
Qualified Rigging Personnel
Cert or verify training
Crane supported and level
Daily inspections current
Dist power lines/de-ener
Fire extinguisher in crane
Signalman identified/certified
Gates and signals
Lift plan on file
Load chart posted
Loads properly secured
Means of communication
Operator appears competent
Operator manual in crane
Outrig extend/cribbing
Rig insp/rated/rated
Safety latches used
Swing radius barricaded
Tag lines used
Weight of load verified
   Electrical 1926.400 Subpart K               Safe                 Unsafe            Comments/Observations:
Breaker box in good condition
Knockouts in place/missing
Circuits labeled
Cords in good condition
Cords protected from traffic
Elect Hot Work Procedures
                                                                        Page 2 of 9
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   Electrical 1926.400 Subpart K                Safe                 Unsafe            Comments/Observations:
Electrical room protected
Energized parts protected
Equipment firmly mounted
Temporary lighting adequate/safe
Generators grounded
GFCI's used
LO/TO procedures
NFPA 70 E for Energized work
Proper use temp pwr bxs
Extension cords inspected daily
Signage present
           Environmental                        Safe                 Unsafe            Comments/Observations:
Adequate ventilation
Atmospheric contaminants
Containers labeled
Dust control measures
Erosion ctrl measures maint/adeq
Haz material properly stored
Noise control measures
Regular air sampling as needed
Spill containment adequate
Asbestos issues addressed
Lead issues addressed
 Excavations 1926.650 Subpart P                 Safe                 Unsafe            Comments/Observations:
Competent person present
Daily inspections documented
Access in/out excavation within 25 ?
Excav > 20' engineered
Manuf. data on shoring
Perimeter prot/barricade
Sloped, benched, or shored
Spoil 2' from edge
Surface encumbrances
Surface traffic exposure
Water entering excavation
Fall hazards addressed
                                                                         Page 3 of 9
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Fall Protection 1926.500 Subpart M            Safe                 Unsafe            Comments/Observations:
Ext/int guardrails
Fall protection at 6'
Fall protection plan
Fall rescue plan & equip avl
Floor/wall opening protected
Flr covrs/holes adeq,secure,label
Guardrail system in place/adequate
Proper anchorage points
Roof edge protected
Safety harness and lanyard
Stair/ramp/walkway prot
Training/competent person
Warning line systems
Controlled access zone
Fire Protection 1926.150 Subpart F            Safe                 Unsafe            Comments/Observations:
Emergency vehicle access
Ext charged and inspected
Fire suppression equip avail
Sprinkler system in place/in service
Fire watch when applicable
Hot work permits
Interior structure 1-hr rated
LPG storage & use
Flammable liquid storage adequate
Fueling areas adequate
Prop signs in store areas
Proper fuel containers used
Temp heaters
 Hand And Power Tools 1926.300
                                              Safe                 Unsafe            Comments/Observations:
           Subpart I
Cord in good condition
Ground prong in place
Guards in place
Information label on tool
Hand tools in good shape
                                                                       Page 4 of 9
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 Hand And Power Tools 1926.300                  Safe                 Unsafe            Comments/Observations:
Laser in use signage
Powder actuated equipment
Trained operator for powder actuated
tool
Proper tool for the job
Secure air hose couplings
Strain relief functioning
Tool in good condition
      Hazard Communications
                                                Safe                 Unsafe            Comments/Observations:
             1910.1200
Copy of program on computer
desktop
Employees trained
eMSDS program on
desktop/accessible via intranet
Inventory list
Proper labels on containers
Readily available
            Housekeeping                        Safe                 Unsafe            Comments/Observations:
Clear access to bldg/site
Designated employee parking
Impalement protection
Portable toilets avail/clean/maint
Proper material storage
Roadway around proj clear
Slip, trip, fall hazards
Trash in protected cont
Walkways clear
Work areas clear of debris
    Ladders / Stairs 1926.1050
                                                Safe                 Unsafe            Comments/Observations:
            Subpart X
Stairs illuminated
3' above landing
Access break >19"
Clear of debris/materials
Extension ladder 4:1 pitch
Inspected for defects
Job-blt ldrs const properly
                                                                         Page 5 of 9
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    Ladders / Stairs 1926.1050                 Safe                 Unsafe            Comments/Observations:
Ladders in good condition
Ladders secured
Landings and treads filled
Proper use of ladder
Rails at stairs/landings
Safe work dist from hazd
Slip trip exposure elim
Stairways properly built
         Medical / Emergency                   Safe                 Unsafe            Comments/Observations:
1st aid kit
1st Aid/CPR on site
Emergency action plan
Emergency numbers posted
Emergency procs supplies
Eye wash
Map to medical facility
Team contact numbers
  Motorized Equipment 1926.600
                                               Safe                 Unsafe            Comments/Observations:
            Subpart O
Back up alarm functioning
Flagman used if applicable
Glass free of obstructions
Horn functioning
Operator appears competent
Seat belts used
Training docs available
      P.P.E. 1926.95 Subpart E                 Safe                 Unsafe            Comments/Observations:
Face shields
Gloves
Hard Hats
Hearing protection
High visibility vest
Metatarsal protection
Respirators
Safety Glasses
                                                                        Page 6 of 9
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      P.P.E. 1926.95 Subpart E                  Safe                 Unsafe            Comments/Observations:
Proper glasses for welding /cutting
Work Boots
V rated or F.R. Clothing worn
Proper Clothing
Rebar caps
   Scaffolds 1926.450 Subpart L                 Safe                 Unsafe            Comments/Observations:
Bracing and pins in place
Climbing mast scaffold
Compatible components used
Competent person present
Daily tag inspect. system
Guardrails in place @ 6'
Platforms fully planked
Prop secured to structure
Proper access to platforms
Proper loading of materials
Safe work distances
Sills, plates, jacks installed
Surface in safe condition
Swing scaffolds
Wheels locked/secured
Employees trained
         Scissor / Arial Lifts                  Safe                 Unsafe            Comments/Observations:
Equipment loaded properly
Gate or chain secured
Harness while in boom lifts
Nothing to increase height
Operating on flat surface
Operator training
Safe work distances
Surface free of holes
       Site / Public Protection                 Safe                 Unsafe            Comments/Observations:
Adequate lighting
Barricades installed properly
                                                                         Page 7 of 9
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       Site / Public Protection                 Safe                 Unsafe            Comments/Observations:
Company rep present
Excavations protected
Falling object protection
Perimeter fences
Public protection signage
Security system in place
Street closure identified
Traffic Control plan
Steel Erection 1926.750 Subpart R               Safe                 Unsafe            Comments/Observations:
2 bolts per connection
Adequate site conditions
Anchor bolts certification
Anchorage points meet req
CDZ training / utilized
Concrete @ 75%
Decking secured
EE above 30' protected
EE btwn 15-30' fall prot pres
Erector notif of modification
Qualified rigger
Fall pro training provided
Falling object protection
Mult lift proced utilized
Mult lift/rig/con training
Proper anch of colmns/beam
Proper erection plan
Site layout / sequence plan
Struct flooring requirements
Written approv conc strength
     Welding / Cutting 1926.350
                                                Safe                 Unsafe            Comments/Observations:
             Subpart J
Bottles upright/cap/secured
Cylinder ID
Fire ext present
Flash arrest on torches
Flash protection available
Gauges working properly
                                                                         Page 8 of 9
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    Welding / Cutting 1926.350              Safe                 Unsafe            Comments/Observations:
Leads in good condition
Lead repairs adequate
Proper Storage of cylinders
Prop PPE in use
Torch hoses good cond
Weld machine ventilated
Welding boots on device
                                                                     Page 9 of 9
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Construction Safety Comprehensive Checklist
 Construction Safety Comprehensive Checklist
    Inspection                                                                       Inspection
         Type:                                                                            Date:
       Project:                                                                   Inspected By:
                                                                                      Reviewed
                                                                                          With:
 Category : Sub-Category
           Administration                      Safe                 At Risk                       Comments/Observations:
Document pre-construction meetings
JHA submitted
Contractors JHA’s reviewed
SDS Binder (site specific)
OSHA Posters - 300 Log
Safety manual
Weekly safety meetings
Safety sign - warnings posted
State - Fed posters (English -
Spanish)
Visitor PPE available
Coordination with local EMS - FD
Safety talk conducted daily with crew
Storage areas clean
Trailer kept clean/orderly
Streets kept clean
Housekeeping daily
Spill control plan
Snow removal plan
Water removal plan
Emergency number posted
SWPP Plan Posted
                                                                       Page 1 of 16
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           Confined Space                    Safe                 At Risk           Comments/Observations:
Secured Area
Signage Present
Competent Person
Attendant Present
Authorized Entrant
Entry Supervisor Present
Permit Completed & Posted
First Aid kit available
Equipment Inspected
Intrinsically Safe Equipment
Air Monitoring
Rescue plan & equipment
Respiratory equipment
Ventilation
Training Documentation
 Cranes and Hoisting Equipment               Safe                 At Risk           Comments/Observations:
Anti Two- Block device
Boom angle indicator
Operator manual in crane
Load Chart Present
Spreader Safe Working Load
Indicated
Fire extinguisher in crane
Daily-Monthly-Annual Inspection on
file
Certify or verify training
Critical Lift Plan
Means of communication
Signal person trained
Hand signal chart posted
Crane supported and level
Outrigger extend - cribbing
Distance power lines - de-energized
Crane Grounded
Overhead Signs Present
                                                                     Page 2 of 16
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 Cranes and Hoisting Equipment                 Safe                 At Risk           Comments/Observations:
Swing radius barricaded
Weight of load verified
Safety Latches on Hooks
Loads properly secured
Rigging not overloaded
Softeners used on loads
Tag Lines Utilized
Elevator and hoist capacity posted
Qualified riggers assigned and
training confirmed
Rigging inspected, rated for
capacities and loads
               Blasting                        Safe                 At Risk           Comments/Observations:
Area Barricaded and Protected
Dust control in place
Hazardous materials Identified
Pre-blast checklist
Post-blast checklist
Safety fuse requirements met
Detonating cord requirements met
Pre-loading checklist
Safety protection installed
Public protected
Proper removal of materials
Explosives properly stored
Misfire controlled
              Concrete                         Safe                 At Risk           Comments/Observations:
Eyewash station available
Form work drawings on site
Adequate bracing
Concrete pump safe distance from
overhead lines
Concrete pump operator competent
Limited access zone
Wash out pits protected
                                                                       Page 3 of 16
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               Demolition                       Safe                 At Risk           Comments/Observations:
Demo plan in place
Hazard assessment conducted
Environmental assessment
conducted
Utility services shut off -safe
Fire services available
Suspended floor safe for loads
Demolition tools used safely
Demolition equipment used safely
Public protection in place
Rigging safe
Employees trained
               Electrical                       Safe                 At Risk           Comments/Observations:
Cords protected from traffic
Electrical room protected
Energized parts protected
Cord designed for Heavy Usage
Grounding Prong present
GFCI's used
Cord condition
Cord Inspection Process
Proper use temp power boxes
Signage present
Verify LO/TO
Employees Trained
Tag appropriate
Lock appropriate
Generators- grounded
Generators -guards in place
Generators - Fire extinguisher
available
Temporary lighting adequate
Temporary lighting cords condition
Temporary lighting bulbs protected
                                                                        Page 4 of 16
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             Excavations                          Safe                 At Risk           Comments/Observations:
Utilities located & marked
Utilities supported
Adjacent building protected
Ladder access within 25'
Competent person present
Daily inspection documented
Signal persons in high visibility vest
Dewatering process in place
Employees protected >5'
Excavations > 20' engineered
Perimeter protection - barricade
Sloped, benched, or shored
Spoil 2' from edge
Surface encumbrances
Surface traffic exposure
Tabulated Data Present
Trench Box lifted properly
Trench Box installed properly
Bracing, shoring, cribbing inspected
Local authorities
notified of high hazard work
           Fall Protection                        Safe                 At Risk           Comments/Observations:
Fall protection plan available
Employees trained
Fall protection at 6 feet
Floor/wall opening protected
Floor opening covered,-secured,
labeled
Guardrails - 42" and 21"
Wire rope clamp installed properly
Cable guardrail flagged every 6 feet
Flagging high visibility material
Guardrail 200 lbs lateral force
Anchorage points rated 5,000 lbs
Adequate number of anchorage
points
Roof edge protected
                                                                          Page 5 of 16
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           Fall Protection                      Safe                 At Risk           Comments/Observations:
Safety harness condition
Safety harness worn appropriately
Lanyard condition
Lanyard adequate length
Lanyard connected according to
manufacturer recommendations
Stair – ramp -walkway protected
Surf >30" have standard guard rail
Controlled access zone at least 6 ft
way from the edge
CAZ flagged every 6 feet
CAZ flagging high visibility material
CAZ line 200 lbs lateral force
CAZ Line no less than 39” from
lowest point
CAZ Line no more than 45” from
highest point
Safety monitor utilized
Safety monitor -safety duties only
Impalement protection
Fall rescue plan available
Local authorities
notified of high hazard work
Fall rescue equipment available
           Fire Protection                      Safe                 At Risk           Comments/Observations:
Employee trained
Fire extinguisher <50 ft for fuel tank
FE charged and inspected
FE Annual Inspection Tag
FE Monthly Inspection Tag
<25 gal flammable - combustible
outside cabinet
<60 gal flammable inside cabinet
<120 gal combustible inside cabinet
Non Exits properly marked
Fire suppression equip avail
<30 feet travel distance fire
extinguisher jobsite
<75 feet travel distance fire
extinguisher building
Proper signs on storage areas
Proper fuel containers used
                                                                        Page 6 of 16
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       Hand And Power Tools                      Safe                 At Risk           Comments/Observations:
Work table utilized
Stability clamps utilized
Cord in good condition
Ground prong -double insulated
Guards in place
Information label on tool
Tool used per manufacturing
recommendations
Proper tool for the job
Tool in good condition
Whip checks used
Inspected prior to use
      Hazard Communications                      Safe                 At Risk           Comments/Observations:
Employees trained
Inventory list
SDS' readily available
Proper labels on containers
Chemical approval process
              Heat Stress                        Safe                 At Risk           Comments/Observations:
Potable drinking water available
Water kept cool -ice
Drinking water cups available
Monitoring of employees
Breaks taken when necessary
Adequate clothing worn
Employees trained
            Housekeeping                         Safe                 At Risk           Comments/Observations:
Dust control in place
Work areas clean-organized
Materials properly stored
Non-potable water labeled
Roadway around project clear
Slip, trip, fall hazards
                                                                         Page 7 of 16
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              Housekeeping                     Safe                 At Risk           Comments/Observations:
Adequate # of Toilet facilities- Wash
stations
Toilet facilities-Wash station
Condition
Trash receptacle provided
Trash in appropriate container
Walkways clear
          Ladders / Stairs                     Safe                 At Risk           Comments/Observations:
Employees trained
Proper ladder for the job
Inspected daily
Ladder labeling is in place
3-point contact maintained
Job-built ladders constructed
properly
Proper use of ladder
Access provided >19"
Clear of debris/materials
Ladders secured
Extension ladder 4:1 pitch
Extension ladder 3ft above landing
Rails at stairs > 4 landings
Stairs illuminated
         Machine Guarding                      Safe                 At Risk           Comments/Observations:
Moving Parts Guarded
Signage posted
Employees trained
Emergency stop buttons labeled &
working
Radial saws return if released
Rip saw anti-kickback device
Blade exposure > 180 degrees
  Medical / First Aid Emergency                Safe                 At Risk           Comments/Observations:
Emergency action plan (EAP)
Evacuation Route Map posted
Map to medical facility posted
                                                                       Page 8 of 16
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   Medical / First Aid Emergency                   Safe                 At Risk           Comments/Observations:
Emergency Numbers Posted
Employee trained on EAP
First Aid kit available
Personnel First Aid -CPR Certified
AED Available
Personnel AED Certified
Safe egress route
Eye wash station available
        Motorized Equipment                       Safe                At Risk             Comments/Observations:
Daily inspections
Deficiencies Corrected/Repaired
Operator manual in cab
Backup alarm functional
Strobe lights installed/functional
Horn functional
Tire condition
Step/platforms condition
Seat belt functional
Emergency shut off functional
Glass free of obstructions
Glass free from cracks
Cab floor free from trash
Parking break functional
Moving parts guarded
Workface illuminated (night)
Equipment cribbed/blocked
Parking Brake set
Wheels chocked
Clearance overhead hazards
Tools/materials secured
Tie down requirements met
Water truck tank marked
Non-Potable
Flagman used if applicable
Seat belts used
Operator Appears Competent
Equipment used safely
Training docs available
                                                                           Page 9 of 16
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 Occupational & Env. Exposures               Safe                 At Risk           Comments/Observations:
Containers labeled
Haz material properly stored
Spill containment adequate
Concrete Dump Area
Adequate ventilation
Atmospheric exposures
Exit signs illuminated
Illumination standards met
Ionizing radiation exposure
Noise exposure
Signage for Laser Use
Signage for Lead, Asbestos
Workface illuminated (night)
                    P.P.E.                   Safe                 At Risk           Comments/Observations:
Safety glasses
Chaps
Face shield
Gloves
Goggles
Hard hats
Hearing protection
Hi visible vest/clothing
Safety-toed work boots
Metatarsal protection
Proper Clothing
Respirators
Concrete boots
Employees trained in use
              Pile Driving                   Safe                 At Risk           Comments/Observations:
Pile driving plan
Competent person on site
Utilities located
Lifting chart reviewed
                                                                    Page 10 of 16
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             Pile Driving                       Safe                 At Risk           Comments/Observations:
Rig hammer adequate for the job
Piles inspected
Piles stored off the ground
Pile driver rig stable
Steam line shut off valve functional
Equip in safe operating condition
Fall Protection on leads
Leads stabilized
Fixed leads- ladders in place
Stop blocks in place/adequate
Guards on head block in
place/adequate
Hose connection protection in place
Hearing protection
Signal men identified
Rigging equipment condition
Materials secure
Training documents available
     Pre-Planning Doc Quality
                                                Safe                 At Risk           Comments/Observations:
          (JHA/JSA/AHA)
Analysis conducted on site
Analysis matches work being
performed
Analysis reviewed by supervisor
Analysis signed by all crew members
Job task clearly identified
Hazards clearly listed
Hazard control steps clearly listed
Control steps being followed
Rescue/emergency steps included
Document is reviewed when
conditions change
Crew knowledgeable of tasks and
hazard controls
JSA/JHA Understood by employees
Copies of analysis readily available
                Rigging                         Safe                 At Risk           Comments/Observations:
Qualified rigger present
Spreader SWL indicated
                                                                       Page 11 of 16
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                Rigging                           Safe                 At Risk           Comments/Observations:
Weight of load verified
Rigging Inspected
Safety latched on Hooks
Drums/ sheaves/ pulley condition
Sheaves aligned and lubricated
Rope capacity sufficient
Material rigged properly
Rigging used per manufacturer
recommendations
Tag lines Utilized
Coupling links/attachments rated
Makeshift fasteners restricted
Slings protected from sharp edges
Rigging stored properly
Training documents available
               Scaffolds                          Safe                 At Risk           Comments/Observations:
Daily inspection
Compatible components used
Competent person present
Guardrails in place @ 6'
Braces properly attached
Scaffold Plum and Level
Working levels fully planked
Plank condition
Planks – min 12” overlap
Planks – gaps min of 1 ‘
Toeboards installed correctly
Sills, plates, jacks installed correctly
Height > 4:1 base ratio
Outriggers properly installed
Prop secured to structure
Proper access to platforms
Proper loading of materials
Rolling scaffold brakes functional
Rolling scaffold wheels secured
Surface in safe condition
Susp scaf- tiebacks secured to
proper anchorage
                                                                         Page 12 of 16
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              Scaffolds                            Safe                 At Risk           Comments/Observations:
Susp saf- tiebacks equivalent
strength to suspension/hoisting rope
Susp scaf – outriggers stabilized
Susp scaf – counterweights
adequate
Susp scaf – Rope adequate for load
Susp scaf – Adequate # of
employees according to load cap.
Susp scaf – Weather conditions
        Scissor / Aerial Lifts                     Safe                 At Risk           Comments/Observations:
Daily Inspection Performed
Operators manual stored lift
Operator certified
Strobe light functional
Backup alarm functional
Control panel- all switches clearly
visible
Safety indicator lights functional
Motion alarms functional
Guardrails condition
Platform extension functional
Emergency stop button functional
Tire condition
Braking devices operational
Gate or chain secured
Fall Protection: Harness & Lanyard
Proper Anchor Point
Nothing used to increase height
Work surface surf/free holes
Overhead obstructions
Equipment loaded properly
Electrical hazards identified and
controlled
Area barricaded
           Site Protection                         Safe                 At Risk           Comments/Observations:
Perimeter fences installed
Public protection signage
Public protection measures
Designated employee parking
                                                                          Page 13 of 16
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           Site Protection                        Safe                 At Risk           Comments/Observations:
Designated visitor parking
Company representative present
Adequate lighting
Safe access to each level - floor
Safe worker access roads - paths
Falling objects protection
Street closures identified
Traffic control plan
Dust control measures
Security system in place
           Structural Steel                       Safe                 At Risk           Comments/Observations:
Competent person ID
Employees certified
Concrete strength confirmed
Site layout plan
Laydown area adequate
Ladder/stairway/means of access
Hoisting plan in place
Adequate hoisting equipment used
Fall protection equip in use
Controlled decking zone in place
CDZ training provided
CDZ Signage for non-authorized
personnel
Floor/wall open protect
Employees not working under
suspended loads
Falling object protection
Life lines are provided
Anchor strength verified
Structural Stability
Tag lines utilized
No more than 8 stories between
erection floor and upper floor
Unfinished bolting or welding does
not exceed 4 floors or 48 feet
Fully planked or decked floor under
erection within 2 stories or 30 feet of
work
Slips, Trips, & Fall Hazards
controlled
Metal decking fully supported
                                                                         Page 14 of 16
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           Structural Steel                         Safe                 At Risk           Comments/Observations:
Derrick floor fully decked or planked
Temporary loads distributed
adequately
Min of 4 anchor bolt per column
Anchor bolt
repair/replacement/modification
approved by engineer
Columns evaluated for guying or
bracing needs
Vertical stabilizer plates in place
Bottom chords stabilized
Steel joints secured
Steel joist load capacity verified
Rescue/Emergency Plan
            Traffic Control                         Safe                 At Risk           Comments/Observations:
Traffic control plan
Work area evaluated
Law enforcement notified
Advanced warning sign placed
(100’-1000’)
Traffic cones for taper (max 20’)
Traffic cones along work area (max
40’)
Staging area established
Buffer space established
Termination area established
Flaggers positioned properly
Flaggers trained
Communication devices used
Required signage in place
Daily verification of traffic control
          Welding / Cutting                         Safe                 At Risk           Comments/Observations:
Hot Work Permit Completed
Work area assessed for hazardous
conditions
Leads in good condition
Bottles upright/cap/secured
Bottles stored in cart w/manifold
Secure vertical transport
                                                                           Page 15 of 16
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          Welding / Cutting                       Safe                 At Risk           Comments/Observations:
Combust materials free of area
Cyl current hydrostatic inspection
Gauges working properly
Fire extinguisher present w/in 25'
Flash arrest on torches
Torch hoses good condition
Flash protection available
Lugs Insulated
Prop PPE utilized
PPE condition
Welding mask shading adequate
FR clothing
Friction Lighter used
Head positioning to prevent inhaling
fumes
Smoke collect operational/maintained
Mech Ventilation Considered
Weld machine ventilated
Equipment grounded/double
insulated
Cut/splices within 10' of stinger
Welding stick not left in stinger
Electrode holders protected
Shield / screen used
Fire watch
                                                                         Page 16 of 16
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Construction & Civil Safety Checklist
 Construction & Civil Safety Checklist
    Inspection                                                                     Inspection
         Type:                                                                          Date:
       Project:                                                                 Inspected By:
                                                                                    Reviewed
                                                                                        With:
 Category : Sub-Category
             Administration                  Safe                 Unsafe                        Comments/Observations:
Asbestos Awareness
Back Injury Prevention
Confined Space
Corporate Fall
Crane & Lift
Document pre-construction meetings
Electrical Hot Work
Electrical LO/TO
Employees trained
Environmental
Excav & Trench
Fire Protection
HazCom
Inventory list
JHA submitted each AI PB
Lead Awareness
MSDS (site specific)
OSHA Posters/300 Log
Readily available
Respirator
Safe Ladder
Safety manual
Safety meetings
Safety sign/warn post
Silica
State / Fed posters (Eng/Sp)
Traffic Control
                                                                     Page 1 of 11
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            Administration                    Safe                 Unsafe            Comments/Observations:
Visitor PPE available
Welding Cutting
            Confined Space                    Safe                 Unsafe            Comments/Observations:
Confined Space
Permit Required Confined Space
Secured Area
Signage Present
Competent Person
Attendant Present
Authorized Entrant
Entry Supervisor Present
Employees Trained
Permit Completed
Entry kit on site
Equipment Inspected
Intrinsically Safe Equipment
Fire Protection Equipment
Air Monitoring
Rescue plan/emerg #'s/map
Respiratory equipment
Ventilation Equipment
Purging, Inerting, Flushing Required
Blocking / Blanking
Lockout / Tagout Utilized
Other
          Cranes and Derricks                 Safe                 Unsafe            Comments/Observations:
Critical Lift Plan
CCO Documentation
Crane Deficiency
Crane supported and level
Anti Two Block device
Boom angle indicator
Daily inspection current
Annual inspection current
Rigging
Dist power lines/de-ener
                                                                      Page 2 of 11
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        Cranes and Derricks                   Safe                 Unsafe            Comments/Observations:
Crane Grounded
Overhead Signs Present
Fire extinguisher in crane
Hand signal chart post
Safety Latches on Hooks
Load Chart Present
Loads properly secured
Means of communication
Operator manual in crane
Outrig extend/cribbing
Rig not overloaded
Signal person trained
Softeners used on loads
Swing radius barricaded
Spreader SWL indicated
Tag Lines Utilized
Weight of load verified
Radius Verified
Other
               Blasting                       Safe                 Unsafe            Comments/Observations:
Area Barricaded and Protected
Dust control in place
Hazardous materials ID
Pre-blast checklist
Post-blast checklist
Safety fuse requirements met
Detonating cord requirements met
Pre-loading checklist
Safety prot installed
Public protected
Proper removal of materials
Explosives properly stored
Misfire controlled
Other
                  Demo                        Safe                 Unsafe            Comments/Observations:
Demo plan in place
                                                                      Page 3 of 11
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               Electrical                     Safe                 Unsafe            Comments/Observations:
Cords prot from traffic
Electrical room prot
Energized parts prot
Cord designed for Heavy Usage
Grounding Prong present
GFCI's used
Receptacles
Cord condition
Proper use temp power boxes
Signage present
Verify LO/TO
Other
            Excavations                       Safe                 Unsafe            Comments/Observations:
Hazardous Atmosphere
Ladder access within 25'
Adjacent building prot
Competent person
Manual/Visual Inspection
Dewatering proc in place
Employees prot >5'
Excav > 20' engineered
Utilities Located
Utilities supported
Perimeter prot/barricade
Sloped, benched, or shored
Spoil 2' from edge
Surface encumbrances
Surface traffic exposure
Tabulated Data Present
Trench Box installed prop
Water entering excavation
Warning Barrier for equip
Trench Shield lifted properly
Other
                                                                      Page 4 of 11
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            Fall Protection                      Safe                 Unsafe            Comments/Observations:
Fall Protection Plan
Emp trained fall PPE
Fall protection at 6'
Floor/wall opening protected
Flr covrs adeq, secure, label
Guardrails - 42" and 21"
Guardrail 200 lbs lat. force
HLL installed correctly
Proper anchorage points
Roof edge protected
Safety harness and lanyard
Stair/ramp/walkway prot
Surf >30" have std grail
Controlled Access Zone
Impalement protection
Safety Monitor Utilized
Other
Wire rope clamp installed properly
            Fire Protection                      Safe                 Unsafe            Comments/Observations:
Emp trained in fire ext
Fire ext <50 ft for fuel tank
Ext charged and inspected
<25 gal flam/comb outside cab
<60 gal flammable inside cab
<120 gal combustible inside cab
NonExits prop mark
Fire suppression equip avail
<30 travel dist fire ext jobsite
<75 travel dist fire ext bldg
Prop signs in store areas
Proper fuel containers used
Other
        Hand And Power Tools                     Safe                 Unsafe            Comments/Observations:
Work Table Utilized
Cord in good condition
                                                                         Page 5 of 11
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        Hand And Power Tools                    Safe                 Unsafe            Comments/Observations:
Ground prong in place
Ground prong/double insulated
Guard/grounding mason saw
Guard/mixer
Guards in place
Information label on tool
Tool used per manufacturer reqs
Proper tool for the job
RPM wheel >= RPM grinder
Tool in good condition
Whip checks used
Hoses Inspected
OSHA Check Valve
Daily Inspection
Other
      Hazard Communications                     Safe                 Unsafe            Comments/Observations:
Employees trained
Inventory list
MSDS' Present
Proper labels on containers
Readily available
Other
            Housekeeping                        Safe                 Unsafe            Comments/Observations:
Designated employee parking
Drinking water available
Dust control in place
Workface clean/organized
Materials prop stored
Nonpotable water labeled
Roadway around proj clear
Slip, trip, fall hazards
Toilet facilities/ Wash station
Trash receptacle provided
Walkways clear/marked
Other
                                                                        Page 6 of 11
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              Ladders / Stairs                 Safe                 Unsafe            Comments/Observations:
Other
3-point cont maint
Access provided >19"
Clear of debris/materials
Employees trained
Extension ladder 4:1 pitch
Inspected daily defects
Job-blt ldrs const properly
Ladders secured
Landings - treads filled
Proper use of ladder
Rails at stairs > 4/landings
Stairs illuminated
          Machine Guarding                     Safe                 Unsafe            Comments/Observations:
Moving Parts Guarded
Arbor/Mandrel firm & secure
Emerg stop buttons
Emerg stop buttons label
Radial saws return if released
Rip saw anti-kickback device
Blade exposure > 180 degrees
Work rest adjusted within 1/8"
Tongue guard adjusted within 1/4"
Pedestal grinder fasten down
Other
   Medical / First Aid Emergency               Safe                 Unsafe            Comments/Observations:
Crisis Management Plan
1st aid kit
Safe Egress
Emergency Numbers Posted
Emergency action plan
Evacuation Route Map
Eye Wash Station
Map to medical facility
Other
                                                                       Page 7 of 11
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        Motorized Equipment                     Safe                 Unsafe            Comments/Observations:
Daily inspections
Flagman used if applicable
Glass free of obstructions
Seat belts used
Strobe Lights installed/working
Training docs available
Backup Alarm Working
Moving Parts Guarded
Workface illuminated (night)
Equipment cribbed/blocked
Parking Brake set
Wheels Chocked
Clearance Overhead Hazards
Tools/Materials Secured
Tie down requirements met
Equipment Manual provided
Other
Occupational & Enviro Exposures                 Safe                 Unsafe            Comments/Observations:
Silica Exposure
Containers labeled
Haz material properly stored
Spill containment adequate
Concrete Dump Area
Adequate ventilation
Atmospheric exposures
Exit signs illuminated
Illumination stds met
Ionizing radiation exposure
Noise exposure
Signage for Laser Use
Signage for Lead, Asbestos
Workface illuminated (night)
NUC Gauge Req
Other
                                                                        Page 8 of 11
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                 P.P.E.                       Safe                 Unsafe            Comments/Observations:
Safety Glasses
Chaps
Face Shield
Gloves
Goggles
Hard Hats
Hearing protection
Hi Visible Const Vest
Safety-toed Work Boots
Life Vest
Metatarsal protection
Proper Clothing
Respirators
Trained in use
Work Boots
              Pile Driving                    Safe                 Unsafe            Comments/Observations:
Pile Driving Checklist
Fall Protection on leeds
Equip in safe operating condition
Hearing Protection
Utilities Located
Piles stored correct
Stop blocks in place/adequate
Vibration monitor
Lifting Chart Reviewed
Other
                 Rigging                      Safe                 Unsafe            Comments/Observations:
Spreader SWL indicated
Rigging Inspected
Rigging
Safety latched on Hooks
Material rigged properly
Tag lines Utilized
Weight of load verified
Rigging used per manufacturer reqs
                                                                      Page 9 of 11
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                Rigging                         Safe                 Unsafe            Comments/Observations:
Rigging stored properly
Other
               Scaffolds                        Safe                 Unsafe            Comments/Observations:
Inspection Daily
Compatible components used
Competent person present
Guardrails in place @ 6'
Height > 4:1 base ratio
Prop secured to structure
Proper access to platforms
Proper loading of materials
Rolling scaffold brakes set
Sills, plates, jacks installed
Surface in safe condition
Susp scaf tiebacks adeq
Toe boards used
Scaffold Plum and Level
Other
         Scissor / Arial Lifts                  Safe                 Unsafe            Comments/Observations:
Daily Inspection Performed
Equipment loaded properly
Strobe Light
Backup Alarm
Gate or chain secured
Fall Protection: Harness & Lanyard
Proper Anchor Point
Nothing used to increase height
Operate flat surf/free holes
Operator Certified
Electrical Hazards
Other
           Structural Steel                     Safe                 Unsafe            Comments/Observations:
Competent person ID
Fall prot equip in use
                                                                       Page 10 of 11
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           Structural Steel                       Safe                 Unsafe            Comments/Observations:
Floor/wall open protect
Hoisting plan in place
Ladder/stairway/means of access
Laydown area adequate
Life lines are provided
Notif. of anchor strength
Structural Stability
Tag lines utilized
Other
          Welding / Cutting                       Safe                 Unsafe            Comments/Observations:
Hot Work Permit Completed
Bottles upright/cap/secured
Bottles stored in cart w/manifold
Friction Lighter used
Combust mat free of area
Cyl current hydrostatic inspec
Fire ext present w/in 25'
Flash arrest on torches
Flash protection available
Gauges working properly
Leads in good condition
Lugs Insulated
Prop PPE in utilized
Smoke collect oper-main
Torch hoses good cond
Mech Ventilation Considered
Weld machine ventilated
Machine Grounded / return
Cut/splices within 10' of stinger
Welding stick not left in stinger
Electrode Holders Protected
Shield / Screen Used
Secure Vertical Transport
Fire Watch
GFCI
Other
                                                                         Page 11 of 11
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Civil Safety Checklist
CIVIL SAFETY CHECKLIST
    Inspection                                                                          Inspection
        Type:                                                                         Date - Time:
     Location:                                                                       Inspected By:
                                                                                           Weather
                                                                                         Conditions:
              Barricades                           AC                    UA                            Comments-Observations:
Access barricades
Excavations protected
Lifting Zones barricades
Hazardous work zone barricades
Hazard signage (lift zone, excavation
- work at height, radiography- etc)
Public protection signage
Impalement protection- barriers -
Rebar Caps - Curtains
AOA Barricades In Place
Barrier - hazard illumination
Barrier adhered to
Electrical-Lockout-Tag-out - LOTO                  AC                    UA                            Comments-Observations:
Inspection
LO-TO procedures-competence
Locks, Keys, Tags in place
Warning signs
Grounding - GFCI’s - ELCB’s in
place
Cords not in contact with metal
Cords not in contact with water
Electrical equipment free of defects
Electrical cords suspended
Electrical cords protected from
damage
Electrical panels doors secured-
Locked
Electrical outlets free of defect
                Lighting                           AC                    UA                            Comments-Observations:
Egress Lighting
General Lighting
                                                                           Page 1 of 4
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                Lighting                         AC                    UA              Comments-Observations:
Task lighting
Perimeter lighting
Security lighting – plant storage etc
AOA Warning Lights
Drip trays-spill controls for generators
                                                 AC                    UA              Comments-Observations:
                Ladders
Ladder properly used
Correct ladder for the job
3 ft above landing
Extension ladder 4:1 pitch
Ladder secured - tied off
Ladder free of defects
Inspected- tagged
Non skid feet
Job made - specification
Ladders storage
 Fuel-Gas-Oxygen Storage - Use                   AC                    UA              Comments-Observations:
Flammable-accelerants stored
properly - separated
Tank - cylinder in upright position
Correct caps on cylinders
Proper labeling
Proper Extinguisher Present
Back-flow check valve installed
Securing of cylinders
Smoking restrictions
Cylinder transporting arrangements
Spark Striker available
Integrity of gauges
Gauge tool available (Spanner)
Area ventilation and control
Containment
                                                                         Page 2 of 4
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      Pneumatic Tools-Hoses-
                                                  AC                    UA              Comments-Observations:
          Compressors
Whip - checks
Check valves on air compressor
Hose condition, usage
Tool inspected
Pins Connected
Tools/Attachments Comply with
Manufacturers Requirements & No
Field Fabricated Tools/Attachments
Guards in place
Suitability of tool
Powder actuated tool usage
Powder actuated tool cartridge
storage - use and disposal
                      PPE                         AC                    UA              Comments-Observations:
Eye Protection
Face Protection
Foot Protection
Hand Protection
Hearing Protection
Head Protection
High Visibility Vest or Clothing
Fall protection
Respiratory protection
Hazardous work - coveralls - whole
body protection
Heat -cold stress protection
Wet weather protection
PPE storage - welfare - hygiene
Utility Avoidance - Buried Services
                                                  AC                    UA              Comments-Observations:
      - Overhead Obstructions
Schematics -drawings- Location
drawings
Excavation Permit
Trail dig- by hand- air lance - vacuum
excavation
Known Utility Locations Verified with
Proper Authority
Inspection checklists
Ground conditions
Slopes, benching, or shoring
                                                                          Page 3 of 4
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Utility Avoidance - Buried Services             AC                    UA              Comments-Observations:
Goalposts - protective markings -
Warning signage
Protection of exposed services
Proximity to overhead power lines
compliance
                                                                        Page 4 of 4
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Fab Shop Checklist
Fab Shop Checklist
    Inspection Fab Shop/Facility                                                   Inspection
         Type:                                                                          Date:
       Project:                                                                 Inspected By:
                                                                                     Reviewed
                                                                                         With:
Category : Sub-Category
           Record Keeping                  Compliant          Non-Compliant                      Comments/Observations:
OSHA Notice Posted
Emergency Number Posted
Safety Program Available
Hazard Communication Program
Available
Containers Labeled Properly
Tool Box Talks
Conducted/Documented
       Floor/Wall Openings                 Compliant          Non-Compliant                      Comments/Observations:
Stairways Equipped with Handrails
Floor Openings Scaffolds
Barrier Protection Provided
Toe Boards Provided
       Ladders/Scaffolding                 Compliant          Non-Compliant                      Comments/Observations:
Condition of Ladders
Ladder 1/4 Off Working Length of
Wall
Tied Off
Scaffold Equipped w/ Rail/Toe
Boards
             Cylinders                     Compliant          Non-Compliant                      Comments/Observations:
Gas Cylinders Properly Stored
           House Keeping                   Compliant          Non-Compliant                      Comments/Observations:
Trash Picked Up and Disposed of
Regularly
Aisleway Clear of Debris
                                                                       Page 1 of 2
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Lab Checklist
Lab Checklist
    Inspection                                                                       Inspection
        Type:                                                                             Date:
      Building:                                                                   Inspected By:
                                                                                       Reviewed
                                                                                           With:
Category : Sub-Category
          Target Questions                   Complete             Incomplete                       Comments/Observations:
E.R Guide Present
E.R Guide information complete
Fire Extinguishers Present
Fire Extinguishers Inspected
Fume Hoods Present
Number of Registered Fume Hoods
Number of Inspected Fume Hoods
Eye wash station present
Eye wash station flowing propery
Chemtracker door signage present
Chemtracker sign information
complete
Chemtracker sign have 24 hour
contact
Tight fitting respirators being used
Tight fitting respirators assessed by
EHS
Lab Coats available
Lab Coats being used
Mercury thermometers present
Spill kit available
Litters OUTSIDE Flammable Storage
Litters INSIDE Flammable Storage
   Documentation and Training                Complete             Incomplete                       Comments/Observations:
Access to MSDSs either hard copy or
electronically
SOP(s) for haz chem
Training - Emergency procs
Training in lab-specific sfty SOPs for
haz mat
                                                                         Page 1 of 4
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   Documentation and Training                Complete             Incomplete           Comments/Observations:
Training - Safe use of Lab Equip.
Training - Minor chemical spill clean-
up
    Fire Prevention/Emergency
                                             Complete             Incomplete           Comments/Observations:
           Preparedness
Exit Access clear
Exit signs in place and working
Exit - Evacuation maps posted in
hallway
Emergency shower available
Emergency Shower - Signs in place
and tested
First aid kit available
Is area sprinklered
Storage within 18 inches of sprinkler
heads
Sprinkler - Horns and strobes in lab
Smoke detection/ fire detection
present
Fire doors closed (or self-closing)
Proper fire stopping
    Compressed Gas Cylinders                 Complete             Incomplete           Comments/Observations:
Cylinders in good condition
Cylinders secured/upright/capped
Segregated storage where required
(e.g. oxidizers and flammables)
Toxic gases properly ventilated with
mechanically ventilated enclosure or
gas cabinet
Flammable gas cylinders equipped
with flame arresters
Oxygen cylinders have proper
regulators
     Chemical Use and Storage                Complete             Incomplete           Comments/Observations:
Haz warning labels on all containers
High hazard chemicals in use
Designated fume hood for high haz
chem (blue sticker #)
Peroxide forming chemicals present
Perchloric acid in lab
Perchloric acid - wash down hood
available
Is HF (Hydrofluoric Acid) being used
in Lab?
                                                                         Page 2 of 4
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    Chemical Use and Storage                  Complete             Incomplete           Comments/Observations:
HF - Calcium Gluconate tubes readily
accessible
Labels/signs/SOP's for safe handling
of HF
Is Pcric Acid being used in lab?
Is Picric Acid in good cond and
stored properly?
No Glass bottles on floor without
secondary containment
Stored chemicals properly
segregated
Refrigerated storage appropriately
labeled NO FOOD OR BEVERAGE
Approved refrigerator used for
flammable storage
Approved flammable storage cabinet
available
Properly labeled "Flammable -- Keep
Fire Away"
Approved Corrosive/Acid storage
cabinet available
         Waste Chemicals                      Complete             Incomplete           Comments/Observations:
Chem stocks and waste stored
separately
SAA (Satellite Accumulation Area)
signage posted
Proper containers in good condition
Containers are capped
Segregated and in secondary
containment
Nitric Acid Segregated from all other
acids in own secondary containment
Containers appropriately labeled
Containers Label - Waste in full
words
Containers Label - Haz boxes
checked
Dated container not stored more than
3 days
One Container Per Waste Stream
  Personal Protective Equipment               Complete             Incomplete           Comments/Observations:
Appropriate gloves available
Appropriate eye/face protection
available
Respirators appropriately used and
stored
PPE appropriately stored
                                                                          Page 3 of 4
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          Radiation Safety                   Complete             Incomplete           Comments/Observations:
If working with radioactive isotope(s)
or an X-ray machine, is room posted
with a "Caution Radioactive Material"
sign?
Are Class 3B or 4 lasers registered
with the RPO?
Are NMR, UF or RF devices
registered with the RPO?
              Electrical                     Complete             Incomplete           Comments/Observations:
Disconnects in lab are clearly marked
Power cords in good condition
No ext. cords for permanent
equip/lighting
Power outlets properly used
GFCI used appropriately
Electrical cables and cords secured
Elec panels closed and unobstructed
Elec Panels - All field blanks are in
place
Power strips are not connected to
one-an-other (Daisy chaining
             Ventilation                     Complete             Incomplete           Comments/Observations:
Working flow indicator present on
fume hoods
Operable flow alarms are in place
Fume hood has current certification
Fume Hood is not cluttered or overly
contaminated
Fume Hood Sash Lowered
Vacuum pumps appropriately
ventilated or filtered
Other LEV used where necessary
           General Safety                    Complete             Incomplete           Comments/Observations:
Housekeeping is adequate
No indication of food/beverage in lab
           Miscellaneous                     Complete             Incomplete           Comments/Observations:
Centrifuges inspected and used
appropriately
Hoists and rails inspected and
labeled
Belts, pulleys and other moving parts
appropriately guarded.
                                                                         Page 4 of 4
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  Personal Protective Equipment           Compliant          Non-Compliant          Comments/Observations:
PPE Provided & Used When
Required
First Aid Equipment/Supplies
Provided
        Tools & Equipment                 Compliant          Non-Compliant          Comments/Observations:
Tools/Equipment Inspected Regularly
Corrective Action Taken
Unsafe/Unusable Eqpt
Tagged/Taken Out
Condition of Extension Cords
        Temporary Wiring                  Compliant          Non-Compliant          Comments/Observations:
GFI Provided Grounding
         General Liability                Compliant          Non-Compliant          Comments/Observations:
Public Protection Provided
Exits Free From Obstructions
Customer/Public Complaints
                                                                      Page 2 of 2
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Marine Checklist
Marine Checklist
     Inspection                                                                    Inspection
          Type:                                                                         Date:
        Project:                                                                Inspected By:
                                                                                     Reviewed
                                                                                         With:
Category : Sub-Category
     Diving Operations - (1910)               Safe                 Unsafe                        Comments/Observations:
No wake zones signage
No wake zones enforced
Boat speed limits enforced
Diver Two-way Radio
Navy Line pulls in place
Rescue operations plan
ID Overhead structures
Debris control in Water
Diver lines secured
Air lines secured
Hot water lines secured
Back-up air tanks
Safe practices manual
Safety procedures checklist
Assignments checklist
Equip procedures checklist
Emergency procedures
Dive termination procedures
Dive Operations HASP
Dive operations checklist
Emergency first aid list
First aid kit at dive site
Thermal protection for diver
Operations procedures
Changes to operations
Operations coordinated
Diver briefings conducted
Environ conditions identified
                                                                       Page 1 of 4
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     Diving Operations - (1910)               Safe                 Unsafe            Comments/Observations:
Hazards identified
Breathing supply inspected
Dive suit inspected
Diver platform for entry
Diver platform for exit
Entry extends below water
Exit extends below water
Pre-Planning meetings
   Work on or Adjacent to Water               Safe                 Unsafe            Comments/Observations:
Workers wearing PFD?s
Safety Orientations
PFD's Coast Guard Approved
Life Rings with 90 ft of line
Life rings every 200'
Lifesaving skiff available
Skiff with oars or motor
No obstructions at gangways
Gangways illuminated
Required Signage
Safe Gang plank access
Condition of electrical cords
Perimeter Protection
Proper Access / Egress
Bulkhead capacity verified
Barge load capacity verified
Pier load capacity verified
Gang plank load posted
Equipment weight verified
Tag out/Lock Out
Curbs at waterside edges
Equipment guards provided
Gas cylinders separated
Gas cylinders properly stored
Fall protection @ 6' or more
Confined Space procedures
Housekeeping
Grounding of equipment
                                                                       Page 2 of 4
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   Work on or Adjacent to Water               Safe                 Unsafe            Comments/Observations:
Competent person identified
Competent person on site
Mechanical Ventilation
Protection from blasting
Protection from painting
Protection from chemicals
Open hatch protection
Deck openings covered
Rail and fall protection
Tie off at 6' per TCCo
Hot work permits
Provision and use of PPE
Tools in good condition
Fire safety Plan posted
Evacuation plan posted
River bank sloped
River bank protected
Waterproof First Aid kit
Access to water within 200?
Fixed ladder access
Extension ladder access
No aluminum ladders
Ladder 3' above platform
Ladder inspected for defects
Slippery surfaces eliminated
Emergency Plan provided
Fall protection plan provided
Grounded electric cords
GFCI?s provided
Cords with no cuts or repairs
Pre-Planning meetings
Temp electric panel grounded
Barge grounded
Lockout Tag-out
Worker orientations
Weekly tool box talks
Deck stub-ups marked
Fuel spill kit provided
                                                                       Page 3 of 4
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   Work on or Adjacent to Water             Safe                 Unsafe            Comments/Observations:
Fuel spill containment
Proper storage of chemicals
MSDS Sheets book on site
Proper fuel storage
No fuel in plastic cans
Wood floats secured
Barge 2 means of egress
Wheels on lifts chocked
OSHA 30 Competent person
                                                                     Page 4 of 4
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Manufacturing Safety Checklist
Manufacturing Safety Checklist
  Observation                                                                      Observation
       Type:                                                                             Date:
    Building:                                                                    Inspected By:
                                                                                     Reviewed
                                                                                         With:
Category : Sub-Category
        Chemical Exposure                     Safe                 At-Risk                       Comments/Counts:
Eyewash/safety showers provided
Flam/toxic chem. kept in closed
container
SOP's estab/followed when chemical
spills cleaned
Respirator stored properly
Confined Spaces: Permit required              Safe                 At-Risk                       Comments/Counts:
Atmospheric conditions
Comm/secure area/signage
Electrical/fire prevention
Entry super/monitor/entrant
Harness/extraction equip.
Is permit required
Regular insp/air monitor
Rescue plan/emerg 's/map
Respiratory equipment
Sfty person/rescue equipt/PPE
Training Documentation
Ventilation
          Electrical Safety                   Safe                 At-Risk                       Comments/Counts:
LO/TO procedures
Hand tools/equipt not grounded are
double-insulated
Cords have a grounding conductor
GFCI's used on temporary power
Cords in good condition
Cords protected from traffic
Elect. Hot work procedures
                                                                       Page 1 of 4
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          Electrical Safety                      Safe                At-Risk            Comments/Counts:
Electrical room protected
Energized part protected
Signage present
         Elevated Surfaces                       Safe                At-Risk            Comments/Counts:
Capacity of elevated flrs posted
Guardrails instld if elevated above 4'
Toeboards installed
Permanent access/egress to elevtd.
surfs.
Material prevented from
displacement
Dock brds/bridge plates used
properly
Dock brds/bridge plates secured
      Emergency Action Plan                      Safe                At-Risk            Comments/Counts:
Emergency action plan established
Communicated to all employees
Employees completing critical plant
operations before evacuating known
procedures
Alarm systems maintained/tested
Emerg Plan Revwd/Revised
periodically
         Employer Posting                        Safe                At-Risk            Comments/Counts:
OSHA info posted
Safety committee meeting minutes
OSHA 300 Summary as required
Emergency numbers posted
Signage present
      Environmental Controls                     Safe                At-Risk            Comments/Counts:
Proper lighting
Hazardous substances identified
Proper ventilation
Restrooms and washrooms sanitary
Exit doors are properly marked
                                                                          Page 2 of 4
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        Ergonomics: general                      Safe                At-Risk            Comments/Counts:
Work performed w/o eye strain/glare
Limited repetitive lifting above
shoulders
Hands/wrists in neutral position
Mechanical aids provided
     Hand tools and Equipment                    Safe                At-Risk            Comments/Counts:
Tools in good condition
Handles used on files/similar tools
Fit for task
Used correctly
           Industrial Trucks                     Safe                At-Risk            Comments/Counts:
Capacity rating posted
Overhead PPE Provided
Lift truck rules posted
Directional lighting as required
Warning horn, whistled
Brakes checked
          Machine Guarding                       Safe                At-Risk            Comments/Counts:
Employee trained to operate
Adq supervision for safe procedures
Machine/Equipt in
Machinery/Equipt-clean/maintained
Clearance sufficient
Equipt/Machine-placed/anchored
Power shutoff within reach
Machine bonded/grounded
Foot operated switch guarded
Manual Valves/Switches
identified/accessible
Emergency stop buttons colored red
Pulleys and belts properly guarded
Moving chains and gears properly
guarded
                                                                          Page 3 of 4
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        Materials Handling                     Safe                At-Risk            Comments/Counts:
Materials stored properly
Clearance for equip in
aisles/doorways
Aisles marked and cleared
Vehicles/equipment inspected
Vehicles shut off/brakes set
Combustible/flammables stacked
properly
Trucks/Trailers secured
Dock boards/plates used properly
Dock plts/load ramps maintained
Hand trucks maintained
Chutes/gravity roller placed/secured
Pallets inspected before use
Chains, ropes, chokers, secured
                P.P.E                          Safe                At-Risk            Comments/Counts:
Appropriate respirators are used as
required
Employees protected from noise
above 85db
Employees trained on proper use of
PPE
Face shields or goggles are used as
required
Food/beverages consumed in
designated areas
Hard hats properly used
Hazard assessment has been
completed
PPE maintained in sanitary condition
PPE stored properly
Proper foot protection is worn
Safety glasses used
         Welding & Cutting                     Safe                At-Risk            Comments/Counts:
Curtains/shields in place
                                                                        Page 4 of 4
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Stormwater Checklist
Stormwater Checklist
    Inspection                                                                    Inspection
         Type:                                                                         Date:
       Project:                                                                Inspected By:
                                                                                    Reviewed
                                                                                        With:
Category : Sub-Category
 Erosion / Sediment Control Plan
                                          Compliant              At-Risk                        Comments/Observations:
             SWPPP
Areas soil disturbance
Batch plant
Chem material
Concrete Washout
Construction entrance
Construction office
Drainage patterns / slopes
Drawings updated
Employee parking
Equipment staging area
Material Staging/Storage
Off site storage identified
Port restrooms
Resp decl from all trades
Stabilization practices
Structural controls
Surface waters
Waste storage
Water discharge
         Final Stabilization              Compliant              At-Risk                        Comments/Observations:
70% density coverage
Notice of Termination filed
Notice to co-permitee
Notice to MS4 operator
Soil-disturbing act comp
Temp erosion contr rem
                                                                      Page 1 of 4
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       Storm Water > 5 Acres                Compliant              At-Risk            Comments/Observations:
BMP's effective
NOI posted
NOI to City
NOI to State w payment
Proj > 10 acres: sed basin
SWPPP prepared
       Storm Water 0-5 Acres                Compliant              At-Risk            Comments/Observations:
< acre city require SWPPP
BMP's effective
CSN Posted
CSN to city
Inspections to date
Project 1-5 SWPPP prepared
SWPPP avail on site
     SWPPP BMPs Inspection                  Compliant              At-Risk            Comments/Observations:
BMP inspec comp w/plan
BMP's effective
Conc washout area prot
Construction entrance
Diversion Dike
Dust control
Entrance re-structure
Erosion Control Mats
Final Seeding
Haz Material Storage
Inlet Protection
Interceptor Swale
Interim Stabilization
Local, state, fed iss's resolv
Mulching
Necessary BMPs implemented
Permanent Structural Controls
Pipe Slope Drain
Required signage
Rock check dam
                                                                        Page 2 of 4
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     SWPPP BMPs Inspection                Compliant              At-Risk            Comments/Observations:
Sand Bag Berms
Sandblast Waste Mgmt
Sediment Basin
Signs mater exp to runoff
Signs pollut leaving site
Silt catch areas cleaned
Silt Fence
Stabilized Construction Entrance
Stone Outlet Sediment Trap
Straw Bale Dike
Street sweeping
Temp Sediment Tank
Temp Seeding
Vegetation
           SWPPP Contents                 Compliant              At-Risk            Comments/Observations:
3rd prty design letter comp
Approved drawings
BMP maintenance schedule
BMP modification
Chemical inventory list
Concrete batch plant
Construction BMP schedule
Cont NOI
Copy of General Permit
Description approp BMP
Description of soil
Endanger spec imp stmnt
Erosion control plan SWPPP
Gen location map
Haz mat storage identified
Hist pres stmnt
Insp qualify suffic
Inspections to date
Non storm water disch
Owner NOI
Project description
Receiving water
                                                                      Page 3 of 4
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           SWPPP Contents                 Compliant              At-Risk            Comments/Observations:
Resp decl from all trades
Runoff Coefficients
Signatory designation comp
Site map
Spill Control Procedures
SW train complete
SWPPP Certification complete
       SWPPP Modifications                Compliant              At-Risk            Comments/Observations:
BMP changes up to date
Inspector changes up to date
Other changes up to date
Subs changes up to date
                                                                      Page 4 of 4
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Traffic-Workzone Checklist
 Traffic-Workzone Checklist
    Inspection                                                                       Inspection
         Type:                                                                            Date:
       Project:                                                                   Inspected By:
                                                                                      Reviewed
                                                                                          With:
 Category : Sub-Category
             Work Zone                         Safe                 Unsafe                        Comments/Observations:
Advanced Warning Signs/Spacing
Blunt Ends Protected
Channelizing Devices/Condition
Communications
Escort Vehicle
Flagger Station Illuminated
Flaggers Trained
Flagging Operations
MPT Competent Person
MPT Crew Trained
MPT Inspections Conducted
MPT Permit Completed
MPT Staging Area
Other
Pavement Drop Offs
Police Support
PPE Vest & Pants
Red Flags
Road Closure Approved
Road Closure Posted
Stop/Slow Paddles
Tangent Spacing
Taper Length/Spacing
Temp. Lighting
Temp. Pavement Markings
TMA / MPT Truck
Traffic Control Plan
                                                                        Page 1 of 2
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            Work Zone                       Safe                 Unsafe            Comments/Observations:
Traffic Signals/Temp. Flash
VMS
                                                                     Page 2 of 2
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Underground Plumbing Checklist
Underground Plumbing Checklist
    Inspection                                                                        Inspection
         Type:                                                                             Date:
       Project:                                                                    Inspected By:
                                                                                        Reviewed
                                                                                            With:
Category : Sub-Category
      Underground Plumbing                  Conformance        Non-Conformance                      Comments/Observations:
All pipe ends not actively being
worked on are capped
All drainage piping is pitched
minimum of 1/8? per foot
All piping installed is backfilled to
give support to lower third of pipe for
the full length of pipe
All underground sanitary and storm
piping is Bell & Spigot SV Cast Iron
All gaskets for underground sanitary
piping Bell & Spigot SV Gaskets
All under slab lab waste or decon
waste piping is polypropylene
All under slab lab waste piping is
protected, stored flat, and out of
direct sunlight
All under slab lab waste pipe joint
installers have been factory trained
All risers, stub ups are plumb after
back fill
All risers, stub ups, are marked so as
to be visible to other trades
All domestic water piping is Ductile
Iron Class 52
All piping foundation penetrations
have link seals installed and
accessible from 1 side
Approved pipe bedding installed
Proper backfill and compaction
Restoration of grade to original
condition
Drain bodies set to proper elevations
Drain bodies coordinated with
flooring material and finish
Covers level and square
Covers protected prior to concrete
pour
Plumber on standby at concrete pour
                                                                          Page 1 of 1
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02 Focused Inspection
Checklist
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Behavior-Based Safety Checklist
 Behavior-Based Safety Checklist
    Inspection                                                                    Inspection
         Type:                                                                         Date:
       Project:                                                                Inspected By:
                                                                                   Reviewed
                                                                                       With:
 Category : Sub-Category
           Access & Egress                  Safe                 Unsafe                        Comments/Observations:
Barricades/shields
Cleaning as work progresses
Clear Path
Eyes on Path
Footing
Material storage
Three-point of contact
          Tools & Equipment                 Safe                 Unsafe                        Comments/Observations:
Correct tool for job
Inspected before use
Safe use
           Body Positioning                 Safe                 Unsafe                        Comments/Observations:
Assistance
Body mechanics
Eyes on task
Line of Fire
Pinch Point
                   PPE                      Safe                 Unsafe                        Comments/Observations:
Body Protection
Eye and face protection
Fall protection
Foot protection
Hand protection
                                                                    Page 1 of 2
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                  PPE                    Safe                 Unsafe            Comments/Observations:
Head protection
Hearing protection
Respiratory protection
Special body protection
           Communication                 Safe                 Unsafe            Comments/Observations:
Means of communication
Pre-task plan followed
            Environment                  Safe                 Unsafe            Comments/Observations:
Housekeeping
Walking/working surfaces
Storage & labeling
Industrial Hygiene
Lighting
                                                                 Page 2 of 2
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Fall Protection Audit Checklist
Fall Protection Audit
    Inspection                                                                         Inspection
         Type:                                                                              Date:
       Project:                                                                     Inspected By:
                                                                                         Reviewed
                                                                                             With:
Category : Sub-Category
         General Questions                        Safe                 Unsafe                        Comments/Observations:
Stop work policy in place
Competent person on site
Disciplinary action in effect
Vendor training been conducted
Trained in fall protection
             Guard Rails                          Safe                 Unsafe                        Comments/Observations:
Top Rail @ 42"
Mid Rail @ 21"
Max 3" deflection
Will withstand 200 Lbs Force
Toe boards
Wire rope flagged
          Vertical Lifelines                      Safe                 Unsafe                        Comments/Observations:
Free from knots
Independently secured to anchor
Anchor to support 5000 lbs
Line & rope grab inspected daily
Has rating been verified
One worker per lifeline
Abrasion protection for lifelines
                  Tie Off                         Safe                 Unsafe                        Comments/Observations:
Mandatory Tie off at 6' or above
No one ties off to handrails
Equipment approved & inspected
                                                                          Page 1 of 3
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                  Tie Off                       Safe                 Unsafe            Comments/Observations:
"D" ring between shoulder blades
Leg straps intact
Free fall no greater than 6'
Lanyard inspected
Rescue Plan in place
      Self-Retracting Lanyards                  Safe                 Unsafe            Comments/Observations:
Inspected daily
              Holes/Openings                    Safe                 Unsafe            Comments/Observations:
Cover secured
Will support 2X intended load
Minimum ¾" plywood or guardrail
Are covers color coded or marked
Handrail at opening more than 2x2
Barricade used for ScissorLifts
                 Ladders                        Safe                 Unsafe            Comments/Observations:
Base level & free from debris
No one stands on top 2 steps
Ladder/Stair/ramp elev break 19"
Inspected by competent person
Non - conductive
Slip resistant
Job made ladders built properly
Proper climbing angle
Work facing ladder
               Scaffolding                      Safe                 Unsafe            Comments/Observations:
Supervision of competent person
Sill plates
Cross bracing in place/secure
Guardrails in place
Fully decked/Scaffold grade plank
Proper access
Toeboards on all open sides
Not overloaded
                                                                        Page 2 of 3
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             Scaffolding                          Safe                 Unsafe            Comments/Observations:
Canopy for public liability
Inspected & tagged daily
Scaffold user training conducted
Scaffold Release on file
        Suspended Scaffold                        Safe                 Unsafe            Comments/Observations:
Independent lifelines
Counter weights secured
Wire rope inspected daily
Competent person inspects daily
Proper counterweight verified
             Aerial Lifts                         Safe                 Unsafe            Comments/Observations:
Tie off inside boom lift platform
Competent person daily inspection
           Concrete Work                          Safe                 Unsafe            Comments/Observations:
Impalement hazards covered
 Steel Erection, Welding, Bolting,
                                                  Safe                 Unsafe            Comments/Observations:
          Metal Decking
Head clearance for multiple lift
Tag lines in use
Perimeter protection installed
Leading edge delineated 15' back
                                                                          Page 3 of 3
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Body Positioning Checklist
 Body Positioning
  Observation                                                                   Observation
        Type:                                                                         Date:
  Department:                                                                 Inspected By:
                                                                                  Reviewed
                                                                                      With:
 Category : Sub-Category
          Body Positioning                 Safe                 At-Risk                       Comments/Behaviors:
Lifting, Bending
Reaching, Twisting
Pushing, Pulling
Neutral, Stable Posture
Eyes on Task
Line of fire, Pinch points
                                                                   Page 1 of 1
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Concrete Post Pour Checklist
Concrete Post Pour
    Inspection                                                                     Inspection
        Type:                                                                           Date:
         Area:                                                                  Inspected By:
                                                                                     Reviewed
                                                                                         With:
Category : Sub-Category
       Concrete - Post Pour               Acceptable           Unacceptable                      Comments/Observations:
Are all finishing tools clean and in
good working order?
Are the required tools and qualified
personnel available for the finishing
operations?
Is concrete being protected from
mechanical or physical stresses
(such heavy equipment loads or
Were the initial finishing operations
started as soon as the concrete has
been placed and screeded to
Are forms being removed in line with
specified requirements
Is concrete adequately cured for the
required period and per the approved
Method Statement?
Is contractor waiting until bleedwater
is no longer present and concrete
has started initial set to start
Is the works supervisor
knowledgeable on the work operation
and the inspection and testing
                                                                      Page 1 of 1
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Guardrails Checklist
 Guardrails
  Inspection                                                                 Inspection
       Type:                                                                      Date:
    Project:                                                             Inspected By:
  Comments                                                                   Reviewed
                                                                                 With:
 Category : Sub-Category
                Fall Protection                              Safe              Unsafe      Comments/Observations:
Ext/int guardrails
    • 42” top- and 21” mid- rail
    • < 3” deflection
    • 3/8” cable or 2 x 4 lumber
    • 3 clamps per connection
    • “Do not saddle dead horse”
    • Support posts every 8’ (wood)
    • Flagged every 6’
    • 1 obs = each 15’ section
    • Expected Severity = High
        (Life threat if missing rails)
               Ladders / Stairs                           Safe               Unsafe       Comments/Observations:
Rails at stairs/landings
    • Self-closing gate where ladders
        enter guardrails
    • No climbing through top/mid rails
        to access landings
        Site / Public Protection                          Safe               Unsafe       Comments/Observations:
Falling object protection
    • Toe boards if working below
    • 4” height
    • Mesh screen at elevator pits
                                                              Page 1 of 1
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Hand Safety Checklist
Hand Safety
    Inspection Safety Focused Hand                                                   Inspection
         Type:                                                                            Date:
       Project:                                                                   Inspected By:
                                                                                       Reviewed
                                                                                           With:
Category : Sub-Category
      Material Handling Tasks                   Safe                 Unsafe                        Comments/Observations:
Are hands out of line of fire?
Carry out a material inspection
before handling?
Where will the object be placed?
Housekeeping? Is there a defined
path / Slip, trip & fall hazards?
   Use of Cutting (Power) / Hand
                                                Safe                 Unsafe                        Comments/Observations:
               Tools
Employee has correct body position
Employee cutting away from body
Is the tool held correctly?
Correct PPE being used?
Is the object secure?
Are clamp devices used to hold
objects?
Right tools for the job and in good
condition?
Has tool inspection been completed
before use?
Distraction eyes and hands on task?
Guards/barriers are in place?
Rotating machinery? Look for loose
clothing or jewelry that may get
caught
Hot work PPE / barrier controls or
coolant in place
             PPE / Gloves                       Safe                 Unsafe                        Comments/Observations:
Correct gloves for task
Glove selection per MSDS
Gloves in good condition
Holes/Cuts/General
Wear/Fraying/Velcro missing
Proper size / fit of glove
                                                                         Page 1 of 1
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Moisture Control Checklist
Moisture Control
    Inspection                                                                        Inspection
         Type:                                                                             Date:
       Project:                                                                    Inspected By:
                                                                                        Reviewed
                                                                                            With:
Category : Sub-Category
   Opening Enclosure Schedule               Conformance        Non-Conformance                      Comments/Observations:
Temp drains connected, free of
debris/proper working order
Temp prot of material and building
Elevate stored material to hinder
water infiltration
Remove free standing water from
sump pits, elev pits, etc.
Flooding dealt with immediately
Pre-job quality meeting with sub
Project specific quality requirements
Other
                                                                          Page 1 of 1
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Office Safety Checklist
Office Safety Checklist
    Inspection                                                                     Inspection
         Type:                                                                          Date:
       Project:                                                                 Inspected By:
                                                                                     Reviewed
                                                                                         With:
Category : Sub-Category
      General Safety & Health              Compliant          Non-Compliant                      Comments/Observations:
Housekeeping
Clean bathrooms
Bathroom ventilation
Indoor air quality
Kitchen area
Break area
Food storage areas
Mold (fridge, ceiling, sink)
               Electrical                  Compliant          Non-Compliant                      Comments/Observations:
GFCI on Power strips
GFCI near water sources
Electrical Outlets
Electrical Boxes
36" Free from Electric Panel
Exposed Wires
Proper use of extension cords
Lighting
Covered Lighting
Surge Protectors
Liquid near Electrical Source
Overloaded Outlets
Lock out Tag out Station
    Walking/Working Surfaces               Compliant          Non-Compliant                      Comments/Observations:
Trip Hazards
Slip Hazards
                                                                       Page 1 of 3
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     Walking/Working Surfaces               Compliant          Non-Compliant          Comments/Observations:
Spills
Fall Protection Above 4 feet
Clear/Safe Pathways
Carpet/Mats
            Storage Areas                   Compliant          Non-Compliant          Comments/Observations:
Pest/Vermin Control
Un-obstructed Pathways
Items above 6 ft. secured
Sprinklers have 18? clearance
Fire Extinguisher at Exit
Lighting
Signage of Load Capacity
          Emergency Protocol                Compliant          Non-Compliant          Comments/Observations:
Emergency Evacuation Plan Posted
Disaster Plan in Place
Unobstructed Emergency Egress
Fire Extinguishers
First Aid Kit
CPR/BFA Trained Personnel
AED Available
Blood Borne Pathogen Kit
Bio-Hazard Containers
Sharps Container
Signage
Emergency Lights
Lighted Exit Signs
911 Employee Protocol Plan
MSDS Available
         Ladders and Stairways              Compliant          Non-Compliant          Comments/Observations:
Ladder/Step Stool condition
Proper Use of Ladders/Stools
Handrails
Anti-Slip Treads
Proper Stair Angle
                                                                        Page 2 of 3
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      Ladders and Stairways              Compliant          Non-Compliant          Comments/Observations:
Riser and Tread
Proper platform area
               Office Items              Compliant          Non-Compliant          Comments/Observations:
Proper lifting techniques
Proper use of File Cabinets
Proper use of Paper Cutters
Proper tools
Tools in good condition
Dollies
Trainings
Violence in the workplace
Horse playing
Sexual Harassment
Work Station Ergonomics
Furniture found hazards
                                                                     Page 3 of 3
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Sample 5S Checklist
Sample 5S
    Inspection                                                                      Inspection
        Type:                                                                            Date:
     Location:                                                                   Inspected By:
                                                                                      Reviewed
                                                                                          With:
Category : Sub-Category
                 Sort                          Safe                 Unsafe                        Comments/Observations:
List of necessary equipment and
materials available
Necessary equipment, tools, etc.,
are present
Unneeded items are on walls
(bulletin boards, etc.)
Items clear from aisles, stairways,
corners, etc.
Unneeded inventory, supplies,
parts, materials are removed
             Straighten                        Safe                 Unsafe                        Comments/Observations:
Correct places for items are obvious
Items stored in their correct places
Aisles and equipment locations
clearly identified
Items are put away immediately
after use
Height and quantity limits are
obvious
                 Shine                         Safe                 Unsafe                        Comments/Observations:
Cleaning and looking for ways to
keep it clean
Floors, surfaces, and walls free from
dirt
Equipment kept free from dirt, oil,
and grease
Cleaning materials easily accessible
Lines, labels, and signs clean
                                                                        Page 1 of 2
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            Standardize                        Safe                 Unsafe            Comments/Observations:
Necessary information is visible
All standards are known and visible
Checklists exist for all cleaning and
maintenance jobs
All quantities and limits are easily
recognizable
               Sustain                         Safe                 Unsafe            Comments/Observations:
Workers had 5S training
5S inspections conducted daily
Crew members assigned to 5S tasks
Job aids available and up-to-date
                                                                        Page 2 of 2
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Vehicles Checklist
Vehicles Checklist
    Inspection                                                                      Inspection
         Type:                                                                           Date:
       Project:                                                                  Inspected By:
                                                                                      Reviewed
                                                                                          With:
        Vehicle Operations                 Acceptable           Unacceptable                      Comments/Observations:
Vehicle Operations
Speeding
Speeding Near Crew
Signaling/ Signs
Eyes on job
Seat Belt Worn
Loads secured
Driver Looking in Direction of Travel
Following Distance Maintained
Stopped at Pedestrian Crossings
Loads Safely Secured
Parked in Designated Area
Vehicle Operating Safe Distance
from Excavations/Trenches
Backup Alarm Functioning
                                                                        Page 1 of 1
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03 Leadership Checklists
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Management Audit Checklist
Management Audit
    Inspection                                                                       Inspection
         Type:                                                                            Date:
       Project:                                                                   Inspected By:
                                                                                      Reviewed
                                                                                          With:
Category : Sub-Category
     Management Leadership                  Compliant          Non-Compliant                      Comments/Observations:
Project Safety Plan
Competent Person ID'd
Incident Rate Goal Met
SafetyNet Data Reviewed
          Safety Meetings                   Compliant          Non-Compliant                      Comments/Observations:
Safety Committee Formed
Safety Comm Mtg Held
Follow-up items tracked
Monthly Mgmt Meeting Held
High Hazard Meeting Held
Pre-Con Safety Mtg Held
           Pre-Task Plans                   Compliant          Non-Compliant                      Comments/Observations:
PTP’s Completed
Reviewed/Signed By Crew
All Steps Detailed
All Hazards Identified
Corrective Actions Appropriate
PTP steps verified in field
           Accountability                   Compliant          Non-Compliant                      Comments/Observations:
Program Utilized
Discipline documented
Action plan based on trending
Improvement Plan initiated
Improvement Plan confirmed
                                                                        Page 1 of 3
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      Education and Training                  Compliant          Non-Compliant          Comments/Observations:
Orientation Program Implemented
Meets Minimum Requirements
OSHA 10-hr Compliant
OSHA 30-hr Compliant
Tool-box Talks Documented
Tool-box Talks Relevant
          Communication                       Compliant          Non-Compliant          Comments/Observations:
Post-Incident Bulletin Issued
Project Goals Communicated
Committee Findings distributed
EAP developed/practiced
Worker surveys/feedback
        Safety Inspections                    Compliant          Non-Compliant          Comments/Observations:
1 Per Month by PX
1 Per Month by PM
1 Per Week Super
1 Per Day By Safety
Timely Closure Of Open Issues
       Incident Investigation                 Compliant          Non-Compliant          Comments/Observations:
Incident reported timely
Incident Investigation completed
Post-Incident Review Held
Root Cause Identified
Corrective Measure Identified
Corrective Measure Implemented
CIA Progress Measured
           Site Logistics                     Compliant          Non-Compliant          Comments/Observations:
Dust control methods
Site cleanliness
Public protection measures
Access to upper areas
                                                                          Page 2 of 3
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          Site Logistics               Compliant          Non-Compliant          Comments/Observations:
Snow/Ice removal plan
  Substance Abuse Prevention           Compliant          Non-Compliant          Comments/Observations:
Pre-Employment Screenings
Post-Accident Screenings
                                                                   Page 3 of 3
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MSHA Checklist
 MSHA Checklist
    Inspection                                                                      Inspection
         Type:                                                                           Date:
       Project:                                                                  Inspected By:
                                                                                     Reviewed
                                                                                         With:
 Category : Sub-Category
              Air Quality                     Safe                 Unsafe                        Comments/Observations:
Air Monitoring
Dust Suppression Systems
          Compressed Air                      Safe                 Unsafe                        Comments/Observations:
Pressure Vessel Inspection
Whip Checks
              Electricity                     Safe                 Unsafe                        Comments/Observations:
Disconnects
Electrical Matting
Equipment Grounding
Hand Held Electric Tools
Junction Boxes
Labeling of Switches
Lightning Protection
Lockout/Tagout
Signage/Warning
Wiring
           Fire Prevention                    Safe                 Unsafe                        Comments/Observations:
Abandoned Electrical Circuits
Battery Charging Station
Cylinder Storage
Cylinder Transportation
Equipment Fueling
Fire Extinguisher Annual Certification
                                                                       Page 1 of 4
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             Fire Prevention                   Safe                 Unsafe            Comments/Observations:
Fire Extinguisher Availability
Fire Extinguisher Monthly Inspection
Hot-Work Permit
Signage/Warning
Storage of Flammable/Combustible
Material
Welding/Cutting/Compressed Gases
             Ground Control                    Safe                 Unsafe            Comments/Observations:
Bench/Floor Condition
Haul Road Condition
Highwall Condition
      Hazard Communication                     Safe                 Unsafe            Comments/Observations:
Current MSDS's Onsite
Labeling
MSDS's Readily Available
Signage/Warning
              Illumination                     Safe                 Unsafe            Comments/Observations:
Adequate Lighting
Light Functionality
Light Guarding
    Loading, Hauling, Dumping                  Safe                 Unsafe            Comments/Observations:
Berms
Dump Site Stability
Equipment Speed
Load Securement
Seatbelts
Stockpiles
Traffic Pattern
Traffic Signage/Signals
     Machinery and Equipment                   Safe                 Unsafe            Comments/Observations:
Backstops
Backup Alarms
                                                                        Page 2 of 4
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     Machinery and Equipment                    Safe                 Unsafe            Comments/Observations:
Blocking/Cribbing
Brakes
Controls
Correction of Defects
Guarding
Horns
Inspection Records
Pre-Shift Inspection
Pull Cords/Emergency Stops
ROP's Certification
Signage/Warning
Tires
                  Misc                          Safe                 Unsafe            Comments/Observations:
Housekeeping
Potable Water
Restrooms
Waste Receptacles
         Occupational Noise                     Safe                 Unsafe            Comments/Observations:
Annual Audiograms
Hearing Conservation Program
Hearing Protection Availability
Signage/Warning
         Personal Protection                    Safe                 Unsafe            Comments/Observations:
Eye Protection
Fall Protection
First Aid Material
Hard Hats
Life Jackets
Protective Footwear
           Safety Programs                      Safe                 Unsafe            Comments/Observations:
Emergency Action Plan
Emergency Numbers Posted
First Aid/CPR Training
                                                                         Page 3 of 4
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            Safety Programs                  Safe                 Unsafe            Comments/Observations:
Work Place Examinations
               Training                      Safe                 Unsafe            Comments/Observations:
Current Annual Refresher Training
Current Task Training
Current Training Plan Onsite
Employee Training Records
Site-Specific Training
              Travelways                     Safe                 Unsafe            Comments/Observations:
Catwalks
Handrails
Ladders
Safe Access
Stairs
Toe boards
Walkways
                                                                      Page 4 of 4
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04 Quality Checklists
      © 2016, Predictive Solutions, All rights reserved.   Page 113
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Concrete Checklist
Quality – Concrete
    Inspection                                                                      Inspection
         Type:                                                                           Date:
       Project:                                                                  Inspected By:
                                                                                      Reviewed
                                                                                          With:
Category : Sub-Category
         Concrete Materials                 Compliant          Non-Compliant                      Observations/Recommendations:
Concrete placement procedure
     Forming and Accessories                Compliant          Non-Compliant                      Observations/Recommendations:
Forming procedures
             Reinforcing                    Compliant          Non-Compliant                      Observations/Recommendations:
Rebar free of dirt/debris
Rebar clearances
Rebar layout
     Embed Plate/Anchor Bolt                Compliant          Non-Compliant                      Observations/Recommendations:
Embed dwgs available
Embed layout
      Cast-in-Place Concrete                Compliant          Non-Compliant                      Observations/Recommendations:
Hot/Cold plan available
Hot/Cold plan compliance
Vapor barrier installed
Built per plan
Concrete finish per plan/specs
Curing procedures
           Post Placement                   Compliant          Non-Compliant                      Observations/Recommendations:
FF/FL compliance
Control joints installed
                                                                        Page 1 of 2
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      Post-Tension Concrete               Compliant          Non-Compliant          Observations/Recommendations:
PT cable ends treatment
         Precast Concrete                 Compliant          Non-Compliant          Observations/Recommendations:
Eng. bracing plan available
Compliant w/bracing plan
Condition of delivered mat'l
Connections inspected
        Tilt-up Panel Const.              Compliant          Non-Compliant          Observations/Recommendations:
Eng. bracing plan available
Compliant w/bracing plan
Panel forming
Reinforcing installed
Connections inspected
Temporary bracing installed
               Concrete                   Compliant          Non-Compliant          Observations/Recommendations:
Other (note)
                                                                      Page 2 of 2
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Plumbing Checklist
Quality - Plumbing
    Inspection                                                                       Inspection
         Type:                                                                            Date:
       Project:                                                                   Inspected By:
                                                                                       Reviewed
                                                                                           With:
Category : Sub-Category
        Plumbing - General                   Compliant          Non-Compliant                      Observations/Recommendations:
Protected from freezing
Roof drain flashing
Drains protected from debris
Access to cleanouts
Pipe testing
Plumbing firestop penetrations
Location of isolation valves
Water hammer arrestors install
Vent distance to air intakes
Roof piping supports
Condensate drains HVAC equip.
PRV on water heaters to drain
Drains on water heaters
Elect. disconnect @ circ. pumps
DHW circ. pump controls
AHU traps clean & size correct
Stop covers urinals & toilets
Operation of automatic lavs
Operation of automatic flush
                                                                         Page 1 of 1
                                  © 2016, Predictive Solutions, All rights reserved.                                               Page 116
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  What Is
 SafetyNet?
SafetyNet is the leading safety management system for saving lives by predicting workplace
injuries. It’s the only software solution in the world that can answer the question, “when and
where will my next injury occur?”
With a smartphone or tablet, users efficiently collect high-quality safety data. SafetyNet’s
predictive model then predicts, with accuracy rates as high as 97%, when and where a
company’s next injury will occur.
SafetyNet Makes It Easy To:
Collect high-quality safety data using mobile phones and tablets;
Analyze the data to uncover actionable information and even leading indicators and predictions
about future risk;
Communicate the results in real time to those who are at risk and to those who can take
action to prevent incidents and injuries.
                                           Request More Information
                                               about SafetyNet
                    © 2016, Predictive Solutions, All rights reserved.                  Page 117
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Predictive Solutions saves lives by predicting workplace injuries. Its software
solutions help customers predict the likelihood, frequency and location of
workplace injuries. With more than 225 million unique observations and nearly
80,000 observers from more than 16,000 worksites around the world, Predictive
Solutions is the industry leader in predicting injuries before they occur.
                                Our Mission: We Save Lives, By Predicting Workplace Injuries.
                                              1 Life Way | Pittsburgh, PA 15205-7500 | USA
                         Tel: 412.809.1888 | 1.800.991.3262 | Fax: 412.788.8353 | info@predictivesolutions.com
                                                     www.predictivesolutions.com
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