• Worksite Inspection Form

    Worksite Inspection Form

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  • GENERAL INSTRUCTIONS:

  • The Worksite Inspection is to be conducted by the HSE Advisor and/or Site Supervision monthly. All unsafe acts/conditions/practices observed during this inspection must be documented on the Corrective Action Plan on page 2. A description is required for each corrective action identified and each item must be assigned to an individual, stating a due date for completion. Once corrective actions have been completed, a completion date is to be stated. All items should be completed before the following inspection, as applicable. The Worksite Inspection and Corrective Action Plan are to be reviewed by supervision with all Territorial Electric employees on site. A copy of the most recent inspection is to be retained on site and the original inspection form is to be sent in with the Safety Binder at the end of each month.

  • If items are acceptable or N/A leave them blank. Mark the item with an (X) if findings are unsatisfactory.

  • CORRECTIVE ACTION PLAN

  • FINDINGS

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  • RECOMMENDED CORRECTIVE ACTION

  • ASSIGNED TO AND DUE DATE

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  • Should be Empty: