Site Inspection Form

Site Inspection Form
Name
First NameLast Name
Site*
Date*
MonthDayYear
Date

PPE - Personal protective equipment is worn to minimize exposure to hazards that cause serious workplace injuries and illnesses.

Rows	Yes	No	N/A
Eye protection provided and being utilized
Hearing protection provided
Hard hats are provided and being utilized
Work boots worn by employees (steel-toed where required)
Respirators/respiratory protection program in place. (fit test records available)
Welding/cutting helmets, eye protection, gloves, and bibs are available and worn when required
Welding/cutting helmets, eye protection, gloves, and bibs are available and worn when required

Ladders/Stairways - Working on and around stairways and ladders is hazardous. Stairways and ladders are major sources of injuries and fatalities among construction workers.

Rows	Yes	No	N/A
Ladders inspected for defects
Ladders extend 3' above landing and secured
Ladders pitched at 1' out from vertical for every 4' of height
Ladders secured in place.
Stairways free of debris, slip, trip and fall hazards
Stairways equipped with stair rails and handrails

General Fall Protection - Fall protection is the use of controls designed to protect personnel from falling or in the event they do fall, to stop them without causing severe injury. Typically, fall protection is implemented when working at heights over 6', but may be relevant when working near any edge, such as near a pit or hole, or performing work on a steep surface.
Rows Yes No N/A
Floor openings covered or guarded (cover secured)
Workers exposed to falls 6’ or more are protected

Scaffolds - Each employee more than 10 feet above a lower level shall be protected from falls by guardrails or a fall arrest system.

Rows	Yes	No	N/A
Competent person assigned to supervising erection/disassembly
Competent person assigned to conduct regular or pre-use inspections
Working surfaces 10' or higher equipped with guardrails
Working surfaces clear of debris, slip, trip and fall hazards

Excavations and Trenches - Employers must ensure that a competent person inspects all excavations, adjacent areas, and protective systems daily for possible cave-ins, indications of failures in protective systems and equipment, hazardous atmospheres, and other hazardous conditions. Inspections must be done prior to the start of work and as needed throughout the shift.

Rows	Not Satisfied	Somewhat Satisfied	Satisfied	Very Satisfied
Competent person assigned to supervise operations at all times
All excavations and trenches 4' or deeper equipped with protective system
Ladders or other means of quick exit within 25' of each worker
Spoil pile at least 2' from edge of excavation or trench

Electrical - Electrical hazards can cause burns, shocks and electrocution (death). Assume that all overhead wires are energized at lethal voltages.

Rows	Yes	No	N/A
GFCI or Assured Equipment Grounding Conductor Program in place
All outlets checked for proper wiring and GFCI checked if applicable
All tools and equipment inspected for defects in cords and plugs
All tools and equipment were inspected for defects in cords and plugs
Extension cords are in good condition
Sources of electricity such as panel boxes, overhead lines, etc. marked

Cylinders - Mishandling compressed gas cylinders – which can have an internal pressure of up to 2,500 pounds per square inch – can be disastrous. Dropping, tipping over, or exposing a cylinder to heat can cause weaknesses or cracks in the cylinder’s shell, which can result in a shrapnel-laden explosion.

Rows	Not Satisfied	Somewhat Satisfied	Satisfied	Very Satisfied
Oxygen and fuel cylinders properly separated and secure
Compressed gas cylinders labeled
Cylinders turned off and valve caps in place when not in use
Hoses and torches free from defects

Fire Prevention - A fire extinguisher is one of your first lines of defense in a small fire. If working on a multi-level structure, make sure there is access to an extinguisher on each floor. Extinguishers should be clearly-visible and easily accessible. According to OSHA 1926.150(c)(1)(i), an extinguisher shall be provided for every 3,000 square feet of the protected building.

Rows	Not Satisfied	Somewhat Satisfied	Satisfied	Very Satisfied
Flammable/combustible liquids stored away from ignition sources
Portable containers of such liquids are approved and have self-closing lids
Adequate number of properly charged fire extinguishers available
Extinguishers properly located with current inspection tag
Flammable/combustible, debris/trash kept from welding and cutting operations
Oily rags disposed of in approved self-closing waste containers

Tools and Equipment - Employees should be trained in the proper use of all tools. Workers should be able to recognize the hazards associated with the different types of tools and the safety precautions necessary.

Rows	Not Satisfied	Somewhat Satisfied	Satisfied	Very Satisfied
Tools and equipment in good condition
Defective equipment tagged as such and removed from the work area
Tool and equipment guards in place and in good condition

Confined Space - Work areas that (1) are large enough for an employee to enter, (2) have limited means of entry or exit, and (3) are not designed for continuous occupancy are deemed confined spaces. These spaces can present physical and atmospheric hazards that can be prevented if addressed prior to entering the space to perform work.

Rows	Yes	No	N/A
Air sampling equipment calibrated
Air samples show acceptable oxygen concentration. (19.5% to 23.5%)
Air samples show space is free of toxic/flammable/ explosive gasses
Trained attendant assigned to keep constant contact with all workers inside space
Trained person assigned to recheck air quality frequently throughout the project

Hazard Communication - All employers with hazardous chemicals in their workplaces must have labels and safety data sheets for their exposed workers, and train them to handle the chemicals appropriately.

Rows	Yes	No	N/A
Written Hazard Communication Program in place
The written program includes a complete list of all chemicals
SDS is available for every chemical on the list
Chemical containers properly labeled

First Aid - First-aid kits should be provided at the work site or additional quantities of supplies should be included in the first-aid kits:1. Gauze pads (at least 4 x 4 inches).2. Two large gauze pads (at least 8 x 10 inches).3. Box adhesive bandages (band-aids).4. One package gauze roller bandage at least 2 inches wide.5. Two triangular bandages.6. Wound cleaning agent such as sealed moistened towelettes.7. Scissors.8. At least one blanket.9. Tweezers.10. Adhesive tape.11. Latex gloves.12. Resuscitation equipment such as resuscitation bag, airway, or pocket mask.13. Two elastic wraps.14. Splint.15. Directions for requesting emergency assistance.

Rows	Yes	No	N/A
First aid kits readily accessible to all workers
Contents of first aid kits approved by qualified health care provider
First aid kits include rubber gloves, eye protection, and CPR mask
Properly trained first aid provider on-site

Housekeeping - Construction sites can present many hazards to employees when they are performing construction-related activities. Keeping a construction site relatively clean of debris can further reduce hazards. The benefits of good housekeeping far exceed the small additional effort required to establish good housekeeping practices at a construction site.

Rows	Yes	No	N/A
Suitable containers available for disposal of trash and debris
Walkways, aisles, hallways, and passageways clear of trash, debris, and materials
Trash and debris containers are empty
Equipment is not use stored properly
Tools not in use stored in job boxes
Pipe, conduit, ductwork and other materials stored neatly

Other

Rows	Yes	No	N/A
Potable water readily accessible to all workers
Clean, private toilets accessible to all workers
OSHA Job Site Poster posted
Emergency telephone numbers posted or made available to all workers

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Items that need corrective action
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Signature*
Clear
Should be Empty:

Rows	Yes	No	N/A
Floor openings covered or guarded (cover secured)
Workers exposed to falls 6’ or more are protected

Site Inspection Form

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