Piling Work Safety Checklist Form
Complete this checklist to ensure all key safety aspects are reviewed during piling work site inspections.
Project or Site Name
*
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspection Time
*
Hour Minutes
AM
PM
AM/PM Option
Inspector Full Name
*
First Name
Last Name
Piling Rig/Equipment Condition
*
Excellent
Good
Needs Attention
Unsafe – Do Not Operate
Personal Protective Equipment (PPE) Compliance
*
Hard hats worn
High-visibility clothing
Safety boots
Eye/face protection
Hearing protection
Other PPE (specify below)
Ground and Exclusion Zone Checks
*
Ground conditions stable
Exclusion zone clearly marked
No unauthorized personnel present
Barriers/fencing in place
Other (specify below)
Permit and Briefing Confirmation
*
All permits valid and available
Briefing completed with all personnel
Permit/briefing issues (details below)
Incident or Hazard Observations
Final Safety Status
*
Safe to proceed
Action required before proceeding
Unsafe – Stop work
Additional Comments or Actions Taken
Submit Checklist
Should be Empty: