Pre-Job Inspection Checklist
Please submit a Safety Form daily.
First Name
*
Last Name
*
Select a date
*
Job #
*
Contractor
Personl Hazards
*
Instructions for each task
Ability to perform the task
Ability to use tools properly
Distractions in the work area
Working Alone
Weather conditions
Noise conditions
Other
Preventative Measures for Personal Hazards
Activity Hazards
*
Cutting / Nailing material
Handling materials
Airborne particles
Working with / near gas
Working with / near electrical
Preventative Measures for Activity Hazards
Environmental Hazards
*
Climate conditions
Ventilation required
Heat exposure
Cold exposure
Lighting levels
Housekeeping
Other
Preventative Measures of Environmental Hazards
Ergonomic Hazards
*
Working in tight areas
Working above your head
Pinch points identified
Repetative movements
Preventative Measures of Ergonomic Hazards
Access Hazards
*
Nearby excavations
Falling debris
Powered platforms
Heights / Ladders / Scaffolding
Slippery surfaces
Confined space
Preventative Measures of Access Hazards
PPE Requied
*
Foot protection
Hearing protection
Eye protection
Safety harness
Hand protection
Respiratory protection
Head protection
Skin protection
Your Signature
*
Clear
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