Safety Inspection Checklist Job Site InformationJob Site Name, City, State*(Ex: VA Bldg 9, Asheville, NC) Overall Site DescriptionDate MM slash DD slash YYYY Inspected by:* First Last Are first aid supplies readily available?*YesNoN/AIf not this must be corrected immediately, contact Safety Director ASAP 828-767-2183. Are HVAC, Inc. work areas neat with materials and tools safely out of the way?*YesNoN/AAre there any sharp protruding points like sheet metal corners or nails in the work area?*YesNoN/AAre waste containers provided and being used?*YesNoN/AAre dust masks available for voluntary use?*YesNoN/AAre all HVAC, Inc. operations done in accordance with our Silica Exposure Plan?*YesNoN/AAre there adequate fire extinguishers in the work area?*YesNoN/AAll welding sites MUST have a fire extinguisher.Are the job boxes free of petroleum products and volatile chemicals?*YesNoN/AHave all HVC, Inc. extension cords been inspected for ground prong and knicks?*YesNoN/APlease inspect each cord for nicks and firm ground pin. If the cord is damaged discontinue from use immediately. Teach coworkers to do this when they lay-out and put-up the cord each time.Are all power sources GFCI protected?*YesNoN/AMake sure all power sources are either a GFCI outlet or pigtail. Please remind employees to test the GFCI EVERY SINGLE TIME they plug-in.Are extension cords out of stairwells and walkways?*YesNoN/AMake sure all extension cords are safely out of the way and never in a stairwell or walkway.Have tools with a ground pin been inspected this week?*YesNoN/AAlways make sure grounded tools have a firm ground pin in place. Never use a tool with a loose or missing ground pin.Are the power tools in good condition and all moving parts properly guarded?*YesNoN/ANever try to repair or alter a power tool or machine.Employees exposed to fall hazards are working in accordance with our PFAS plan*YesNoN/AEmployees using a scissor lift have the proper harness and lanyard?*YesNoN/AEmployees below protected from falling objects?*YesNoN/ADo extensions ladders onto another level extend 36" above the landing and are tied off?*YesNoN/ALadders are secured to prevent slipping and the feet are in good condition?*YesNoN/ALadders are inspected daily and removed service at any sign of damage or defect?*YesNoN/AEmployees are not using the top two steps of a ladder?*YesNoN/APlease remind coworkers about this rule, ladders become very unstable if you are on the top two rungs.How many HVAC, Inc. scaffolds are on the job site?*01-33-55+All scaffolds are inspected daily?*YesNoN/AAll penetrations greater than 2" are covered, secured, and marked?*YesNoN/AAny hole or penetration in the floor greater than 2" must be covered with a board and secured with 2x4 in the hole. The board must be marked "HOLE" in orange spray paint. This includes circular and square penetrations.Leading edge perimeters are protected with proper barricade?*YesNoN/AMaterials and tools are stored away from edges?*YesNoN/ACompetent person on hand inspecting daily?*NoYesN/AExcavations over 5' in depth are shored or sloped back?*NoYesN/ALadders every 25 feet when trench is more than 4 feet deep?*NoYesN/AUnderground utilities have been located?*NoYesN/AMaterials are properly and neatly stored or stacked out of the way?*YesNoN/AGas cylinders stored upright and secured?*YesNoN/AProper seperating barrier between fuels and oxygen?*YesNoN/AEnsure there is a 20 minutes barrier between fuel and oxygen tanks.Welding goggles and proper PPE are being used?*YesNoN/AFire extinguisher in area of welding?*YesNoN/AWelding screens are used properly?*YesNoN/AHot work permit posted when required?*YesNoN/AHard hats are being worn?*YesNoN/ASafety glasses are always worn while working?*YesNoN/ADust masks are avaible to use voluntarily?*YesNoN/AEnsure dust masks for available for any employee who wants one.Hearing protection is available for employees?*YesNoN/AHigh visibility outer layer worn when required?*YesNoN/AAll employees have been trained on the Hazcom program and SDS?*YesNoN/AEnsure all employees know how to access the digital SDS on job site tablet or online.What PPE is needed to cover the entire scope of work?Check all that apply Hard Hat Safety Glasses Face Sheild Hearing Protection Fall Protection Welding Protection High Visibility Outer Layer Conclusion & SignaturePlease be accurate and use the additional space for any notes, special considerations, and suggestions to improve the safety program.Final Conclusion - Overall job site*Excellent - No issues at all, totally by the bookOk with a few exceptionsBad - Needs attention immediatelyBased on your observations today, how would you rate the overall safety of the entire job site including other contractors?Final Conclusion - HVAC, Inc. operations*Excellent - No issues at all, totally by the bookOk with a few exceptionsBad - Needs attention immediatelyBased on your observations today, how would you rate the safety of HVAC, Inc.'s work and safety awareness? *Please explain if anything other than excellent*Additional NotesOptional - Notes for safety program improvementUse this space to provide any suggestions that could improve the HVAC, Inc. safety program. Signature* Reset signature Signature locked. Reset to sign again Sign your initials here with your finger to acknowledge that you have completed this form to the best of your ability and that the job site is either totally safe, proper corrective actions have been taken, or the safety director has been contacted.