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Weekly Tailgate Sign-in Sheet
Archived Tailgate Meetings
Please input all fields marked with *
Date
*
Time
*
Jobsite Location
*
Topic
*
Alternate Topic
Discussion Leader
*
1. First Name
*
Last Name
*
Date Of Birth
*
Sign Name
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Comments/Suggestions:
Next Meeting Date
1. Foreman Signature
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1. Foreman print
*
1. Foreman Division
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Select Division
Northern California
Southern California
Mountain West Division
Mid-Atlantic
ABS
Corporate
Energy Services
Burns Mechanical
Northwest
Brandt
1. Foreman Email:
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Jobsite Safety Checklist
Job Name
*
Job Number
*
Checked By
*
Date
*
1.
RecordKeeping
*
a. Notices, Posters Federal 5in 1,OSHA notice,Payroll:
Compliant
Deficient
N/A
b. Emergency Contacts:
Compliant
Deficient
N/A
c. OSHA 300 Log:
Compliant
Deficient
N/A
2.
Personal Protective Equipment
*
a. In use safety glasses,hard hats work boots and gloves:
Compliant
Deficient
N/A
b. Face shields oor goggles used for overhead work:
Compliant
Deficient
N/A
c. Respirators available:
Compliant
Deficient
N/A
d. Welding screens:
Compliant
Deficient
N/A
3.
First Aid Kits
*
a. Available in gang box add jobsite trailer:
Compliant
Deficient
N/A
b. Stocked adequately with gloves,bandages and antiseptics:
Compliant
Deficient
N/A
c. CPR and First Aid trained personnel:
Compliant
Deficient
N/A
d. Medical Facility location and contact information communicated:
Compliant
Deficient
N/A
4.
Scaffold
*
a. Competent person certified:
Compliant
Deficient
N/A
b. Scaffold grade planking:
Compliant
Deficient
N/A
c. Fall Protection:
Compliant
Deficient
N/A
d. Clear of trash/debris:
Compliant
Deficient
N/A
5.
Ladders
*
a. Free from defects, with safet feet,blocked,cleated or otherwise secured:
Compliant
Deficient
N/A
b. straight ladders at 1 to 4 pitch:
Compliant
Deficient
N/A
6.
Cylinders
*
a. Capped,stored in an upright position:
Compliant
Deficient
N/A
b. Oxygen/Accetylene property separated:
Compliant
Deficient
N/A
c. Empty gas cylinders marked:
Compliant
Deficient
N/A
7.
Tools/Equipment
*
a. Inspected to ensure safe operating condition:
Compliant
Deficient
N/A
b. Hand tools free from defects:
Compliant
Deficient
N/A
c. Unsafe/Unusable tools/equipment tagged "Do Not Use":
Compliant
Deficient
N/A
d. Tools/Equipment property guarded:
Compliant
Deficient
N/A
8.
Housekeeping
*
a. Maintained:
Compliant
Deficient
N/A
b. Aisles and exitways clear with 24" clearance:
Compliant
Deficient
N/A
c. Work areas unculttered and debris removed:
Compliant
Deficient
N/A
9.
Electrical
*
a. Electrical equipment gounded:
Compliant
Deficient
N/A
b. Tools doubled insulted:
Compliant
Deficient
N/A
c. Cords in good condition:
Compliant
Deficient
N/A
d. Electrical pannels covered if energized:
Compliant
Deficient
N/A
10.
Fall Protection
*
a. Guardrails,midrails,toeboards:
Compliant
Deficient
N/A
b. Fall restraint systems:
Compliant
Deficient
N/A
c. Open sided floors or platforms equiped with standard railing:
Compliant
Deficient
N/A
d. Opening (interior/perimeter) properly barricaded or covered:
Compliant
Deficient
N/A
11.
Fire Prevention
*
a. Flammable and explosive materials stored safely:
Compliant
Deficient
N/A
b. Adequate number of fire extinguishers available with tags and clips:
Compliant
Deficient
N/A
c. Vehicles and mobile equipment provided with extinguishers:
Compliant
Deficient
N/A
12.
Excavations
*
a. Over 4 ft shored, benched or sloped as required:
Compliant
Deficient
N/A
b. Steps or ladders at 25 ft intervals:
Compliant
Deficient
N/A
c. Competent person on site:
Compliant
Deficient
N/A
13.
Hazard Communication
*
a. SDS and Labels available:
Compliant
Deficient
N/A
b. Employees briefed on HAZCOM:
Compliant
Deficient
N/A
c. HAZCOM information Poster posted:
Compliant
Deficient
N/A
d. Employees familiar with SDS familiar with books and their location:
Compliant
Deficient
N/A
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