| Project Name | Date | ||
|---|---|---|---|
| Subcontractor Name | Supervisor | ||
| Location | Contact |
| Item | Yes | No | N/A | Comments |
|---|---|---|---|---|
| Approved Safety Plan Submitted | ||||
| Valid Insurance Certificates Provided | ||||
| Job Safety Analysis Completed | ||||
| Pre-task Meeting Conducted | ||||
| PPE Provided & Properly Used | ||||
| Equipment Inspected | ||||
| MSDS/SDS Available | ||||
| Permits Obtained (Hot Work, Confined Space, etc.) | ||||
| Workers Trained/Certified | ||||
| Incident & Near-Miss Reporting Procedures in Place | ||||
| Site Housekeeping Maintained |