A: B:
C: D: E:
F: G: H:
A B C D E F G H
1. Are adequate and serviceable fire extinguishers provided?
2.
3. Are rear view mirrors provided and in good condition?
4. Are reverse signal alarms on equipment operational?
5. Are belts, gears, shafts, electrical contacts, moving parts, etc.
6. Are all hot pipes, hoses and surfaces guarded?
7. Are tires in serviceable condition?
8. Are approved seat belts and roll over protection provided?
9. Is recommended preventive maintenance being performed?
10.
11.
Are only "Authorized" employees allowed to operate equipment?
Authorized Operator: Equipment
Authorized Operator: Equipment
Authorized Operator: Equipment
Authorized Operator: Equipment
Authorized Operator: Equipment
If yes, is current Air Pollution Permit posted on equipment?
* TAKEN FROM EM-385-1-1 REQUIREMENTS
Project Name:
Project:
Foreman:
Subcontractor Signature:
Date:
Comments / Corrective Action Required:
repairs to equipment maintain the same factor of safety
as the original designed equipment?
adequately guarded?
Does equipment have separate engine over 50 hp not used to
DAILY SAFETY INSPECTION CHECKLIST FOR CONSTRUCTION EQUIPMENT
Company:
Equipment Inspected (Make/Model)
addressed in the comments/Correction action required section below.
Please mark Y for Yes; N for No; or N/A for Not Applicable. Any items marked No need to be
Do all modifications, extensions, replacement parts and/or
propel/drive equipment?:
