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WEEKLY INSPECTION (FORM E)
JOB INFO
SUPERVISOR
Andre
Fernando
Fatmir
Andrew
Alan
Arsim
Other
*Days On Project
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
*Check off and submit the following
Pre-Job Assessment or equivalent
Weekly Tool Box Talk
Weekly Subcontractor Safety Inspections
Equipment Inspections (heavy equipment, suspended work platforms etc)
# Submitted
Number of Total Personnel on Site (including management, staff & workers)
Person hours worked this week (average # of personnel daily x 40 hours)
Name(s) of First Aider(s):
Names of Supervisors (Foreman) on Site
Supervisor 1
Supervisor 2
Supervisor 3
Supervisor 4
Supervisor 5
Supervisor 6
Number of Disciplinary Actions
Warnings
Suspensions
Number of Incidents
Lost Time
First Aid
Medical Treatment
Near Miss
Restricted Work
Damage
List of all "Sub" Subcontractors (attach "Sub" Sub's Weekly Safety Documentation and submit as a package)
Sub 1
Sub 2
Sub 3
Sub 4
Sub 5
Sub 4
Comments
*Signature
General Contractor Email
SUBMIT