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u � <br /> JOB SAFE'T'Y CUSS INSPFCI'ION CHECKLIST AND CORRECTION FORM <br /> Class: All Laborers <br /> Instructions: Checklist is based on the Code of Safe Practices for the area. If <br /> corrections are required, distribute copies to the responsible <br /> person(s). <br /> Condition, Practice, or Equipment. Initial Corrective Action <br /> 1. Workers fatigued or impaired'? <br /> 2. Horseplay evident'? _ <br /> 3. Proper lilting procedures' _ <br /> 4. Proper shoe wear'? --__-- — <br /> 5. Proper eye protection? _ _—__-- <br /> Proper protective clothing? <br /> 7. Proper use of equipment or <br /> note hinety? <br /> 8. Proper pr'ocedur'es used for <br /> excavations or instal hu ions? <br /> Yard hats worn? <br /> Corrective Action (specify in dcuaii): <br /> Person responsible for correction: _ <br /> Page - 34 <br />