Templates
Pipeline Construction Safety Checklist Template

Pipeline Construction Safety Checklist Template

Use this template to regularly inspect the occupational health and safety measures during pipeline construction. Download for free as a pdf or fill it out with the app.

Use this template
or download pdf
Pipeline Construction Safety Checklist Template

Use this template to regularly inspect the occupational health and safety measures during pipeline construction. Download for free as a pdf or fill it out with the app.

Use this template
or download pdf

About the Pipeline Construction Safety Checklist Template

A management checklist can help workers inspect their pipeline for safety concerns during construction.

Adhere to OSHA’s occupational health and safety regulations and document the relevant information under the following headings:

  • • JSA/JHA
  • • Environmental emergency response
  • • Hazards communication
  • • Hygiene
  • • PPE
  • • Material handling
  • • Vehicle/equipment/crane
  • • Material storage
  • • Fall prevention/protection
  • • Hand tools
  • • Electrical
  • • Hot work
  • • Fire protection/prevention
  • • Excavation
  • • Signs & barricades
  • • Housekeeping
  • • Walking surfaces
  • • Traffic control
  • • Overhead powerlines
  • • Radiation sources
  • • Pressure testing
  • • Abrasive blasting
  • • Lock out/tag out
  • • Confined space

Related categories

Preview of the template
Audit
JSA/JHA
Performed
Appropriate for task/Task covered
Reviewed
Signed
Environmental/Emergency Response
Emergency Action Plan
Spill Response Kit
Certified Responders
First-Aid Kit
Hazardous Communication
MSDS Available
MSDS Reviewed
Containers Labeled Properly
Handling Procedures Followed
Language/Bilingual MSDS Available
Hygiene
Restrooms
Potable Water Available
Adequate Drinking Water for Employee Hydration
Washing Facilities
PPE
Hard Hat
Eye/Face
Hand
Hearing
Footwear
Hi-Vis Vest
Respirator
Respiratory Program in Place (MEQ, Fit Test, Training, etc...)
FRC
Monitors Available, In Use, Calibrated (4-Gas, H2S or Other)
Other:
Material Handling
Body Mechanics
Manual Lifting Devices (Come-a-Longs, Chain falls, etc…)
Safety Latch
Slings
Hooks & Shackles
Wire Rope
Lifting Chains
Load Secure, Rigged Properly
Tag Lines Used
Other:
Vehicle/Equipment/Crane
Authorized/Qualified Operator
Designated Signal Person
Seatbelt Used
Backup Alarm
Hand Signal Chart
Daily/Weekly/Annual Inspection
Inspection Completed Properly
Other:
Material Storage
Material Stored Properly
Flammable/Combustible Storage
Pipe Chocked
Other:
Fall Prevention/Protection
Access/Egress
Fall Protection
Fall Protection Inspected
Scaffolds/Ladders - Proper Type
Scaffolds/Ladders - Inspected
Scaffolds/Ladders - Use
Handrails
Hand Tools
Condition
Guards/Handles
Proper for Job/Use
Electrical
GFCI/Assured Grounding Program
Cords/Tools – Inspected
Hot Work
Permit
Permit Conditions Followed
Fire Watch
Gas Cylinder Management
Leads/Hoses/Gauges
Other:
Fire Protection & Prevention
Fire Suppression Equipment
Annual/Monthly Fire Extinguisher Inspection
Properly Rated/Size (BC versus ABC)
Combustible/Flammable Material Away from Hot Work
Excavation
Excavation Type:
Documented Inspection by Competent Person
Sloped Properly
Benched Properly
Trench Box/Shoring Proper
Trench Box Certifications
Access/Egress Points
Spoil Pile Minimum 2-Feet From Excavation
Signs, Signals & Barricades
One Call Made
Utilities Identified
Signs/Barricades
Condition
Proper Type
Marking Hazards
Housekeeping
Dunnage
Trash
Trash Receptacles
Crew Trucks/Trailers
Walking Surfaces
Holes Guarded
Pathways
Trip Hazards
Traffic Control
Designated Flagger
Signs Posted per MUTCD
Escort Required/Used
Overhead Power Lines
Power Lines Marked with Goal Post and Signs
Designated Spotter
Proper Equipment for Spotter (Air Horn, Vest, etc…)
Radiation Sources
Type:
Signs, Signals & Barricades
Film Badges for X-Ray Crew
Pressure Testing
Equipment Integrity
Whip Checks/Connections Pinned
Signs, Signals & Barricades
Abrasive Blasting
Trap and Carbon Filter Installed
CO Alarm in use
Dead-Man Switch Operable
Proper PPE
Lock-Out/Tag-Out
Potential Energy Sources Identified
Isolated
Type of Isolation:
Verified
Affected Personnel Informed
Confined Space
Permitted
Personnel Trained
Emergency Rescue Plan
Rescue/Retrieval Equipment (Anklets, Harness, Life Line, etc...…)
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This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.