Pre-Task Planning Checklist: Two-Part Spray Foam Application

Date: 2025-07-21

Inspector: [INSPECTOR NAME]

Location/Area: [LOCATION/AREA]

Department: [DEPARTMENT]

Purpose

To ensure a safe work environment and prevent potential hazards associated with the application of two-part spray foam. This checklist is to be completed prior to each application of two-part spray foam.

Instructions for Use

1. 1. Review all checklist items prior to commencing work. 2. Verify each item by visual inspection or other appropriate means. 3. If all items pass, proceed with the task. 4. If any item fails, immediately take corrective action and re-inspect. 5. Document the inspection results and any corrective actions taken.

Frequency

This checklist should be completed: Before each application

Safety Checklist

Hazard Assessment

Item	Pass	Fail	Comments
Review Safety Data Sheets (SDS) for all spray foam components. Check: SDS are present, reviewed, and understood for all components. Ensure that all workers have read and understood the SDS. If failed: Obtain and review SDS before proceeding. Brief all workers on the content of the SDS.			_________________

Personal Protective Equipment (PPE)

Item	Pass	Fail	Comments
Eye protection Check: Safety glasses with side shields or goggles are worn. If failed: Provide and ensure proper use of safety glasses or goggles.			_________________
Skin protection Check: Suitable protective clothing is worn to prevent skin contact. If failed: Provide and ensure proper use of protective clothing, e.g., gloves, long sleeves, and pants.			_________________
Hand protection Check: Chemical-resistant gloves are worn (e.g., Polychloroprene, Nitrile rubber, Butyl rubber, Fluorinated rubber). If failed: Provide and ensure proper use of chemical-resistant gloves.			_________________
Respiratory protection Check: Appropriate respiratory protection is used, if ventilation is insufficient or exposure limits are exceeded. If failed: Provide and ensure proper use of appropriate respiratory protection.			_________________

Environmental Conditions

Item	Pass	Fail	Comments
Ventilation Check: Adequate ventilation is present, especially in confined areas. If failed: Improve ventilation by opening windows/doors or using mechanical ventilation.			_________________
Housekeeping Check: Work area is clean and free of obstructions. If failed: Clear the work area of any obstructions or hazards.			_________________

Equipment and Materials

Item	Pass	Fail	Comments
Spray foam equipment Check: Equipment is in good working order and properly maintained. If failed: Repair or replace faulty equipment.			_________________
Material storage Check: Spray foam components are stored properly, away from heat, sparks, and flames. If failed: Relocate materials to a safe storage area.			_________________

Safe Work Procedures

Item	Pass	Fail	Comments
No eating, drinking, or smoking Check: Eating, drinking, and smoking are prohibited in the work area. If failed: Enforce the no eating, drinking, and smoking policy.			_________________

General Requirements

Item	Pass	Fail	Comments
Emergency contact information is readily available. Check: Emergency contact information is posted and easily accessible. If failed: Post emergency contact information in a visible location.			_________________
First aid kit is available and stocked. Check: A fully stocked first aid kit is available at the work site. If failed: Provide a fully stocked first aid kit.			_________________

Failed Item Procedures

1. 1. Stop work immediately if any checklist item fails. 2. Take corrective action to address the failed item. 3. Re-inspect the item after corrective action. 4. If the item passes after re-inspection, proceed with work. 5. If the item fails after re-inspection, consult with a supervisor before proceeding.

Documentation Requirements

The completed checklist must be documented and retained for future reference.

Checklist Completion

Overall Status: ☐ Pass     ☐ Fail     ☐ Corrective Actions Required

Inspector Signature: Date:

Supervisor Review: Date:

Corrective Actions Completed By: Date:

References and Standards

• Refer to 29 CFR 1910.134 CSA Z94.4 for information on selection and use of appropriate respiratory protection equipment. [1]

This checklist must be retained for [RETENTION PERIOD].

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