1397 Site Safety Inspection - duplicate

• Conducted on:

  Date

• Site:

• Prepared By:

• Site Supervisor:

PPE

• Hard hats meeting Z89.1-1669 standard and high visibility clothing is being worn by everyone onsite?

  Yes

  No

  Partially

  N/A

• Safety glasses meeting Z87.1-1968, hearing protection, and gloves are available and being used when applicable?

  Yes

  No

  Partially

  N/A

• Safety-toed footwear meeting Z41.1-1967 is being worn by everyone onsite?

  Yes

  No

  Partially

  N/A

• Are personal fall arrest systems available to all employees required to work at elevations over 6 feet?

  Yes

  No

  Partially

  N/A

• Are dust masks or respirators available for any workers doing potentially silica dust producing activities?

  Yes

  No

  Partially

  N/A

• Comments/Corrective Actions

Site Hazards

• Is the site in generally orderly condition (minimal trip, slip and fall hazards, temporary fencing secured, stockpiled material stored safely)?

  Yes

  No

  Partially

  N/A

• Do workers have access to clean drinking water?

  Yes

  No

  Partially

  N/A

• Are potential impalement hazards capped or turned to face in a harmless direction?

  Yes

  No

  Partially

  N/A

• Are traffic control measures in place?

  Yes

  No

  Partially

  N/A

• If so, have they been inspected within the work week?

  Yes

  No

  Partially

  N/A

• Are underground utility markers intact and plainly visible?

  Yes

  No

  Partially

  N/A

• Are overhead lines being kept a minimum 10 feet from all work activities occurring? (excavator arms included)

  Yes

  No

  Partially

  N/A

• Are all fuels and other flammable chemicals being stored properly?

  Yes

  No

  Partially

  N/A

• Is there adequate fire extinguishers onsite?

  Yes

  No

  N/A

• Has the monthly inspection been performed and inspection tag filled out?

  Yes

  No

  Partially

  N/A

• Is there a first aid kit and eyewash bottles onsite?

  Yes

  No

  N/A

• Are all components inside within their expiration date?

  Yes

  No

  Partially

  N/A

• Are proper shoring/benching/sloping practices being used for all trenches over 5 feet?

  Yes

  No

  Partially

  N/A

• Are spoil piles being kept at least 24” back from the edge of the excavation?

  Yes

  No

  N/A

• Are road plates in use positioned to allow 18” of contact with the road on either side?

  Yes

  No

  Partially

  N/A

• Are proper lockout/tagout procedures being followed?

  Yes

  No

  Partially

  N/A

• Comments/Corrective Actions

Tools and Equipment

• Are all hand tools in good working order? (Free from frayed or exposed wires and damaged mechanisms)

  Yes

  No

  Partially

  N/A

• Is all masonry cutting and grinding being done with water?

  Yes

  No

  Partially

  N/A

• If so, is a respirator being used by the operator?

  Yes

  No

  Partially

  N/A

• Are working, tested GFCI’s being used for all plug-in hand tools?

  Yes

  No

  Partially

  N/A

• Are all extension cords free of fraying/exposed wires?

  Yes

  No

  Partially

  N/A

• Are all ladders in good repair and being used properly?

  Yes

  No

  Partially

  N/A

• Are all pieces of equipment in good working order?

  Yes

  No

  Partially

  N/A

• Has an equipment inspection form been completed for all pieces of equipment used this week?

  Yes

  No

  Partially

  N/A

• Do all operators have their licenses on their person?

  Yes

  No