Information
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Job number & Name
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Conducted on
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Prepared by
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Location Address
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Forman/Mechanic-in-Charge
Instructions
Employee PPE
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The intent of this survey is to create a safe work place for your employees. If a hazard is found, mark it as "At Risk" and note the remediation in the comments section. Also, document the violation by photograph and insert into this survey. Be sure to inform the contractor of any safety issues involving his work or the work of other trades.<br><br>Forward a copy of this survey to FQA (Ivan Andrews) and to your local Safety commmittee chairman. if you understand these instruction marke "yes" and begin the survey.
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Employees are wearing hard hats during work where required.
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Employee are wearing eye and hand protection when working.
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Face shields are available for use.
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Workers are wearing foot protection with an EH rating.
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Employee company safety training is current.
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Safety bag does not require replenishment of missing or lost items.
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First aid kit available and not expired.
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Fall harness is damage free and inspection is current.
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Lockout/tagout kit available for use.
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Jumper kit parts all accounted for and available for use.
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Are employee PPE (hard hat), uniforms (FOR THOSE UNIFORMS THAT WERE SEEN) free from graffiti, stickers, writings, and images other than the Mitsubishi Electric logo, IUEC sticker and manufacturer logo for the item in question?
Documentation
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The IIPP and Safety Handbook are available for review (hard copy or digital).
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Safety Data Sheets (SDS) are available for reference (hard copy or digital).
Task Area Lighting
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Task area lighting adequate and functioning.
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Hoistway pit lighting adequate.
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Machine room has adequate lighting.
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Service technician has backup lighting (work light).
Fall Protection
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Barricades and screening barriers (exclusion zones) in place when required).
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All identified fall hazards have been eliminated and properly addressed.
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Fall protection devices are in good condition and available for use.
Work Area
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Work area is clean, free of unnecessary tripping hazards.
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Machine room door is self-closing.
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All lubricants and flammable liquids are clearly marked and safely stored.
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Used rags, oils, cleaners, and paints are properly disposed of.
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Has the property owner or property manager created any hazards?
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Are the elevator staging/gang box areas and elevator employee break areas (if applicable) free of any offensive graffiti, stickers, writing, images, items or other material?
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Reminded employees to take their meal breaks timely and to be sure to take their morning and afternoon rest breaks.
Energized Panels and Disconnects
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All machine guards in place where required.
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Disconnects clearly marked and able to be locked out if required.
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Lock out/tag out in use where required.
Vehicle
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Employee work vehicle free from graffiti, stickers, writings, and images other than the Mitsubishi Electric logo and manufacturer logo for the item in question
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Company issued vehicle has insurance and registration information.
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Company issued vehicle is damage free (if not list damage below).
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Company vehicle has current emergency accident packet.
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Maintenance is current.
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Seat belts are functional.
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Vehicle lights, signal indicators and break lights are working properly.
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Tires have adequate tread available (not balding).
