Information
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Company Name
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Conducted on
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Prepared by
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Location
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Company Contact
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Company Contact Phone
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Company Contact Email
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Owner/ GC/ Sub-tier/ Other
Principal Commitment
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1.1 A written safety policy statement signed by a company principal<br> <br>
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1.2 Each company must comply with one (1) or more of the following:
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1.3 Employ a designated Safety Coordinator/ Manager/ Director:
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1.3.1 Safety responsibilities clearly defined in writing
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1.3.2 Safety Coordinator must report to executive management of the company
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1.3.3 Safety Coordinator attends all management/ project/ safety meetings
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1.4 Be active in an AGC Safety Committee
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1.5 Participation in the Safety Team audit by a Company Principal
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1.6 Principal has been a presenter at an industry safety function
A Written Accident Prevention Program (per WAC-296-155-110) That Addresses:
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2A. A Written New Hire Orientation that Contains the Following Items
(each item must be itemized in a written format): -
2.1 How, where, and when to report injuries
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2.2 Location of first aid kits/facilities
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2.3 How to report unsafe conditions and practices
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2.4 Use and care of personal protective equipment
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2.5 Actions to take in the event of emergencies
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2.6 Identification of chemical hazards and proper use
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2.7 An outline of the company’s overall safety program
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2.8 A definition of your company’s safety roles and responsibilities
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2.9 Chemical Hazard Communication Training (WAC 296-800-170)
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2.10 Fire Prevention Training (WAC 296-155 Part D)
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2.11 Fall Protection Training (WAC 296-155 Part C-1)
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2.12 Site Specific Training (i.e. confined space)
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2.13 In-house or AGC safety classes/ training
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2B. A Written Policy on the Following Safety Items:
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2.14 Asbestos and Lead Policy
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2.15 Assured Grounding Program or Ground-Fault Circuit Interrupter (WAC 296-155-447)
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2.16 Bloodborne Pathogen Exposure Policy (WAC 296-823)
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2.17 Chemical Hazard Communication Policy (WAC 296-800-170)
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2.18 Confined Space Policy (WAC 296-809)
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2.19 Crane Usage Policy
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2.20 Disciplinary procedures & enforcement of health & safety rules for Subcontractors & Employees
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2.21 Emergency procedure plan
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2.22 Employee Safety Concerns Procedure
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2.23 Fall Protection Policy (WAC 296-155 Part C-1)
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2.24 Fire Prevention Policy (WAC 296-155 Part D)
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2.25 Hearing Loss Prevention Program (WAC 296-817)
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2.26 Heat Stress Program (WAC 296-62-095)
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2.27 Lock-out/Tag-out Policy (WAC 296-803)
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2.28 Motorized Vehicle/Fleet Safety Policy (WAC 296-155 Part M)
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2.29 Respiratory Protection Policy (WAC 296-842)
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2.30 Trenching & Shoring Policy (WAC 296-155 Part N)
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2.31Workplace Violence Policy
First Aid/CPR & Record Keeping
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3. All Supervisors’ First Aid/CPR cards checked at start of all new projects
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3.1 Certification information for employees are tracked and on file
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3.2 OSHA 300
Accident Investigations and Reports
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4. Reporting procedures are clarified at the time of hire (see Orientation Checklist)
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4.1 Investigation procedures for “near misses”
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4.2 Investigations are conducted in 24 hours
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4.3 Investigations are documented on a company report form
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4.4 Investigations of accidents & “near misses” are discussed during weekly safety meeting<br><br>
Substance Abuse
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5. A written Drug & Alcohol Policy, reflecting current company policies
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5.1 Drug Testing (optional) For example: Pre-employment, post-accident, for-cause, random, DOT
Participation
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6. Participation in at Least One Construction Safety Activity by One or More Employees: (For example: AGC Safety Symposiums, AGC Safety Committee meetings, ASSE meetings or seminars, Puget Sound Safety Summit meetings, Seattle Vicinity Construction Safety Council meetings, or Evergreen Safety Council)
Return-to-Work Program (Optional)
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7. AGC RETRO PARTICIPANT
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7.1 Written Return-to-Work Program
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7.2 Written Light Duty job descriptions
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7.3 Documentation of supervisory training in Return-to-Work criteria
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7.4 Top management commitment to a Return-to-Work program
Safety Management Items/ Jobsite
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8.0 Accident prevention program on site
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8.1 Job Hazard Analysis
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8.2 Confined Space Permit
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8.3 Fall Protection Work Plan
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8.4 Complete inspection forms: Assured Grounding/GFCI Program
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8.5 Weekly Jobsite Inspection Forms
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8.6 Weekly Toolbox Meeting Minutes
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8.7 Site Specific Safety Plan
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8.8 Cranes documentation:
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8.8.a Crane Operator Certification and hours
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8.8.b Crane Certification with proof of load testing
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8.8.c Certifier Certification
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8.8.d Rigger Qualification (by Type)
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8.8.e Signal Person Qualification
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8.9 WAC Standards for construction located on worksite
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8.10 Safety Bulletin Board with required posting
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8.11 Emergency phone numbers posted
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8.12 OSHA 300A (Posted February through April)
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8.13 First Aid/CPR training certification cards (Superintendents, Foremen)
Employee Facilities/ Jobsite
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9.0 Toilet
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9.1 Wash area with temperate water/ Sanitizer
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9.2 Dry shack - lunch room
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9.3 Above listed facilities clean and sanitary
Jobsite Protective Equipment/ Jobsite
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10.0 First aid kit suitable for crew size (office, dry shack, tool van)
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10.1 Fire protection (extinguisher date and type correct for situation)
Housekeeping/ Jobsite
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11.0 Work Areas clean and orderly
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11.1 Deck free of: protruding nails, holes, loose boards
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11.2 Aisles and walkways clear of obstructions
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11.3 Guardrails in place where required
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11.4 Trash chute for over 20’ heights
Required Personal Protectice Equipment/ Jobsite
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12.0 Head Protection - hard hats
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12.1 Hearing protection - ear plugs<br>Sound Level Meter: _____dB reading <br>
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12.2 Leg protection - chain saw chaps
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12.3 Foot protection - work boots
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12.4 Eye and face protection - safety glasses
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12.5 Respiratory protection - mask dependent on exposure
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12.6 Fall protection - safety harness, lanyards
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12.7 Reflective Clothing- vest, 360 degrees
General Jobsite Safety Items/ Jobsite
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13.0 Office trailer step railings
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13.1 Only approved ladders in use (and secured)
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13.2 Machine guards in place (saws, grinding wheels, etc.)
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13.3 All power equipment is properly grounded
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13.4 Extension cords and power equipment checked for shorts
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13.5 Compressed gas cylinders in secured storage area
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13.6 Fuel gas stored at a minimum of 20 feet from compressed gas cylinders
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13.7 Flash back protectors for oxygen-acetylene torches in place/use
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13.8 Proper access/egress for trenches more than 4 feet deep
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13.9 Gas and diesel fuel stored in approved and properly marked safety cans
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13.10 Proper barricades around pinch point exposure area (revolving cranes)
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13.11 Proper Scaffold erection and usage
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13.12 Back-up alarms on appropriate motorized equipment
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13.13 Provisions for public safety