Information

  • Company Name

  • Conducted on

  • Prepared by

  • Location
  • Company Contact

  • Company Contact Phone

  • Company Contact Email

  • Owner/ GC/ Sub-tier/ Other

Principal Commitment

  • 1.1 A written safety policy statement signed by a company principal<br> <br>

  • 1.2 Each company must comply with one (1) or more of the following:

  • 1.3 Employ a designated Safety Coordinator/ Manager/ Director:

  • 1.3.1 Safety responsibilities clearly defined in writing

  • 1.3.2 Safety Coordinator must report to executive management of the company

  • 1.3.3 Safety Coordinator attends all management/ project/ safety meetings

  • 1.4 Be active in an AGC Safety Committee

  • 1.5 Participation in the Safety Team audit by a Company Principal

  • 1.6 Principal has been a presenter at an industry safety function

A Written Accident Prevention Program (per WAC-296-155-110) That Addresses:

  • 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

  • 2.2 Location of first aid kits/facilities

  • 2.3 How to report unsafe conditions and practices

  • 2.4 Use and care of personal protective equipment

  • 2.5 Actions to take in the event of emergencies

  • 2.6 Identification of chemical hazards and proper use

  • 2.7 An outline of the company’s overall safety program

  • 2.8 A definition of your company’s safety roles and responsibilities

  • 2.9 Chemical Hazard Communication Training (WAC 296-800-170)

  • 2.10 Fire Prevention Training (WAC 296-155 Part D)

  • 2.11 Fall Protection Training (WAC 296-155 Part C-1)

  • 2.12 Site Specific Training (i.e. confined space)

  • 2.13 In-house or AGC safety classes/ training

  • 2B. A Written Policy on the Following Safety Items:

  • 2.14 Asbestos and Lead Policy

  • 2.15 Assured Grounding Program or Ground-Fault Circuit Interrupter (WAC 296-155-447)

  • 2.16 Bloodborne Pathogen Exposure Policy (WAC 296-823)

  • 2.17 Chemical Hazard Communication Policy (WAC 296-800-170)

  • 2.18 Confined Space Policy (WAC 296-809)

  • 2.19 Crane Usage Policy

  • 2.20 Disciplinary procedures & enforcement of health & safety rules for Subcontractors & Employees

  • 2.21 Emergency procedure plan

  • 2.22 Employee Safety Concerns Procedure

  • 2.23 Fall Protection Policy (WAC 296-155 Part C-1)

  • 2.24 Fire Prevention Policy (WAC 296-155 Part D)

  • 2.25 Hearing Loss Prevention Program (WAC 296-817)

  • 2.26 Heat Stress Program (WAC 296-62-095)

  • 2.27 Lock-out/Tag-out Policy (WAC 296-803)

  • 2.28 Motorized Vehicle/Fleet Safety Policy (WAC 296-155 Part M)

  • 2.29 Respiratory Protection Policy (WAC 296-842)

  • 2.30 Trenching & Shoring Policy (WAC 296-155 Part N)

  • 2.31Workplace Violence Policy

First Aid/CPR & Record Keeping

  • 3. All Supervisors’ First Aid/CPR cards checked at start of all new projects

  • 3.1 Certification information for employees are tracked and on file

  • 3.2 OSHA 300

Accident Investigations and Reports

  • 4. Reporting procedures are clarified at the time of hire (see Orientation Checklist)

  • 4.1 Investigation procedures for “near misses”

  • 4.2 Investigations are conducted in 24 hours

  • 4.3 Investigations are documented on a company report form

  • 4.4 Investigations of accidents & “near misses” are discussed during weekly safety meeting<br><br>

Substance Abuse

  • 5. A written Drug & Alcohol Policy, reflecting current company policies

  • 5.1 Drug Testing (optional) For example: Pre-employment, post-accident, for-cause, random, DOT

Participation

  • 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)

  • 7. AGC RETRO PARTICIPANT

  • 7.1 Written Return-to-Work Program

  • 7.2 Written Light Duty job descriptions

  • 7.3 Documentation of supervisory training in Return-to-Work criteria

  • 7.4 Top management commitment to a Return-to-Work program

Safety Management Items/ Jobsite

  • 8.0 Accident prevention program on site

  • 8.1 Job Hazard Analysis

  • 8.2 Hazard Communication (MSDS)

  • 8.3 Confined Space Permit

  • 8.4 Fall Protection Work Plan

  • 8.5 Complete inspection forms: Assured Grounding/GFCI Program

  • 8.6 Weekly Jobsite Inspection Forms

  • 8.7 Weekly Toolbox Meeting Minutes

  • 8.8 Site Specific Safety Plan

  • 8.9 Cranes documentation:

  • 8.9.a Crane Operator Certification and hours

  • 8.9.b Crane Certification with proof of load testing

  • 8.9.c Certifier Certification

  • 8.9.d Rigger Qualification (by Type)

  • 8.9.e Signal Person Qualification

  • 8.10 WAC Standards for construction located on worksite

  • 8.11 Safety Bulletin Board with required posting

  • 8.12 Emergency phone numbers posted

  • 8.13 OSHA 300A (Posted February through April)

  • 8.14 First Aid/CPR training certification cards (Superintendents, Foremen)

Employee Facilities/ Jobsite

  • 9.0 Toilet

  • 9.1 Wash area with temperate water/ Sanitizer

  • 9.2 Dry shack - lunch room

  • 9.3 Above listed facilities clean and sanitary

Jobsite Protective Equipment/ Jobsite

  • 10.0 First aid kit suitable for crew size (office, dry shack, tool van)

  • 10.1 Fire protection (extinguisher date and type correct for situation)

Housekeeping/ Jobsite

  • 11.0 Work Areas clean and orderly

  • 11.1 Deck free of: protruding nails, holes, loose boards

  • 11.2 Aisles and walkways clear of obstructions

  • 11.3 Guardrails in place where required

  • 11.4 Trash chute for over 20’ heights

Required Personal Protectice Equipment/ Jobsite

  • 12.0 Head Protection - hard hats

  • 12.1 Hearing protection - ear plugs<br>Sound Level Meter: _____dB reading <br>

  • 12.2 Leg protection - chain saw chaps

  • 12.3 Foot protection - work boots

  • 12.4 Eye and face protection - safety glasses

  • 12.5 Respiratory protection - mask dependent on exposure

  • 12.6 Fall protection - safety harness, lanyards

  • 12.7 Reflective Clothing- vest, 360 degrees

General Jobsite Safety Items/ Jobsite

  • 13.0 Office trailer step railings

  • 13.1 Only approved ladders in use (and secured)

  • 13.2 Machine guards in place (saws, grinding wheels, etc.)

  • 13.3 All power equipment is properly grounded

  • 13.4 Extension cords and power equipment checked for shorts

  • 13.5 Compressed gas cylinders in secured storage area

  • 13.6 Fuel gas stored at a minimum of 20 feet from compressed gas cylinders

  • 13.7 Flash back protectors for oxygen-acetylene torches in place/use

  • 13.8 Proper access/egress for trenches more than 4 feet deep

  • 13.9 Gas and diesel fuel stored in approved and properly marked safety cans

  • 13.10 Proper barricades around pinch point exposure area (revolving cranes)

  • 13.11 Proper Scaffold erection and usage

  • 13.12 Back-up alarms on appropriate motorized equipment

  • 13.13 Seat-belt Usage

  • 13.14 Provisions for public safety

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