A-Core Hand Saw - Jobsite Audit

• Branch / Division:

  Select

• Audit Number:

• Audit Title:

• Conducted on:

  Date

• Prepared by:

• Customer / Jobsite Name:
  Address
• Location:
  Address

• List of A-Core Personnel on site?

Service Truck

• Pre-Trip Inspection has been completed and documented

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Service Truck is clean and orderly

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Service Truck has all required Safety items per DOT Regulations (Fire Extinguisher, Triangles, First Aid Kit, Lights, ETC.)

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• SDS Binder is located in truck or on project

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Operator completed a JHA, and communicated all hazards with other A-Core staff on site

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Required Posters/Signs posted and legible

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Measures in place to protect the public or other trades from hazards created by A-Core

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Operator communicated with others in the area that could be exposed to hazards created by A-Core

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• If needed, a SWWP has been developed prior to work starting

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Project has sufficient lighting to work and move around safely

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Hard Hats worn by all A-Core personnel on job

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Eye & Face protection worn as required

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Hearing Protection worn as required

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Safety Toed foot protection worn

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Hand Protection worn as required

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• High Visibility shirt or vest being worn

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Respirator or dust mask used as per Table 1

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

Excavation, Trenching, and Shoring

• Operator is working in an Open Excavation?

  Yes

  No

  N/A

• Excavation is properly shored or sloped as per OSHA Regulations

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Spoils, materials, or equipment set back a minimum of 2' from the edge of excavation

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Trench has legal means of egress? 25 lateral feet from work area

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Workers protected from loose rock or soil

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• If trench boxes or shoring are used, they have been inspected and have proper pinning/bracing

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Excavation is protected according to the soil type

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

Fall Protection

• Job task requires elevated work above 6' from working surface or near a leading edge

  Yes

  No

  N/A

• Operator is utilizing a ladder, scaffold, scissor lift, or boom lift to reach work location

  Yes

  No

  N/A

• The tool or equipment being used to gain elevation has been inspected prior to use

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Operator is using proper Fall Protection

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• The Harness and Lanyard have been inspected prior to use

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Operator has a documented "Fall Rescue Plan" in place

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• The Tie Off point is able to hold a minimum of 5000 lbs per person

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Work area is kept clean and clear of material or debris

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Slurry being created is vacuumed, funneled, and disposed of legally

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Cords & Hoses are strung or routed to prevent trip and fall hazards

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Cords strung or routed to prevent being cut, sliced, crushed, or damaged

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

Electrical

• Tools and power cords have been tested and color coded as per A-Core's Assured Grounding Program

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Ground fault circuit interrupters provided on all temporary electrical circuits

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Extension cords have 3-prong plugs and all 3 prongs are intact

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Electrical cords are inspected and in good working condition (No splices, frays, ground prong missing, cord ends are tight)

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Operator is using the right tool for the job

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Hand tools are maintained and in safe working condition (Hammer, chisel, anchor setter, etc.)

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Rotor Hammer Drills are maintained in safe working condition

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Dustless attachment is utilized on Hammer Drill

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Hammer Drill Bit being used, is the right diameter for anchor size

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Hammer Drill Bit has legal side clearance for safe anchor setting procedure

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Operator is utilizing a Hand Saw

  Yes

  No

  N/A

• Operator is trained to operate saw using safe work practices

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Saw has been inspected prior to use

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Guard is in safe working condition

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Proper Power Source being used to power the saw (GPM, Electricity, Mixed Gasoline)

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Correct blade being used on saw

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• LOTO observed when changing blade

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Operator deemed competent with a Hand Saw

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Operator is utilizing a Ring Saw

  Yes

  No

  N/A

• Operator is trained to operate saw using safe work practices

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Saw has been inspected prior to use

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Saw has been properly maintained (Greased, rollers are adjusted and within spec, etc.)

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Machine guarding in working condition and in place

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Correct power source used to power the saw (GPM, Electricity, Mixed Gasoline)

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• LOTO observed when changing blade or adjusting saw

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Operator is deemed competent with a Ring Saw

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Operator is utilizing a Chain Saw

  Yes

  No

  N/A

• Operator is trained to operate saw using safe work practices

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Saw has been inspected prior to use

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Saw has been properly maintained and is good working condition

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Bar and Chain inspected prior to use

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Correct power source being used to power the saw (GPM, Electricity, Mixed Gasoline)

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• LOTO observed when changing or adjusting bar or chain

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Operator is deemed competent with a Chain Saw

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Operator is following Table 1 chart for Silica Dust Controls

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Integrated Water Delivery system is working properly and providing adequate water supply to blade

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• When Sawing all day in enclosed area with no circulation, Operator is wearing a dust mask or Respirator

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Controls are in place to prevent others from being exposed to Silica Dust created by A-Core

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

Traffic Control

• Proper signs placed so to alert other drivers of construction zone ahead

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• A-Core truck is placed so to help protect worker(s)

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

Utility Strikes

• Saw cutting possesses potential risk of cutting into any utilities

  Yes

  No

  N/A

• Utilities were located prior to saw cutting

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Operator has a safe plan in place to eliminate cutting into utility

  Select Safe / Compliant Level 1 Failure - Must be corrected ASAP Level 2 Failure - Must be corrected within 2 weeks Level 3 Failure - Must be corrected immediately N/A

  • Safe / Compliant
  • Level 1 Failure - Must be corrected ASAP
  • Level 2 Failure - Must be corrected within 2 weeks
  • Level 3 Failure - Must be corrected immediately
  • N/A

• Sub-surface-survey or GPR Scanning completed prior to saw cutting

  Yes

  No

  N/A

• Customer signed our ticket, releasing liability prior to saw cutting operations

  Yes

  No

  N/A

• Operator is prepared and completing project in a safe manner?

• Operator has a positive attitude and is representing the brand well.

• Notes:

• Action Items: