Information

  • Document No.

  • Member

  • Project

  • Superintendent

  • Date/Time

  • Prepared by

  • Location

Administration

  • State & Federal postings are in place

  • OSHA Notice / 300 Log

  • Emergency Telephone #'s and directions to clinics & hospitals posted

  • First Aid Kit/Blood Spill Kits in place and fully stocked

  • First aid & CPR trained employee on site

  • Toolbox Talks/Safety Meetings Documented

Aerial/Scissors Lifts

  • Daily inspections

  • Proper use, maintenance

  • Fall protection in place

Communication

  • Pre-task planning

  • Pre-con meeting conducted

Concrete/masonry

  • All impalement hazards addressed

  • Limited access zones in place

  • Wall bracing in place

  • Engineering controls in place (water, ventilation, vacuum)

Confined Space

  • Competent Person evaluated permit and non-permit spaces

  • Air monitor on site (properly calibrated and used)

  • Atmosphere test results documented

  • Energy sources locked out

  • Adequate ventilation

  • Rescue plan in place

Cranes, Rigging, Signaling

  • Daily, monthly, annual inspections

  • Qualified rigger/signal person

  • Swing radius controlled

  • Critical lift plan

  • Rigging inspected, tags in place, damage free, stored properly

  • Overhead power line plan in place and training provided

  • Crane signals posted in immediate work area

Demolition

  • Engineering survey completed

  • All utilities located and disconnected/marked

  • Work area and structure adequately guarded and supported

  • Airborne particulates controlled/monitored

Electrical

  • GFCI and/or Assured Grounding in use

  • Cords condition / grounding

  • Damaged equipment tagged/removed from service

  • Good work practices (cords out of pathways, kept out of water, etc.)

  • Temp lighting adequate and good condition

  • Live parts properly guarded (panel covers, box covers, etc)

  • Lockout/Tagout

  • NFPA 70 E work practices in place

Excavations

  • Overhead & Underground utilities located

  • Competent person inspection documented daily

  • Access/Egress provided

  • Utilities protected/supported

  • Spoil piles, equipment and materials minimum of 2' from edge of excavation

Fall Protection

  • Proper fall protection at 6' or greater

  • Fall protection equipment inspected

  • Personnel below are protected from falling objects

  • Roof fall hazards addressed

  • Warning lines

  • Open sided floors or platforms 6' or more from ground equipped with proper guardrail

  • Hole covers in place secured and marked appropriately

  • Openings properly barricaded or covered

  • Stairs equipped with handrails

  • Slips/trips/fall issues addressed

  • Snow/ice/mud managed

  • Protective system

Fire protection and housekeeping

  • Housekeeping maintained regularly

  • Materials stacked properly, lumber is free of protruding nails

  • Aisles, stairwells, passageways clear

  • Flammable/combustibles stored and handled safely

  • Fire ext. properly located and inspected monthly

  • All vehicles & other mobile equipment provided with fire protection

  • LP cylinders stored outdoors

  • Approved safety gas cans

  • No smoking signs posted

  • Adequate lanes for emergency vehicle access

Hand/Power Tools

  • Tools inspected and maintained

  • Guards/safety features maintained

  • Compressed air lines secured

  • Proper tool for the job being used

Health and Hazard Communication

  • Employees trained

  • Updated SDS book on site

  • Containers properly labeled

  • Spills cleaned up appropriately

  • Asbestos risks assessed and addressed

  • Lead risks assessed and addressed

  • Silica exposures assessed and controlled

  • Carbon monoxide monitored/exhaust ventilated

  • Other hazardous materials identified and risks controlled

  • Heat/Cold exposures addressed

  • Drinking water available

Ladders

  • Ladders inspected/no defects

  • Ladders properly used

Mobile Equipment/Material Handling

  • Back-up alarms

  • Daily inspections conducted

  • Trained operators

  • Seat belts & rollover protection in place

  • Loads not flown over people

  • Tag lines used as necessary

PPE

  • Appropriate clothing in use

  • Head protection

  • Eye & Face protection

  • Hand protection

  • Hearing protection

  • Proper work boots

  • High visibility clothing

  • FR clothing (welding, arc flash)

  • Respiratory protection

  • Other PPE being used properly (protective sleeves and cut resistant gloves during demo)

Scaffolding

  • Set up & used properly

  • Proper access

  • Inspected before use

  • Secured/tied/guys in place @4:1

  • Fall protection in place all open sides and edges

  • Mobile Scaffolds set up & used properly

Welding, Cutting, & Cylinders

  • Compressed gas cylinders stored and secured upright

  • Cylinders capped when not in use

  • Cylinders, hoses, regulators free from damage

  • Welding screens provided

  • Engineering controls in place (ventilation, fume eaters, fresh air)

  • PPE provided

  • Equipment in good repair, insulators, grounding, welding leads

  • Hot work permits in place

  • Fire watch in place

Notes

  • Notes

Signatures

  • Safety Evaluator

  • Project Superintendent

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