Information
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Document No.
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Member
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Project
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Superintendent
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Date/Time
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Prepared by
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Location
Administration
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State & Federal postings are in place
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OSHA Notice / 300 Log
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Emergency Telephone #'s and directions to clinics & hospitals posted
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First Aid Kit/Blood Spill Kits in place and fully stocked
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First aid & CPR trained employee on site
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Toolbox Talks/Safety Meetings Documented
Aerial/Scissors Lifts
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Daily inspections
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Proper use, maintenance
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Fall protection in place
Communication
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Pre-task planning
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Pre-con meeting conducted
Concrete/masonry
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All impalement hazards addressed
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Limited access zones in place
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Wall bracing in place
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Engineering controls in place (water, ventilation, vacuum)
Confined Space
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Competent Person evaluated permit and non-permit spaces
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Air monitor on site (properly calibrated and used)
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Atmosphere test results documented
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Energy sources locked out
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Adequate ventilation
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Rescue plan in place
Cranes, Rigging, Signaling
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Daily, monthly, annual inspections
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Qualified rigger/signal person
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Swing radius controlled
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Critical lift plan
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Rigging inspected, tags in place, damage free, stored properly
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Overhead power line plan in place and training provided
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Crane signals posted in immediate work area
Demolition
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Engineering survey completed
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All utilities located and disconnected/marked
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Work area and structure adequately guarded and supported
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Airborne particulates controlled/monitored
Electrical
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GFCI and/or Assured Grounding in use
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Cords condition / grounding
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Damaged equipment tagged/removed from service
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Good work practices (cords out of pathways, kept out of water, etc.)
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Temp lighting adequate and good condition
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Live parts properly guarded (panel covers, box covers, etc)
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Lockout/Tagout
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NFPA 70 E work practices in place
Excavations
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Overhead & Underground utilities located
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Competent person inspection documented daily
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Access/Egress provided
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Utilities protected/supported
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Spoil piles, equipment and materials minimum of 2' from edge of excavation
Fall Protection
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Proper fall protection at 6' or greater
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Fall protection equipment inspected
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Personnel below are protected from falling objects
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Roof fall hazards addressed
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Warning lines
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Open sided floors or platforms 6' or more from ground equipped with proper guardrail
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Hole covers in place secured and marked appropriately
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Openings properly barricaded or covered
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Stairs equipped with handrails
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Slips/trips/fall issues addressed
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Snow/ice/mud managed
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Protective system
Fire protection and housekeeping
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Housekeeping maintained regularly
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Materials stacked properly, lumber is free of protruding nails
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Aisles, stairwells, passageways clear
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Flammable/combustibles stored and handled safely
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Fire ext. properly located and inspected monthly
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All vehicles & other mobile equipment provided with fire protection
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LP cylinders stored outdoors
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Approved safety gas cans
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No smoking signs posted
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Adequate lanes for emergency vehicle access
Hand/Power Tools
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Tools inspected and maintained
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Guards/safety features maintained
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Compressed air lines secured
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Proper tool for the job being used
Health and Hazard Communication
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Employees trained
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Updated SDS book on site
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Containers properly labeled
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Spills cleaned up appropriately
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Asbestos risks assessed and addressed
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Lead risks assessed and addressed
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Silica exposures assessed and controlled
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Carbon monoxide monitored/exhaust ventilated
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Other hazardous materials identified and risks controlled
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Heat/Cold exposures addressed
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Drinking water available
Ladders
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Ladders inspected/no defects
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Ladders properly used
Mobile Equipment/Material Handling
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Back-up alarms
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Daily inspections conducted
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Trained operators
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Seat belts & rollover protection in place
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Loads not flown over people
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Tag lines used as necessary
PPE
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Appropriate clothing in use
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Head protection
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Eye & Face protection
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Hand protection
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Hearing protection
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Proper work boots
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High visibility clothing
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FR clothing (welding, arc flash)
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Respiratory protection
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Other PPE being used properly (protective sleeves and cut resistant gloves during demo)
Scaffolding
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Set up & used properly
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Proper access
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Inspected before use
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Secured/tied/guys in place @4:1
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Fall protection in place all open sides and edges
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Mobile Scaffolds set up & used properly
Welding, Cutting, & Cylinders
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Compressed gas cylinders stored and secured upright
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Cylinders capped when not in use
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Cylinders, hoses, regulators free from damage
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Welding screens provided
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Engineering controls in place (ventilation, fume eaters, fresh air)
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PPE provided
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Equipment in good repair, insulators, grounding, welding leads
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Hot work permits in place
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Fire watch in place
Notes
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Notes
Signatures
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Safety Evaluator
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Project Superintendent
