AEP Site Safety Observation Report

• Job Number

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Superintendent/Foreman

Efficiencies

• Adequate staging of materials.

  Yes

  No

  N/A

• Employee emergency access/egress maintained.

  Yes

  No

  N/A

• Utilization of equipment.

  Yes

  No

  N/A

• Other areas for improvement.

Environmental

• Chemicals stored properly?

  Yes

  No

  N/A

• Spill kits available?

  Yes

  No

  N/A

• Erosion/Sediment & runoff controlled?

  Yes

  No

  N/A

• Rock Entrance?

  Yes

  No

  N/A

Excavation/Trench

• Competent Person

• Excavation/Trench Safety Checklist Complete?

  Yes

  No

  N/A

• Properly benched/sloped or shored?

  Safe

  At Risk

  N/A

• Access/Egress within 25ft.?

  Yes

  No

  N/A

• Spoils properly placed from edge of excavation/trench?

  Yes

  No

  N/A

Fire Prevention

• Proper storage of flammable materials?

  Yes

  No

  N/A

• Extinguishers tagged and inspected?

  Yes

  No

  N/A

• Compressed gas cylinders separated & secured?

  Yes

  No

  N/A

• Hot work permit completed?

  Yes

  No

  N/A

Traffic Control

• Proper approach signs?

  Yes

  No

  N/A

• Transition area?

  Yes

  No

  N/A

• Equipment

  Select Radios Paddles Hi-Viz Vests

  • Radios
  • Paddles
  • Hi-Viz Vests

Hoisting/Rigging Equipment

• Is the correct rigging system used?

  Yes

  No

  N/A

• Condition of rigging hardware

  New

  Fair

  Needs replaced

  Good

Housekeeping

• Good appearance?

  Yes

  No

  N/A

• Proper trash disposal?

  Yes

  No

  N/A

• Prevention of slips/trips/ falls?

  Yes

  No

  N/A

Ladders

• Correct ladder for the task?

  Yes

  No

  N/A

• Ladder set at proper angle?

  Yes

  No

  N/A

• Ladder secured?

  Yes

  No

  N/A

• Condition of ladder

  New

  Fair

  Needs replaced

  Good

Mobile Equipment

• Operation of equipment.

  Safe

  At Risk

  N/A

• Proximity to employees.

  Safe

  At Risk

  N/A

• Equipment inspected

  Yes

  No

  N/A

• Back-up alarms operational?

  Yes

  No

  N/A

• Condition of equipment.

  Safe

  At Risk

  N/A

PPE

• PPE used for task

  Select Hard hats Safety glasses Respirators Gloves Face shields Earplugs Hi-Viz Reflective Vest Safety Toed Work Boots Chainsaw Chaps FR Clothing

  • Hard hats
  • Safety glasses
  • Respirators
  • Gloves
  • Face shields
  • Earplugs
  • Hi-Viz Reflective Vest
  • Safety Toed Work Boots
  • Chainsaw Chaps
  • FR Clothing

Tools & Equipment

• Condition of electrical cords.

  New

  Fair

  Needs replaced

  Good

• Condition of hand tools and power.

  New

  Fair

  Needs replaced

  Good

• Guards on tools & equipment?

  Yes

  No

  N/A

Welding

• Proper guards?

  Yes

  No

  N/A

• PPE

  Select Safety glasses Welding helmet Faceshield Gloves

  • Safety glasses
  • Welding helmet
  • Faceshield
  • Gloves

• Condition of welding leads

  New

  Fair

  Needs replaced

  Good

• Hot work permit completed?

  Yes

  No

  N/A

• Fire extinguisher readily available?

  Yes

  No

  N/A

• Area free of combustibles?

  Safe

  At Risk

  N/A

• Fire watch in place?

  Yes

  No

  N/A

Observations to Initiate Improvement

• Pre-Job Plan/Inspect.

  Safe

  At Risk

  N/A

• Proper Tool for the Job.

  Safe

  At Risk

  N/A

• Line of Fire.

  Safe

  At Risk

  N/A

• Eyes on Path.

  Safe

  At Risk

  N/A

• Protective Equipment/PPE.

  Safe

  At Risk

  N/A

• Housekeeping.

  Safe

  At Risk

  N/A

Safety Task Daily Debriefing

• Was today incident free?

  Yes

  No

  N/A

• Explain Below.

• Was the JSA / Review Completed?

  Yes

  No

  N/A

Corrective Actions

• If any, please state corrective action(s) to be implemented on this site.

Comments

• Please list any comments you have for this site.

Surveyor's Name

• Surveyor's Name

• Surveyor's Signature

  Sign