AEP Site Safety Observation Report (2022)

• Job Number

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Superintendent/Foreman

  Radios

  Paddles

  Hi-Viz Vests

Atmospheric Monitoring

• Is a gas monitor required for work being performed?

  Yes

  N/A

  No

• Is the gas monitor calibrated and in good working order?

  Yes

  N/A

  No

• Has a bump test been performed?

  Yes

  N/A

  No

Cranes/Critical Lifts

• Has a lift plan been completed?

  Yes

  N/A

  No

• Is the annual inspection for the crane completed?

  Yes

  N/A

  No

• Does the operator have the valid and applicable certification?

  Yes

  N/A

  No

• Has a daily inspection been completed?

  Yes

  N/A

  No

• Is a spotter/signal person in place?

  Yes

  N/A

  No

• Are alarms working and audible?

  Yes

  N/A

  No

• Has the lifting capacity and work to be performed been verified?

  Yes

  N/A

  No

• Is the proper rigging being utilized and inspected prior to use?

  Yes

  N/A

  No

Electrical Hazards

• Are electrical cords and extension cords in good condition?

  New

  Good

  Fair

  Remove from Service

  N/A

• Overhead electrical lines and cables clearly identified and safety work distances maintained?

  Yes

  N/A

  No

• GFCIs used where required?

  Yes

  N/A

  No

Excavation/Trench

• Competent Person

• Has the competent person completed a trench/excavation inspection?

  Yes

  N/A

  No

• Properly benched/sloped or shored when exceeding 5 ft. in depth?

  Yes

  N/A

  No

• Is there safe access/egress when exceeding 4 ft. in depth?

  Yes

  N/A

  No

• Access/Egress within 25ft.?

  Yes

  N/A

  No

• Spoil material at least 2 ft. from edge of the excavation?

  Yes

  N/A

  No

• Have underground utility installations been identified and safely excavated?

  Yes

  N/A

  No

• Are open excavations protected when necessary?

  Yes

  N/A

  No

Fire Prevention

• Is the fire extinguisher inspected for the current month?

  Yes

  N/A

  No

• Is the fire extinguisher annual inspection current?

  Yes

  N/A

  No

• Does the fire extinguisher appear to be in good working order, charged and free of damage?

  Yes

  N/A

  No

• Are fire extinguishers properly located and mounted?

  Yes

  N/A

  No

• Compressed gas cylinders separated & secured?

  Yes

  N/A

  No

• Proper storage of flammable materials? Approved Containers?

  Yes

  N/A

  No

• Are fuel tanks properly grounded?

  Yes

  N/A

  No

Hand & Power Tools

• Condition of hand tools and power.

  New

  Good

  Fair

  Remove from Service

  N/A

• Are all tools being used for their intended use?

  Yes

  N/A

  No

• Guards on tools & equipment?

  Yes

  N/A

  No

Hoisting/Rigging Equipment

• Is the correct rigging system used?

  Yes

  N/A

  No

• Is there a permanently affixed and legible identification to indicate SWL?

  Yes

  N/A

  No

• Condition of rigging hardware

  New

  Good

  Fair

  Remove from Service

  N/A

Hot Work/Welding

• Is proper PPE being worn for welding, cutting, grinding, etc. activities?

  Select Yes N/A No

  • Yes
  • N/A
  • No

• Are all employees wearing FR Clothing?

  Yes

  N/A

  No

• Condition of welding leads

  New

  Good

  Fair

  Remove from Service

  N/A

• Is a Hot Work Permit completed?

  Yes

  N/A

  No

• Is a dedicated Fire Watch in Place?

  Yes

  N/A

  No

• Area free of combustibles?

  Safe

  At Risk

  N/A

Housekeeping

• Good appearance?

  Yes

  N/A

  No

• Proper trash disposal?

  Yes

  N/A

  No

• Prevention of slips/trips/ falls?

  Yes

  N/A

  No

Ladders

• Is the ladder appropriate for the task?

  Yes

  N/A

  No

• Is the ladder set at proper angle?

  Yes

  N/A

  No

• Is the ladder extending 3' beyond the work surface or leading edge?

  Yes

  N/A

  No

• Is the ladder adequately secured to prevent movement?

  Yes

  N/A

  No

• Condition of the ladder

  New

  Good

  Fair

  Remove from Service

  N/A

Mobile Equipment/Vehicle Safety

• Operation of equipment and vehicles.

  Safe

  At Risk

  N/A

• Condition of equipment.

  Safe

  At Risk

  N/A

• Seat belts being worn while operating equipment?

  Yes

  N/A

  No

• Are vehicles/equipment left running and unattended?

  Yes

  N/A

  No

• Is equipment properly secured when not in use? (Attachments grounded, brake engaged, parked in safe location, etc.)

  Yes

  N/A

  No

• Proximity to employees. Are spotters in place?

  Yes

  N/A

  No

• Has the operator performed a daily inspection?

  Yes

  N/A

  No

• Back-up alarms operational?

  Yes

  N/A

  No

• Are vehicle wheels chocked when parked on grade?

  Yes

  N/A

  No

• Are vehicles in good condition or free from creating additional hazards?

  Yes

  N/A

  No

• Are vehicles or equipment being loaded beyond their capacity?

  Yes

  N/A

  No

• Load Securement

  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

• Are all employees wearing appropriate PPE required for the task and work location?

  Yes

  N/A

  No

• Is all PPE in good condition and being worn properly?

  Yes

  N/A

  No

Traffic Control

• Is traffic control being performed by a subcontractor?

  Yes

  N/A

  No

• Are approach signs in place and adequate for work activities?

  Yes

  N/A

  No

• Is proper communication being utilized?

  Yes

  N/A

  No

• Is a transition area and work zone delineation properly set up?

  Yes

  N/A

  No

• Are appropriate traffic control devices being utilized?

  Yes

  N/A

  No

• Are the appropriate measures being taken for night time flagging operations?

  Yes

  N/A

  No

Jobsite (General)

• Is the JSA onsite and complete?

  Yes

  N/A

  No

• Are other applicable permits completed (Confined Space, Critical Lift, Hot Work, Excavation, Lift Plan, etc.)?

  Yes

  N/A

  No

• Were there any incidents reported (Injury, Property Damage, Line Strike, Near Miss, Etc.)?

  Yes

  N/A

  No

• Are first aid kits available and stocked?

  Yes

  N/A

  No

• Are all employees trained for the tasks being performed (Competent Person, Confined Space, Aerial Lifts, HAZWOPER, Fire Watch, etc.)?

  Yes

  N/A

  No

Efficiencies

• Adequate staging of materials.

  Yes

  N/A

  No

• Employee emergency access/egress maintained.

  Yes

  N/A

  No

• Utilization of equipment.

  Yes

  N/A

  No

• Other areas for improvement.

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