Any Company USA

• Document No.

• Project Safety Inspection

• Inspection Conducted by:

• Project Name:

• Conducted on:

  Date

• Superintendent

• Personnel on site:

General

• Job site photo's.

  Yes

  No

  N/A

• Have all previous issues been cleared?

  Yes

  No

  N/A

• Are First Aid kits readily available?

  Yes

  No

  N/A

• Quick drenching or flushing available where the eyes or body may be exposed to injurious corrosive materials?

  Yes

  No

  N/A

• Documentation of at least 1 person trained in First Aid?

  Yes

  No

  N/A

• Weekly Toolbox Talks documented?

  Yes

  No

  N/A

• Have all isues identified today been corrected?

  Yes

  No

  N/A

Hazard Communication

• MSDS Chemical Inventory list and SDS available upon request?

  Yes

  No

  N/A

• All containers properly labeled?

  Yes

  No

  N/A

• Written program available upon request?

  Yes

  No

  N/A

• Training regarding the new label elements and safety data sheets format by 12/1/2013?

  Yes

  No

  N/A

Subpart E - Personal Protective Equipment

• Are employees wearing proper PPE for task? (glasses, hard hat, respiratory protection, gloves)

  Yes

  No

  N/A

• Is visitor PPE available?

  Yes

  No

  N/A

• Is hearing protection required?

  Safe

  At Risk

  N/A

Subpart F - Fire Protection and Prevention

• Are adequate fire extinguishers provided? (100' of travel & 3000 sq. ft.)

  Yes

  No

  N/A

• Are fire extinguishers available near fuel storage area (25'-75')?

  Yes

  No

  N/A

• Are extinguishers inspected at start of shift?

  Yes

  No

  N/A

• Are fire extinguisher inspections up to date?

  Yes

  No

  N/A

• Are flammable materials stored properly?

  Yes

  No

  N/A

• Is fuel storage area protected from vehicular traffic?

  Yes

  No

  N/A

• Flammable liquid containers OSHA approved? (metal w/ labels)

  Yes

  No

  N/A

• Is "No Smoking" signage present near fuel storage

  Yes

  No

  N/A

Subpart G - Signs Signals and Barricades

• OSHA and Jobsite Posters present?

  Yes

  No

  N/A

• Is OSHA Log Posted (Feb 1 - April 30)

  Yes

  No

  N/A

• Proper signage present?

  Yes

  No

  N/A

• Are barricades and traffic control devices available and being used properly?

  Yes

  No

  N/A

Subpart H - Material Handling and Storage

• Rigging inspected prior to use?

  Yes

  No

  N/A

• Rigging properly used?

  Yes

  No

  N/A

• Is rigging properly protected from sharp edges?

  Yes

  No

  N/A

• Materials properly stored?

  Yes

  No

  N/A

• Good housekeeping practices in place?

  Yes

  No

  N/A

Subpart I - Tools - Hand & Power

• Hand tools in good conition?(taped/cracked handles)

  Yes

  No

  N/A

• Power tools have required guards?

  Yes

  No

  N/A

Subpart J - Welding and Cutting

• Power tool cords in good condition?

  Yes

  No

  N/A

• Is Hot Work Perimt required?

  Yes

  No

  N/A

• Area free of flammable and combustibles within 35 feet

  Yes

  No

  N/A

• Fire protection equipment readily available?

  Yes

  No

  N/A

• Proper PPE in use?

  Yes

  No

  N/A

• Are bottles stored properly?

  Yes

  No

  N/A

Subpart K - Electrical

• GFCI or Assured Grounding Program in use?

  Yes

  No

  N/A

• Is temporary lighting available and properly protected?

  Yes

  No

  N/A

• Have electrical panels been protected?

  Yes

  No

  N/A

• Extension cords in proper condition? (ground prong/electrical tape)

  Yes

  No

  N/A

• Extension cords protected from traffic?

  Yes

  No

  N/A

• Is a Lo/To procedure in place?

  Yes

  No

  N/A

Subpart L - Scaffolds

• Scaffolding inspected and tagged?

  Yes

  No

  N/A

• Scaffolding not over loaded?

  Yes

  No

  N/A

• Wheels on rolling scaffolding locked while in use?

  Yes

  No

  N/A

• Scaffolding fully decked?

  Yes

  No

  N/A

• Fall protection in use during assembly and dismantling?

  Yes

  No

  N/A

• Proper access provided?

  Yes

  No

  N/A

Subpar M - Fall Protection

• Impalement protection provided?

  Yes

  No

  N/A

• Is handrail properly installed?

  Yes

  No

  N/A

• All components of Fall Proction equipment inspected before each use?

  Yes

  No

  N/A

• Employees using proper anchorage?

  Yes

  No

  N/A

• Hole and floor coveres properly installed?

  Yes

  No

  N/A

• Proper connection used for tie off?

  Yes

  No

  N/A

Subpart N/CC - Cranes

• Operator trained?

  Yes

  No

  N/A

• Crane inspections current?

  Yes

  No

  N/A

• Crane properly set up?

  Yes

  No

  N/A

• Swing radius barricaded?

  Yes

  No

  N/A

• Proper distance to energized power lines maintained?

  Yes

  No

  N/A

• Anti 2-block functioning?

  Yes

  No

  N/A

Subpart O - Motor Vehicles and Mobile Equipment

• Have operators been properly trained?

  Yes

  No

  N/A

• Employees wearing seat belts while operating?

  Yes

  No

  N/A

• Glass free from obstructions?(clean/cracks)

  Yes

  No

  N/A

• Back up alarms functional?

  Yes

  No

  N/A

• Proper tie off inside baskets?

  Yes

  No

  N/A

Subpart P - Trenching and Excavation

• Trench box installed properly?

  Yes

  No

  N/A

• Benching and sloping properly used?

  Yes

  No

  N/A

• Propery access and egress provided?

  Yes

  No

  N/A

• Utilities physically located?

  Yes

  No

  N/A

• Utilities protected in open excavation?

  Yes

  No

  N/A

• Soil classification identified?

  Yes

  No

  N/A

• Surface traffic protected from falls?

  Yes

  No

  N/A

Subpart Q - Concrete and Masonry

• Elevated pour properly supported?

  Yes

  No

  N/A

Subpart R - Steel Erection

• Employees not working under suspended loads?

  Yes

  No

  N/A

• Has Site Specific erection plan been provided?

  Yes

  No

  N/A

• 100% Fall protection over 15' ?

  Yes

  No

  N/A

• Connectors trained and protected above 30 feet?

  Yes

  No

  N/A

• Perimiter safety handrail installed properly?

  Yes

  No

  N/A

• Wire rope hand rail flagged off?

  Yes

  No

  N/A

• Less than 3" slack in handrail?

  Yes

  No

  N/A

Subpart X - Stairs and Ladders

• Proper access provided for elevation change > 19"?

  Yes

  No

  N/A

• Is the proper ladder for the job being used?

  Yes

  No

  N/A

• Job built ladders constructed according to ANSI standards?

  Yes

  No

  N/A

• Are stairways free of obstructions?(including cords)

  Yes

  No

  N/A

• Are walking/working surfaces free from obstructions?

  Yes

  No

  N/A

• Is ladder at proper pitch? (4:1 ratio)

  Yes

  No

  N/A

• Add drawing

  Drawing

• Additional notes:

• Updated 12.5.2013