ATD Jobsite Safety Inspection

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

A) Jobsite Set-up & Administration

• 1. Jobsite Binder/Safety Program/SSSP/MSDS/SDS

  Yes

  No

  N/A

• Blank safety & accident forms/signage in binder?

  Yes

  No

  N/A

• 2. Gang box has first aid kit/eye wash/fire extinguisher?

  Yes

  No

  N/A

• 3. Emergency procedures communicated to crew?

  Yes

  No

  N/A

• 4. Foreman check crew for fitness of duty?

  Yes

  No

  N/A

• 5. Daily huddle/pre-task plan/JHA/stretch & bend completed?

  Yes

  No

  N/A

• 6. Foreman observes/corrects unsafe behaviors/conditions?

  Yes

  No

  N/A

• 7. Weekly TBT complete?

  Yes

  No

  N/A

• 8. Near-misses/hazard recognitions reported regularly?

  Yes

  No

  N/A

• 9. Properly trained/authorized personnel performing tasks?

  Yes

  No

  N/A

• 10. Orientations current?

  Yes

  No

  N/A

• 11. Equipment secure at end-of-shift?

  Yes

  No

  N/A

• 12. Other

  Yes

  No

  N/A

B) Personal Protective Equipment (PPE)

• 1. Hard hats worn?

  Yes

  No

  N/A

• 2. Eye and face protection adequate?

  Yes

  No

  N/A

• 3. Hearing protection available & worn in high noise areas?

  Yes

  No

  N/A

• 4. Proper gloves being worn?

  Yes

  No

  N/A

• 5. Employees have proper workboots?

  Yes

  No

  N/A

• 6. Proper work clothing (long pants, sleeved shirts)?

  Yes

  No

  N/A

• Class II reflective vests/hi-viz clothing

  Yes

  No

  N/A

• 7. Body protection (Tyvek suits/rain suits/spray suits)?

  Yes

  No

  N/A

• 8. Other

  Yes

  No

  N/A

C) General Safety

• 1. Access/egress to & from jobsite safe?

  Yes

  No

  N/A

• 2. Debris kept clear of work areas, passageways, and aisle ways?

  Yes

  No

  N/A

• 3. Combustible debris regularly removed to control fire hazards?

  Yes

  No

  N/A

• 4. Materials free from protruding nails/sharp edges?

  Yes

  No

  N/A

• 5. Floor obstructions/protruderances marked or guarded?

  Yes

  No

  N/A

• 6. Containers available for disposal of waste materials (dumpster, trash container)?

  Yes

  No

  N/A

• 7. Are waste containers regularly emptied to avoid overfilling?

  Yes

  No

  N/A

• 8. Are hoses and cords managed to prevent trip hazards?

  Yes

  No

  N/A

• 9. Are work ares free from spills, snow, ice, oil, mud, and other slip hazards?

  Yes

  No

  N/A

• 10. Materials, equipment & tools stacked/stored to prevent falling, collapse, sliding?

  Yes

  No

  N/A

• 11. Aisles and passageways clear and adequate for safe material handling?

  Yes

  No

  N/A

• 12. Signage, barricades, cones, flagging, and/or red danger tape in place?

  Yes

  No

  N/A

• 13. Pedestrian walkways (general public) free of slip/trip/fall hazards?

  Yes

  No

  N/A

• 14. Are rebar caps needed to eliminate impalement potential?

  Yes

  No

  N/A

• 15. Stairways & stairwells clean & clear?

  Yes

  No

  N/A

D) Abrasive Blasting Safety Practices

• 1. Operator properly trained/authorized?

  Yes

  No

  N/A

• 2. Abrasive & equipment loading/moving/handling procedures adequate?

  Yes

  No

  N/A

• 3. Slip/trip/fall hazards controlled?

  Yes

  No

  N/A

• 4. Electric shock/static electricity hazards controlled?

  Yes

  No

  N/A

• 5. Hearing protection worn by operator and/or other personnel?

  Yes

  No

  N/A

• 6. Compressor/air lines/fittings/couplings/hoses/blast pot/remote control system/nozzle inspected & in good condition?

  Yes

  No

  N/A

• 7. Whip checks installed at each connection?

  Yes

  No

  N/A

• 8. Chicago couplings secured with pins (no tie wire)?

  Yes

  No

  N/A

• 9. Nearby personnel protected?

  Yes

  No

  N/A

• 10. Dust control/containment adequate?

  Yes

  No

  N/A

• 11. Operator safety equipment adequate?

  Yes

  No

  N/A

E) Respiratory Protection

• 1. Have employees received respiratory protection training?

  Yes

  No

  N/A

• 2. Have respirator users been medically qualified for respirator use?

  Yes

  No

  N/A

• 3. Respirator users have a fit test card indicating a fit test performed within the last 12 months?

  Yes

  No

  N/A

• 4. Do the make, model and size of the respirator being worn correspond with the fit test card?

  Yes

  No

  N/A

• 5. Is Respirator adequate for the specific respiratory hazard?

  Yes

  No

  N/A

• 6. Are respirators properly stored, cleaned and disinfected?

  Yes

  No

  N/A

• 7. Respirators properly used (user seal check, worn correctly, clean shaven, etc)?

  Yes

  No

  N/A

F) HAZCOM/GHS

• 1. Have employees received GHS training?

  Yes

  No

  N/A

• 2. Have employees reviewed the MSDS/SDS for specific materials in use?

  Yes

  No

  N/A

• 3. Are MSDS on site and available to employees?

  Yes

  No

  N/A

• 4. Are containers labeled with contents?

  Yes

  No

  N/A

G) Fall Protection

• 1. Have employees received Fall Protection Training?

  Yes

  No

  N/A

• 2. Is fall protection equipment inspected prior to each use?

  Yes

  No

  N/A

• 3. Changes in elevation greater than 6ft are protected with guardrails or equivalent?

  Yes

  No

  N/A

• 4. Floor openings/roof openings/wall openings: covered/clearly marked/guarded?

  Yes

  No

  N/A

• 5. Guard rails properly constructed with top-rail, mid-rail and toe board?

  Yes

  No

  N/A

• 6. Employees using personal fall arrest systems (PFAS) when exposed to falls > 6-feet?

  Yes

  No

  N/A

• 7. Any step ladder/stilt use exposure near temporary guard rails?

  Yes

  No

  N/A

• 8. Anchorage points rated for 5000 lbs/employee connected?

  Yes

  No

  N/A

• 9. Skylight protection adequate?

  Yes

  No

  N/A

• 10. Warning Line system in use/properly installed?

  Yes

  No

  N/A

H) Spray equipment

• 1. Inspected before use?

  Yes

  No

  N/A

• 2. Tip guard complete and in place?

  Yes

  No

  N/A

• 3. When unit unattended, is it shut off, gun triggered to relieve pressure, & trigger safety latch set in locked position?

  Yes

  No

  N/A

• 4. Does each sprayer have a spray injection wallet card?

  Yes

  No

  N/A

• 5. Adequate ventilation?

  Yes

  No

  N/A

• 6. Proper respiratory protection?

  Yes

  No

  N/A

• 7. Proper electrical connections?

  Yes

  No

  N/A

• 8. Static electricity discharge precautions in place?

  Yes

  No

  N/A

• 9. Fire extinguishing equipment readily available?

  Yes

  No

  N/A

• 10. Proper pressure relief procedures (clogged tip, changing tip, shutting system down, etc.) practiced at all times?

  Yes

  No

  N/A

• 11. Proper signage posted?

  Yes

  No

  N/A

I) Suspension Scaffolds

• 1. Have employees received swing stage scaffold user training and/or City of Chicago certification?

  Yes

  No

  N/A

• 2. Suspension scaffold platform properly constructed & inspected by a competent person before each shift?

  Yes

  No

  N/A

• 3. Support structure able to safely support the loads?

  Yes

  No

  N/A

• 4. Roof setup (support equipment, tiebacks, PFAS, loose materials, etc.) properly constructed & inspected by competent person before each shift?

  Yes

  No

  N/A

• 5. Weight of employees, tools & equipment within scaffold rating?

  Yes

  No

  N/A

• 6. Ten-foot minimum clearance from power lines?

  Yes

  No

  N/A

• 7. Electrical power systems properly installed & in good condition?

  Yes

  No

  N/A

• 8. ATD Daily Suspended Scaffold Checklist affixed to platform?

  Yes

  No

  N/A

• 9. Landing areas and platforms free of debris and trip hazards?

  Yes

  No

  N/A

J) Stationary Supported Scaffolds

• 1. Scaffold properly erected, dismantled & inspected by ATD competent person before each shift?

  Yes

  No

  N/A

• 2. Scaffold & components in good condition and properly installed?

  Yes

  No

  N/A

• 3. Guardrail system in place and properly constructed on open sides/ends at heights > 10-feet?

  Yes

  No

  N/A

• 4. Employees NOT using improvised objects to increase working height on scaffold?

  Yes

  No

  N/A

• 5. Falling object protection in place?

  Yes

  No

  N/A

• 6. Is scaffold adequately and properly supported (i.e. base plates, mud sills, firm foundation)?

  Yes

  No

  N/A

• 7. Weight of employees, tools & equipment within scaffold rating?

  Yes

  No

  N/A

• 8. All working levels properly and fully planked?

  Yes

  No

  N/A

• 9. Has a ladder and/or safe access/egress been provided?

  Yes

  No

  N/A

• 10. Scaffold plumb, level, square and/or secured against tipping at 4:1 ratio?

  Yes

  No

  N/A

• 11. Minimum distances from power lines maintained?

  Yes

  No

  N/A

K) Rolling Scaffold

• 1. Scaffold inspected and in good condition?

  Yes

  No

  N/A

• 2. Wheels locked?

  Yes

  No

  N/A

• 3. Floor in good condition for scaffold?

  Yes

  No

  N/A

• 4. Guard rails in place at platform height > 4-feet above floor?

  Yes

  No

  N/A

• 5. Scaffold plumb, level, square, and properly braced?

  Yes

  No

  N/A

• 6. Outriggers installed properly on Bakers when platform at highest setting and when stacking frames?

  Yes

  No

  N/A

L) Stilts

• 1. Stilts only used by trained & authorized personnel?

  Yes

  No

  N/A

• 2. Stilts properly inspected, used, and maintained?

  Yes

  No

  N/A

• 3. Is working surface safe for stilt use?

  Yes

  No

  N/A

• 4. Safe distance being maintained from temporary guard rails?<br><br>

  Yes

  No

  N/A

M) Aerial lifts (boom and scissor)

• 1. Only trained & authorized personnel operating lift?

  Yes

  No

  N/A

• 2. Lift inspected & controls tested prior to use?

  Yes

  No

  N/A

• 3. Guard rails and/or PFAS?

  Yes

  No

  N/A

• 4. Everyone in lift standing on platform, NOT on toe board, mid rail, or top rail?

  Yes

  No

  N/A

• 5. Ground conditions good to prevent lift from tipping over?

  Yes

  No

  N/A

• 6. Proper clearance from power lines and/or other energized sources?

  Yes

  No

  N/A

• 7. Body parts being kept clear from stationary objects?

  Yes

  No

  N/A

• 8. Outdoor conditions safe for operation of lift?

  Yes

  No

  N/A

• 9. Lift capacity NEVER exceeded?

  Yes

  No

  N/A

N) Portable Ladders and Stairways

• 1. Has ladder been properly inspected and is it in good condition?

  Yes

  No

  N/A

• 2. Is the step or extension ladder being used properly?

  Yes

  No

  N/A

• 3. Is extension ladder at proper angle, tied off @ top and extending 3 ft. above landing?

  Yes

  No

  N/A

• 4. Is the floor/ground in good shape to support the ladder?

  Yes

  No

  N/A

• 5. Is the proper ladder being used for the task at hand?

  Yes

  No

  N/A

• 6. Is the ladder rated a minimum of TYPE 1A?

  Yes

  No

  N/A

• 7. Is stairway free of debris, sand, oil, ice, electric cords, hoses, materials, etc.?

  Yes

  No

  N/A

• 8. Are stair rails provided for stairs with 4 or more risers?

  Yes

  No

  N/A

• 9. Is stairway properly illuminated?

  Yes

  No

  N/A

• 10. Are stairway handrails, risers, platforms and landings safe?

  Yes

  No

  N/A

• 11. Does stairway need to be closed and signs posted to protect our operations?

  Yes

  No

  N/A

• 12. Stairway or ladder provided when break in elevation is > 19"?

  Yes

  No

  N/A

O) Electrical

• 1. Cords, tools and receptacles inspected and in good condition?

  Yes

  No

  N/A

• 2. Cords, tools and receptacles being used properly?

  Yes

  No

  N/A

• 3. GFCI in use?

  Yes

  No

  N/A

• 4. Energized panels covered & secured?

  Yes

  No

  N/A

• 5. Safe working distance maintained around power lines?

  Yes

  No

  N/A

• 6. Power lines properly covered/jacketed?

  Yes

  No

  N/A

P) Pressure Washer/Water Blaster/Compressed Air Blower

• 1. Is operator authorized and properly trained?

  Yes

  No

  N/A

• 2. Has the equipment been inspected daily before use?

  Yes

  No

  N/A

• 3. Equipment being used properly?

  Yes

  No

  N/A

e)      Motor Vehicles

• i)        In safe operating condition (lights, windshield, horn, tires, brakes, gauges operable)?

  Yes

  No

  N/A

• ii)      State inspection current?

  Yes

  No

  N/A

• iii)    License/Registration current?

  Yes

  No

  N/A

• iv)    Driver has valid state issued driver’s license and designated as an approved driver?

  Yes

  No

  N/A

• v)      Trailer/equipment connected properly (safety chains, lights, hitch, and brakes)?

  Yes

  No

  N/A

• vi)    Load is stable, secured properly, does not overload vehicle?

  Yes

  No

  N/A

• vii)  Fire extinguisher mounted in bed of pickup?

  Yes

  No

  N/A

• viii)Operat0065d safely, seat belt worn?

  Yes

  No

  N/A

• ix)    Running equipment not left unattended?

  Yes

  No

  N/A

• x)      Cab and truck bed cleaned & free of debris?

  Yes

  No

  N/A

7)      JOBSITE SAFETY REQUIREMENTS

a)      Postings

• i)        6 IN 1 Poster (0SHA, Minimum Wage, Discrimination, etc.)

  Yes

  No

  N/A

• ii)      Emergency Action Plan poster is completely filled out and posted?

  Yes

  No

  N/A

b)      Medical/First Aid

• i)        Local clinic for injury treatment identified in the Safety Execution Plan?

  Yes

  No

  N/A

• ii)      Local hospital with emergency room facilities identified in the Safety Execution Plan?

  Yes

  No

  N/A

• iii)    Trained First Aid/CPR provider been identified by name in the Safety Execution Plan?

  Yes

  No

  N/A

• iv)    First Aid/CPR provider has unexpired FA/CPR Training card?

  Yes

  No

  N/A

• v)      First aid kit is available on site and inspected regularly?

  Yes

  No

  N/A

• vi)   Is emergency eyewash station available when corrosive or other injurious materials are used?

  Yes

  No

  N/A

• vii)  Bloodborne pathogens kits available

  Yes

  No

  N/A

c)      Electrical Safety

• i)        GFCI’s in use or assured grounding program implemented?

  Yes

  No

  N/A

• ii)      Electric cords inspected before use?

  Yes

  No

  N/A

• iii)    Electric panels properly constructed with covers & inspected?

  Yes

  No

  N/A

d)      Sanitation

• i)        Is an adequate supply of drinking water available?

  Yes

  No

  N/A

• ii)      Portable drinking water containers cleaned, sanitized and rinsed daily and properly marked/dated?

  Yes

  No

  N/A

• iii)    Disposable cups and trash receptacle available?

  Yes

  No

  N/A

• iv)    Adequate number of toilets/wash facilities provided (1 toilet/50 employees or less; 1/each additional 50)?

  Yes

  No

  N/A

• v)      Do mobile crews have transportation to toilet/wash facilities nearby?

  Yes

  No

  N/A

• vi)    Are eating/drinking areas located to prevent exposure to harmful materials?

  Yes

  No

  N/A

• vii)  Trash disposal available at eating/drinking areas?

  Yes

  No

  N/A

a)      Gas Cylinder Safety

• i)        Compressed cylinders stored and secured vertically?

  Yes

  No

  N/A

• ii)      Caps on cylinders when not in use?

  Yes

  No

  N/A

• iii)    O 2 and fuel gases stored 20' apart?

  Yes

  No

  N/A

• iv)    Flash back arresters on torch handle & at cylinder?

  Yes

  No

  N/A

• v)      Compressed gas cylinders handled and moved safely?

  Yes

  No

  N/A

f)       Fuel Handling and Flammable Liquids

• i)        OSHA fuel cans with flash arrester?

  Yes

  No

  N/A

• ii)      Equipment turned off while fueling?

  Yes

  No

  N/A

• iii)    Fuel storage area: Signs/Containment/> 20lbs Extinguisher?

  Yes

  No

  N/A

• iv)    Proper storage of flammable liquid construction products?

  Yes

  No

  N/A

g)      Fire Protection

• i)        Adequate fire extinguishers: Inspection/placement/size?

  Yes

  No

  N/A

• ii)      Welding, burning, cutting: No combustibles in area?

  Yes

  No

  N/A

• iii)    Fire watch provided when necessary?

  Yes

  No

  N/A

• iv)    Oily rags stored in proper container?

  Yes

  No

  N/A

• v)      Designated smoking area provided/No smoking signs posted?

  Yes

  No

  N/A

• vi)    Fire extinguishers being maintained?

  Yes

  No

  N/A

• vii)  Employees trained in proper use of fire extinguishers?

  Yes

  No

  N/A

h)      Ventilation

• i)        20 air changes per hour in confined space?

  Yes

  No

  N/A

• ii)      Provides clean, breathable air (Constant Monitoring)?

  Yes

  No

  N/A

• iii)    Air flow sufficient to reduce contaminants to a safe level?

  Yes

  No

  N/A

i)        Other

i)        Confined Space

• (1)   Following Confined Space Entry Permit process?

  Yes

  No

  N/A

• (2)   Employees trained in Confined Space Entry?

  Yes

  No

  N/A

• (3)   Entry Supervisor Trained?

  Yes

  No

  N/A

• (4)   Rescue services available?

  Yes

  No

  N/A

ii)      Working On, Over or Near Water

• (1)   Life vests available?

  Yes

  No

  N/A

• (2)   Life Ring w/ 90 ft. of line present every 200 ft.?

  Yes

  No

  N/A

• (3)   Rescue skiff available?

  Yes

  No

  N/A

iii)    Excavation/Trenching

• (1)   Following trenching procedures

  Yes

  No

  N/A

• (2)   Employees competent in trenching procedures

  Yes

  No

  N/A

• (3)   Qualified person assessing effective trench Procedures

  Yes

  No

  N/A

• (4)   Shoring, Benching, Sloping engineered

  Yes

  No

  N/A

• (5)   Proper entry and exits provided

  Yes

  No

  N/A

iv)    Third Party Safety (other contractors, general public)

• (1)   Public warning/hazard signs, signals or communication?

  Yes

  No

  N/A

• (2)   Traffic control: signs, direction, barrels, barricades?

  Yes

  No

  N/A

• (3)   Dust/Vapor: Dust curtains, tape doors/windows, ventilated area?

  Yes

  No

  N/A

• (4)   Public Protected from flying/spilled construction debris/chemicals?

  Yes

  No

  N/A

• (5)   Pedestrian walkways protected from trip & slip hazards?

  Yes

  No

  N/A

• (6)   Adequate pedestrian barriers/fences/gates/flagging?

  Yes

  No

  N/A

• (7)   Overhead protection from falling/flying debris/tools/equip.?

  Yes

  No

  N/A

• j)        Adequate lighting in all areas?

  Yes

  No

  N/A

• k)      Embedded utilities located?

  Yes

  No

  N/A

8)      SAFETY CULTURE

• a)      Safety Execution Plan developed and on site?

  Yes

  No

  N/A

• b)      Front Line Safety Initiatives implemented?

  Yes

  No

  N/A

• c)      Project Manager dedicates time to ensure safety related obligations are fulfilled?

  Yes

  No

  N/A

• d)      JSA's when new tasks start?

  Yes

  No

  N/A

• e)      Pre Project Planning (PrePP) done for changed conditions?

  Yes

  No

  N/A

• f)       Pre Task Planning (PreTP) done prior to starting new tasks?

  Yes

  No

  N/A

• g)      Site specific safety training from PrePP completed?

  Yes

  No

  N/A

• h)      Follow-up on action items from JSA's, MSA's, PrePP, PreTP?

  Yes

  No

  N/A

• i)        Site Specific Safety Plan from PrePP implemented?

  Yes

  No

  N/A

• j)        New emp. given Standard Orientation prior to starting work?

  Yes

  No

  N/A

• k)      “Danger - Do Not Use” tags available and in use where needed?

  Yes

  No

  N/A

9)      COMPETENT PERSONS

• a)      Personal Protective Equipment:

• b)      Respiratory Protection:

• c)      Fall Protection:

• d)      Scaffolds, Platforms and Ladders:

• e)      Motorized Access Equipment:

• f)       Confined Space:

• g)      Forming:

• h)      Grouting:

• i)        Trenching:

• j)        Cranes/Hoists & Rigging:

• k)      Welding:

Signatures

• Job Site Supervisor

  Sign

• Auditor

  Sign