Balcony Liquid membrane - duplicate

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Are all workers requiring fall protection tied off correctly eliminating swing fall hazard?

  Safe

  At Risk

  N/A

• Have workers inspected their personal fall protection system before use?

  Yes

  No

  N/A

• Have all workers reviewed and signed the site specific fall protection plan?

  Yes

  No

  N/A

• Are tools and materials secured to prevent falling objects?

  Yes

  No

  N/A

• Is a control zone required below the work area?

  Yes

  No

  N/A

Respiratory protection

• Are all employees working with liquid membrane using respiratory protection?

  Yes

  No

  N/A

• Are respirators fit tested?

  Yes

  No

  N/A

• All workers clean shaven?

  Yes

  No

  N/A

• Have workers recently replaced their filters on their mask?

  Yes

  No

  N/A

• Are workers storing their mask in sealed zip lock bag when not in use?

  Yes

  No

  N/A

Exposure

• Are controls in place to prevent exposure to unprotected workers?

  Yes

  No

  N/A

• Is signage and red danger tape available?

  Yes

  No

  N/A

• Is danger tape and signage being used to prevent unprotected workers from entering work area?

  Yes

  No

  N/A

• Is mechanical ventilation required for this application?

  Safe

  At Risk

  N/A

• Are lids replaced on buckets when moving to new work area?

  Yes

  No

  N/A

• Is mixing being conducted in an area of the site with open air and limited exposure to other trades?

  Yes

  No

  N/A

• Yes

  No

  N/A