Baycon / Concrete form-work

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Concrete form-work

• Date of Inspection

  Date

• Tittle & Position

• Project #:
  Address

• Job - Hazard - Analysis (JHA)

  Yes

  No

  N/A

• Who is responsible for the JHA?

Material handling

• Forklift

• Board cart

• Access & Egress

• Clear path of travel, unobstructed of tools, materials, etc...

• Garbage buggy / Dumpster for cuts / waste?

  Yes

  No

  N/A

Hand and Power tools / Electrical

• All hand and power tools must be used in accordance with Manufacturers specifications.
  Training is required on proper tool use, Apprentices must be shown, (carpenter material handlers are not allowed to use power tools)

• Circular Skill-saw

• Saws-all

• Grinder (peanut / full-sized)

• All grinders must have guards in place when in use.
  Face-shields are required
  

• Table saw

• Only authorized personnel can operate / Guard must be in place when in use

• Rotor-hammer

• If used to drill into concrete, follow our Accident Prevention Program (APP) / Injury & Illness Prevention Program (IIPP), section 12, silica policy (Table 1)

• Extension cords and electrical cords on hand & power tools

• 1. GFCI Protection<br>2. Ground plug in tact<br>3. No damage to cord (i.e. cuts, nicks, excessive curling, exposed wires, etc...)<br>

  Yes

  No

  N/A