Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Select date
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Project name & number
General
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All-In-One OSHA Poster / Safety Bulletin Board
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Hospital & Clinic information posted
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First Aid kit
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OSHA 300 A (posted Feb.1-Apr. 28)
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Bayley SSSP & SSSP for all Subs
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Electronic
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Hard copy (Binder)
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SS Orientation (Video & Packet)
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Crisis Manual (Site-specific pages)
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Safety Data Sheets (Binder, Inventory)
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SWPPS / CECLE
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Applicable Permits
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Bldg.
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Demolition / Abatement
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AHERA Bldg. Inspection Report
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Letter of Good Faith (Bldg. contains no Asbestos)
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Project Security (Fencing)
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Site Sanitation (toilets / hand wash)
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Clean lunch room / garbage cans
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Emergency Response kits
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Trucking Haul route
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Fire Prevention
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Hydrant & Hoses
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Fuel Storage Cabinet
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Fire Extinguishers (2ab every 3000 sq.ft.)
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Existing system
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Fire Extinguisher within 25ft. of storage
Trenching & Excavation
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Engineering Soils Report
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811 Call before you dig utility locates
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Select date
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Designated Competent Person
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Bayley
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Sub-tier Contractor
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Name of CP
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Soil Classification
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Daily Inspection for changing conditions
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Benching (Type A or B soil only)
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Sloping (Type C soil)
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Spoil pile (min. of 2ft. from trench)
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Ladder or steps within 25ft. (all directions)
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Bridge / Ramp / Walkway (18in. wide / secured)
Heavy Equipment
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Check one or more boxes if this work is present on your project.
All heavy equipment operators are required to complete a visual walk around inspection as well as a controls function test to ensure the machine is in sound safe condition for use. -
Only qualified personnel are allowed to operate / Certain equipment requires a certification
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All machines must have an operators manual
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If machine has a Roll-Over Protection System<br>Then the operator must wear the seatbelt
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Excavators
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Loaders
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Dump Trucks
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Back hoes
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Cranes
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Drill Rigs
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Aerial Boom lifts
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Requires certification
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Scissor lifts
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Requires certification
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Skid Steer (Bob cat)
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Fork lift
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Requires certification
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Concrete Pump Truck
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All work activities require a Job - Hazard - Analysis or Pre-task Work Plan
Heavy Equipment Inspection & Hazards
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Injuries - Struck by moving equipment / Caught between 2 objects
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Controlled access zones / Signage / Barriers / Deliniation
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High Visibility Vest / Shirt (ANZI Class II)
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Spotter(s)
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Pedestrian "Foot" traffic - Access & Egress walking path
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Overhead obstructions
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Existing structures
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Utility lines
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Flagging for visibility
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De-energize / Relocate
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Weather conditions
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Ground conditions
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Crane work requires special conditions
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NCCCO Crane Operators Certification<br>Rigger ,certification
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Crane pick plan
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Pre-shift safety meeting
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Designated lift director / Rigging & Signalman /
Concrete & Formwork
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JHA for all work activities, signed by all who perform the work
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Does the JHA address all of the associated hazards with work activities
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Are there fall hazards<br>* Ladders<br>*Scaffold<br>*Aerial Boom lift<br>*Elevated slabs<br>*Roof work
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Do we have a written Fall Protection Work Plan for elevations greater than 10 ft.?<br>Did all of the employees sign the work plan?
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Power tools
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Ever used by worker?
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Double insulated or grounded
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Inspected?
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Electrical cords
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Inspected prior to use?
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Hung or protected from damage?
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Plugged into a Ground Fault Circuit Interrupter?
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Material handling
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JHA? Signed?
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Can material be moved by forklift, hand-truck or pallet jack?
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Is the material stacked, racked or blocked to prevent a struck by or pinch point injury?
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Over 50 lbs. - use two persons
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Keep hands / fingers out of pinch points
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Clean & Clear path of travel - access & egress?
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Bridge or walkway planking over trenches?<br>*Must be at least 18 in. and secured
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Form work
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JHA? Signed?
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Saw horses for cutting (no cutting from your foot)?
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Dumpster for debris?<br>*Keep our work stations clean & clear to prevent slip & trip hazards
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PPE<br>* Hearing protection<br>*Safety Glasses or Goggles?<br>*Gloves (if deemed necessary by Sup. - Forman)
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Access & Egress<br>*Ladder or steps (elevations 19 in. or greater)<br>*Clear path of travel
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Nails? Bent over or removed?
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Ladders? Appropriately used? Correct Ladder choice?
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Training needed?
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Electrical cords?
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Inspected & protected?
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GFCI protected?
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Concrete work
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JHA? Signed?
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Workers aware of struck by hose hazards?
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PPE?<br>*Gloves<br>*Eye wash<br>*Neutralizer or Barrier cream (Burns)<br>Safety Glasses or Goggles
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Concrete Pump Truck?
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Outriggers on solid ground? Pads? Steel plates?
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Eco pan / Plastic?
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Crew informed on the hazard of a plug in the hose line?
Fall Hazard Exposure
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Check one or more boxes if these activities are present on your project
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You must fill out a Fall Protection Work Plan if fall exposure is greater than 10 ft.
This applies to our Sub-contractors as well! -
Do workers have Fall Prevention Training (FPWP)?
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Has the FPWP been reviewed and signed by the workers performing this work?
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JHA? Signed by workers?
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Scaffolding
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Who is the Competent Person inspecting the scaffold daily?
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Do we have Engineered scaffolding specs?
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Do workers have scaffold awareness training?
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JHA? Signed by workers?
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Is there warning signage (Red or Green tags)
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Set up on Mud sills, concrete, asphalt, etc...?
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Frames stood plumb?
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Fall protection railings?
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Falling object protection?
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Controlled access zone below? Delineation? Physical Barriers?
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Ladder access & egress?
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10 ft. or more from Overhead power lines?
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Guyed or tied to the structure (4 x the base to height ratio)?
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Planks kept clean and clear of construction material / debris?
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Ladders
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Inspected prior to use? Is the ladder free of physical defects?
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Has the safety stickers / decals?
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Appropriate ladder for the task?
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Extended 36 in. above the elevated deck?
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Secured at the top & bottom?
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Clean & Clear (access & egress) of debris at the top & bottom?
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Roof work
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Roof work has a fall exposure greater than 10 ft. FPWP must be filled out and signed by the workers.
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Warning line must be 15 ft. from the perimeter edge unless engaged in roofing activities.
Roofing activities - 6 ft. from perimeter edge.
Warning line must be taunt & flagged every 6 ft.
100% Tie off signage beyond this point (unless using a Safety Monitor system) -
JHA? Signed by workers?
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Anchor points present?
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Proper warning line set-up?
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Skylights present?
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Protection Handrail / Cover / Engineered for fall thru hazard?
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Parapet wall present?
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Floor openings present?
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Fall Restraint can be achieved by one of the following means:
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Cover - Plywood or Steel plate
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Plywood covers must be able to withstand 4 x the intended load
Secured in place to prevent accidental displacements
Marked to be highly visible or HOLE -
Wood or Cable railing
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Wood - top-rail (200 lbs. of force, smooth, 42 in. in height); mid-rail (halfway between top-rail and walking surface, 150 lbs. of force); Falling object protection.
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Cable rail - same as above for forces imposed on the cable.
Cable must be flagged every six ft. and cannot sag more than 3 in. (+/-) -
Warning line
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Cannot be made of tape (caution or danger)
Must have signage & flagged
Must be set at least 6 ft. from the opening (farther is better) -
Elevated Decks / Floors
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An elevated deck or slab includes any surface above ground level.
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Leading edge work?
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Required controlled access zones (above and below) working surface in addition to the area directly below.
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Hand-railing or cable railing (Guidelines listed above or in our SSSP)
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Is there any fall protection system in place around the perimeter of the upper level?
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Structural Steel Erection
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This is a high risk work activity and you must ensure the trades are using appropriate Fall Protection System or Personal Fall Arrest PPE!
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Crane work?
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Hot work?
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Fire Suppression for refueling or welding operations
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Hot work permit - Fire watch - Fire extinquishers
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Gas cylinders stored properly / secured with 20 ft. of separation between O2 and compressed gas?
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Fall Protection Systems?
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Leading edge work?
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Boom or Scissor lift activities?
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Ladders?