Berkeley Electric Coop Field Observation

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Crew Members

Job Safety Briefing

• job Saftey Briefing Completed

  Yes

  No

  N/A

• Signed by everyone on job site

  Yes

  No

  N/A

• All hazards identified

  Yes

  No

  N/A

Personal Protective Equipment

• Hard Hats used by all personnel

  Yes

  No

  N/A

• Eye Protection used by all personnel

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Proper foot protection

  Yes

  No

  N/A

• Fire Resistant Clothing

  Yes

  No

  N/A

• Fall Protection

  Yes

  No

  N/A

• Face Shield in good condition and used as required

  Yes

  No

  N/A

• All PPE in good condition and clean

  Yes

  No

  N/A

Tools and Equipment

• Tools and Equipment in good condition

  Yes

  No

  N/A

• All hot stick tested and clean

  Yes

  No

  N/A

• All hot line tools properly stored? ( hot hoists )

  Yes

  No

  N/A

• Rigging/Lift Equipment in good condition ( slings )

  Yes

  No

  N/A

• Ladders inspected, tied back and extended 3 ft beyond landing

  Yes

  No

  N/A

Vehicles and Trailers

• Daily inspection completed?

  Yes

  No

  N/A

• Azuga plugged in?

  Yes

  No

  N/A

• Vehicles safe / good condition; DOT compliant

  Yes

  No

  N/A

• Has all emergency equipment and its in good shape? ( reflective triangles and fuses)

  Yes

  No

  N/A

• Fire Extinguishers good and up to date

  Yes

  No

  N/A

• Trailers safe / good condition; DOT compliant

  Yes

  No

  N/A

• Cone is out?

  Yes

  No

  N/A

• Wheel Chalks in place?

  Yes

  No

  N/A

• First Aid kit available and stocked

  Yes

  No

  N/A

• Vehicles clean and organized

  Yes

  No

  N/A

• Good housekeeping and material storage

  Yes

  No

  N/A

• Outriggers down on the pads

  Yes

  No

  N/A

• Four point tie down on all heavy equipment (tractors).

  Yes

  No

  N/A

• Vehicles / Trailers on site (Unit #, Make, Model)

Heavy Equipment

• Operator qualified to operate equipment

  Yes

  No

  N/A

• Seat Belt/Fall Protection worn during operation

  Yes

  No

  N/A

• Back up alarm operable / Guide used

  Yes

  No

  N/A

• Fire Extinguisher mounted, inspected, and in good condition

  Yes

  No

  N/A

• Equipment on site (Unit #, Make, Model)

Traffic control

• Cones utilized?

  Yes

  No

  N/A

• Signage utilized?

  Yes

  No

  N/A

• Flag an utilized?

  Yes

  No

  N/A

• Safety vest utilized?

  Yes

  No

  N/A

• Strobe lights and flashers utilized?

  Yes

  No

  N/A

Hazardous Materials

• Material Safety Data Sheets available?

  Yes

  No

  N/A

• Proper containers used with correct label?

  Yes

  No

  N/A

• All aerosol cans have tops on?

  Yes

  No

  N/A

Working off a pole

• Rubber gloves utilized?

  Yes

  No

  N/A

• Rubber sleeves utilized?

  Yes

  No

  N/A

• Adequate cover up utilized?

  Yes

  No

  N/A

• If climbing, was pole checked?

  Yes

  No

  N/A

• Climbing tools checked?

  Yes

  No

  N/A

• Hand line utilized?

  Yes

  No

  N/A

• Is protective device set on one-shot?

  Yes

  No

  N/A

• Lockout-Tag-out utilized?

  Yes

  No

  N/A

Comments / Observations

• What follow up action is required?

• Comments, Concerns, Reccomendations

Reviewed by:

• Crew leader of job

  Sign

• Safety Representative

  Sign

• District Superintendent

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• Manager Distribution Operations

  Sign