Brazos/Legacy Masonry Safety Inspection

• Project Site

• Conducted on

  Date
• Location
  Address

• Prepared by

• Superintendent

• Project Manager

• Overview job pictures

  Media

• Performance rating:10 being the best( little to no risk), and 1 being worst( high risk for injuries or fines)

• General audit comments

• Manpower

• Costumer Comments

Explanation of audit scoring

• "Yes" (green color) 2 points
  (the job site performance met or exceeded expectations for this specific audit question)
  "improve" (yellow color) 1 point
  (the performance generally met expectations, but some specific improvements are needed.)
  "no" (red color) 0 points
  (The performance failed to meet expectations or serious violations.)
  "N/A" (blue color)
  (If a question does not apply to the job site activities, the auditor will select N/A for "not applicable ", and no score will be added or
  Subtracted from the audit.)

Items Inspected

• Superintendent's Attitude?

  Safe

  At Risk

  N/A

• Employee's Attitude?

  Safe

  At Risk

  N/A

• Pre-Task Plan Completed?

  yes

  improve

  no

  N/A

• Stretch/Flex Performed?

  yes

  improve

  no

  N/A

• Fire Extinguisher(s) In Place?

  yes

  improve

  no

  N/A

• Tool/Equipment Guards in place?

  yes

  improve

  no

  N/A

• PPE Worn? (Glasses, gloves, hard hats, hi-vis clothing, face-shield on saw/grinder, PFAS worn on scaffolds)

  yes

  improve

  no

  N/A

• Are labor laws posting displayed?

  yes

  improve

  no

  N/A

• Safety Data Sheets and Safety Policy onsite?

  yes

  improve

  no

  N/A

Scaffolds/Fall Protection

• Fall Protection Used At Hazard Area?

  yes

  improve

  no

  N/A

• Are mud sills in place?

  yes

  improve

  no

  N/A

• Are screw jacks in place, nailed and are not jacked up to high?

  yes

  improve

  no

  N/A

• Have all braces been put in place?

  yes

  improve

  no

  N/A

• Are scaffolds fully planked?

  yes

  improve

  no

  N/A

• Do plank extend 6" minimum over bearer?

  yes

  improve

  no

  N/A

• Are all guard rails, and end rails in place?

  yes

  improve

  no

  N/A

• Have all toe boards been installed on all decks with material on them, including material landing area?

  yes

  improve

  no

  N/A

• Are scaffolds tied to structure (30' feet horizontally, 20 feet vertically to first tie?

  yes

  improve

  no

  N/A

• Are the levels the employees are working on free of debris and can be easily walked through?

  yes

  improve

  no

  N/A

• Is ladder or safe access to all work areas?

  yes

  improve

  no

  N/A

• Are scaffold tags present, signed and dated?

  yes

  improve

  no

  N/A

• Does the scaffold have pig tails installed if chance of uplift?

  yes

  improve

  no

  N/A

Electrical equipment (power tools)

• Have assured grounding tests been conducted on tools and extension cord in use?

  yes

  improve

  no

  N/A

• Are all extension cords in good condition?

  yes

  improve

  no

  N/A

• Are extension cords plugged in to GFCI protected outlets?

  yes

  improve

  no

  N/A

House keeping

• Are materials being stored properly?

  yes

  improve

  no

  N/A

• Has used material and debris been cleaned up?

  yes

  improve

  no

  N/A