BRC's Pre Planning Site Evaluation

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General Site Conditions

• General site evaluation(first look)?

  Yes

  No

  N/A

TRAFFIC CONTROL

• Traffic or Street Exposure?

  Yes

  No

  N/A

STRUCTURE ENTRANCE

• Are there any building entrances that may be protecting or temporarily be closed?

  Yes

  No

  N/A

PUBLIC PROTECTION

• Any Public protection that is going to be needed (sidewalks, entrances, bikers, general pedestrian traffic)?

  Yes

  No

  N/A

FIRE PROTECTION & PREVENTION

• Are we going to be doing any welding or cutting? Permits Required?

  Yes

  No

  N/A

• Any recognized Fire Hazards?

  Yes

  No

  N/A

ELECTRICAL

• Any overhead Power Lines Present? Are there any recognized Electrical Hazards we maybe exposed to?

  Yes

  No

  N/A

STAIRWAYS AND LADDERS

• Identify all stairways and ladders that maybe used as access, egress or existing stairways?

  Yes

  No

  N/A

SCAFFOLDING

• Will we be using Swing Stage or Tubular Scaffolding?

  Yes

  No

  N/A

• Do we have the proper documentation for our anchor for Swing Stage or Fall Protection Anchor Points?

  Yes

  No

  N/A

FALL PROTECTION

• Are we going to be working at heights greater than 6'?

  Yes

  No

  N/A

• Is there any leading edge fall exposures?

  Yes

  No

  N/A

• What is the height of Parapet walls if we are working on roof tops?

  Yes

  No

  N/A

AERIAL MANLIFTS/SCISSORS LIFTS

• Are we using boom lifts? Any potential hazards(overhead power lines)?

  Yes

  No

  N/A

HOISTS AND CRANES

• Are we planning on using a crane? Pre plan crane location, riggers and signal callers?

  Yes

  No

  N/A

HEAVY EQUIPMENT

• Any unique equipment to be used? Forklifts traveling on streets or boom lifts operating from street locations?

  Yes

  No

  N/A

HANDLING & STORAGE OF MATERIALS

• BRC Jobsite Trailer placement on-site? Storage of building materials?

  Yes

  No

  N/A

EXCAVATION AND SHORING

• Are we working in or near an excavation deeper than 4'?

  Yes

  No

  N/A

CONCRETE AND MASONRY CONSTRUCTION

• Are we protecting ourselves and public from Silica?

  Yes

  No

  N/A

CONFINED SPACES

• Have confined spaces been identified? Are we going to be performing work in a confined Space?

  Yes

  No

  N/A

COMMENTS & ADDITIONAL ITEMS

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• Attachment #1

  Media

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• Item #5

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• Item #6

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• Item #7

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• Item #8

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• Item #9

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• Item #10

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• Item #11

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• Item #12

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• Item #13

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• Item #14

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• Item #15

• Attachment #1

  Media

• Signatures

• SAFETY MANGER

  Sign

• SUPERINTENDENT

  Sign