Brick Arches Daily Safety Log - rev 3

• Audit Title

• Conducted on

  Date

• Prepared by

General Information

• Safety Engineer/Supervisor:

  John Burke, CSP

  Francisco Isla

  Gavin Chatoorang

  William Spero

  Paul Haffner

• Select date

  Date

• Shift:

• Weather:

• Contract/Title: A-36193 Brick Arch Repairs at 168th and 181st St. Stations

• General Order

  Off

  On

Sub-contractors (check subs working on site)

• Admiral Construction

• Future Tech Consultants

• Gayron de Bruin

• Carnak

• Five Star Electric

• Walsh Electric

• Forsythe Plumbing

• Garden State Surveying

• J-Track, LLC

• L&L Painting

• MT Group

• Risa Management Corp.

• Safway Atlantic

• Seiko / Lago Ironworks

• Suburban Pest Control

• Wang Engineering

Contract Work Locations (Check off areas working today)

• 157th Street

  Off

  On

• 168th St. Station

  Off

  On

• 168th St. Mezzanine / Other

  Off

  On

• 181st Street

  Off

  On

• Train Yard (specify yard)

  Off

  On

Safety Visits/Inspections/Activities

• OCIP or CPM Safety Visit?

  Off

  On

• Regulatory Agency?

  Off

  On

• OSHA, DOB, FDNY, Other

  OSHA

  DOB

  FDNY

  Other

• Scaffold inspections

  Safe

  At Risk

  N/A

• Fire Extinguishers inspected?

  Yes

  No

• General safety

  Safe

  At Risk

  N/A

• Public safety / Platforms / Mezzanine

  Safe

  At Risk

  N/A

• Safety meeting (meeting minutes must be forwarded to CM's office within 3 business days).

  Off

  On

• Other safety issues?

  Yes

  No

• Additional safety issues?

  Yes

  No

• Additional safety issues?

  Yes

  No

Accidents/Injuries

• Were there any reported accidents?

  Off

  On

Safety Engineer's signature

• Add signature

  Sign