BTI MSHA Daily Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General Safety Checklist

• Do you know the location of the closest medical treatment facility?

• Do you have all the required PPE for todays Tasks?

• Are you Fit For Work today?

• Safety and Sanitation Supplies Available

  Yes

  No

  N/A

• Hand Sanitations Available

  Yes

  No

  N/A

• Eye Wash Available

  Yes

  No

  N/A

• Spill/Clean-Up Kit Available

  Yes

  No

  N/A

• Are Toilet Facilities Available and Clean

  Yes

  No

  N/A

• Is "House Keeping" in Order?

• Drinking Water Available?

• First Aid Kit Available

• Do you have a Emergencies Communication Plan?

• Do you understand your responsibilities today

• Have you completed your risks assessment for todays tasks?

SITE INSPECTION

• Axle High Berms on Roadways

  Yes

  No

  N/A

• Traffic Patterns Known and Established

  Yes

  No

  N/A

• Wheel Chocks Available and properly used?

  Yes

  No

  N/A

• Have Trips, Slips and Falls been Identified and Mitigated?

  Yes

  No

  N/A

• Are Fall Restraint - Fall Protection measures correctly being implemented?

  Yes

  No

  N/A

• Have High-Walls been Examined and cleared?

  Safe

  At Risk

  N/A

• Have "Caught In-Between" risks been identified and mitigated?

  Yes

  No

  N/A

• Have Entanglement Hazards been Identified and Mitigated?

• Required Signs In Place

• Have all Utilities'; Underground and Overhead been Identified?

  Off

  On

• Can you work at a safe/proper distance from all utilities ?

• Document any irregular site conditions

  Media

• Document any irregular site conditions

  Drawing

Equipment and Materials

• Have you performed ZONAR Inspection on all equipment?

• Is all Equipment and Tools in good working order?

• Does all Equipment have proper ROP

  Yes

  No

  N/A

• Proper Rigging/Lifting Equipment - Inspected and in working order?

  Yes

  No

  N/A

• Flammables Stored in Approved Containers?

  Yes

  No

  N/A

• Is there Adequate Lighting if Night Work is Required?

  Yes

  No

  N/A

• Are Fire Extinguishers Current on Inspections?

• SDS Available for Hazardous Materials

• Is all Glass and Mirrors Clean and Unbroken?

• Seat Belts Available and in working order?

• Have Ladders, Catwalks, and Railings been inspected and in good working order?

• Have Cranes and Hoisting Equipment been inspected and in good working order?

• Is Fuel being stored properly

  Yes

  No

  N/A

General Maintenance Checklist

• Guards (All types) inspected and in good working order?

• Emergency Shutoff Switches working properly

• Electrical Connections and grounding in good working order?

• Lubrication (General)

• Dust Control

• Housekeeping

Signature

• Signature

  Sign