Cahull Safety Week Test

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Fall Prevention and Protection

• 100% Tie-Off > 6'

  Yes

  No

  N/A

• Training

  Yes

  No

  N/A

• Vertical Lifelines

  Yes

  No

  N/A

• Horizontal Lifelines

  Yes

  No

  N/A

• Holes Covered

  Yes

  No

  N/A

• Guardrails

  Yes

  No

  N/A

• Site Specific Items

  Yes

  No

  N/A

• Plan/Method

  Yes

  No

  N/A

• Equipment Inspection

  Yes

  No

  N/A

• Anchor Point

  Yes

  No

  N/A

• Fall Clearance

  Yes

  No

  N/A

• Connectors

  Yes

  No

  N/A

Aerial Boom and Scissor Lifts

• Training

  Yes

  No

  N/A

• Pre-Op Inspection

  Yes

  No

  N/A

• Controls Tested

  Yes

  No

  N/A

• Personal Fall Arrest System

  Yes

  No

  N/A

• 100% Tie-Off Inspection

  Yes

  No

  N/A

• Ground Conditions

  Yes

  No

  N/A

• Powerline Clearance

  Yes

  No

  N/A

• Capacity not Exceeded

  Yes

  No

  N/A

• Feet on Platform

  Yes

  No

  N/A

• Site Specific Items

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Rigging and Crane Signals

• Weight/Center of Gravity

  Yes

  No

  N/A

• Inspection

  Yes

  No

  N/A

• Load Control

  Yes

  No

  N/A

• Proper Load Retention/Control

  Yes

  No

  N/A

• Correct Methods (Angles, etc.)

  Yes

  No

  N/A

• Qualified Rigger/Signal Person

  Yes

  No

  N/A

• Safety Latches on Hooks

  Yes

  No

  N/A

• Site Specific Items

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Personal Protective Equipment

• Personal Fall Arrest System

  Yes

  No

  N/A

• Breathing Air Equipment

  Yes

  No

  N/A

• Site Specific Items

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

• Hard Hats

  Yes

  No

  N/A

• Glasses/Face Shield

  Yes

  No

  N/A

• Blast Hoods

  Yes

  No

  N/A

• Hi-Vis Clothing

  Yes

  No

  N/A

• Ear Plugs/Muffs

  Yes

  No

  N/A

• Respiratory/Fit Test

  Yes

  No

  N/A

• Gloves/Hand Protection

  Yes

  No

  N/A

• Protective Work Clothes

  Yes

  No

  N/A

• Protective Footwear

  Yes

  No

  N/A

• PFDs (Life Jacket)

  Yes

  No

  N/A

Access and Walkways

• Ramps with Guardrails

  Yes

  No

  N/A

• At Least 18'' Wide

  Yes

  No

  N/A

• Steps > 19''

  Yes

  No

  N/A

• Slippery Surfaces

  Yes

  No

  N/A

• Site Specific Items

  Yes

  No

  N/A

• Ladders Secured 36'' Above

  Yes

  No

  N/A

• Holes Covered

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Emergency Preparedness, Rescue and First Aid

• First Aid Kit/Eyewash

  Yes

  No

  N/A

• Local EMS Notified

  Yes

  No

  N/A

• Stokes Basket

  Yes

  No

  N/A

• Communication Equipment

  Yes

  No

  N/A

• Evacuation Plan

  Yes

  No

  N/A

• Rescue Plan in Place/Discussed

  Yes

  No

  N/A

• Fall Arrest Rescue

  Yes

  No

  N/A

• CPR/Fist Aid Training

  Yes

  No

  N/A

• Assembly Area

  Yes

  No

  N/A

• Site Specific Items

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Hazard Communication

• Training/Written Program

  Yes

  No

  N/A

• Material Safety Data Sheets

  Yes

  No

  N/A

• Containers Labeled

  Yes

  No

  N/A

• Site Specific Items

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Fire Protection

• Fire Extinguishers

  Yes

  No

  N/A

• No Smoking Signs Posted

  Yes

  No

  N/A

• Bonding and Grounding

  Yes

  No

  N/A

• Flammable/Combustible Storage Areas Defined

  Yes

  No

  N/A

• Site Specific Items

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Hand and Power Tools, Welding and Cutting

• Air Hose Connections

  Yes

  No

  N/A

• Cylinders Secured

  Yes

  No

  N/A

• Grounded

  Yes

  No

  N/A

• Cords/Leads Inspected

  Yes

  No

  N/A

• Circuit Not Overloaded

  Yes

  No

  N/A

• Site Specific Items

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

• Pre-Op Inspection

  Yes

  No

  N/A

• Guards/Handles in Place

  Yes

  No

  N/A

Housekeeping

• Site Specific Items

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

• Waste Containers

  Yes

  No

  N/A

• Cords/Cables/Hoses

  Yes

  No

  N/A

• Organization of Work Area(s)

  Yes

  No

  N/A

• Walkways Clear

  Yes

  No

  N/A

Traffic Control and Protection

• Overspray Protection/Containment

  Yes

  No

  N/A

• Site Specific Items

  Yes

  No

  N/A

• Setup per Plan and/or MUTCD

  Yes

  No

  N/A

• Flagger Needed/Trained

  Yes

  No

  N/A

• Sign/Devices Satisfactory

  Yes

  No

  N/A

Miscellaneous

• Drinking Water

  Yes

  No

  N/A

• Toilet/Hand Washing Facilities

  Yes

  No

  N/A

• Traffic Control/Flagger

  Yes

  No

  N/A

• Site Specific Items

  Yes

  No

  N/A