Citrus Safety Inspection

• Location
  Address

• Conducted on

  Date

• Document No.

• Location Information

• Inspector?

ELECTRICAL SAFETY

• Plugs, sockets and switches in good condition? No modification or alterations?

  Yes

  No

  N/A

• Walkways and work stations are free from power cords that pose a tripping hazard?

  Yes

  No

  N/A

• Power cords are in good condition, maintain the ground post, not altered, repaired or modified?

  Yes

  No

  N/A

FIELD EDGES, PARKING AREAS AND DRIVEWAYS

• Are walkways / paths clear of debris, tools and other tripping or slipping hazards?

  Yes

  No

  N/A

• Are walk paths reasonably even and free of holes?

  Yes

  No

  N/A

• Parking lots and areas free of trash and debris that can cause a slip or trip?

  Yes

  No

  N/A

• Parking lot or parking locations fully lit for night work?

  Yes

  No

  N/A

• Trash cans provided near the parking lots?

  Yes

  No

  N/A

• Driveway(s) free from slip hazards (loose dirt, sand, gravel etc)?

  Yes

  No

  N/A

FIELD (GROVE) SAFETY

• Are toilet facilities present, good condition, stocked and cleaned regularly?

  Yes

  No

  N/A

• Is there drinkable water present, cups and a trash can present?

  Yes

  No

  N/A

• Are hand washing stations present, filled, stocked and in good condition?

  Yes

  No

  N/A

• Are the workers wearing the proper PPE's required for the job?

  Yes

  No

  N/A

• Workers using equipment, (trucks, yard goats, ATV, etc) been recently trained on the equipment they are using (within the last 12 months)?

  Yes

  No

  N/A

FIRE SAFETY

• All fire extinguishers in place?

  Yes

  No

  N/A

• Extinguishers serviced within the past 12 months? Is the extinguisher being monthly Inspected?

  Yes

  No

  N/A

• Extinguisher free of all obstructions? Noting being stored on the extinguisher?

  Yes

  No

  N/A

• Exits clear of obstructions?

  Yes

  No

  N/A

FIRST AID KITS

• Cabinets / kits are clearly labeled?

  Yes

  No

  N/A

• First aid kits are easily located and are unobstructed?

  Yes

  No

  N/A

• Kits / cabinets / kits clean and orderly?

  Yes

  No

  N/A

• Cabinets / kits contents are regularly inspected?

  Yes

  No

  N/A

• All first aid supplies are good and not expired?

  Yes

  No

  N/A

PESTICIDE STORAGE

• All containers labelled correctly?

  Yes

  No

  N/A

• Empty containers clean and properly stored?

  Yes

  No

  N/A

• Spill kit present and complete? Easily accessible?

  Yes

  No

  N/A

• Are containers stored in good condition to prevent contamination

  Yes

  No

  N/A

• Decontamination facilities available? Close to exposure area?

  Yes

  No

  N/A

• Eye wash station within 20 feet? Being inspected?

  Yes

  No

  N/A

SHOP SAFETY

• Employees are wearing proper PPE's?

  Yes

  No

  N/A

• Compressed gasses stored upright and with caps?

  Yes

  No

  N/A

• Oxygen and acetylene (fuel gas) stored at least 20 feet apart from one another?

  Yes

  No

  N/A

• Floor surfaces even and uncluttered?

  Yes

  No

  N/A

• Floor surfaces are free from any slip hazards / spills

  Yes

  No

  N/A

• Entryways and walkways kept clear?

  Yes

  No

  N/A

• Benches, tables and shelves in good condition and free of trash and debris?

  Yes

  No

  N/A

• Work stations are free from sharp edges or hazard points?

  Yes

  No

  N/A

• Materials and tools stored on hooks or on shelves whenever possible?

  Yes

  No

  N/A

• Floor around storage areas remain clear of trash and debris?

  Yes

  No

  N/A

• Work areas free of excess trash?

  Yes

  No

  N/A

• Power tools free from damage and have not been altered or modified?

  Yes

  No

  N/A

• Tools, not in use, kept in place or put away?

  Yes

  No

  N/A

• Grinders and other moving equipment have guards? Guards are being used?

  Yes

  No

  N/A

• Hand tools free from damage and have not been altered or modified?

  Yes

  No

  N/A

• Eye wash station present and being inspected?

  Yes

  No

  N/A

• Does lifted equipment have proper guards / secondary jack?

  Yes

  No

  N/A

• Open Breaker spots have protective barrier? Barrier meets standards? (cardboard does NOT meet standards)

  Yes

  No

  N/A

• All electrical panels are closed and labeled?

  Yes

  No

  N/A

SORTING FACILITY

• Are the OSHA / LAW posters posted in a common room?

  Yes

  No

  N/A

• Hospital / Clinic information posted?

  Yes

  No

  N/A

• Employees are wearing proper PPE's?

  Yes

  No

  N/A

• Break room kept clean, no trash left on tables and trash cans being emptied?

  Yes

  No

  N/A

• All unnecessary packaging or materials have been removed?

  Yes

  No

  N/A

• All walkways, safety zones, (emergency showers, exits, fire extinguisher etc.,) are clearly marked, signed and not obstructed?

  Yes

  No

  N/A

• Work areas are clean and clear of trash?

  Yes

  No

  N/A

• Floors in good condition, free from slip / trip / fall hazards?

  Yes

  No

  N/A

• Facility has plenty of light? All walkways and work areas are fully lit?

  Yes

  No

  N/A

• Facility has plenty ventilation?

  Yes

  No

  N/A

• Crates are being used for the intended purpose of packaging and not used to sit / stand on?

  Yes

  No

  N/A

• Electrical is in good condition? no exposed wires or damaged equipment?

  Yes

  No

  N/A

• Equipment is in good condition and has not been modified?

  Yes

  No

  N/A

ADDITIONAL INFORMATION

• Any immediate hazardous situations? Please explain what they are and what steps were / are being taken.

• Any item that was observed but not listed on this form? Please list them here.

• Notes:

• If needed, draw condition(s)

  Drawing

AERIAL and SCISSOR LIFTS

• Workers have been trained in the use of equipment?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Lift occupants wearing harness correctly? Employees been trained in fall protection?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Workers tied off to boom or basket? (Not required in scissor lifts unless the lift moves when lift is up)

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Lift controls clearly marked and readable?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Workers not tied off to adjacent structures?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Both feet remain on the floor of the basket?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Operators not exceeding the load limits of the basket / lift?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Lift is stationary when boom is elevated?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Employees are not transferring at height while in a scissor lift?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Mid-rail chain / gate used when in operation?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Operators maintaining safety compliance while operating lift?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Notes:

CONCRETE / MASONRY

• Rebar / flat stakes guarded (covered) to eliminate impalement hazard?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Employees working in concrete wearing proper hand and foot protection?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Connectors, ties or whips used to secure pressurized air hoses?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Guard down on pump (on pump truck)?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Masonry saw blades guarded?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Fugitive dust controlled while cutting block or conducting finish work?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Masons wearing face shields AND safety glasses while cutting block?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Formwork capable of supporting vertical / lateral loads?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Shoring equipment inspected?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Base plates secured to foundation / mud sill / formwork?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Jacks / supports do not exceed the rated capacity?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Limited access zone equal to the wall height plus 4 feet?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Limited access zone strictly enforced?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Walls over 8 feet braced to prevent collapse?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Masons maintaining safety compliance?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Notes:

CONFINED SPACE

• JSA and rescue plan on-site and available? Employees been trained on the plan?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Entry permit completed and signed?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Air sampling completed and documented prior to entry?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Proper warning signage posted at entry to the permit space?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Forced air ventilation used for the duration of entry?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Proper lighting provided?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Rescue team trained and readily available?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Retrieval system (Tripod) available and utilized?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Entrants attached to the retrieval line?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Attendant on duty outside the permit space?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Attendant only performs monitoring duties?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Confined space team is maintaining safety compliance?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Notes:

CRANES / RIGGING

• Crane(s) inspected and properly maintained?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Crane operator, rigger and signal person certified?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Crane load charts visible to the operator?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Hand signal charts posted or available?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Fire extinguisher located within the cab?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Pick (Lift) plan on-site, reviewed and the load is within load capacity?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Crane outriggers fully extended and on cribbing properly?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Swing radius identified and barricaded?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Workers remained clear of the in the swing radius and under suspended loads?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• All power lines are a minimum 15 feet away from all lifting and boom swing radius?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Rigging equipment inspected and in good condition?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Rigging equipment maintain lift capacity markings?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Crane operations maintaining safety compliance?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Notes:

ELECTRICAL

• Electrical cords maintain ground posts?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Electrical cords are free from damage / repair / alterations?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Electrical cords protected from damage and roll over?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Electrical cords are not ran through door ways or windows?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Electrical cords kept clear of work areas and walk ways?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Electrical cords are rated for construction? Flat cords removed from site?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Spider box being inspected quarterly?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Power strips and 3 way splitters construction rated?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Electrical equipment being used per the manufacturers specifications?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• GFCI being used on 120V single-phase, 15/20 amp outlets?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• All outlets have cover plates when outlets are energized?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Temp light cords are hung with non-metallic fastener, off the ground and does not cause a hazard?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Temp light bulbs maintain cages and all bulbs?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Electrical rooms maintain proper warnings and labels per NFPA 70e?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Access to electrical room(s) restricted per NFPA 70e?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Electrical panels are covered, labeled and all breaker slots are covered?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• 3 foot clearance around all electrical panels being maintained?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Employees are not allowed to work near unprotected circuits / panels?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Employees are locking and tagging out equipment and panels and NOT working on hot equipment?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Employees working with energy maintaining safety compliance?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Notes:

FALL PROTECTION

• JSA and fall protection rescue plan has been established and all effected employees have been trained?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• All employees have been trained in fall protection?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• A fall protection system is provided for all employees working above 7 1/2 feet? (6 feet for rod busters)

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• PFA rigged to prevent contact with any surface? (Max fall distance allowed is 6 feet)

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Harnesses have been inspected prior to use?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Employee wearing harness correctly, wearing the appropriate lifeline (lanyard) and attached to an anchor?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Fall protection anchors are set up per specifications and all elements are rated to 5000 lbs?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Guardrails are able to with stand 200 lbs outward and down force?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Guardrails do not exceed 2 inch deflection in any direction?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Guardrails and mid-rails are at the proper height?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Guardrail posts are not more than 8 foot OC?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Guardrails / mid-rails are constructed to be on the inside on the guardrail posts?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Guardrails and mid-rails have been placed around floor / roof openings?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Floor holes greater than 2 inches have been covered, properly labeled and secured from movement?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• The fall protection selected is appropriate for the fall exposure?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Floor hole covers are capable of handling 2 times the intended load?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Safety monitor performs only monitoring duties?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Safety monitor is at the same surface as the work with visual and verbal contact?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Warning line 6 feet back for roofing activities?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Warning line 15 feet for non-roofing activities?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Warning line erected on all open sides?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Warning line flagged and suspended at proper height?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Access and hoisting areas guarded?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• All materials stored more than 6 feet back from roof or deck edge?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Safety compliance being maintained?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Notes:

FIRE SAFETY

• Employees trained in the use of fire extinguishers?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Fire extinguishers in good condition, fully charged and recently inspected?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Fire extinguishers replaced annually?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Fire extinguishers are within 75 feet of workers?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Fire extinguishers within 15 feet of hot work?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Minimum of 1 fire extinguisher per floor / level?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Fire extinguishers within 50 feet of flammable materials?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Flammables stored in an approved and closed containers?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• No smoking signs posted near flammables?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Flammable liquids protected from ignition sources?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Flammables not stored near access and egress locations?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Scrap piles, debris and trash stored more than 10 feet from building or structure?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Maintaining fire safety compliance?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Notes:

FORKLIFTS

• Forklift operators been trained for the specific forklift they are operating?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Forklift inspected prior to use?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Forklifts have not been modified or altered?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Outriggers being used on extended reach fork lift?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Forklift is operating within lift capacities?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Forklift slings have been inspected and maintain lift capacity tags?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Forklifts have lift, load and angle charts?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Forklift has fire extinguisher in the cab?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Forklift forks are down when not in operation?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Forklift operator wearing seat belt when in operation?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Forklift has an audible back up alarm that can be heard up to 200 feet away?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Spotters are used when forklift has to travel through barrier curtains or blind accesses?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Operator is traveling less than 10 MPH, stopping at all intersections and stop signs?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Workers under lifted / suspended loads?

  No

  Yes

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Lift basket secured to forklift?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Forklift maintains an operator when the lift basket has employees in it?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Forklift operators maintaining safety compliance?

  Yes

  No

  N/A

• Exposing Contractor

  Select Abe Olivarez Baghouse Sheet Metal Blue Mtn Const. Braaten Electric Central Cal. Const. Industrial Design JTI Lentz Const MD Concrete Potential Design Precision Process Unlimited R & C Refrigeration Ross Fab Superior Universal Welding Valadon Plumbing Valley Tree Walker Concrete Other

  • Abe Olivarez
  • Baghouse Sheet Metal
  • Blue Mtn Const.
  • Braaten Electric
  • Central Cal. Const.
  • Industrial Design
  • JTI
  • Lentz Const
  • MD Concrete
  • Potential Design
  • Precision
  • Process Unlimited
  • R & C Refrigeration
  • Ross Fab
  • Superior
  • Universal Welding
  • Valadon Plumbing
  • Valley Tree
  • Walker Concrete
  • Other

• Notes: