Title Page
-
Conducted on
-
Prepared by
-
Location
General Safety
-
Are personnel active on the project?
-
All personnel are wearing hard hats
-
All personnel are wearing safety glasses
-
All personnel are wearing high visibility clothing
-
All personnel are wearing work boots
-
All personnel onsite have successfully completed orientation
-
All personnel are conducting daily planning activities (THA, JHA, JSA)
-
Work area is clean and material organized
-
Lighting in all work areas is adequate to allow for clear view of all activities
-
Emergency Action Plan and escape routes are complete and readily available
-
Ventilation in work area is effective
-
Potable water is available to personnel
-
1 restroom per 40 personnel is available and clean (1 restroom minimum)
-
First aid services are stocked and available
-
Medical care is available within 3-4 minutes of the site
Trenching and Excavation
-
Are there trenches or excavations on site?
-
811 locates are done
-
Daily inspection has been done
-
Access/egress is within 25’ of travel
-
Trench/excavation is free of standing or seeping water
-
Spoil piles are located a minimum of 2’ back from edge of trench/excavation
-
Trench/excavation edge is identified and/or protected
-
Does trench/excavation have sloping, benching or shoring?
-
Trench/excavation is sloped or benched in accordance with type of soil
-
Shoring is in place and braced according to manufacturer specifications
Crane, Rigging, Hoisting
-
Are Cranes being utilized?
-
Operator has training certification on person and available
-
Operator appears to be competent in running crane
-
Crane has annual and daily inspection
-
Barriers around crane are established to protect for swing radius
-
Outriggers and cribbing is effectively utilized
-
If necessary, a critical lift plan is completed and approved
-
Are suspended loads present?
-
The personnel rigging and signaling are trained
-
Rigging equipment has been inspected and is in good working condition
-
Loads are balanced and rigged correctly
-
Suspended loads are away from personnel
-
Tag lines are used on all suspended loads
-
Entire swing of load is protected from personnel being beneath the load
-
Is Rigging or Hoists being used?
-
Hoist has been inspected
-
Rigging is tagged to identify load capabilities
-
Rigging is inspected and in good working condition
-
Hoist, chain fall, or come-along is secured to material capable of handling load
Mobile Equipment
-
Is mobile equipment (i.e. earth moving, lull, fork truck, aerial lift, pallet jack, duct lift) being utilized on the project?
-
Mobile equipment has been inspected
-
All mobile equipment is shut down for refueling
-
Operator is using equipment as trained
-
Spotter(s) is/are being utilized to assist in backing up and protecting operator’s blind spots
-
Backup alarm and horn are operational
-
Operator is wearing safety belt
-
Pedestrians are aware and are separated from mobile equipment operation
-
Operator has training for equipment being operated
-
Mobile equipment is in original from manufacturer condition (no modifications, no missing parts)
-
Pallet jacks are being used as intended by manufacturer
-
Duct lifts are being used as intended by manufacturer
-
Is equipment being used with additional attachments? (lifting, rigging, platforms)
-
Equipment manufacturer approved attachment is being used
-
Attachment is being used in a manner intended for use
-
Attachment is securely fastened to the equipment
-
Are scissor lifts being used?
-
Scissor lift has been inspected
-
Scissor lift is being operated on level surface
-
Personnel have feet on deck of scissor lift
-
Chain on scissor lift is attached
-
Are boom or articulating lifts being used?
-
Lift has been inspected
-
Ground is suitable for safe operation
-
Personnel in basket are utilizing fall protection (i.e. harness and lanyard) and are tied off to the basket
-
Personnel in basket are only working off basket platform (i.e. not standing on rails)
-
Operator of lift is doing so in a safe manner
-
Personnel are clear below working area of elevated lift
-
Operator has training for equipment being operated
-
Is equipment used in the building?
-
Floor is capable of supporting weight (point load, total per sqft)
Scaffold
-
Are scaffolds used on the jobsite?
-
Daily inspection by competent person has been completed
-
Guardrails or fall protection is in place for decks over 10’
-
Access to platforms is sufficiently provided
-
Bracing is installed and sufficient per manufacturer
-
Mudsills, plates or wheels are in place
-
Scaffold is not overloaded
-
Scaffold has tie in or outriggers at 4:1 base to height ratio
Fall Protection
-
Are personnel working with their feet at/or above 6 feet?
-
Are guardrails present?
-
Top rail, mid-rail, and toe board present in all areas
-
Top rail, mid-rail, and toe board at proper heights (42” +/-3”, 21” +/-3”, within an inch of deck)
-
Top rail, mid-rail and toe board sturdy (200lbs of force and 50lbs of force) and in good condition
-
Guardrail is surfaced as to prevent injury to an employee from punctures or lacerations, and to prevent snagging of clothing
-
Is a harness, lanyard, and anchor point being used?
-
Harness, lanyard, and anchor points have been inspected
-
Anchor point is secure and can withstand 5,000lbs
-
Lanyard is securely affixed to anchor point and harness
-
Lanyard is in good condition and the correct type of lanyard is utilized for working environment
-
Harness fits well and is in good condition
-
Are covers being utilized to protect floor penetrations greater than 2 inches in diameter?
-
Covers are secured and labeled as “HOLE”
-
Material used for floor penetration protection has sufficient load capacity for activity in work area
-
Are stairways present?
-
There is at least one handrail and one system per unprotected side
-
The handrail is 37”-30” off the face of the tread
-
The handrail is surfaced as to prevent injury to an employee from punctures or lacerations, and to prevent snagging of clothing
-
Stairways are free and clear of slippery materials
-
An effective system (Mid-rails, screens, mesh, intermediate vertical members, or equivalent intermediate structural members) is in place between the handrail and the tread
-
Handrails provide adequate handhold to prevent personnel from falling
-
Pan stairs are filled with material prior to concrete
-
Is warning line being used to warn of potential fall hazards on roof?
-
Warning line is set up 6’ (for roofers) or 15’ (non-roofing trades) from roof edge
-
Warning line has flagging at 6’ minimum intervals
-
Warning line is between 34”-39” from walking/working surface
-
Warning line is connected to each stanchion so as to not pull slack from adjacent stanchions
Electrical
-
Is electrical power for tools, equipment, lighting, etc. being used?
-
Electrical panels and/or cabinets are identified and secured
-
Electrical cords, plugs, and/or outlets are in good working condition
-
Ground Fault Circuit Interrupter (GFCI) is used with all electrical tools and equipment
-
Electrical cords are out of walkways
-
Electrical cords do not run through doors or wall openings without being protected from damage
-
Temporary lighting has cages and bulbs intact
-
Is there lockout/tagout being used?
-
The LOTO plan is being followed
-
All energy sources have been determined and rendered inoperative
-
Tags or locks are in place at all points of possible energy release
Ladders
-
Are ladders being used?
-
Ladders are free of damage and defects
-
Ladders are set up and secured
-
Personnel using ladder is maintaining three points of contact
-
Ladders are made of fiberglass
-
Ladders used as access extend 3’ above landing
-
A 4:1 height to base ratio is used for all extension ladders
-
Are Job made wood ladders on site?
-
Ladder is surfaced to prevent injury from punctures or lacerations
-
2x4 side rails are used for ladders up to 14’ in length
-
Ladder is between 16”-20” wide
-
Each cleat is continuous across the ladder
-
Cleats are level and spaced 12” from top of cleat to top of next
-
Filler blocks are same thickness as cleat and beneath each cleat
-
Ladder is secured at both top and bottom
Tools
-
Are tools being utilized on the job site?
-
Guards are in place
-
Handles are in place
-
Hand tools are in good working order
-
Proper tool is being used for the job
-
Are powder actuated tools being used?
-
Personnel have been trained in proper use of tool
-
Loaded tools are not left unattended
-
Material being penetrated is of sufficient thickness
-
Tool is treated as if it is loaded at all times
Fire Protection
-
Are Flammable and/or combustible materials being stored on the project?
-
All flammable and combustible materials are stored in a safe location
-
Metal cans designed for gasoline storage are being used
-
All flammable and combustible materials are labeled
-
Location of stored flammable and combustible materials are identified with signage and secure
-
Compressed gas cylinders are secured, upright, and are capped
-
Bulk(over 25 gallons) fuel storage is minimum of 20’ from any building
-
Secondary containment of above ground fuel storage is sealed and can contain 1.5x the fuel stored
-
Are grinding, cutting, welding or any other spark producing activities being conducted?
-
If required, Hot Work Permits are completed, reviewed, and approved
-
A fire extinguisher is available for the activity being conducted
-
All flames, sparks and/or slag is contained from spreading (i.e. floor penetrations, stairways, etc.)
-
Gauges, hoses, cables, and welding leads in good working condition
-
Flash arrest protection is present with torches
-
When welding, flash protection is used (hoods, screens)
-
Are Fire extinguishers present on the site?
-
Fire extinguishers have had an annual inspection and have been inspected for the current month
-
Fire extinguishers are located at each floor level of the stairwell
-
There are sufficient extinguishers (100’ of travel and/or 1 per 3,000sqft) for the job
-
Fire extinguishers are available at all access and egress points
-
Are Fire Hydrants accessible to the site?
-
The areas around the hydrant(s) are accessible to fire department
-
There are clear paths to the building from the hydrant(s)
-
No smoking policy is enforced
-
Equipment is shut down during refueling
Material Storage
-
Is material stored on site?
-
Construction material to be used on site is stored out of walkways and traffic
-
Is material stored outside?
-
Material is protected and secured from elements (wind, rain, snow)
-
Clear access to material is maintained
-
Is material stored inside?
-
Material is secured from movement (rolling, scooting, falling, tipping)
-
Is trash and debris stored on site?
-
Proper trash receptacles are used
-
Nails or impalement hazards are removed from all material
Emergency Action
-
Exit signs are in place and visible at all egress points
-
A minimum of two means of access and egress are available per floor
Public Safety
-
Does the work potentially interact with public and/or staff?
-
The perimeter of the work area is identified and protected
-
Signage is present identifying work areas as “Construction Zone”
-
Mobile and vehicle equipment is coordinated with a spotter/flagger