Conewago Safety Inspection Report

• Job Number

• Job Name

• Project Manager

• Personnel

• Location
  Address

• Conducted on

  Date

• Prepared by

JOB INFORMATION

• OSHA 300 forms complete and posted from February 1 - April 30?<br>

  Yes

  No

  N/A

• OSHA and DOL posters posted?

  Yes

  No

  N/A

• Emergency phone numbers posted?

  Yes

  No

  N/A

• Safety Huddles completed?

  Yes

  No

  N/A

• MSDS filed?

  Yes

  No

  N/A

• Work areas properly signed and barricaded?

  Yes

  No

  N/A

• Site Specific up to date?

  Yes

  No

  N/A

• Tool box safety talks log up to date?

  Yes

  No

  N/A

• Catastrophic loss Sheet posted on jobsite?

  Yes

  No

  N/A

• Job Safety Analysis - Available as needed

  Yes

  No

  N/A

• Daily Site Inspections up to date?

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

HOUSEKEEPING

• Work areas neat?

  Yes

  No

  N/A

• Projecting nails or screws bent over or removed?

  Yes

  No

  N/A

• Waste containers provided and used?

  Yes

  No

  N/A

• Passageways and walkways clear?

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

FIRST AID

• First Aid Kit inspected and documented

  Yes

  No

  N/A

• First Aid Kit onsite and properly stocked

  Yes

  No

  N/A

• First Aid log kept with First Aid kit

  Yes

  No

  N/A

• Certified first aid provider onsite

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

FIRE PREVENTION

• No tobacco use or vaping

  Yes

  No

  N/A

• Adequate fire extinguishers, checked and accessible?

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

EQUIPMENT

• Backup Alarm Working?

  Yes

  No

  N/A

• All Glass intact?

  Yes

  No

  N/A

• Seatbelt being used?

  Yes

  No

  N/A

• Rear view mirrors intact

  Yes

  No

  N/A

• Fire Extinguisher up to date?

  Yes

  No

  N/A

• Catastrophic Loss sheets in equipment and truck

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

ELECTRICAL

• Terminal boxes equipped with required covers?

  Yes

  No

  N/A

• Extension wires with bare wires or missing ground prongs taken out of service?

  Yes

  No

  N/A

• Temporary lighting has shrouds and all have bulbs

  Yes

  No

  N/A

• Ground fault interrupters being used?

  Yes

  No

  N/A

• Electric cords protected from damage

  Yes

  No

  N/A

• Does electrical work comply with NFP70E and OSHA Standards

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

HAND, POWER & POWDER ACTUATED TOOLS

• Hand tools inspected regularly?

  Yes

  No

  N/A

• Guards in place on machines?

  Yes

  No

  N/A

• Correct tool being used for job at hand?

  Yes

  No

  N/A

• Operators of powder actuated tools licensed?

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

FALL PROTECTION

• Safety rails and cables secured properly,mid rail and mid chain

  Yes

  No

  N/A

• Fall protection equipment inspected. Harness. Lanyard, retractable so and tie off points

  Yes

  No

  N/A

• Safety harnesses worn properly?

  Yes

  No

  N/A

• Employees exposed to fall hazards tied off?

  Yes

  No

  N/A

• Employees below protected from falling objects?

  Yes

  No

  N/A

• Protection from clarifiers in place

  Yes

  No

  N/A

• Warning lines used appropriately

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

LADDERS

• Ladders being used @ 4:1 (H:B) rule for placement

  Yes

  No

  N/A

• Ladders inspected and documented daily

  Yes

  No

  N/A

• Ladders being used at elevation changes of 19" or more

  Yes

  No

  N/A

• Ladders extended at least 36" above landing?

  Yes

  No

  N/A

• Ladders are secure to prevent slipping, sliding or falling?

  Yes

  No

  N/A

• Ladders with split or missing rungs taken out of service?

  Yes

  No

  N/A

• Stepladders used in fully open position?

  Yes

  No

  N/A

• No step at top two rungs of stepladder?

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

Scaffolds

• Documented daily scaffold inspections

  Yes

  No

  N/A

• Erected on sound footing

  Yes

  No

  N/A

• Erected with mud sills, feet, and/or wheels

  Yes

  No

  N/A

• Planking is sound and sturdy

  Yes

  No

  N/A

• Fully planked at each working level

  Yes

  No

  N/A

• No climbing on X-braces

  Yes

  No

  N/A

• Clear and safe proper access

  Yes

  No

  N/A

• Tied to structure as required

  Yes

  No

  N/A

• Guardrails, intermediate rails, and toeboards in place

  Yes

  No

  N/A

• Employees below protected from falling objects

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

SILICA

• Silica plan on file

  Yes

  No

  N/A

• Employees following plan

  Yes

  No

  N/A

Scissors lifts

• Guardrails, midrails, toe boards, and midchains in place

  Yes

  No

  N/A

• Proper access provided

  Yes

  No

  N/A

• Employees refraining from climbing on guardrails or toe boards

  Yes

  No

  N/A

• Employees below protected from falling objects

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

Aerial Lifts

• Aerial lift operators certified and licensed

  Yes

  No

  N/A

• Employee tied off

  Yes

  No

  N/A

• Floor of basket clear of material<br><br>

  Yes

  No

  N/A

• No standing on toe board, mid rail, or top rail

  Yes

  No

  N/A

• Being operated on a level surface

  Yes

  No

  N/A

• Nothing being lifted on handrail

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

FLOOR & WALL OPENINGS

• All floor openings planked over or barricaded?

  Yes

  No

  N/A

• All planked openings identified as "HOLE" or "OPENING"

  Yes

  No

  N/A

• Perimeter protection in place?

  Yes

  No

  N/A

• Deck planks secure?

  Yes

  No

  N/A

• Materials stored away from edge?

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

ROOFING

• Proper Roof Access

  Yes

  No

  N/A

• Proper warning line dimensions

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

TRENCHES, EXCAVATION & SHORING

• One Call utilized

  Yes

  No

  N/A

• Competent person identified and present?

  Yes

  No

  N/A

• Excavations are shored and sloped back?

  Yes

  No

  N/A

• Materials are stored at least 2' away from trench?

  Yes

  No

  N/A

• Ladders provided every 25' in trench?

  Yes

  No

  N/A

• Equipment is at a safe distance from edge of trench or excavation?

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

MATERIAL HANDLING

• Forklift operator certified and licensed

  Yes

  No

  N/A

• Materials properly stored or stacked?

  Yes

  No

  N/A

• Containers Properly Marked

  Yes

  No

  N/A

• Employees using proper lifting techniques?

  Yes

  No

  N/A

• Tag lines used to guide loads?

  Yes

  No

  N/A

• Proper number of workers for each operation?

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

WELDING AND BURNING

• Gas cylinders stored upright?

  Yes

  No

  N/A

• Proper separating distances between fuels & oxygen?

  Yes

  No

  N/A

• Goggles or shields used?

  Yes

  No

  N/A

• Fire extinguishers readily available?

  Yes

  No

  N/A

• Hoses in good condition?

  Yes

  No

  N/A

• Torch being lit with striker

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

CRANES

• Outriggers extended and swing radius barricade in place?

  Yes

  No

  N/A

• Operator is familiar with load charts?

  Yes

  No

  N/A

• Hand signal charts on crane?

  Yes

  No

  N/A

• Signal person qualified

  Yes

  No

  N/A

• Crane operator logs up to date?

  Yes

  No

  N/A

• Rigger qualified

  Yes

  No

  N/A

• Employees kept from under suspended loads?

  Yes

  No

  N/A

• Chains and slings inspected and tagged as required?

  Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

CONCRETE CONSTRUCTION

• Employees are protected from cement dust?

  Yes

  No

  N/A

• Exposed Rebar Capped

  Yes

  No

  N/A

• Yes

  No

  N/A

• CORRECTIVE ACTION

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Hard hats being worn properly?<br>

  Yes

  No

  N/A

• Safety glasses being worn?

  Yes

  No

  N/A

• Gloves being worn when required?

  Yes

  No

  N/A

• Respirators used when required? Proper respirator documentation available?

  Yes

  No

  N/A

• Long Pants being Worn<br>

  Yes

  No

  N/A

• Sleeves being worn?

  Yes

  No

  N/A

• Hearing protection being worn when required?

  Yes

  No

  N/A

• Traffic vests or high visibility clothing material being worn?

  Yes

  No

  N/A

• Safety Toed Work Boots

  Yes

  No

  N/A

• CORRECTIVE ACTION<br>

  Yes

  No

  N/A

Notes

• Safety Manager

  Sign

• Superintendent

  Sign