Information
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MarketOne Builders
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Job Site Name
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Job Number
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Conducted on
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SUPERINTENDENT/FOREMAN:
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Number of M1B Employees / Number of Subcontractor Companies
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Prepared by
Postings
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300A Posted Feb.1 to April 30?<br>
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Emergency Phone#?
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Cal/OSHA/CSO/Code Safe Practices/Clinic/Hospital Info?
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SDS/Labeling?<br>
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Excavation Notification/Project/Permits/USA?
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Door or Gate Signage/Wall Map
Lighting
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Lighting/String Lights/Cages/Securing?
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Task/Area lighting sufficient/Flashlights?
SWPPP
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Inspections/Weather Reports?
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Rain Gauge Readings/Spill Kit/Waste Handling?
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BMP's Maintained?
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Porta-can Secured In Place?
TRAINING
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Training Cards/Safety Meetings/Special Tailgates?
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Safety Audit Conducted/Documented/JHA?
ELECTRICAL
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Temp Boxes/GFCI?
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Cords/Plugs/Properly Placed/Protected/Inspected?
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Overhead Power Lines/Signage?
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Grounded/Bonded/LOTO/NFPA70E?
FIRE PROTECTION
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Fire Extinguishers/Monthly Inspection Tag/Trailer/Exit Sign?
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Fire Extinguisher/Accessible<75'/Hung?
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Safety Cans/Flammable Storage Cabinets/Signage No Smoking 50'?
FALL PROTECTION
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Caps/Trough/Lanyards/SRL?
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Perimeter Rail/Cable/Openings/Holes Covered
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Scaffolded/ Inspected/Tied/Ladder/Tagged/ToeBoard?
GENERAL
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Ladder/Use/Access/Secured/Guarded/Labels?
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Access/Temporary Job Built Stair or Ramp<br>
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Excavation/25' to Stair/Ladder/Ramp/Trench
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Forms/Falsework/Rebar/Bracing/Cap?
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Traffic/Paddle/Signs/Barricades?
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Water Supply/Cups/Bottles/Covered Disposal?
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Ventilated/Shade/100% Seating?
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Laser/Warning Signage/PAT?
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Cutting/Grinding/Concrete/Wetting/Vacuuming?
Personal Protective Equipment (PPE)
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Eye Protection/Side Shields/Face Shield/Goggles?
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High Visibility Vest/Clothing
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Foot Protection/Rubber Boots/Toe Caps?
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Hands/Gloves/Leather/Nitrile?
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Head Protection/Overhead Cover?
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Hearing Protection/Plugs/Muffs?
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Respiratory Protection/Storage/ Disposal?
HOUSEKEEPING AND MAINTENANCE
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Floor/Aisles/Obstructions/Cords?
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Parking Area/Storage Areas/Lunch Areas?
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Secondary Containment/Diesel/Gasoline
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Slipping/Tripping Hazard/Ramps/Walkways?
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Toilet/Wash/Maintained/Covered Waste Disposal?
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Tools and Material Properly Stored?
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Work Areas Maintained Clean/Orderly?
MACHINERY AND EQUIPMENT
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Cylinders/Stored/Secured/BFP/Cart Fire Wall?
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Adequate Housekeeping on floorboards?
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Equipment-Visual Inspection Documentation/Condition/ Records?
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Air Compressor <30 psi/Pins/Valves/Whip Checks
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Proper Tools/Good Condition?
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Safeguards in Place/Guards/Tool Rest?
Corrective Actions
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Enter any corrective actions that will be undertaken
Sign Off
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On Site Representative
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Auditor's signature