Corporate Construction Group (CCG) - Earth Moving Equipment

• Project Name

• Prepared by

• Title

• Project Manager

• Conducted on

  Date
• Add location
  Address

A. Safe Work Practices

• 1. Only authorized personnel operating earthmoving equipment

  Yes

  No

  N/A

• 2. Personnel maintaining safe distance from operating equipment

  Yes

  No

  N/A

• 3. Personnel and equipment operator in close communication when personnel must be in proximity of operating equipment<br>

  Yes

  No

  N/A

• 4. Personnel approach operating equipment safely

  Yes

  No

  N/A

• 5. Personnel wearing high-visibility and/or reflective vests when close to operating equipment

  Yes

  No

  N/A

• 6. Personnel riding only in seats of equipment cab and using seat belts

  Yes

  No

  N/A

• 7. Personnel not positioned under hoisted loads

  Yes

  No

  N/A

• 8. Personnel not hoisted by equipment

  Yes

  No

  N/A

• 9. Personnel instructed not to approach equipment that has become electrically energized

  Yes

  No

  N/A

• 10. Personnel wearing appropriate PPE, per HSP/FSI

  Yes

  No

  N/A

B. General

• 11. Daily safety briefing/meeting conducted with crew

  Yes

  No

  N/A

• 12. Daily inspection of equipment and equipment accessories conducted before use

  Yes

  No

  N/A

• 13. At least one fire extinguisher available at the equipment operating area

  Yes

  No

  N/A

C. Earthmoving Equipment Components

• 14. Backup alarm or spotter used when backing equipment

  Yes

  No

  N/A

• 15. Operational horn provided on bi-directional equipment <br>

  Yes

  No

  N/A

• 16. Seat belts are provided and used

  Yes

  No

  N/A

• 17. Rollover protective structures (ROPS) provided

  Yes

  No

  N/A

• 18. Braking system capable of stopping full payload

  Yes

  No

  N/A

• 19. Headlights and taillights operable when additional light required

  Yes

  No

  N/A

• 20. Brake lights in operable condition

  Yes

  No

  N/A

• 21. Cab glass provides no visible distortion to the operator

  Yes

  No

  N/A

• 22. Hauling equipment (dump trucks) provided with cab shield or canopy

  Yes

  No

  N/A

• 23. Dump truck beds provided with positive means of support during maintenance or inspection

  Yes

  No

  N/A

• 24. Dump truck operating levers provided with latch to prevent accidental dumping

  Yes

  No

  N/A

D. Earthmoving Equipment Placement

• 25. Location of underground utilities identified

  Yes

  No

  N/A

• 26. Safe clearance distance maintained while working under overhead powerlines

  Yes

  No

  N/A

• 27. Safe distance is maintained while traveling under powerlines (When working under or around powerlines, a spotter is required when conditions hinder or prevent the equipment <br> operator from being able to see or gauge distance.)<br>

  Yes

  No

  N/A

• 28. Unattended equipment visibly marked at night

  Yes

  No

  N/A

• 29. Parking brake set when equipment parked and equipment chocked when parked on incline<br>

  Yes

  No

  N/A

E. Earthmoving Equipment Operation

• 30. Equipment operated on safe roadways and grades

  Yes

  No

  N/A

• 31. Equipment operated at safe speed

  Yes

  No

  N/A

• 32. Equipment not operated during inclement weather, lightning storms

  Yes

  No

  N/A

• 33. Using equipment to lift loads, other than earth, done according to equipment manufacturer specifications <br>

  Yes

  No

  N/A

• 34. Lifting and hauling capacities are not exceeded

  Yes

  No

  N/A

• 35. Equipment components lowered when not in use

  Yes

  No

  N/A

• 36. All machine guards are in place

  Yes

  No

  N/A

• 37. Air monitoring conducted per HSP/FSI for hazardous atmospheres

  Yes

  No

  N/A

F. Earthmoving Equipment Maintenance

• 38. Defective components repaired immediately

  Yes

  No

  N/A

• 39. Suspended equipment or equipment parts are supported prior to work under or between

  Yes

  No

  N/A

• 40. Lockout/tagout procedures used prior to maintenance

  Yes

  No

  N/A

• 41. Tires on split rims removed using safety tire rack or cage

  Yes

  No

  N/A

• 42. Good housekeeping maintained on and around equipment

  Yes

  No

  N/A

Corrective Action Taken

• Corrective actions & dates corrected

• Signature

  Sign