Daily Scaffold and Safety Inspection - duplicate

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Location (Point of Reference) - Building #, Elevation, Column Line, Height of Inspection

Location

Numero de Edificio o Elevacion /Building Number or Elevation

• Lugar/ Edificio/ Elevacion /Location/Building#/Elevation

• Fotos del Area /Area Photos

  Media

• Supervisor

• Foreman

Scaffolding

• El Anadamio esta en Uso ?/ Is scaffolding being used?

  Yes

  No

  N/A

• Cual es el Estatus del Andamio / what's the status of the scaffolding?

  Set

  Being erected or dismantled

Base /Foundation

• Que se esta usando como base? /Whats being used at the foundation?

  screw jacks

  base plates

  roller

• Las bases de Madera son Necesarias? Are mud sills necessary?

  Yes

  No

  N/A

• El piso esta nivelado? /Surface Level?

  Yes

  No

  N/A

Amarres / Ties

• La estructura esta Firme? /Is the structure sound?

  Yes

  No

  N/A

• Se estan usando Suficientes amarres? Sufficient ties being used?

  Yes

  No

  N/A

• Los amarres estan bien apretados ? /Are the ties tightened?

  Yes

  No

  N/A

Braces / Bracing

• Completos // Complete lines?

  Yes

  No

  N/A

• Del el mismo tipo? /Sufficient types?

  Yes

  No

  N/A

• Estan bien Ajustados ? /Correct Fitting?

  Yes

  No

  N/A

Platforms

• Las tablas estan bien soportadas ? /Boards are properly supported?

  Yes

  No

  N/A

• Tablas danadas ? /Boards used are sturdy?

  Yes

  No

  N/A

• Las tablas ests bien superpuestas? ) no menos de 6" no mas de 12" / Do boards have proper overlap? (no less than 6" no more than 12")

  Yes

  No

  N/A

• La Separacion no pasa mas de 1"? Gaps are no greater than 1" on platforms?

  Yes

  No

  N/A

• Que metodo se utiliza para evitar caidas de objetos ?What method is been utilize from preventing falling debris?

  Toe boards

  Green screens

  CAZ

• Platforms clear from tripping hazards?

  Yes

  No

  N/A

Access

• Las escaleras estan en su lugar ? /Ladders in place?

  Yes

  No

  N/A

• Escaleras Aseguradas ? /Ladders are secured?

  Yes

  No

  N/A

• 3 Pies o 3 peldanos por arriba de la plataforma ? /900mm (36inches) above platform?

  Yes

  No

  N/A

• Esta bien Soportada?/ Properly Supported?

  Yes

  No

  N/A

• Hay algun punto de descraga de material? Is there an established loading point?

  Yes

  No

  N/A

• Uso de sistemas contra caidas cuando se carga o descarga? is proper Fall Protection used while loading?

  Yes

  No

  N/A

Standards

• El andamio esta a mas de 10' de distancia de electricidad? /Does the scaffold meet electrical safety clearance standards?

  Yes

  No

  N/A

• Se requiere proteccion conta caidas ? /is Fall Protection required?

  Yes

  No

  N/A

• En Donde ? /where is it being used?

  Yes

  No

  N/A

• Additional Comments

• Are all erectors/dismantlers certified?

  Yes

  No

  N/A

• Are they using the correct fall protection?

  Yes

  No

  N/A

• Show re-tagged scaffold

  Media

2. Equipo / Equipment

• Equipo Danado ? (Incluye Danos y guardas) / Unsafe or damaged equipment? (including missing or damaged guards)

  Safe

  At Risk

  N/A

• El equipo a sido inspeccionado? ( Lifts, Escaleras, Sierras) / Has equipment been inspected? ( ariel lifts, ladders, saws)

  Yes

  No

  N/A

• Do we have fire extinguishers?

  Yes

  No

  N/A

Forklift Checklist

• Before starting the engine

• Las Llantas y rines en buen estado? /Tires and rims in good condition

  Yes

  No

  N/A

• Claxon/Horn

  Yes

  No

  N/A

• Luces /Lights

  Yes

  No

  N/A

• Bateria/Battery

  Yes

  No

  N/A

• Controles y palancas de Cambio Controls and Gear Shifts

  Yes

  No

  N/A

• Sistema de levnatamiento ( Switeches, lilite de carga, cadenas picos etc)Lift system (includes load limit<br>switches, load engagement means, chains, cables, forks, etc.)

  Yes

  No

  N/A

• Nivles de liquido de frenos y liguido de radiador? /Brake and radiator fluid level

  Yes

  No

  N/A

• Direccion /Steering

  Yes

  No

  N/A

• Sistema hydraulico ( fugas) /Hydraulic system (for leaks)

  Yes

  No

  N/A

• Sistema de gasolina ( Fugas) Fuel system (for leaks)

  Yes

  No

  N/A

• Guardas del techo ( Danado) Overhead guards (for damage)

  Yes

  No

  N/A

• Instrumentos (Medidores) Gauges

  Yes

  No

  N/A

• Sistema de bloqueado funciona correcatemente? /Locking mechanism is working correctly

  Yes

  No

  N/A

• La placa en su lugar y es legible? / Load plate is fitted and legible

  Yes

  No

  N/A

• Manual del equipo ?/ Operators Manual Present

  Yes

  No

  N/A

• Cinturon de Seguriadad ?/ Seatbelt

  Yes

  No

  N/A

• After starting the engine

• Indicadores, controles y pedales ?/Controls, pedals and indicators are working correctly

  Yes

  No

  N/A

• Alarma de reversa y Luz amarilla funcionado ?Revers buzzer and beacon are working correctly

  Yes

  No

  N/A

• Luces funcionando /Lights and flashing strobe are in good working condition

  Yes

  No

  N/A

• El volante gira suevemente ?/ Steering wheel turns smoothly from lock to lock

  Yes

  No

  N/A

• Freno de estacionado funcion? /Park brake and foot brake work correctly

  Yes

  No

  N/A

• Los hidraulicos funcionan a su estension total? / Hydraulic lift, tilt and reach work properly for their full extent?

  Yes

  No

  N/A

Crews

• Los empleados tiene EPP correcto ? Lentes, casco, Botas de seguridad ETC? /Does the crew have all the proper PPE? (Glasses, hardhats, footwear, ear protection, high visibility clothing, respiratory masks, face shields,etc)

  Yes

  No

  N/A

• Hay un plande traffico ? /Is there a traffic control plan in place?

  Yes

  No

  N/A

• Plan de proteccion ambiental ?Is there an environmental protection plan in place?

  Yes

  No

  N/A

• Hay un plan de emergencia ? /Is there an emergency response plan in place?

  Yes

  No

  N/A

• Los trabajadores tienen un lugar de trabajo limpio? /Does the crew have a clean work environment?

  Yes

  No

  N/A

• Los empleados estan seguros contra electricidad? /Are crews safe from all electrical hazards?

  Yes

  No

  N/A

• Are crews exposed to any falls grater than 6ft?

  Yes

  No

  N/A

• Los empleados tiene contenedores adecuados para el almacenamiento de productos químicos necesarios? Does the crew have the proper chemical storage containers needed?

  Yes

  No

  N/A

Preocupaciones /Concerns

Acciones Correctivas /Corrective Actions

• Enter any corrective actions that will be undertaken

Sign Off

• Superintendente o Forman de Dutchs / On site Dutchs Masonry superintendent/ Forman

  Sign

• Are employees trying to maintain 6 ft apart from each other?

  Yes

  No

  N/A

• Are employees using working gloves?

  Yes

  No

  N/A

• Are employees using masks?

  Yes

  No

  N/A

• Are employees using hand sanitizer ?

  Yes

  No

  N/A

• Is toilet paper been hand out to employees?

  Yes

  No

  N/A