Title Page
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Daily Start Card
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Client:
CALTRANS -
Site:
- Segment 1
- Segment 2
- Segment 3
- Segment 4
- Segment 5
- Segment 6
- Segment 7
- Segment 8
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Prepared by
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Conducted on:
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Location:
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Superintendent:
- Roland Sarimento (619) 719-7993
- Jim Baxter (760) 600-1543
- Barney Stenlake (951) 830-0324
- Mike Strachota (760) 497-4505
- Luis Ruiz (909) 721-9775
Daily Start Card
Task / Hazard / Corrective Measures:
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Is there a new crew member?
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Has CWP been reviewed?
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Add signature
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What are today's tasks?
Task
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What are today's hazards?
- Fall from heights
- Slips, Trips, and Falls
- Strains and Pulled Muscles
- Power / Hand Tools Injuries
- Struck by / Caught Between
- Foreign Materials in the Face
- Rigging Failure
- Noise Exposure
- Silica Dust Exposure
- Pickup Trucks / Flat Trucks
- Electrocution / Shock
- Confined Space
- Aerial Boom Lift / Scissor Lift
- Hotwork
- Lead Exposure
- Trenching and Excavation Cave-in
- Spill / Leaks
- Inadequate Illumination
- Heat Stress
- Compressor / Air Pnuematic Tools
- Hazardous Soils / Materials
- Scaffolds
- Stairways / Ladders
- Lifting Equipment
- Train / Subway Tracks
- Rebar
- Lock Out - Tag Out
- Impalement Hazards
- Other
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FALL FROM HEIGHTS:
Competent Person Assigned
Use guardrails and install floor hole covers where possible to reduce the exposure to falling.
All persons shall be Fall Protection Awareness trained
Install signage on hole covers.
Install signage in areas that require fall protection.
All guardrails shall have a top rail, mid-rail, and toe-boards.
All holes 2 inches or greater shall be securely covered and labeled.
When using a personal fall arrest system, it shall consist of a full body harness and self retracting lanyard(s).
Shock absorbing lanyards are not permitted.
Adequacy of anchorage points shall be determined by the competent person.
Each worker is responsible for checking their own harness each time they put it on.
Verify that workers are wearing the harness properly and are anchored correctly.
Harnesses should be snug (2 finger tuck) while allowing full movement.
The best place for an anchorage point is directly above the work area.
Restraint systems shall be designed to prevent a fall.
Positioning device systems shall be used in conjunction with a personal fall arrest system. -
SLIPS, TRIPS AND FALLS:
Competent Person Assigned
Work Area Inspection
Tool Box Talks
Designate controlled pathways.
Use cord protection ramps.
Elevate cords a minimum of 7 feet above walkways where feasible.
Provide adequate lighting for work areas and pathways.
Housekeeping shall be performed daily as work progresses.
Perform a 360 degree observation of your surroundings.
Remove materials from stairs and walkways.
Cover or elevate cords.
Store all tools and materials in a designated area.
Keep ramps slip resistant with special anti-slip paint or other slip resistant material.
Avoid carrying materials that will block visibility.
Pay attention to these areas: change in elevation, access around corners, at the base or top of ladders and scaffolds, near equipment or trucks, etc.
Avoid distractions such as talking, texting, and emailing while walking.
Avoid walking backwards as much as possible.
Rebar mats shall have a designated walk path for safe access across.
Operations that require wet methods shall contain and clean the slurry, run-off, water, mud, etc. -
STRAINS AND PULLED MUSCLES:
Competent Person Assigned
Stretch and Flex Program
Tool Box Talks
General Awareness Training
Use material handling equipment as much as possible
Stage material to avoid double handling.
Observe employees' fitness for duty
Make sure there's a clear walkway with good lighting to the work area.
Do not carry a load that obscures your vision.
Stand close to the load, feet hip-width apart, one foot slightly forward pointing in the direction you are going.
Bend your knees and keep your back straight, get a secure grip on the load, and breathe in before lifting to help support your spine.
Keep your back straight and lift using your legs.
Keep the load close to your body, and lift slowly and smoothly.
Avoid jerky movements, and avoid twisting your body when lifting or carrying a load.
Ensure there is clear communication when there are two or more people handling a load. -
POWER / HAND TOOL INJURIES:
Competent Person Assigned
Toolbox talks
Select the appropriate tool for the task.
Ensure that the worker using the tools is properly trained in its safe use.
Ensure that users of powder actuated tool are certified and have their card on them at all times.
Inspect all tools daily.
Tag and remove any damaged tools immediately.
Check wooden handle tools for splinters or cracks.
Ensure that all handles supplied by the manufacturer are installed.
Keep knives and other tools sharp.
Ensure that tools are free from mushroomed heads.
Follow the manufacturer's recommendation for lubricating and maintaining tools.
Control loose clothing, hair, and jewelry.
Use task specific gloves while operating tools.
Ensure that guards are in place before operating a tool.
Maintain a firm footing and safe body position when operating a tool.
Secure work with clamps so you can use both hands to operate the tool.
Chaps are required when using a chain saw or demo saw.
Face shields are required when grinding, cutting, chipping, etc.
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STRUCK BY / CAUGHT BETWEEN:
Competent Person Assigned
Tool Box Talks
General Awareness Training
MPT Training
Visual equipment inspection
Inspect the work area for possible struck by / caught between hazards such as high traffic areas, overhead work, etc.
Maintain and communicate establish controlled access zones.
Ensure that workers on the ground establish eye contact with operators prior to entering their operation area.
Ensure that only qualified operators operate machinery.
If safety devices such as horns or reverse alarms are not functional, red-tag the machine.
Use flaggers when traffic plans dictate.
When operators are unable to see clearly while backing, use a spotter.
Do not stand or walk behind or alongside moving equipment.
Never depend upon hearing a horn or other warning signal.
Identify overhead hazards and add proper signage.
Anticipate stored energy while pulling, pushing, loading, unloading, jacking, blocking, etc.
Secure pneumatic tools with whip checks.
Secure Chicago fittings with a cotter pin or clip. -
FOREIGN MATERIAL IN THE FACE:
Competent Person Assigned
All workers to be trained on proper use of the tool
Workers without experience using the tool or uncomfortable using the tool should be working closely with the Competent Person
Wear proper PPE -
RIGGING FAILURE:
Competent Person Assigned
Daily Inspection of Rigging, Compliance Audits
Materials weight information
Load center of gravity information
Must be a qualified rigger as recognized by FSSW
Identify the rigging in the Lift Plan.
Only qualified riggers shall rig the load.
Identify qualified riggers visually by a means such as unique vests, hard hats, etc.
Inspect all rigging prior to lifting.
Ensure that rigging is free from nicks, cuts, burns, tears, wear or other damage.
Check that safety latches on hooks are in working condition.
Check for wear and pin distortion on shackles.
Check for frayed or severed strands in wire rope slings.
Damaged rigging is to be cut and disposed of immediately.
Use taglines to control the load at all times.
Use softeners to protect rigging as needed.
Ensure that the work area is secure, to prevent people from entering the swing radius or walking under the load.
Review rated capacities on slings, shackles, etc. and know the weight of the load prior to lifts.
Do not alter equipment such as tying knots to shorten slings.
The rigging crew must communicate "all clear" to the signal-person before the lift.
Store rigging in a manner that avoids damage. -
NOISE EXPOSURE:
Competent Person Assigned
Toolbox Talks
Noise monitoring program
Signage for high noise areas
Limit exposure time of cases of extreme exposure
Wear hearing protection if you can't communicate normally within two feet of one another
Rotate employees out of high noise areas.
Inspect equipment for functioning mufflers.
Provide sound barriers for adjacent activities and communities.
Be aware of the effects of noise leaving the project site. -
SILICA DUST EXPOSURE:
Competent Person Assigned
General Awareness Training
Air monitoring program, watch PEL
MEQ
Respirator Fit Test
All workers must be clean shaven to properly wear a respirator.
Workers must be properly trained to use their respirators.
Workers must regularly clean and inspect their respirators.
Provide a designated storage area for respirators.
Wear washable or disposable work clothes.
Workers must wash hands before eating drinking, smoking, etc.
Do not eat, drink, use tobacco or apply makeup near areas containing silica dust.
Use wet methods and/or HEPA vacuums to control dust.
Vacuum away cutting slurry.
Use sweeping compound when sweeping. -
PICKUP TRUCKS / FLAT TRUCKS:
Daily Inspections
Motor Vehicle license required for vehicle being operated
Drivers to abide by all traffic laws
All drivers to follow the company cell phone policy
Drivers and all passengers to wear seat belts at all times.
All loads placed on any type of vehicle must be stacked, racked, blocked, interlocked, and/or secured to prevent sliding, falling, spilling and/or collapse.
Do not climb on unstable, slippery or irregular loads.
If the height of a potential fall from a truck is greater than 6 feet, then fall protection is required.
Do not allow people to stand adjacent to vehicles when dumping a load or when it's in motion.
Do not use cell phones or radios while your vehicle is in motion.
Check overhead clearances, and make personnel in you area aware of your presence. -
ELECTROCUTION/ SHOCK:
Competent Person Assigned
Assured Grounding to be performed on tools, extension cords and GFCI's
Never stand on wet or damp surfaces when using electric tools
Caution for overhead power lines and below ground utilities
Inspect extension cords and discard dysfunctional ones immediately.
Call for utility locates prior to digging.
Identify overhead power lines with signs and flagging to ensure a safe working distance.
Ensure that exposed live parts are protected.
Secure electrical rooms and post proper signage.
Electrical tape is not allowed for repairs.
Energized electrical work requires an approved Energized Electrical Work Plan.
Ensure that conductive material is not used to hang cord sets or welding leads. -
CONFINED SPACE:
Competent Person Assigned
Tool Box Talks
Once a Confined Space is identified, the area is to be marked with a sign designating it as a "Confined Space"
Confined Space Entry Permits must be used for all work in the Confined Spaces
Confined Space Training
Confined Space Checklist -
AERIAL BOOM LIFT / SCISSOR LIFT:
AWP Operator Training is required for all workers operating a manlift
Manlift to be inspected prior to each shift of working with the equipment
If the manlift is not functioning properly, then it must be tagged "DO NOT USE" and the superintendent must be notified immediately
All aerial work platforms must have a controls bump bar
Operators shall wear a full body harness and tie off to the manufacturers attachment point with a self retracting lifeline.
Aerial work platforms must be lowered prior to traveling.
Keep body parts inside the basket when booming, swinging or traveling.
When operating aerial work platforms, stand firmly on the floor of the basket.
Maintain a minimum clearance of at least 10 feet away from the nearest overhead power lines. See OSHA table K-1 for clearance requirements over 50,000 KV.
Do not exceed the load limits of the equipment. Allow for the combined weight of the worker, tools, and materials. -
HOT WORK:
Competent Person Assigned
Hot Work Permits as Required
Fire Watch
Air Sample Results
Maintain Welding License on File
MEQ, Respirator Fit Test, Respirator Training
Fire suppression system and fire watch must be utilized
Oxygen and acetylene bottles must be kept in an upright position and secured.
Oxygen and acetylene bottles will be stored 20' or greater apart or be separated by a barrier with at least a 1/2 hour noncombustible burn rating.
Do not attempt to lift bottles alone by hand. Roll them or use a cart or dolly.
Bottles can be lifted only in a secured cart or rack with an engineered picking eye.
Bottles must have on protective caps when not being used and while being transported.
Ensure that valves are closed at the torch before turning on regulator valves.
All hoses shall have flash arrestors at the torch end.
Check gauges, valves, regulators, torch tips, and hoses for signs of wear or damage.
Listen for leaks.
Inspect welding leads and cords for damage and remove from service if damaged.
Protect the rods and leads and ensure that they are kept dry.
Inspect the area for flammable / combustible material and remove prior to commencing hot work.
Ensure work area is well ventilated and wear proper respiratory equipment.
Welding hoods must be used with a hard hat. Use appropriate lens for cutting and welding.
Light the torch away from your body.
Use a fire watch with a fire extinguisher for a 1/2 hour after hot work ceases. -
LEAD EXPOSURE:
Competent person assigned to determine if lead paint is present
Air monitoring as needed
Lead Exposure General Awareness Training
Comply with Lead Compliance and ADL Plans
Lead work areas shall be identified and controlled to only allow authorized personnel.
Decontamination procedures shall be followed prior to eating, drinking, smoking, or leaving the work site.
Personal monitoring shall be performed to identify potential exposure.
Minimize dust by wet methods, HEPA vacuums, and ventilation. -
TRENCHING AND EXCAVATION CAVE-INS:
Competent person is to supervise all trenching and excavation activities
All workers involved in these activities must have Trenching & General Awareness Training
Support of Excavation Plans
No standing water is allowed in the trench / excavation
Daily inspections by competent person
Verify underground utilities
Proper access and egress
Verify if hazardous atmosphere is present
Stability of adjacent structures
Over 20' excavations it must be engineered
An excavation permit shall be issued that identifies the soil classification and the protective system to be used.
Visible barriers must be placed around the perimeter to prevent unauthorized access
All excavations must have safe access regardless of depth such as a ladder or ramp.
In trenches, access to work area must include a travel distance of no greater than 25 feet for access/egress.
Equipment, materials, tools and excavated soil must be kept at least 2 feet from the edge of pit, to reduce the risk of their falling into the excavation.
Openings such as pipe piles and manholes are to be protected.
Fall protection is required when a fall hazard is present.
Underground installations shall be protected, supported or removed as necessary.
Excavations shall be delineated or barricaded to prevent exposure to traffic. -
SPILL / LEAKS:
All jobsite chemicals to be properly labeled and have an SDS available
All workers unfamiliar with the chemical to review SDS before starting task
Must have a spill kit
Any significant spills must follow steps converted in the SPP
Equipment shall be inspected daily and maintenance schedules shall be followed.
Perform inspections as required per legal and other requirements.
Install barricades around fuel, oil and chemical storage areas.
Ensure that secondary containment is utilized for static equipment or storage facilities.
In the event of a spill / leak, notify the Superintendent immediately.
If the spill / leak is hazardous, follow the emergency action plan.
Properly clean up and dispose of any spilled substance immediately to protect personnel and the environment from potential fire and health hazards.
Ensure that no spilled materials are washed into the streets, gutters, storm drains, or creeks.
If possible, use dry cleaning methods to clean up spills to minimize the use of water.
Never hose down or bury dry material spills. Sweep up the material and dispose of properly.
Clean up chemical materials with absorbents, gels, and foams. Use absorbent materials on small spills rather than hosing down the spill. Remove the adsorbent materials promptly and dispose of it properly.
The competent person must inspect the area after cleanup to ensure the area is safe for workers and pedestrians. -
INADEQUATE ILLUMINATION:
General construction area lighting to be a minimum of 5 foot candles
Make sure the work area is adequately lit
Beware of low lighting in the early morning and late afternoon, especially in the winter months.
Clear safety glasses should be used while working indoors or outside in low light -
HEAT STRESS:
Training on Heat Illness detection, prevetion, and treatment
Loose fitting, Light colored clothes
Hydrate throughout the day
Shade is required at 80 degrees
Follow high heat procedures over 95 degrees
1 quart of water per person per hour for everyone on the job site
Provide acclimatization for workers not used to working in the heat
Provide periodic rest breaks in extreme working conditions -
COMPRESSOR / AIR PNUEMATIC TOOLS:
Competent Person Assigned
Follow the manufacturer's recommendations for lubrication and maintenance.
Keep air hoses free of grease and oil to reduce deterioration.
Inspect tools, equipment and hoses daily.
Inspect to see if shutoff valves are in proper working order.
Remove broken operating mechanisms immediately.
Ensure guards are in place before operating.
Use whip-checks and cotter pins or clips on Chicago fittings.
Maintain a firm footing when using pneumatic tools.
Hoses shall be placed to avoid tripping hazards or puncturing while in use.
Before pneumatic tools are disconnected the air must be turned off at the control valve and the pressure bled.
Do not use compressed air to clean off yourself or for housekeeping. -
HAZARDOUS SOIL / MATERIALS:
An exclusion zone shall be established where the contamination is present.
Post signage to identify hazards and limit access to authorized personnel.
Soil, air, and personal monitoring shall be performed to determine potential exposure.
Continuous monitoring shall be performed.
Stockpiled material will be placed on plastic sheeting, not on the ground.
Based upon monitoring results, the appropriate PPE level shall be established.
Decontamination procedures for people, tools, and equipment shall be determined.
Contaminated tools and equipment shall be disposed.
Eating, drinking, smoking, and putting on make-up are prohibited in contaminated areas. -
SCAFFOLDS:
Competent Person training Scaffolding inspection
General Awareness Training "Ladders and Scaffolds"
All workers using scaffold to ensure scaffold tag is signed off before using
Tool Box Talks
A readiness review shall be completed prior to installing scaffolds / temporary works systems.
Structures shall be erected per the manufacturer's specification and/or engineered design.
The competent person shall supervise erection, conduct inspections, and approve alterations.
Provide safe access to all working levels.
Scaffolds / temporary works shall be tagged at all access and egress points.
Scaffolds / temporary works shall be fully planked / decked.
Any damaged components shall not be used.
Ensure that all components are compatible.
Guardrails shall be in place on all open sides.
Mobile scaffolds shall not be moved while occupied. -
STAIRWAYS AND LADDERS:
Competent Person Training for Inspection
General Awareness Training "Ladders and Scaffolds"
All workers using ladder to ensure ladder tag is signed off before using
Tool Box Talks
Job built ladders must conform to regulatory requirements
Must be installed to a 4:1 ratio
3ft higher than landing point
Must be tied off and secure
Must have three points of contact
Working over 6ft requires fall protection
Access is clear and unobstructed
Handrails shall be free of burrs, slivers, splinters, or other defects.
Keep stairways and ladder access clear of materials, tools, and debris.
Working off of ladders should be considered the last option. Alternatives include portable scaffolds, scissor lifts, lift pods, stair towers, etc.
Ladders shall be inspected before each use, capacity tags must be legible, and monthly inspection tags current. Damaged ladders must be removed from service and destroyed.
Never use a ladder on top of a scaffold or work platform unless it is designed for such use.
Do not lean step ladders against a wall for use. Make sure it's fully open and the spreaders are locked. Do not climb, stand or sit on the top two steps.
Pass through brackets or corrals should be used at the top of access ladders. -
LIFTING EQUIPMENT:
QE License
CD on File
Crane Inspections Records
Maintenance Record
Competent Person Assigned
Daily equipment inspection
Certified operators
Equipment and rigging shall be inspected daily.
Determine weight of all loads and equipment capacities prior to lifting.
Travel paths shall be evaluated prior to moving.
Position equipment properly and plan where loads are to be landed.
Use taglines on all loads.
Plan work according to weather conditions.
Signal person must be properly trained in the use of hand signals.
When lifting with a forklift or material handler under the forks, an engineered lifting attachment must be used.
Overhead utilities shall be identified utilizing signage.
Only manufacturer's fork extensions shall be used. -
TRAIN / SUBWAY TRACKS:
Competent Person Assigned
NCTD OTS track training every year
Inspect the track before returning the G.O
EIC must be present
Every employee must know the protection limits and must be briefed by the EIC
All equipment with the potential to foul the tracks must have railroad protection
Each employee must have proof of railroad training
Rail flaggers are required for working on or near live tracks.
Ensure the track is cleared of personnel and equipment before signaling the work train to move. -
LOCK OUT - TAG OUT:
Competent Person
General Awareness Training
Tool Box Talks
Provide positive lockout protection
Potential stored energy sources shall be identified such as electrical, chemical, mechanical, thermal, steam, hydraulic, pneumatic, and gravity.
The LOTO coordinator shall coordinate with a qualified person to shut down the equipment or system.
The potential stored energy source shall be isolated to prevent the release of energy.
Turn off the power at the panel box, use manually operated circuit breakers, disconnect switches, line valves and safety blocks, etc.
Lock out the energy source. Lockout requires use of a lock or other lockout device to hold the energy.
Any lock should have a tag stating name, company and contact number for employee working on system.
Attempt to restart the equipment or system to visually verify that the energy source is actually shut down and that the equipment or system will not start or function.
Every employee working on the system will place a lock – do not work off another person’s lock – use a group lock box or hasps for large groups.
If an employee leaves without removing their lock, a lock removal permit shall be required for the lock to be removed. -
REBAR:
Rebar shop drawings for weights
Awareness Training Records
Tool Box Talks
Rebar caps and impalement protection when required -
IMPALEMENT HAZARDS:
Impalement hazards include both vertical and horizontal exposures.
Impalement hazards (rebar, form stakes, conduit, pipe stub-ups, etc.) shall be protected by the use of caps, covers, troughs, bending of material, etc.
Mushroom caps are not an acceptable means of impalement protection.
Nails shall be removed as systems are being stripped.
When working from a ladder or elevated work area, protect from impalement hazards.
T-post fencing 6 foot in height or less shall be protected. -
Please Specify other Hazard and Address corrective actions
Access / Egress / Parking:
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What are some access / egress / parking considerations?
- Site Deliveries 3015 Via Poco, Cardiff CA 92007
- Construction Staging Area #1
- Construction Staging Area #2
- Construction Staging Area #3
- Construction Staging Area #4
- Construction Staging Area #5
- Construction Staging Area #6
- Construction Staging Area #7 3065 South Coast Hwy, Solana Beach CA 92007
- Other
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Please Specify
Potential Pinch Points:
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Are there potential pinch points in today's operation?
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Please describe the potential pinch points?
Required PPE:
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What tools are being used?
- Power drill
- Impact drill
- Punch drill
- Cut off saw
- Skill saw
- Chain saw
- Saw zaw
- Table saw
- Chop saw
- Jack hammer
- Rivet buster
- Impact wrench
- Grinder
- Percussion hammer
- Router
- Welding machine
- Cutting torch
- Wacker
- Vibrator compactor
- Vacuum truck
- Vibrator
- Pressure Washer
- Power broom
- Leaf blower
- Weed eater
- Post pounder
- Electrical cords
- Chipping gun
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Power drill
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Impact drill
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Punch drill
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Cut off saw
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Chain saw
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Skill saw
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Saw zaw
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Table saw
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Chop saw
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Jack hammer
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Chipping gun
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Rivet Buster
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Impact wrench
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Grinder
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Percussion hammer
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Router
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Welding machine
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Cutting torch
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Wacker
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Vibrator Plate
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Vacuum truck
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Vibrator
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Pressure washer
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Power broom
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Leaf Eater
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Weed eater
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Post pounder
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Electrical cords
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What additional PPE may be required?
- Abrasive Blast Hood
- Beam Walkers
- Chain Saw Chaps
- Chin Straps
- Cutting Goggles
- Face Shields
- Fire Extinguisher
- Full Body Harness
- Gas Monitor
- Gloves (Specify Types)
- Hard Hats
- Hearing Protection
- Ladder Climbing Devices
- Lanyard
- Life Vests
- Metatarsal Guards
- Reflective Vest
- Respirators
- Rubber Boots
- Safety Glasses
- Safety Goggles
- Self-Retracting Lifeline
- Stop Paddles
- Traffic Control Signage
- Water
- Welding hood
- Welding Leathers
- Welding Screens
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If any other PPE is required, please type here
Heat:
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What is the temperature today?
- 30-40 degrees
- 40-50 degress
- 50-60 degrees
- 60-70 degrees
- 70-80 degrees
- 80-90 degrees
- 90-100 degrees
- 100 degrees and higher
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What measures could be taken for the high heat advisory?
- Shade? (80 degrees)
- Drink Water Frequently
- High Heat Procedures Required? (95 degrees plus)
- High Temperature of the day
- Medical Facility
- Location to Replenish Water
- Preventative cool-down discussed
Forms:
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What are the forms required for today's task?
- Hot Work Permit
- Confined Space Permit
- Equipment Inspection
- Pile Driving Inspection
- Traffic Control Inspector
- Weekly Inspection
- Critical Pick Checklist
- Job Hazard Analysis
- Falsework Lowering
- Trench & Excavation Pre-Construction Checklist
- Trench & Excavation Daily Visual Inspection
- Scaffold / Stair Tower Inspection
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Please Add photos of your completed paper forms
Form
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Add Photo of Form
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Does your task require reviewing a SDS?
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Please list the SDS that applies to the task?
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Please take a picture of the SDS
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Do we have a Utility Ticket?
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Please take a picture of the Utility ticket
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Does this task require special coordination with other trades
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Please explain the required coordination with other trades
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Please take a photo
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Do we need a job briefing from a crew that worked in the area prior?
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What information is needed to work in this area?
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Please take a photo
Environmental:
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Will you be clearing, grubbing, mowing or disturbing any previously undisturbed vegetation?
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Before work can begin call the appropriate contact below.
Segment 1 call Shane Landry (619) 206-1890
Segment 6 call Paul Walsh (619) 972-0651 -
If equipment will be idle onsite during shift a drip pan needs to be placed under equipment.
Crew Signatures:
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Crew Signatures - Each Crew member must sign to acknowledge that they participated in the meeting
Person
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Add signature
During Shift and Post Shift Reviews
Visitors
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If any visitors come to your site throughout the day, review the hazards with them and have them sign in here.
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Visitor sign in
Person
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Add signature
Take 5
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Does the work need to be reevaluated with a Take 5?
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Are there are any new tasks that were not previously identified?
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What are the new tasks?
Task
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Are there are any new hazards that were not previously identified?
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What are the new hazards?
- Fall from heights
- Slips, Trips, and Falls
- Strains and Pulled Muscles
- Power / Hand Tools Injuries
- Struck by / Caught Between
- Foreign Materials in the Face
- Rigging Failure
- Noise Exposure
- Silica Dust Exposure
- Pickup Trucks / Flat Trucks
- Electrocution / Shock
- Confined Space
- Aerial Boom Lift / Scissor Lift
- Hotwork
- Lead Exposure
- Trenching and Excavation Cave-in
- Spill / Leaks
- Inadequate Illumination
- Heat Stress
- Compressor / Air Pnuematic Tools
- Hazardous Soils / Materials
- Scaffolds
- Stairways / Ladders
- Lifting Equipment
- Train / Subway Tracks
- Rebar
- Lock Out - Tag Out
- Impalement Hazards
- Other
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FALL FROM HEIGHTS:
Competent Person Assigned
Use guardrails and install floor hole covers where possible to reduce the exposure to falling.
All persons shall be Fall Protection Awareness trained
Install signage on hole covers.
Install signage in areas that require fall protection.
All guardrails shall have a top rail, mid-rail, and toe-boards.
All holes 2 inches or greater shall be securely covered and labeled.
When using a personal fall arrest system, it shall consist of a full body harness and self retracting lanyard(s).
Shock absorbing lanyards are not permitted.
Adequacy of anchorage points shall be determined by the competent person.
Each worker is responsible for checking their own harness each time they put it on.
Verify that workers are wearing the harness properly and are anchored correctly.
Harnesses should be snug (2 finger tuck) while allowing full movement.
The best place for an anchorage point is directly above the work area.
Restraint systems shall be designed to prevent a fall.
Positioning device systems shall be used in conjunction with a personal fall arrest system. -
SLIPS, TRIPS AND FALLS:
Competent Person Assigned
Work Area Inspection
Tool Box Talks
Designate controlled pathways.
Use cord protection ramps.
Elevate cords a minimum of 7 feet above walkways where feasible.
Provide adequate lighting for work areas and pathways.
Housekeeping shall be performed daily as work progresses.
Perform a 360 degree observation of your surroundings.
Remove materials from stairs and walkways.
Cover or elevate cords.
Store all tools and materials in a designated area.
Keep ramps slip resistant with special anti-slip paint or other slip resistant material.
Avoid carrying materials that will block visibility.
Pay attention to these areas: change in elevation, access around corners, at the base or top of ladders and scaffolds, near equipment or trucks, etc.
Avoid distractions such as talking, texting, and emailing while walking.
Avoid walking backwards as much as possible.
Rebar mats shall have a designated walk path for safe access across.
Operations that require wet methods shall contain and clean the slurry, run-off, water, mud, etc. -
STRAINS AND PULLED MUSCLES:
Competent Person Assigned
Stretch and Flex Program
Tool Box Talks
General Awareness Training
Use material handling equipment as much as possible
Stage material to avoid double handling.
Observe employees' fitness for duty
Make sure there's a clear walkway with good lighting to the work area.
Do not carry a load that obscures your vision.
Stand close to the load, feet hip-width apart, one foot slightly forward pointing in the direction you are going.
Bend your knees and keep your back straight, get a secure grip on the load, and breathe in before lifting to help support your spine.
Keep your back straight and lift using your legs.
Keep the load close to your body, and lift slowly and smoothly.
Avoid jerky movements, and avoid twisting your body when lifting or carrying a load.
Ensure there is clear communication when there are two or more people handling a load. -
POWER / HAND TOOL INJURIES:
Competent Person Assigned
Toolbox talks
Select the appropriate tool for the task.
Ensure that the worker using the tools is properly trained in its safe use.
Ensure that users of powder actuated tool are certified and have their card on them at all times.
Inspect all tools daily.
Tag and remove any damaged tools immediately.
Check wooden handle tools for splinters or cracks.
Ensure that all handles supplied by the manufacturer are installed.
Keep knives and other tools sharp.
Ensure that tools are free from mushroomed heads.
Follow the manufacturer's recommendation for lubricating and maintaining tools.
Control loose clothing, hair, and jewelry.
Use task specific gloves while operating tools.
Ensure that guards are in place before operating a tool.
Maintain a firm footing and safe body position when operating a tool.
Secure work with clamps so you can use both hands to operate the tool.
Chaps are required when using a chain saw or demo saw.
Face shields are required when grinding, cutting, chipping, etc.
-
STRUCK BY / CAUGHT BETWEEN:
Competent Person Assigned
Tool Box Talks
General Awareness Training
MPT Training
Visual equipment inspection
Inspect the work area for possible struck by / caught between hazards such as high traffic areas, overhead work, etc.
Maintain and communicate establish controlled access zones.
Ensure that workers on the ground establish eye contact with operators prior to entering their operation area.
Ensure that only qualified operators operate machinery.
If safety devices such as horns or reverse alarms are not functional, red-tag the machine.
Use flaggers when traffic plans dictate.
When operators are unable to see clearly while backing, use a spotter.
Do not stand or walk behind or alongside moving equipment.
Never depend upon hearing a horn or other warning signal.
Identify overhead hazards and add proper signage.
Anticipate stored energy while pulling, pushing, loading, unloading, jacking, blocking, etc.
Secure pneumatic tools with whip checks.
Secure Chicago fittings with a cotter pin or clip. -
FOREIGN MATERIAL IN THE FACE:
Competent Person Assigned
All workers to be trained on proper use of the tool
Workers without experience using the tool or uncomfortable using the tool should be working closely with the Competent Person
Wear proper PPE -
RIGGING FAILURE:
Competent Person Assigned
Daily Inspection of Rigging, Compliance Audits
Materials weight information
Load center of gravity information
Must be a qualified rigger as recognized by FSSW
Identify the rigging in the Lift Plan.
Only qualified riggers shall rig the load.
Identify qualified riggers visually by a means such as unique vests, hard hats, etc.
Inspect all rigging prior to lifting.
Ensure that rigging is free from nicks, cuts, burns, tears, wear or other damage.
Check that safety latches on hooks are in working condition.
Check for wear and pin distortion on shackles.
Check for frayed or severed strands in wire rope slings.
Damaged rigging is to be cut and disposed of immediately.
Use taglines to control the load at all times.
Use softeners to protect rigging as needed.
Ensure that the work area is secure, to prevent people from entering the swing radius or walking under the load.
Review rated capacities on slings, shackles, etc. and know the weight of the load prior to lifts.
Do not alter equipment such as tying knots to shorten slings.
The rigging crew must communicate "all clear" to the signal-person before the lift.
Store rigging in a manner that avoids damage. -
NOISE EXPOSURE:
Competent Person Assigned
Toolbox Talks
Noise monitoring program
Signage for high noise areas
Limit exposure time of cases of extreme exposure
Wear hearing protection if you can't communicate normally within two feet of one another
Rotate employees out of high noise areas.
Inspect equipment for functioning mufflers.
Provide sound barriers for adjacent activities and communities.
Be aware of the effects of noise leaving the project site. -
SILICA DUST EXPOSURE:
Competent Person Assigned
General Awareness Training
Air monitoring program, watch PEL
MEQ
Respirator Fit Test
All workers must be clean shaven to properly wear a respirator.
Workers must be properly trained to use their respirators.
Workers must regularly clean and inspect their respirators.
Provide a designated storage area for respirators.
Wear washable or disposable work clothes.
Workers must wash hands before eating drinking, smoking, etc.
Do not eat, drink, use tobacco or apply makeup near areas containing silica dust.
Use wet methods and/or HEPA vacuums to control dust.
Vacuum away cutting slurry.
Use sweeping compound when sweeping. -
PICKUP TRUCKS / FLAT TRUCKS:
Daily Inspections
Motor Vehicle license required for vehicle being operated
Drivers to abide by all traffic laws
All drivers to follow the company cell phone policy
Drivers and all passengers to wear seat belts at all times.
All loads placed on any type of vehicle must be stacked, racked, blocked, interlocked, and/or secured to prevent sliding, falling, spilling and/or collapse.
Do not climb on unstable, slippery or irregular loads.
If the height of a potential fall from a truck is greater than 6 feet, then fall protection is required.
Do not allow people to stand adjacent to vehicles when dumping a load or when it's in motion.
Do not use cell phones or radios while your vehicle is in motion.
Check overhead clearances, and make personnel in you area aware of your presence. -
ELECTROCUTION/ SHOCK:
Competent Person Assigned
Assured Grounding to be performed on tools, extension cords and GFCI's
Never stand on wet or damp surfaces when using electric tools
Caution for overhead power lines and below ground utilities
Inspect extension cords and discard dysfunctional ones immediately.
Call for utility locates prior to digging.
Identify overhead power lines with signs and flagging to ensure a safe working distance.
Ensure that exposed live parts are protected.
Secure electrical rooms and post proper signage.
Electrical tape is not allowed for repairs.
Energized electrical work requires an approved Energized Electrical Work Plan.
Ensure that conductive material is not used to hang cord sets or welding leads. -
CONFINED SPACE:
Competent Person Assigned
Tool Box Talks
Once a Confined Space is identified, the area is to be marked with a sign designating it as a "Confined Space"
Confined Space Entry Permits must be used for all work in the Confined Spaces
Confined Space Training
Confined Space Checklist -
AERIAL BOOM LIFT / SCISSOR LIFT:
AWP Operator Training is required for all workers operating a manlift
Manlift to be inspected prior to each shift of working with the equipment
If the manlift is not functioning properly, then it must be tagged "DO NOT USE" and the superintendent must be notified immediately
All aerial work platforms must have a controls bump bar
Operators shall wear a full body harness and tie off to the manufacturers attachment point with a self retracting lifeline.
Aerial work platforms must be lowered prior to traveling.
Keep body parts inside the basket when booming, swinging or traveling.
When operating aerial work platforms, stand firmly on the floor of the basket.
Maintain a minimum clearance of at least 10 feet away from the nearest overhead power lines. See OSHA table K-1 for clearance requirements over 50,000 KV.
Do not exceed the load limits of the equipment. Allow for the combined weight of the worker, tools, and materials. -
HOT WORK:
Competent Person Assigned
Hot Work Permits as Required
Fire Watch
Air Sample Results
Maintain Welding License on File
MEQ, Respirator Fit Test, Respirator Training
Fire suppression system and fire watch must be utilized
Oxygen and acetylene bottles must be kept in an upright position and secured.
Oxygen and acetylene bottles will be stored 20' or greater apart or be separated by a barrier with at least a 1/2 hour noncombustible burn rating.
Do not attempt to lift bottles alone by hand. Roll them or use a cart or dolly.
Bottles can be lifted only in a secured cart or rack with an engineered picking eye.
Bottles must have on protective caps when not being used and while being transported.
Ensure that valves are closed at the torch before turning on regulator valves.
All hoses shall have flash arrestors at the torch end.
Check gauges, valves, regulators, torch tips, and hoses for signs of wear or damage.
Listen for leaks.
Inspect welding leads and cords for damage and remove from service if damaged.
Protect the rods and leads and ensure that they are kept dry.
Inspect the area for flammable / combustible material and remove prior to commencing hot work.
Ensure work area is well ventilated and wear proper respiratory equipment.
Welding hoods must be used with a hard hat. Use appropriate lens for cutting and welding.
Light the torch away from your body.
Use a fire watch with a fire extinguisher for a 1/2 hour after hot work ceases. -
LEAD EXPOSURE:
Competent person assigned to determine if lead paint is present
Air monitoring as needed
Lead Exposure General Awareness Training
Comply with Lead Compliance and ADL Plans
Lead work areas shall be identified and controlled to only allow authorized personnel.
Decontamination procedures shall be followed prior to eating, drinking, smoking, or leaving the work site.
Personal monitoring shall be performed to identify potential exposure.
Minimize dust by wet methods, HEPA vacuums, and ventilation. -
TRENCHING AND EXCAVATION CAVE-INS:
Competent person is to supervise all trenching and excavation activities
All workers involved in these activities must have Trenching & General Awareness Training
Support of Excavation Plans
No standing water is allowed in the trench / excavation
Daily inspections by competent person
Verify underground utilities
Proper access and egress
Verify if hazardous atmosphere is present
Stability of adjacent structures
Over 20' excavations it must be engineered
An excavation permit shall be issued that identifies the soil classification and the protective system to be used.
Visible barriers must be placed around the perimeter to prevent unauthorized access
All excavations must have safe access regardless of depth such as a ladder or ramp.
In trenches, access to work area must include a travel distance of no greater than 25 feet for access/egress.
Equipment, materials, tools and excavated soil must be kept at least 2 feet from the edge of pit, to reduce the risk of their falling into the excavation.
Openings such as pipe piles and manholes are to be protected.
Fall protection is required when a fall hazard is present.
Underground installations shall be protected, supported or removed as necessary.
Excavations shall be delineated or barricaded to prevent exposure to traffic. -
SPILL / LEAKS:
All jobsite chemicals to be properly labeled and have an SDS available
All workers unfamiliar with the chemical to review SDS before starting task
Must have a spill kit
Any significant spills must follow steps converted in the SPP
Equipment shall be inspected daily and maintenance schedules shall be followed.
Perform inspections as required per legal and other requirements.
Install barricades around fuel, oil and chemical storage areas.
Ensure that secondary containment is utilized for static equipment or storage facilities.
In the event of a spill / leak, notify the Superintendent immediately.
If the spill / leak is hazardous, follow the emergency action plan.
Properly clean up and dispose of any spilled substance immediately to protect personnel and the environment from potential fire and health hazards.
Ensure that no spilled materials are washed into the streets, gutters, storm drains, or creeks.
If possible, use dry cleaning methods to clean up spills to minimize the use of water.
Never hose down or bury dry material spills. Sweep up the material and dispose of properly.
Clean up chemical materials with absorbents, gels, and foams. Use absorbent materials on small spills rather than hosing down the spill. Remove the adsorbent materials promptly and dispose of it properly.
The competent person must inspect the area after cleanup to ensure the area is safe for workers and pedestrians. -
INADEQUATE ILLUMINATION:
General construction area lighting to be a minimum of 5 foot candles
Make sure the work area is adequately lit
Beware of low lighting in the early morning and late afternoon, especially in the winter months.
Clear safety glasses should be used while working indoors or outside in low light -
HEAT STRESS:
Training on Heat Illness detection, prevetion, and treatment
Loose fitting, Light colored clothes
Hydrate throughout the day
Shade is required at 80 degrees
Follow high heat procedures over 95 degrees
1 quart of water per person per hour for everyone on the job site
Provide acclimatization for workers not used to working in the heat
Provide periodic rest breaks in extreme working conditions -
COMPRESSOR / AIR PNUEMATIC TOOLS:
Competent Person Assigned
Follow the manufacturer's recommendations for lubrication and maintenance.
Keep air hoses free of grease and oil to reduce deterioration.
Inspect tools, equipment and hoses daily.
Inspect to see if shutoff valves are in proper working order.
Remove broken operating mechanisms immediately.
Ensure guards are in place before operating.
Use whip-checks and cotter pins or clips on Chicago fittings.
Maintain a firm footing when using pneumatic tools.
Hoses shall be placed to avoid tripping hazards or puncturing while in use.
Before pneumatic tools are disconnected the air must be turned off at the control valve and the pressure bled.
Do not use compressed air to clean off yourself or for housekeeping. -
HAZARDOUS SOIL / MATERIALS:
An exclusion zone shall be established where the contamination is present.
Post signage to identify hazards and limit access to authorized personnel.
Soil, air, and personal monitoring shall be performed to determine potential exposure.
Continuous monitoring shall be performed.
Stockpiled material will be placed on plastic sheeting, not on the ground.
Based upon monitoring results, the appropriate PPE level shall be established.
Decontamination procedures for people, tools, and equipment shall be determined.
Contaminated tools and equipment shall be disposed.
Eating, drinking, smoking, and putting on make-up are prohibited in contaminated areas. -
SCAFFOLDS:
Competent Person training Scaffolding inspection
General Awareness Training "Ladders and Scaffolds"
All workers using scaffold to ensure scaffold tag is signed off before using
Tool Box Talks
A readiness review shall be completed prior to installing scaffolds / temporary works systems.
Structures shall be erected per the manufacturer's specification and/or engineered design.
The competent person shall supervise erection, conduct inspections, and approve alterations.
Provide safe access to all working levels.
Scaffolds / temporary works shall be tagged at all access and egress points.
Scaffolds / temporary works shall be fully planked / decked.
Any damaged components shall not be used.
Ensure that all components are compatible.
Guardrails shall be in place on all open sides.
Mobile scaffolds shall not be moved while occupied. -
STAIRWAYS AND LADDERS:
Competent Person Training for Inspection
General Awareness Training "Ladders and Scaffolds"
All workers using ladder to ensure ladder tag is signed off before using
Tool Box Talks
Job built ladders must conform to regulatory requirements
Must be installed to a 4:1 ratio
3ft higher than landing point
Must be tied off and secure
Must have three points of contact
Working over 6ft requires fall protection
Access is clear and unobstructed
Handrails shall be free of burrs, slivers, splinters, or other defects.
Keep stairways and ladder access clear of materials, tools, and debris.
Working off of ladders should be considered the last option. Alternatives include portable scaffolds, scissor lifts, lift pods, stair towers, etc.
Ladders shall be inspected before each use, capacity tags must be legible, and monthly inspection tags current. Damaged ladders must be removed from service and destroyed.
Never use a ladder on top of a scaffold or work platform unless it is designed for such use.
Do not lean step ladders against a wall for use. Make sure it's fully open and the spreaders are locked. Do not climb, stand or sit on the top two steps.
Pass through brackets or corrals should be used at the top of access ladders. -
LIFTING EQUIPMENT:
QE License
CD on File
Crane Inspections Records
Maintenance Record
Competent Person Assigned
Daily equipment inspection
Certified operators
Equipment and rigging shall be inspected daily.
Determine weight of all loads and equipment capacities prior to lifting.
Travel paths shall be evaluated prior to moving.
Position equipment properly and plan where loads are to be landed.
Use taglines on all loads.
Plan work according to weather conditions.
Signal person must be properly trained in the use of hand signals.
When lifting with a forklift or material handler under the forks, an engineered lifting attachment must be used.
Overhead utilities shall be identified utilizing signage.
Only manufacturer's fork extensions shall be used. -
TRAIN / SUBWAY TRACKS:
Competent Person Assigned
NCTD OTS track training every year
Inspect the track before returning the G.O
EIC must be present
Every employee must know the protection limits and must be briefed by the EIC
All equipment with the potential to foul the tracks must have railroad protection
Each employee must have proof of railroad training
Rail flaggers are required for working on or near live tracks.
Ensure the track is cleared of personnel and equipment before signaling the work train to move. -
LOCK OUT - TAG OUT:
Competent Person
General Awareness Training
Tool Box Talks
Provide positive lockout protection
Potential stored energy sources shall be identified such as electrical, chemical, mechanical, thermal, steam, hydraulic, pneumatic, and gravity.
The LOTO coordinator shall coordinate with a qualified person to shut down the equipment or system.
The potential stored energy source shall be isolated to prevent the release of energy.
Turn off the power at the panel box, use manually operated circuit breakers, disconnect switches, line valves and safety blocks, etc.
Lock out the energy source. Lockout requires use of a lock or other lockout device to hold the energy.
Any lock should have a tag stating name, company and contact number for employee working on system.
Attempt to restart the equipment or system to visually verify that the energy source is actually shut down and that the equipment or system will not start or function.
Every employee working on the system will place a lock – do not work off another person’s lock – use a group lock box or hasps for large groups.
If an employee leaves without removing their lock, a lock removal permit shall be required for the lock to be removed. -
REBAR:
Rebar shop drawings for weights
Awareness Training Records
Tool Box Talks
Rebar caps and impalement protection when required -
Impalement hazards include both vertical and horizontal exposures.
Impalement hazards (rebar, form stakes, conduit, pipe stub-ups, etc.) shall be protected by the use of caps, covers, troughs, bending of material, etc.
Mushroom caps are not an acceptable means of impalement protection.
Nails shall be removed as systems are being stripped.
When working from a ladder or elevated work area, protect from impalement hazards.
T-post fencing 6 foot in height or less shall be protected. -
Are there potential pinch points in the operation that weren't previously identified?
-
Please describe the potential pinch points.
-
Are there are any tools being used that weren't previously identified?
-
What tools are the new tools being used?
- Power drill
- Impact drill
- Punch drill
- Cut off saw
- Skill saw
- Chain saw
- Saw zaw
- Table saw
- Chop saw
- Jack hammer
- Rivet buster
- Impact wrench
- Grinder
- Percussion hammer
- Router
- Welding machine
- Cutting torch
- Wacker
- Vibrator compactor
- Vacuum truck
- Vibrator
- Pressure Washer
- Power broom
- Leaf blower
- Weed eater
- Post pounder
- Electrical cords
- Chipping gun
-
Power drill
-
Impact drill
-
Punch drill
-
Cut off saw
-
Chain saw
-
Skill saw
-
Saw zaw
-
Table saw
-
Chop saw
-
Jack hammer
-
Chipping gun
-
Rivet Buster
-
Impact wrench
-
Grinder
-
Percussion hammer
-
Router
-
Welding machine
-
Cutting torch
-
Wacker
-
Vibrator Plate
-
Vacuum truck
-
Vibrator
-
Pressure washer
-
Power broom
-
Leaf Eater
-
Weed eater
-
Post pounder
-
Electrical cords
-
Is there any additional PPE required that was not previously identified?
-
What additional PPE may be required?
- Abrasive Blast Hood
- Beam Walkers
- Chain Saw Chaps
- Chin Straps
- Cutting Goggles
- Face Shields
- Fire Extinguisher
- Full Body Harness
- Gas Monitor
- Gloves (Specify Types)
- Hard Hats
- Hearing Protection
- Ladder Climbing Devices
- Lanyard
- Life Vests
- Metatarsal Guards
- Reflective Vest
- Respirators
- Rubber Boots
- Safety Glasses
- Safety Goggles
- Self-Retracting Lifeline
- Stop Paddles
- Traffic Control Signage
- Water
- Welding hood
- Welding Leathers
- Welding Screens
-
If any other PPE is required, please type here
-
Are there are any additional forms that weren't previously idetified?
-
What are the forms required for today's task?
- Hot Work Permit
- Confined Space Permit
- Equipment Inspection
- Pile Driving Inspection
- Traffic Control Inspector
- Weekly Inspection
- Critical Pick Checklist
- Job Hazard Analysis
- Falsework Lowering
- Trench & Excavation Pre-Construction Checklist
- Trench & Excavation Daily Visual Inspection
- Scaffold / Stair Tower Inspection
-
Does your task require reviewing a SDS that wasn't previously identified?
-
Please list the SDS that applies to the task?
-
Please take a picture of the SDS
-
Do we have a Utility Ticket that wasn't previously identified?
-
Please take a picture of the Utility ticket
-
Does this task require special coordination with other trades that wasn't previously identified?
-
Please explain the required coordination with other trades
-
Please take a photo
-
Crew Signatures - Each Crew member must sign to acknowledge that they participated in the Take 5 meeting
Person
-
Add signature
Audit
-
Was this Daily Start Card Reviewed by Project Management?
-
Does the Daily Start Card adequately address hazards present?
-
Please list additional Hazards and corrective actions
-
Auditors
Person
-
Add signature
Safety end-of-shift review:
-
Were there any work related injuries?
-
Please describe below
-
Add media
-
Any equipment / property damage reported?
-
Please describe below
-
Please take a photo
-
Any near misses reported?
-
Please describe below
-
Please take a photo
-
Does the Construction Work Plan Adequately Address the work being performed?
-
Please cc your Engineer on the Daily Start Card Email
-
Please specify:
-
Equipment Inspections
Equipment
-
Does this equipment require attention from the equipment department?
-
Please cc Ted Dexheimer on your Daily Start Card Email.
-
Equipment Inspection Sheet
Environmental:
-
Is there any equipment on site?
-
Place drip pan under equipment.
-
Please take photo.
Foreman's Signature:
-
End of shift picture
Signature
-
Add signature
