VDC -Site Safety Inspection

• Conducted on

  Date

• Prepared by

• Location
  Address

• Site Safety Inspection

  Yes

  No

  N/A

• JOB NO

AREA SUPERVISOR:

PROJECT:

• LOCATION:

• INSPECTION TYPE:

  Yes

  No

  N/A

• Formal

  Yes

  No

  N/A

• Informal

  Yes

  No

  N/A

• FREQUENCY

  Yes

  No

  N/A

• Weekly

  Yes

  No

  N/A

• Monthly

  Yes

  No

  N/A

• Quarterly

  Yes

  No

  N/A

• Other:

  Yes

  No

  N/A

• INSPECTION CONDUCTED BY:

• Name:

• Title:

• Signature:

  Sign

• Name:

• Title:

HAZARD RATING CLASSIFICATIONS:

ALL INSPECTIONS WILL BE RATED ACCORDING TO THE DEGREE OF SEVERITY TO SET PRIORITY OF ACTION

• ALL “A” HAZARDS IDENTIFIED MUST BE IMMEDIATELY ADDRESSED

• A Hazard: A condition or practice likely to cause immediate permanent disability, loss of life, or extensive loss of structure, equipment or material and/or reportable environmental release/spill. Requires immediate corrective action as is defined as an imminent hazard. Activity must be discontinued until hazard has been corrected / resolved

• B Hazard: A condition or act likely to cause moderate injury or illness, resulting in temporary disability, property damage or environmental release/spill that is disruptive but not extensive. An urgent situation, requiring attention as soon as possible

• C Hazard: A condition or practice likely to cause minor (non-disabling) injury or illness, non-disruptive property damage or minor environmental impact. Not an emergency, however to be addressed without delay

• O: Outstanding item from previous inspection

  Yes

  No

  N/A

PLAN THE INSPECTION:

• Identify inspection Type and Frequency

  Yes

  No

  N/A

• Review severity classifications

  Yes

  No

  N/A

• Assign specific categories on which to focus efforts when there is more than one person conducting the inspection

  Yes

  No

  N/A

• Confirm access requirements and authorizations for specific areas or processes

  Yes

  No

  N/A

PERFORM THE INSPECTION:

• Identify each element and relative compliance conditions per the Safety Inspection Matrix

  Yes

  No

  N/A

• Record the specific Hazard Class for each observation

  Yes

  No

  N/A

• Record the correction of any unsafe practice or condition observed

  Yes

  No

  N/A

• Assign responsibility for correcting the hazard or unacceptable behaviour

  Yes

  No

  N/A

• Detail any positive interactions with Supervision and Workers as identified through the inspection

• EXECUTE RESULTS:

  Yes

  No

  N/A

• Communicate the inspection results to Management, Supervision and Workers

  Yes

  No

  N/A

• Assure that all corrective actions from the inspection are completed

  Yes

  No

  N/A

DESCRIPTION / OBSERVATION

• HAZARD RATING

  Yes

  No

  N/A

CORRECTIVE ACTION

RESPONSIBILITY

• COMPLETION DATE

  Date

POSITIVE OBSERVATIONS

14.0 REPORTING

• Copies To:

  Yes

  No

  N/A

• Name:

• Title:

• Name:

• Title:

INSPECTION MATRIX

Project Requirements

• JHA / POWSEA completed for Task

  Yes

  No

  N/A

• Emergency Response Plan and Procedures posted

  Yes

  No

  N/A

• Workers fit for duty

  Yes

  No

  N/A

• Free from slipping/tripping hazards (mud, ice, water)

  Yes

  No

  N/A

• Safe access/egress of walkways / stairways

  Yes

  No

  N/A

• Adequate task and area lighting

  Yes

  No

  N/A

Hot Work

• Hot Work Permit Complete

  Yes

  No

  N/A

• Check valves and flashback arrestors in place

  Yes

  No

  N/A

• Fuel gases and oxygen stored in accordance with regulation

  Yes

  No

  N/A

• Cylinders secured in the upright position

  Yes

  No

  N/A

• Gauges removed and protective caps in place when not in use

  Yes

  No

  N/A

• Tagging system for unused oxy/fuel equipment employed

  Yes

  No

  N/A

• Flammables removed from hot work areas

  Yes

  No

  N/A

• Welding shield/barrier in place

  Yes

  No

  N/A

• Proper ventilation

  Yes

  No

  N/A

• Areas below are identified by a barrier

  Yes

  No

  N/A

• Slag and spark containment

  Yes

  No

  N/A

• Rod stubs are stored properly

  Yes

  No

  N/A

• Respiratory protection used as required

  Yes

  No

  N/A

• Fire Extinguishers available, charged and inspected

  Yes

  No

  N/A

Ladders

• Suited to task

  Yes

  No

  N/A

• On firm footing

  Yes

  No

  N/A

• Rubber cleats on feet

  Yes

  No

  N/A

• Regulated height/base ratio

  Yes

  No

  N/A

• Secured at top and base

  Yes

  No

  N/A

• One-meter extension at grade

  Yes

  No

  N/A

• No cracks or splices

  Yes

  No

  N/A

• Non-conductive for electrical use

  Yes

  No

  N/A

• Three-point contact employed

  Yes

  No

  N/A

• Doors, stairway/landing not obstructed by ladder(s)

  Yes

  No

  N/A

• Landing clear and level

  Yes

  No

  N/A

Elevated Work Platforms

• Annual certification

  Yes

  No

  N/A

• Operator is trained

  Yes

  No

  N/A

• Pre-inspection completed

  Yes

  No

  N/A

• Function test complete

  Yes

  No

  N/A

• Path of travel has been reviewed (holes, soft spots)

  Yes

  No

  N/A

• Weight of materials and equipment do not exceed manufacturer’s specifications

  Yes

  No

  N/A

• Surface is firm, level and can support the machine weight

  Yes

  No

  N/A

• Fall protection requirements observed

  Yes

  No

  N/A

• No standing on mid-rail/top-rails

  Yes

  No

  N/A

• Spotters used in confined areas properly spaced

  Yes

  No

  N/A

• Piping

  Yes

  No

  N/A

• Safe rigging practices observed

  Yes

  No

  N/A

• Pipe supports are in place and bolted tight and/or welded

  Yes

  No

  N/A

• Pipe is adequately supported throughout

  Yes

  No

  N/A

• Shoes on their supports, spring hangers adjusted

  Yes

  No

  N/A

• Fasteners secured to prevent movement and/or leakage

  Yes

  No

  N/A

• Labels/information is legible and tagged with Equipment ID

  Yes

  No

  N/A

• Lines purged/cleaned prior to hot works

  Yes

  No

  N/A

• In-process work identified

  Yes

  No

  N/A

• Lockout of hazardous systems verified for process work

  Yes

  No

  N/A

• Safety precautions observed for testing (hydro/pneumatic)

  Yes

  No

  N/A

Hazard Assessment Audits

• Does the POWSEA Card represent the task performed

  Yes

  No

  N/A

• Hazards are specific to the task

  Yes

  No

  N/A

• Is there a acceptable control for the hazards

  Yes

  No

  N/A

• Has the Foreman / Supervisor reviewed the POWSEA

  Yes

  No

  N/A

• Does the worker understand the process

  Yes

  No

  N/A

• Is the worker revisiting the POWSEA after breaks or through changes in plan?

  Yes

  No

  N/A

Hoisting Equipment & Rigging

• Work area and path of lift cleared/secured for lifting

  Yes

  No

  N/A

• Weights of lift known

  Yes

  No

  N/A

• Rigging equipment has been inspected / certified (as required)

  Yes

  No

  N/A

• Equipment & rigging rated for lift

  Yes

  No

  N/A

• Softeners applied

  Yes

  No

  N/A

• Rigging applied correctly by competent personnel

  Yes

  No

  N/A

• Safety applied (as required) for angle-adjusted lifts

  Yes

  No

  N/A

• Crane inspection completed

  Yes

  No

  N/A

• Operating within manufacturers limits

  Yes

  No

  N/A

• Rigging & Hoisting checklist completed

  Yes

  No

  N/A

• Critical Lift Plans developed

  Yes

  No

  N/A

• Signaller is identified

  Yes

  No

  N/A

• Proper signals used

  Yes

  No

  N/A

• Blind lifts are using radio communication

  Yes

  No

  N/A

• Tag lines employed for control

  Yes

  No

  N/A

Scaffolding

• Firm level, stable surface

  Yes

  No

  N/A

Top and mid-rails

• Toe boards

  Yes

  No

  N/A

• Acceptable work platform

  Yes

  No

  N/A

• Load rated platform

  Yes

  No

  N/A

• Acceptable access/egress

  Yes

  No

  N/A

• Mud sills in place

  Yes

  No

  N/A

• Outriggers/screw jacks

  Yes

  No

  N/A

• Tagged with daily inspection frequency

  Yes

  No

  N/A

• Compatible hardware used

  Yes

  No

  N/A

• Regulated height/base ratio

  Yes

  No

  N/A

• Wheels blocked or locked

  Yes

  No

  N/A

• All members firmly fastened/secured

  Yes

  No

  N/A

• Housekeeping

  Yes

  No

  N/A

• Good hygiene practices – lunchrooms/offices/toilets

  Yes

  No

  N/A

• General appearance of work areas free of clutter

  Yes

  No

  N/A

• Adequate waste containers throughout

  Yes

  No

  N/A

• Receptacles not overflowing

  Yes

  No

  N/A

• Walkways, entrances and stairwells free from obstructions

  Yes

  No

  N/A

• Materials stored safely and secured from falling

  Yes

  No

  N/A

• Cords/cables stored neatly/overhead

  Yes

  No

  N/A

Mobile & Heavy Equipment

• Pre-Use inspection completed and documented

  Yes

  No

  N/A

• Regular maintenance completed

  Yes

  No

  N/A

• Fire Extinguisher and safety equipment installed/available

  Yes

  No

  N/A

• Backup alarms installed

  Yes

  No

  N/A

• Seat belts available and in use

  Yes

  No

  N/A

• Loads secured during transport

  Yes

  No

  N/A

• Beacon operational and all necessary lights on/working

  Yes

  No

  N/A

• Use of spotter(s) throughout operation (as necessary)

  Yes

  No

  N/A

• Safe operation practices observed

  Yes

  No

  N/A

Material Handling/Storage

• Proper lifting techniques used (≤ 50lbs)

  Yes

  No

  N/A

• Weight of object known

• Storage/laydown area organized

  Yes

  No

  N/A

• Materials securely stored (free from tipping, rolling or falling)

  Yes

  No

  N/A

• Entrances/exits/walkways not obstructed

  Yes

  No

  N/A

• Signs and delineators available for traffic flow

  Yes

  No

  N/A

Hand & Power Tools

• Worker familiar with use

  Yes

  No

  N/A

• Inspected prior to operation

  Yes

  No

  N/A

• Used in accordance with the manufacturer guidelines

  Yes

  No

  N/A

• Guards are in place

  Yes

  No

  N/A

• Tool has not been modified/altered

  Yes

  No

  N/A

• Line of Fire/Pinch Points observed

  Yes

  No

  N/A

• Electrically grounded

  Yes

  No

  N/A

• Cutting implements sharp

  Yes

  No

  N/A

• PPE

  Yes

  No

  N/A

• Hard hats

  Yes

  No

  N/A

• Eye and face protection

  Yes

  No

  N/A

• Footwear

  Yes

  No

  N/A

• High visibility vests

  Yes

  No

  N/A

• Hearing protection

  Yes

  No

  N/A

• Gloves

  Yes

  No

  N/A

• Protective and reflective clothing

  Yes

  No

  N/A

• Gloves suited to task

  Yes

  No

  N/A

Fire Protection/Suppression

• Extinguishers provided on vehicles/equipment

  Yes

  No

  N/A

• Available near Hot Work operations

  Yes

  No

  N/A

• Available in offices and lunchrooms

  Yes

  No

  N/A

• Fuel/chemical storage areas

  Yes

  No

  N/A

• Smoking limited to designated areas only

  Yes

  No

  N/A

• Fire blankets employed (as necessary)

  Yes

  No

  N/A

• Suitable barricades and flagging erected

  Yes

  No

  N/A

Fall Protections/Prevention

• Fall Protection Plan developed and implemented (as applicable)

  Yes

  No

  N/A

• Workers trained in requirements

  Yes

  No

  N/A

• Equipment is inspected (harness, lanyard, anchor sling, hardware)

  Yes

  No

  N/A

• Labels are clearly marked and legible

  Yes

  No

  N/A

• SRL’s are inspected

  Yes

  No

  N/A

• Control zones are established

  Yes

  No

  N/A

• Handrails/guardrails are in place

  Yes

  No

  N/A

• Floor/roof openings securely covered and identified

  Yes

  No

  N/A

• WHMIS-2015

  Yes

  No

  N/A

• Workers are trained in WHMIS 2015

  Yes

  No

  N/A

• SDS’s are current and immediately available

  Yes

  No

  N/A

• Hazardous products labeled

  Yes

  No

  N/A

• Labels on applicable workplace containers

  Yes

  No

  N/A

• Exposure control plans in place (as required)

  Yes

  No

  N/A

• Workers employing controls (including PPE) in accordance with SDS

  Yes

  No

  N/A

Electrical

• Permit(s) received and reviewed (as required)

  Yes

  No

  N/A

• Properly rated tools and equipment

  Yes

  No

  N/A

• Cords and cables in good condition following inspection criteria and quarterly colour code (grounding assurance)

  Yes

  No

  N/A

• Ground Fault Circuit Interceptors (GFCI) operable

  Yes

  No

  N/A

• Lock-Out procedure in place and observed

  Yes

  No

  N/A

• Zero energy state verified

  Yes

  No

  N/A

• Proper locks/tags utilized

  Yes

  No

  N/A

• Formwork completed

  Yes

  No

  N/A

• Limits of approach observed

  Yes

  No

  N/A

Environmental

• Spill containment kits are sufficient

  Yes

  No

  N/A

• Hazardous material storage

  Yes

  No

  N/A

• Emergency Response Plan includes specifics for spills

  Yes

  No

  N/A

• Environmental Policy is posted

  Yes

  No

  N/A

• Contaminants are stored and disposed of by a licensed carrier (as applicable)

  Yes

  No

  N/A

• Reporting process is known and followed

  Yes

  No

  N/A

• Secondary containment for fuels and lubricants

  Yes

  No

  N/A

• Establish/contain concrete washout areas

  Yes

  No

  N/A

• Control of airborne dusts (as applicable)

  Yes

  No

  N/A

• Maintenance of storm water and runoff

  Yes

  No

  N/A

• Erosion & sediment control

  Yes

  No

  N/A

• Equipment maintenance to limit environmental impacts (leaks)

  Yes

  No

  N/A

• Procedures for working in and around bodies of water

  Yes

  No

  N/A