Digco Gas Construction "Safety Dept" Revised

• Document No.....

• "Job Foreman"

• Client /Job Site......

• "Date Conducted on"

  Date

• Prepared By....

• "Crew Location"
  Address

• Personnel And Crew Type....Main Line...Leaks....Kills.....

• "Are Crews At This Location">?

  Yes

  No

  N/A

• Digco Crew Truck #..?

  Yes

  No

  N/A

• Are The Truck/Trailer Inspection "Tags Current"/ " All Tires" Within "Company Policy And D.O.T Compliance" And Regulations?

  Yes

  No

  N/A

• All Seat Belts Being Worn While Riding/Driving Company Vehicle?

  Yes

  No

  N/A

• D.V.I.R....LOG.. Completed?

  Yes

  No

  N/A

• Competent Person At Jobsite For Trench Inspections?

  Yes

  No

  N/A

• Are The Trenches/Excavations...Shored...Sloped.....And Spoils Fenced In Correctly.....

  Yes

  No

  N/A

• Means Of Access And Egress Inside Excavations? >(Ladders, Etc)?

  Yes

  No

  N/A

• Are All Underground Facilities Marked Correctly?

  Yes

  No

  N/A

• Are There CGI/02 Meters Onsite?>(Calibrated)

  Yes

  No

  N/A

• Are There Locate Request Copies On Jobsite?>(Filled Out And Completed'Properly)

  Yes

  No

  N/A

• All Spoil Piles Back> 3 ft...Or Better And Properly Fenced In?

  Yes

  No

  N/A

"Tools/Equipment"

• "Are There Any Heavy Equipment Hazards Present "Oil Or Hydraulic"Leaks">?

  Safe

  At Risk

  N/A

• Are All Safety Guards In Place On Hand<And Power Tools>? (Drills, Grinders, Hammers, Etc?

  Yes

  No

  N/A

• Operators Trained Properly On All Heavy Equipment?

  Yes

  No

  N/A

• Are Seat Belts Being Worn While Operating All Heavy Equipment?

  Yes

  No

  N/A

• Does The Housekeeping Look Good On Both Crew Trucks And Trailers?

  Yes

  No

  N/A

• Are The Proper "Metal" Cans Being Used Safely For Gasoline/Diesel?

  Yes

  No

  N/A

• Are Fire Extinguishers> Available, Inspected, mounted properly, Tagged, And Trained To Use>?

  Yes

  No

  N/A

• Are All Lifting Devices /Tie-Downs>(Straps, Chains, Binders) In Good Condition?

  Yes

  No

  N/A

• Does Digco In House Welders >Welding Machines/"Leads" And >High Pressure Bottles/"Hoses"Are In Compliance With DOT And Company Safety Policies>??

  Safe

  At Risk

  N/A

"Health And Safety"

• Certified First Aid/ CPR Person Available On Jobsite?

  Yes

  No

  N/A

• First Aid Kit Fully Stocked, Accessible And Usable?

  Yes

  No

  N/A

• "Is There Drinking Water Available> And Cups Properly Mounted On Crew Trucks?

  Yes

  No

  N/A

"Personal Protective Equipment"

• Safety Vest/High-Vis Shirt Being Worn While Working Throughout Jobsite?

  Yes

  No

  N/A

• Hard Hat> Being Worn While Working?

  Yes

  No

  N/A

• Safety Glasses>Being Worn In And Around Job Site And While Working">?

  Yes

  No

  N/A

• Was Employee Wearing Proper Hearing Protection if Needed?

  Yes

  No

  N/A

• Was Employee Wearing Proper Foot Protection (Toe Protection) As Needed">?

  Yes

  No

  N/A

• Was Employee Wearing Proper "Hand Protection" As Needed While Working?

  Yes

  No

  N/A

"General Audit Info"

• "Job" Briefing Completed Each Morning Before Work Starts?

  Yes

  No

  N/A

• "JHA" Briefing Completed Each Morning Before Work Starts And Properly Filled Out For The Intended Job Being Worked For Each Job Site">?

  Yes

  No

  N/A

• "Are All Crew "Trucks/Trailers" Parked Properly/Not Blocking Traffic And Coned Up">?

  Safe

  At Risk

  N/A

• "Traffic Control/Signs" Out In All Directions Needed For Employees And Public Safety?

  Yes

  No

  N/A

• "AED" Monthly Inspection Completed And Signed?

  Yes

  No

  N/A

• "Housekeeping" Looks Good Around Job Site?

  Yes

  No

  N/A

• "Is This Crew Eligible For Monthly Drawing At 95% Or Better??

  Yes

  No

  N/A

• Gas Construction "Comments" (Public Safety, Employee Safety, Equipment Safety Etc, Job Safety.)"

  None At This Time

  "Comments Below"

• Add signature

  Sign