DIGCO Utilities Jobsite Safety Inspection Copy

• Document No.

• Audit Title

• Truck Number

• Conducted on

  Date

• Prepared by

• Location
  Address

VEHICLES

• Is the crew at the location?

  Yes

  No

  N/A

• Weather Conditions

• Has DVIR been completed?

  Yes

  No

  N/A

• Is the equipment trailer in good/safe condition?

  Yes

  No

  N/A

• Are seat belts being worn while riding in or operating vehicles?

  Yes

  No

  N/A

• Is Housekeeping on the trucks and trailer good?

  Yes

  No

  N/A

TRAFFIC CONTROL

• Are the cones around the vehicles/jobsite sufficient?

  Yes

  No

  N/A

• Are the Utility Work Ahead signs being used?

  Yes

  No

  N/A

• Is traffic control being used around the heavy machinery?

  Yes

  No

  N/A

• Are the proper Lane Closure signs being used as needed?

  Yes

  No

  N/A

• Are all trucks parked facing the correct direction on the roadway?

  Yes

  No

  N/A

• Are sidewalk closed signs used when necessary?

  Yes

  No

  N/A

• Are Arrow Boards required and being used?

  Yes

  No

  N/A

• Have pedestrians been given safe passage around the work area?

  Yes

  No

  N/A

TRENCHING and EXCAVATIONS

• Has the Job Hazard Analysis/Tailboard meeting been completed?

  Yes

  No

  N/A

• Is the Competent Person on the jobsite?

  Yes

  No

  N/A

• Are Trenches/Excavations more than 4' deep sloped or shored?

  Yes

  No

  N/A

• Is the Spoil Pile at least 3' from the edge of the excavation?

  Yes

  No

  N/A

• Has water been removed?

  Yes

  No

  N/A

• Is there a safe means of access/egress?

  Yes

  No

  N/A

• Is the ladder in safe condition and tied off properly?

  Yes

  No

  N/A

• CGI/02 Meter onsite?

  Yes

  No

  N/A

• Has the CGI/02 meter been calibrated?

  Yes

  No

  N/A

• Is the locate request on the jobsite?

  Yes

  No

  N/A

• Have exposed utilities been properly supported?

  Yes

  No

  N/A

• Has the excavation and spoil pole been properly fenced/guarded when unattended?

  Yes

  No

  N/A

TOOLS/EQUIPMENT

• Is Heavy Equipment in good safe condition?

  Safe

  At Risk

  N/A

• Are ground wires or wet burlap sacks used to prevent static electricity from forming?

  Yes

  No

  N/A

• Are guards in place on all hand/power tools?

  Yes

  No

  N/A

• Are electrical extension cords in good condition?

  Yes

  No

  N/A

• Is all lifting/tie down equipment in good condition?

  Yes

  No

  N/A

• Is "D" Ring mounted on excavator bucket used for lifting?

  Yes

  No

  N/A

• Are seat belts being worn while operating heavy equipment?

  Yes

  No

  N/A

• Are Tag lines used where required?

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Proper Head protection used?

  Yes

  No

  N/A

• Are Safety Glasses being worn?

  Yes

  No

  N/A

• High Visibility Safety Vest/Shirt being worn?

  Yes

  No

  N/A

• Is appropriate Hand Protection being used?

  Yes

  No

  N/A

• Are FRC's used and maintained in good condition?

  Yes

  No

  N/A

• Is any additional PPE needed? (Toe Caps, Face Shield, Goggles, etc.)

  Yes

  No

  N/A

GENERAL

• Are metal gas cans in good condition? (No plastic cans allowed)

  Yes

  No

  N/A

• Is there a certified First aid/CPR Provider onsite?

  Yes

  No

  N/A

• Is Fire Extinguisher charged and properly placed? (downwind))

  Yes

  No

  N/A

• Are First Aid Kits properly stocked and available?

  Yes

  No

  N/A

• Is drinking water available onsite?

  Yes

  No

  N/A

• Is jobsite housekeeping being kept good?

  Yes

  No

  N/A

• Is there good access to the work site?

  Yes

  No

  N/A

COMMENTS

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