District 33 Safe Work Habits

• Document No.

• Audit Title

• Conducted on

  Date

• Observed by:

• Task Observed?

• Location
  Address

• Personnel

Personal Protective Equipment (Proper Use, Storage, and Maintenance)

• Are they using approp

  Safe

  At Risk

  N/A

• Eyes/face protected from flying debris, chemicals and radiant light. Safety glasses worn in mandatory areas?

  Safe

  At Risk

  N/A

• Head protected from impact from objects above and at same height?

  Safe

  At Risk

  N/A

• Feet protected from impact, puncture, electrical?

  Safe

  At Risk

  N/A

• Ice cleats in use while performing snow removal?

  Safe

  At Risk

  N/A

• Fall protection used properly?

  Safe

  At Risk

  N/A

• Hearing protection used in mandatory areas?

  Yes

  No

  N/A

• Respiratory protection for vapors, dust, misc. debris.

  Safe

  At Risk

  N/A

• Clean shaven, mask stored in sealed container?

  Safe

  At Risk

  N/A

Body Position

• 3 Points of contact while ascending/descending ladders or stairs?

  Safe

  At Risk

  N/A

• Using proper Lifting / Twisting technique?

  Safe

  At Risk

  N/A

• Protected from Line of fire? Caught-in, Struck by, Energy Release

  Safe

  At Risk

  N/A

• Workers keeping hands out of danger zone?

  Safe

  At Risk

  N/A

• Workers staying focused...Eyes on path?

  Safe

  At Risk

  N/A

Tools

• Proper Ladders / Scaffolds / Aerial Lifts being used?

  Safe

  At Risk

  N/A

• Proper equipment Selection / Use the proper tool?

  Safe

  At Risk

  N/A

• Tools in Good Condition / Proper Guarding?

  Safe

  At Risk

  N/A

• GFCI in use with portable equipment?

  Safe

  At Risk

  N/A

• Electrical cords inspected for risks? Protected from damage?

  Yes

  No

  N/A

• Temporary power is being used properly?

  Safe

  At Risk

  N/A

• Flammable materials removed when using electrical tools?

  Safe

  At Risk

  N/A

General Safety

• Housekeeping - Area free of unnecessary materials?

  Safe

  At Risk

  N/A

• Flammable and combustibles stored properly?

  Safe

  At Risk

  N/A

• Ladder/stairways clear of materials and debris?

  Safe

  At Risk

  N/A

• Egress unobstructed?

  Safe

  At Risk

  N/A

• Using handrails on stairways?

  Safe

  At Risk

  N/A

• Surface conditions evaluated and controlled (Ice/Oil/Uneven surfaces??

  Safe

  At Risk

  N/A

• Employees know where the nearest fire extinguisher is?

  Safe

  At Risk

  N/A

• Employees know the emergency procedures?

  Safe

  At Risk

  N/A

Other

• Employees aware of chemical hazards?

  Safe

  At Risk

  N/A

• Radiation controls in place?

  Safe

  At Risk

  N/A

• Employees following work-zone traffic controls for Roadside work?

  Safe

  At Risk

  N/A

Lifting Equipment

• Employees trained and using Overhead cranes / hoists properly?

  Safe

  At Risk

  N/A

• Employees trained and using forklifts properly?

  Safe

  At Risk

  N/A

• Are the Slings / Rigging being used rated for the intended load?

  Safe

  At Risk

  N/A

• Mobile cranes are set up/used correctly?

  Safe

  At Risk

  N/A

Construction Area

• Traffic Control systems constructed appropriately?

  Safe

  At Risk

  N/A

• JHA completed (if needed)?

  Safe

  At Risk

  N/A

• Controls in place while working from heights?

  Safe

  At Risk

  N/A

• Barricades / Signs in place?

  Safe

  At Risk

  N/A

• Permits completed and available (if needed)?

  Safe

  At Risk

  N/A

• Excavation area controlled? Employees using proper trench shoring/shielding?

  Safe

  At Risk

  N/A

• Are employees accessing trench appropriately? (ladders, ramps)

  Safe

  At Risk

  N/A

Confined Space Entry

• Permit completed and posted?

  Safe

  At Risk

  N/A

• Attendant performing his duties only?

  Safe

  At Risk

  N/A

• Air Monitoring being completed?

  Safe

  At Risk

  N/A

• PPE / Emergency Equipment in use?

  Safe

  At Risk

  N/A

Lockout / Tagout / Linebreak

• Employees using personal Locks / Tags?

  Safe

  At Risk

  N/A

• Equipment properly De-energized?

  Safe

  At Risk

  N/A

• Employees have knowledge of Procedure?

  Safe

  At Risk

  N/A

• Proper PPE (Goggles, Face Shield, Gloves for Arc Flash?

  Safe

  At Risk

  N/A

Hot Work

• Permit completed and Posted?

  Safe

  At Risk

  N/A

• Fire watch with extinguisher assigned?

  Safe

  At Risk

  N/A

• Work area free of flammables and combustibles?

  Safe

  At Risk

  N/A

• PPE in use (Welding hood, Screen)?

  Safe

  At Risk

  N/A

Vehicle Safety

• Wheel chocks in place?

  Safe

  At Risk

  N/A

• 3 points of contact while Entering / Leaving Vehicle?

  Safe

  At Risk

  N/A

• Pre trip inspections completed?

  Safe

  At Risk

  N/A

• Proper Loading / Unloading (away from power lines/using hand trucks/lift gates?

  Safe

  At Risk

  N/A

• All loads are secured?

  Safe

  At Risk

  N/A

Office Safety

• Housekeeping?

  Safe

  At Risk

  N/A

• Cords (Electrical Hazards)?

  Safe

  At Risk

  N/A

• Trip hazards?

  Safe

  At Risk

  N/A

• Positive comments / safety topic communicated (provide detail):

• Opportunities:

• Signature