Information

  • Project Name

  • Project Number

  • Date Completed

  • Prepared by

  • Location

SUPERINTENDENTS NAME

PERSONAL PROTECTIVE EQUIPMENT

  • Hard Hats

  • Safety Glasses Appropriate for Conditions ( tinted or clear )

  • Reflective Vests and/or High Visibility Shirts

  • Hard Toed Work Boots

  • Gloves (if required)

  • Hearing Protection (if required)

  • Face Shields (if required)

HOUSEKEEPING

  • General Site Housekeeping

  • Trash Cans in Work Area

  • Storage / Conex

  • Safe Walkways or Passages

TEMPORARY BARRICADES

  • All sides of work area barricaded and labeled (if required)

  • Proper tape used, Red for Danger and Yellow for Caution (if required)

  • Road/Sidewalk Closed signs in place (if required)

LADDERS AND ELEVATED WORK

  • Extension ladders tied off and secured

  • Extension ladders extended 3' above upper landing

  • Step ladders fully open and locked

  • Damaged ladders tagged Out-of-Service

FALL PROTECTION

  • Employees 100% tied off when working over 6'

  • Fall protection in place (i.e. handrails and warning lines)

  • Harness and lanyards inspected prior to use

  • Harness and lanyards used correctly

  • Employees anchored off correctly

MOBILE EQUIPMENT

  • Operating at a safe speed (both travel and swing)

  • Operating at a safe distance from ground personnel

  • Inspected and documented prior to each shift

  • Seatbelts used

  • Operators trained

  • Backup and movement alarms working

  • Spotters used when needed

  • Equipment maintained without leaks

HOISTING AND RIGGING EQUIPMENT

  • Annual crane inspection placard and/or hard copy in place

  • Daily crane inspection performed and documented

  • Operators manual in cab

  • Swing radius protection in place

  • Workers staying clear of suspended loads

  • Rigging inspected prior to each use

  • Proper rigging and techniques used

  • Rigging properly stored

  • Qualified rigger/signal person being used

  • Knowledge of crane signals

  • Proper use of tag lines

EXCAVATION

  • Excavations inspected and documented by a competent person

  • Means of entering/exiting for excavations deeper than 4'

  • Daily air quality checked for excavations deeper than 4’

  • Cave-In protection for excavations deeper that 5'

  • Excavation protected from unauthorized personnel (i.e. handrails/barricades)

  • Equipment staged at a safe distance from the edge

  • Spoils and materials at least 2' from leading edge

COMPRESSES GAS CYLINDERS

  • Stored upright and succored

  • Oxygen and acetylene stored at least 20' apart when not in use

  • Hard caps in place when not in use and/or in transport

CONCRETE OPERATIONS

  • Concrete pump and hoses in good condition and used properly

  • Slick lines and hoses properly clamped with safety wire and whip checks

  • Concrete washed from skin in a timely manner

  • Employees involved where concrete dust is present, have been trained in Silica Awareness

CONFINED SPACE

  • Confined spaces identified and posted

  • Permit required spaces controlled by permit and attendant

  • All confined spaces inspected and documented

  • All confined spaces air quality checked and documented

  • Open spaces, such as manholes are protected from pedestrians and vehicular traffic

PREWORK

  • Weekly Toolbox Talks are performed and documented

  • Daily JHA's communicated to all employees and documented

  • SDS for all chemicals on the project are available upon request

  • Supervisors are aware of local Urgent Care and Emergency Room locations

  • All required jobsite work permits (i.e. hot work permits and excavation permits) obtained

  • Underground locates are in place and current

  • Employee training records are available for work being performed

REPRIMANDS OR WARNINGS

  • We're any safety violations issued?

  • We're any verbals warnings or directives given?

  • Was any Stop Work order issued?

COMMENTS

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AUDIT PERFORMED BY:

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AUDITORS TITLE

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