Audit

DSM05 / Retrofit Project "ALL IN"
GENERAL SAFETY

Safety Planning (pre-con meetings, safety plan, JSA, morning huddles, pre-task plans)

Postings (State, Federal, Emergency #'s, Incident Reporting & Crisis Management)

Material Safety Data Sheets (3E MSDS on Demand Posting & Subcontractor MSDS's)

First Aid Kit / Eyewash Replenished

Sanitation (1 toilet per 20 workers)

Housekeeping (trash & debris removed, proper material storage)

Date Corrected:

Motorized Equipment (qualified operator identified, backup alarms, seat belts, equipment condition acceptable)

Date Corrected:
Personal Protective Equipment

Proper Attire (shirts 4" sleeves, pants, boots, hard hat)

Date Corrected:

Eyes (glasses, goggles, face shield)

Date Corrected:

Other (hearing, gloves, respirators, chemical protection, metatarsal guards)

Date Corrected:
Fall Protection System

Guardrails (200#, 42" +/- 3", toeboards, wire rope flagged every 6')

Date Corrected:

Holes (guarded, covered, secured, labeled)

Date Corrected:

Protection @ 6' (anchor point, harness, lanyard, retractable, rope grab, positioner)

Date Corrected:

Other (falling object protection, safety nets, warning lines minimum of 15' from edge)

Date Corrected:
Fire Protection/Prevention

Fire Extinguishers (accessible, identified, charged, w/in 100' of travel, @ stairways)

Date Corrected:

Fuel Storage (location, container, extinguisher, traffic protection)

Date Corrected:

Hot Work (fire watch, fire blankets, permit, extinguisher present, debris clear)

Date Corrected:
Cranes

Daily Lift Plan (Qualified Operator, Signal Person, Rigger, Daily, Periodic and Annual Inspections)

Date Corrected:

Set-Up (barricaded, level, powerlines 20' minimum clearance)

Date Corrected:

Outriggers (extended, pads adequate & level per Daily Lift Plan)

Date Corrected:

Operation (load path, taglines, signal person)

Date Corrected:

Capacity (charts available, critical lift plan, object weights identified)

Date Corrected:

Sling Condition (wire rope, synthetic, hardware)

Date Corrected:
Access Equipment

Extension Ladders (4V:1H, secured at top and base, 3' above landing, 3 points of contact)

Date Corrected:

Step Ladders (stable, proper use, inspected, non-conductive)

Date Corrected:

Stairs (metal pan treads filled, uniform w/in 1/4", rails @ 36", unobstucted, illuminated)

Date Corrected:

Aerial & Scissor Lifts (proper use, fall protection, condition, rails, operator training)

Date Corrected:
Electricity

Panels (covers in place, circuits identified, weatherproof, secured, breakers/holes filled)

Date Corrected:

GFCI (@ breakers, outlets, pigtails, electrician weekly testing log)

Date Corrected:

Electrical Cords (ground, strain relieve, condition, protected from traffic, proper use)

Date Corrected:

Romex (protected to 8', proper splices taped, fastened every 10' with non-conductive fastener, protected from physical damage)

Lighting (adequate- 5 ft candles, protected, secured, sockets filled, separate circuit)

Date Corrected:
Excavation

Daily Dig Permit (Competent Person Inspection, utilities located, cracks, spalling, water accumulation, changed conditions)

Date Corrected:

Access/Egress @ 4' (ladder, ramp, stairs within 25' of travel)

Date Corrected:

Protection @ 5' (slope, bench, shield, shore)

Date Corrected:

Other (spoils 2' back, vibration, hazardous atmosphere potential)

Date Corrected:
Scaffolding

Base (sills/plates/jacks/casters, secured, level, locked)

Date Corrected:

Braces (installed, secured, condition)

Date Corrected:

Frames (compatible, pinned, condition)

Date Corrected:

Platform (fully planked, overhang 6"-12" or cleated, plank condition)

Date Corrected:

Access (integral frame - 16 3/4" rung spacing, ladder w/ gate, stairtower)

Date Corrected:

Other (secured @ 4V:1H, level, tagged, competent person inspected, tarp/debris net engineer approval)

Date Corrected:
Miscellaneous (Items not captured in categories listed above)

Date Corrected:
Positive Observations

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Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.