Duluth - Maurices Copy

• Conducted on

  Date

• Prepared by

• Company name

HOUSEKEEPING

• Fire extinguishers (Distributed, In stands, Inspected Monthly)

  Yes

  No

  N/A

• First aid kits (Distributed, Filled adequately)

  Yes

  No

  N/A

• Adequate lighting (Common areas lit, Subs utilizing task lighting where needed)

  Safe

  At Risk

  N/A

• Job site free of slips, trips and fall hazards (cords, steps, holes, rebar, frost, wet, etc.)

  Safe

  At Risk

  N/A

• Stairways / walkways clear (cords, material, equipment off to the side or removed)

  Safe

  At Risk

  N/A

• Debris cleared (dump carts used and emptied, etc)

  Yes

  No

  N/A

• Break areas orderly<br> (Food is in covered waste containers)

  Yes

  No

  N/A

• Floor openings (covered, fastened, labeled)

  Safe

  At Risk

  N/A

• NOT APPLICABLE<br>

  Yes

  No

  N/A

• Sprinkler shutoff located/labeled/accessable

  Yes

  No

  N/A

ELECTRICAL / UTILITY

• Good Cords (look for knicks, cuts, grounds, strain relief, water resistance)

  Safe

  At Risk

  N/A

• Temporary lighting guarded (light cages)

  Safe

  At Risk

  N/A

• Temporary Electrical panels labeled and covered (checked monthly)

  Safe

  At Risk

  N/A

• GFCI protection utilized on house power

  Safe

  At Risk

  N/A

HAND AND POWER TOOLS

• Hand tools in good working order (good condition, good cords, etc)

  Safe

  At Risk

  N/A

• All mechanical safeguards in use (equipment guards)

  Safe

  At Risk

  N/A

• Tool drop protection used when working above people

  Yes

  No

  N/A

• Proper PPE while in use

  Safe

  At Risk

  N/A

MOBILE EQUIPMENT

• Brakes, lights, signals, and alarms operative

  Safe

  At Risk

  N/A

• Daily inspections filled out

  Safe

  At Risk

  N/A

• Seat belts worn - LULLS, FORK TRUCKS, ETC.

  Safe

  At Risk

  N/A

• Lifts - 100% tie off

  Safe

  At Risk

  N/A

• Crane - protecting people from overhead loads

  Safe

  At Risk

  N/A

• Rigging equipment inspected - tag showing

  Safe

  At Risk

  N/A

BARRICADES / GUARDRAILS

• Guardrails 100% protecting the area where people are not tied off and is above 6'

  Yes

  No

  N/A

• Barricades affixed with proper signage

  Safe

  At Risk

  N/A

• Floor openings planked or barricaded

  Safe

  At Risk

  N/A

• Wall, roof openings covered or barricaded

  Safe

  At Risk

  N/A

• Rooftops/edges protected<br> (100% guardrail or personal fall protection... no flagging unless discussed with safety)

  Safe

  At Risk

  N/A

LADDERS

• Ladders in good condition<br> (stickers, rungs, feet, spreaders, rivets, fiberglass...)

  Safe

  At Risk

  N/A

• Side rails extend 36 inches above landing for access to a level

  Safe

  At Risk

  N/A

• Ladder not being used too close to the edge of a deck or opening (Rule of thumb: Height of the ladder +4')

  Yes

  No

  N/A

• Proper for job and secure

  Safe

  At Risk

  N/A

• Step ladders fully open when in use

  Safe

  At Risk

  N/A

• Placement of ladder safe<br>(tied off if necessary, clean/dry surface...)

  Safe

  At Risk

  N/A

• Use of the ladder properly<br> (standing on the correct rungs, not leaned up stepladders, facing the correct way between the uprights...)

  Safe

  At Risk

  N/A

SCAFFOLDING

• All scaffolds plumb and level

  Safe

  At Risk

  N/A

• Are adequate sills and base plates being used

  Safe

  At Risk

  N/A

• Are metal scaffold planks installed correctly with none extending past their end supports

  Safe

  At Risk

  N/A

• Are wooden scaffold planks installed past their end supports no less than 6 inches and no more than 12 inches

  Yes

  No

  N/A

• Are guardrails including top and mid rail in place

  Safe

  At Risk

  N/A

• To protect from falling objects, are toe boards or area barricaded below

  Safe

  At Risk

  N/A

• Is there a scaffold tag and has it been inspected

  Yes

  No

  N/A

• Is their a safe access ladder, steps or equivalent means for safe access to the scaffold<br> (Step no greater than 24")

  Safe

  At Risk

  N/A

• Is the scaffold rated for the proper weight capacity

  Safe

  At Risk

  N/A

FIRE PREVENTION

• Are hot work permits in order if necessary

  Yes

  No

  N/A

• Is a fire watch monitoring the area

  Safe

  At Risk

  N/A

• Propane tanks - barricade installed - labeled -( flammable,no smoking, fuel type)

  Safe

  At Risk

  N/A

• Compressed gas cylinders secured- upright- protected from damage

  Safe

  At Risk

  N/A

PPE

• Hard hats worn 100%

  Safe

  At Risk

  N/A

• Gloves (worn and adequate for the work activity)

  Safe

  At Risk

  N/A

• Face shields (used where required)

  Safe

  At Risk

  N/A

• Welding hoods being worn in conjunction with hardhats safety glasses

  Safe

  At Risk

  N/A

• Eye protection (worn and adequate for the work activity)

  Safe

  At Risk

  N/A

• Respirators and masks utilized, when needed

  Safe

  At Risk

  N/A

• High visible clothing in use, when needed

  Safe

  At Risk

  N/A

• Safety harness and lanyards utilized with adequate anchorage points

  Safe

  At Risk

  N/A

MCGOUGH NOTES

• Specific requests

  Yes

  No

  N/A

• Injuries or losses since last audit

  Yes

  No

  N/A