EB Construction - Chipping Work Safety Survey

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Daily Paperwork & General Safety

• Daily JHA/Toolbox Talk completed properly?

  Yes

  No

  N/A

• Daily Crane & Equipment Inspection completed?

  Yes

  No

  N/A

• Safety Manual & SDS on site?

  Yes

  No

  N/A

• Job specific paperwork available (AHA and/or SSJHA)?

  Yes

  No

  N/A

• Federal, Ethics and EEO Statement Posted?

  Yes

  No

  N/A

• No Cuts Locate number(s) available?

  Yes

  No

  N/A

• Emergency numbers and facilities identified?

  Yes

  No

  N/A

• Proper First Aid Kit on site?

  Yes

  No

  N/A

• Fresh drinking water available on site?

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• Employee(s) dressed properly for work (shirts w/ 4" sleeves, long pamts and sturdy safety -toe work boots)?

  Yes

  No

  N/A

• Hardhats?

  Yes

  No

  N/A

• Safety Glasses?

  Yes

  No

  N/A

• Gloves (if required)?

  Yes

  No

  N/A

• High Visibility Clothing and/or Reflective Vest?

  Yes

  No

  N/A

• Hearing Protection?

  Yes

  No

  N/A

• Type:

  Select Muffs Plugs Multiple

  • Muffs
  • Plugs
  • Multiple

• Face Shield?

  Yes

  No

  N/A

• Activity:

  Select Chipping Grinding Saw Cutting Hot Work Multiple

  • Chipping
  • Grinding
  • Saw Cutting
  • Hot Work
  • Multiple

• Respiratory Protection (face mask. if required, fit test needed)?

  Yes

  No

  N/A

• Type:

  Select Disposible N95 Half Face w/ cartridges Multiple

  • Disposible N95
  • Half Face w/ cartridges
  • Multiple

• All suppliers and subcontractors involved with HJ/EB are in compliance w/PPE requirements?

  Yes

  No

  N/A

Excavations

• Permit Required?

  Yes

  No

  N/A

• Competent Person(s)?

  Yes

  No

  N/A

• Materials/Debris 2 feet away from edge at top of excavation?

  Yes

  No

  N/A

• Ladder extends 3' above top of excavation?

  Yes

  No

  N/A

• Ladder used for excavation over 4' in depth?

  Yes

  No

  N/A

• Proper Excavation Protection used for excavations over 5' in depth?

  Yes

  No

  N/A

• Type:

  Select Benching Shoring Sloping Multiple

  • Benching
  • Shoring
  • Sloping
  • Multiple

• Guard rails or other fall protection used in excavations 6' or more?

  Yes

  No

  N/A

• Trench box extends 18" higher than sloped ground?

  Yes

  No

  N/A

• Mid rails for guard rail system at 21" above ground level?

  Yes

  No

  N/A

• Air Monitoring completed?

  Yes

  No

  N/A

• Oxygen level inside excavation 19.5% or under? Oxygen deficient environment?

  Safe

  At Risk

  N/A

• If excavation is over 20' in depth, has a Professional Engineer designed and approved the excavation?

  Yes

  No

  N/A

• Oxygen level inside excavation 23.5% or more? Oxygen enriched environment?

  Safe

  At Risk

  N/A

• Access/Egress Points within 25' of Employees?

  Yes

  No

  N/A

• Type:

  Select Approved Ladder Sloped (Can be climbed w/o use of hands)? Multiple

  • Approved Ladder
  • Sloped (Can be climbed w/o use of hands)?
  • Multiple

• Slopping angle for "Class C" soils 34 degrees or less?

  Yes

  No

  N/A

• Top rail at excavation 42" (+/-3") above ground level?

  Yes

  No

  N/A

• Slopping angle for "Class B" soils 45 degrees or less?

  Yes

  No

  N/A

• Slopping angle for "Class A" soils 53 degrees or less?

  Yes

  No

  N/A

• Slopping angle for "Stable Rock" 90 degrees or less?

  Yes

  No

  N/A

• Decibel Monitoring completed?

  Yes

  No

  N/A

• Water at or below ankles of workers?

  Yes

  No

  N/A

Fall Protection

• Competent Person(s)?

  Yes

  No

  N/A

• Excavation Hazard present? >6' in Depth

  Yes

  No

  N/A

• Proper guard rail system used? Toe boards @ 3", Mid rail @ 21", Top rail @ 42" (+/-3").

  Yes

  No

  N/A

• Rebar Caps in use?

  Yes

  No

  N/A

Chipping Operations

• Chipping in already formed pile cap is not permitted unless approved by HJ/EB Safety Dept.

  Safe

  At Risk

  N/A

• During ladder use, workers maintaining 3-point contact at all times?

  Yes

  No

  N/A

• Workers lowering equipment (Chipping guns/hoses) into excavation safely? Using rope or strap to lower.

  Yes

  No

  N/A

• Top of piles free of loose rocks/rubble/debris that may injure workers below?

  Yes

  No

  N/A

• Workers chipping at One Pile Spacing Minimum?

  Yes

  No

  N/A

• Air hoses free of cuts/lacerations, not leaking air?

  Yes

  No

  N/A

• Air Hoses have Whip-Checks/Cotter Key? Or at a minimum secured with tie-wire at connections.

  Yes

  No

  N/A

• Water hose or sprayer being used to control dust?

  Yes

  No

  N/A

Heavy Equipment (Breaker)

• Certified Operator(s)?

  Yes

  No

  N/A

• Machine Type:

  Select Excavator Bobcat Multiple

  • Excavator
  • Bobcat
  • Multiple

• Operator's Manual inside cab?

  Yes

  No

  N/A

• E-Stop(s) Operational?

  Yes

  No

  N/A

• Swing Alarm Operational?

  Yes

  No

  N/A

• Back Up Alarm Operational?

  Yes

  No

  N/A

• Mirrors and Windows in good condition?

  Yes

  No

  N/A

• Tracks Clean?

  Yes

  No

  N/A

• Mechanical deficiencies reported?

  Yes

  No

  N/A

Cutting Steel/Hot Work

• Hot Work Permit pulled?

  Yes

  No

  N/A

• Fire Extinguisher within worklers reach?

  Yes

  No

  N/A

• Fire Watch?

  Yes

  No

  N/A

• Area clear of combustibles?

  Yes

  No

  N/A

• Proper Torch Tip used for application?

  Yes

  No

  N/A

• Compressed Gas Cylinders properly stored?

  Yes

  No

  N/A

• Storage Type:

  Select Fire Wall Torch Cart (if used w/in 24hrs) 20' Separation Multiple

  • Fire Wall
  • Torch Cart (if used w/in 24hrs)
  • 20' Separation
  • Multiple

• Striker used for ignition?

  Yes

  No

  N/A

• Hoses in good condition?

  Yes

  No

  N/A

• Gauges in good condition?

  Yes

  No

  N/A

• Caps on Compressed Gas Cylinders if Gauges are removed?

  Yes

  No

  N/A

Fire Safety

• Fire Extinguisher(s) are charged and in good condition?

  Yes

  No

  N/A

• Fire Extinguisher(s) have up-to-date tag(s)?

  Yes

  No

  N/A

• All Equipment has an accessible Fire Extinguisher?

  Yes

  No

  N/A

Weather

• Weather Application Installed on Superintendent/Foreman Phone?

  Yes

  No

  N/A

• Shelter Available for safe hiding from inclement weather? Grounded Conex, Mobile Office, or Personal Vehicle?

  Yes

  No

  N/A

Company Vehicle

• Truck reasonably clean?

  Yes

  No

  N/A

• Truck is well organized?

  Yes

  No

  N/A

• Back-up Alarm/Camera Operation?

  Yes

  No

  N/A

• Mirrors, Seat Belts & Windows in good condition?

  Yes

  No

  N/A

• Mechanical deficiencies reported?

  Yes

  No

  N/A

Signatures

• Superintendent

  Sign

• Inspector

  Sign