EB Construction - Pile Cutoff Safety Survey

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General Safety

• Are all employees familiar with the JHA for this operation?

  Yes

  No

  N/A

• Have the Daily Task Analysis/Toolbox Talk & Equipment Inspections been properly filled out and signed?

  Yes

  No

  N/A

• Is there a first aid kit on site? Are emergency numbers and facilities identified?

  Yes

  No

  N/A

• Is there drinking water available on site?

  Yes

  No

  N/A

• Is the job site clean? Is the work area well maintained?

  Yes

  No

  N/A

• Are employees wearing the required PPE? (High visibility vest or clothing, hardhat, safety glasses, steel toe boots, gloves)

  Yes

  No

  N/A

Excavations

• Is excavation access/egress properly restricted using snow fencing, barricades, caution tape or other means? Are Materials/Debris 2 feet away from edge at top of excavation?

  Yes

  No

  N/A

• Are ladders being used for an excavation over 4' in depth? Does it extend 3’ above excavation with no tripping hazards at top?

  Yes

  No

  N/A

• Is proper cave in protection in place for excavation 5’ or greater? (Sloping, shoring, shielding, benching)

  Yes

  No

  N/A

• Are guard rails or other fall protection being used for an excavation 6' or more? Are they set up properly?

  Yes

  No

  N/A

• Top rail must be 42” (+/-3”) above ground level and withstand 200 lbs of horizontal force.

• Mid rail must be 21” above ground level and withstand 150 lbs of horizontal force.

• Toe boards secured to bottoms of posts, must be at least 3” in height.

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

  Yes

  No

  N/A

• Is excavation sufficiently dewatered? (No water above ankles)

  Yes

  No

  N/A

Pile Chipping

• Are employees wearing the required additional PPE for the task? (Hearing protection, face shield and respiratory protection)?

  Yes

  No

  N/A

• Are employees properly trained for this task (Chipping and Silica)

  Yes

  No

  N/A

• Are ladders being used according to manufactures specifications? (No modifications, 3 points of contact)

  Yes

  No

  N/A

• Are workers lowering equipment (Chipping guns/hoses) into excavation safely? (Using rope or strap)

  Yes

  No

  N/A

• Are workers chipping at One Pile Spacing Minimum?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are air hoses secured using whip-checks, cotter keys or at a minimum secured with tie-wire at connections.

  Yes

  No

  N/A

• Are employees using dust control when chipping piles? (Water, vacuum, etc)

  Yes

  No

  N/A

Steel Cutoff

• Are employees wearing the required additional PPE for this task? (Hot work face shield)

  Yes

  No

  N/A

• Are employees properly trained for this task? (Hot Work)

  Yes

  No

  N/A

• Has Hot Work Permit been completed? (If required)

  Yes

  No

  N/A

• Is there a Fire Watch present during cutting who is carrying a working fire extinguisher?

  Yes

  No

  N/A

• Is the working area clear of combustibles?

  Yes

  No

  N/A

• Are Compressed Gas Cylinders properly stored? (Full and empty ones)

  Yes

  No

  N/A

Weather

• Is the Superintendent/Foreman monitoring weather conditions?

  Yes

  No

  N/A

• Is there shelter available for safe hiding from inclement weather? Grounded Conex, Mobile Office, or Personal Vehicle?

  Yes

  No

  N/A

Discussion

• Do all employees know the HJ Way for the week? Do all employees know the Weekly Safety Focus? Do all employees know the Keller Safety Principals [M.A.N.]?

  Yes

  No

  N/A

• Are employees aware of the Stop Work Authority program? Do all employees know that S.A.F.E stands for?

  Yes

  No

  N/A

Feedback/Opportunities for Improvement

• Add media

  Media

Signatures

• Superintendent/Foreman

  Sign

• Safety Inspector

  Sign