EB Constrution - Testing Program 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

• 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

• Face Shield?

  Yes

  No

  N/A

• Activity:

  Select Chipping Grinding Saw Cutting Hot Work Multiple

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

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

  Yes

  No

  N/A

Mobilizing Testing Equipment (HJ Yard)

• Test Layout Plan Available for review?

  Yes

  No

  N/A

• Boom Truck Operator Qualified?

  Yes

  No

  N/A

• Overhead Utilities hazards Identified?

  Safe

  At Risk

  N/A

• Loading area surface even/leveled?

  Safe

  At Risk

  N/A

• Boom Truck Outriggers extended?

  Yes

  No

  N/A

• Signal Person Qualified?

  Yes

  No

  N/A

• Rigging Person Qualified?

  Yes

  No

  N/A

• Straps Inspected?

  Safe

  At Risk

  N/A

• Rigging Chains/Hooks/Shackles Tagged and Inspected?

  Safe

  At Risk

  N/A

• Attachment points on beams inspected prior to lift?

  Yes

  No

  N/A

• Tag Line Used?

  Yes

  No

  N/A

• Personnel Carry Involved? (Load cell, any additional loose equipment)

  Yes

  No

  N/A

• Proper Lifting Techniques? (Lift with legs, Gloves used, Slow movements)

  Safe

  At Risk

  N/A

Setting Up Test

• Test Layout Plan Available for review?

  Yes

  No

  N/A

• Boom Truck Operator Qualified?

  Yes

  No

  N/A

• Overhead Utilities hazards Identified?

  Safe

  At Risk

  N/A

• Unloading area surface even/leveled?

  Yes

  No

  N/A

• Boom Truck Outriggers extended?

  Yes

  No

  N/A

• Signal Person Qualified?

  Yes

  No

  N/A

• Rigging Person Qualified?

  Yes

  No

  N/A

• Straps Inspected?

  Yes

  No

  N/A

• Rigging Chains/Hooks/Shackles Tagged and Inspected?

  Yes

  No

  N/A

• Attachment points on beams inspected prior to lift?

  Yes

  No

  N/A

• Tag Line Used?

  Yes

  No

  N/A

• Personnel Carry Involved? (Load cell, any additional loose equipment)

  Yes

  No

  N/A

• Proper Lifting Techniques? (Lift with legs, Gloves used, Slow movements)

  Yes

  No

  N/A

• Test area marked with Danger Tape?

  Yes

  No

  N/A

• Rebar Caps used on stakes? (Danger Tape/Reference Beams)

  Yes

  No

  N/A

Compression/Tension Test Set-up

• Manlift used for all activities over 6'?

  Yes

  No

  N/A

• Qualified Manlift Operator?

  Yes

  No

  N/A

• Full Body Harness Used and Inspected?

  Yes

  No

  N/A

• Self Retracting Lifeline (SRL) Used and Inspected? (Only Authorized System By HJ/EB)

  Yes

  No

  N/A

• Proper Anchorage/Tie-off used for SRL on Manlift?

  Yes

  No

  N/A

• Portable gas generator used in well-vented area?

  Yes

  No

  N/A

• Electric Band Saw in proper operating condition?

  Yes

  No

  N/A

• Electric Band Saw plugged into Generator GFCI Outlet?

  Yes

  No

  N/A

• Spotter (person) used while cutting Dywidag bars?

  Yes

  No

  N/A

• Areas under and around test free of tripping hazards/cut steel?

  Yes

  No

  N/A

Lateral Test Set-up

• Excavator Machine Operator Qualified?

  Yes

  No

  N/A

• Underground Utilities Cleared/Marked?

  Yes

  No

  N/A

• Excavation 4' or more in depth?

  Yes

  No

  N/A

• Select As Applicable:

  Select Ladder used after 4'? Sloping/Shoring used after 5'? Guard Rails/Fall Protection used after 6'? Access/Egress within 25' of workers? Class C Soils Sloped @ 34 Dregrees?

  • Ladder used after 4'?
  • Sloping/Shoring used after 5'?
  • Guard Rails/Fall Protection used after 6'?
  • Access/Egress within 25' of workers?
  • Class C Soils Sloped @ 34 Dregrees?

• Water in excavation pumped out?

  Yes

  No

  N/A

• Attachment points and rigging inspected on Lateral Beam?

  Yes

  No

  N/A

• Hydraulic Jack is leveled where load is applied?

  Yes

  No

  N/A

• Excavation is backfilled to ground elevation after testing is complete?

  Yes

  No

  N/A

Testing

• Portable Generator in well vented area?

  Yes

  No

  N/A

• Hydraulic hoses and fittings inspected for cuts/lacerations?

  Yes

  No

  N/A

• Strain Gauges/Hydraulic hoses properly connected/bundled to prevent a trip hazard?

  Yes

  No

  N/A

• Hydraulic load gradually applied safely?

  Yes

  No

  N/A

• Test area secured with Danger Tape at end of day?

  Yes

  No

  N/A

Equipment

• Certified Operator(s)?

  Yes

  No

  N/A

• Machine Type:

  Select Boom Lift Excavator Multiple

  • Boom Lift
  • Excavator
  • Multiple

• Operator's Manual inside cab?

  Yes

  No

  N/A

• E-Stop(s) Operational?

  Yes

  No

  N/A

• Swing Radius?

  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

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

Electrical

• Generator in vented area?

  Yes

  No

  N/A

• GFCI working properly?

  Yes

  No

  N/A

• Power Tools in good condition?

  Yes

  No

  N/A

• Extension Cords free from defects?

  Yes

  No

  N/A

• Overhead Power Lines (proper distance indicated and observed)?

  Yes

  No

  N/A

• Underground Utilities properly identified/marked?

  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

Other

• Housekeeping (trash & debris) controlled?

  Yes

  No

  N/A

• Other Essential Finding?

  Yes

  No

  N/A

Signatures

• Superintendent

  Sign

• Inspector

  Sign