Safety Program Administration
Appropriate Signage in Place
Compliant
Corrected
Action Required
Repeat
Not Inspected
Safety Policy & Standard Operating Procedure Manual Onsite & Updated
Compliant
Corrected
Action Required
Repeat
Not Inspected
Site Specific MSDS available for all chemicals
Compliant
Corrected
Action Required
Repeat
Not Inspected
Legal compliance (General Register available, Equipment fitness certificates...etc)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Pre-job safety moment Performed (Green area, Tool box..etc)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Topic Covered:
JSA Completed Prior to Hazardous/Non-routine Tasks
Compliant
Corrected
Action Required
Repeat
Not Inspected
Site Specific Emergency Action Plan
Compliant
Corrected
Action Required
Repeat
Not Inspected
Applicable Permits Onsite (Trench/Excavation, Scaffold/Falsework, etc.,)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Safety Inspections Performed (Planned or spot..etc)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
First Aid Machinery Safety
Guards in Place
Compliant
Corrected
Action Required
Repeat
Not Inspected
Grounded System
Compliant
Corrected
Action Required
Repeat
Not Inspected
GFCI Protection (Test Operation)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Hazardous energy isolation and securing is done in a reasonable manner when engaging with machinery hazards
Compliant
Corrected
Action Required
Repeat
Not Inspected
Emergency Stops (where applicable)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Damaged Outlets
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Air Compressors
Belts and Pulleys Guarded
Compliant
Corrected
Action Required
Repeat
Not Inspected
Pressure Gauge Working
Compliant
Corrected
Action Required
Repeat
Not Inspected
Pressure Relief Valve Operational
Compliant
Corrected
Action Required
Repeat
Not Inspected
Hose Connections Secured
Compliant
Corrected
Action Required
Repeat
Not Inspected
Pressure Reduced at Operation
Compliant
Corrected
Action Required
Repeat
Not Inspected
Hoses in Good Condition
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Fire Extinguishers
Readily Accessible/Mounted
Compliant
Corrected
Action Required
Repeat
Not Inspected
Proper Type and Size Available
Compliant
Corrected
Action Required
Repeat
Not Inspected
Proper Maintenance/Tagged
Compliant
Corrected
Action Required
Repeat
Not Inspected
Inspected Monthly/Annually
Compliant
Corrected
Action Required
Repeat
Not Inspected
Employees Trained Annually on Usage
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Flammable Liquids (Gasoline) / Chemical Handling
Stored in Approved Containers/Cabinets
Compliant
Corrected
Action Required
Repeat
Not Inspected
Containers Properly Labeled (Identity, Hazard Warnings)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Spill Containment and Cleanup Supplies
Compliant
Corrected
Action Required
Repeat
Not Inspected
Oxygen Cylinders Separated from Fuel Gas Cylinders or Combustible Materials
Compliant
Corrected
Action Required
Repeat
Not Inspected
Fire Extinguisher Available Near Storage Areas
Compliant
Corrected
Action Required
Repeat
Not Inspected
Hydrants are Clear
Compliant
Corrected
Action Required
Repeat
Not Inspected
Signs Posted NO SMOKING "Flammable Materials"
Compliant
Corrected
Action Required
Repeat
Not Inspected
Hazardous Chemicals in Secondary Containment, Proper Disposal
Compliant
Corrected
Action Required
Repeat
Not Inspected
Storage Area Bermed for Spill
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Power Cords / Extension Cords / Electrical Hazards
Cords Protected From Damage
Compliant
Corrected
Action Required
Repeat
Not Inspected
Grounding Pin Present
Compliant
Corrected
Action Required
Repeat
Not Inspected
Damaged Insulation Exposed Wiring
Compliant
Corrected
Action Required
Repeat
Not Inspected
Plug Ends & Insulation Connected
Compliant
Corrected
Action Required
Repeat
Not Inspected
Cords Protected From Damage
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Hand and Power Tools
All Mechanical Safeguards In Place as per Manufacturer
Compliant
Corrected
Action Required
Repeat
Not Inspected
User Properly Trained
Compliant
Corrected
Action Required
Repeat
Not Inspected
Tools Are in Good Condition
Compliant
Corrected
Action Required
Repeat
Not Inspected
Correct Tool Being Used For The Job
Compliant
Corrected
Action Required
Repeat
Not Inspected
Tools are Stored Neatly When Not In Use
Compliant
Corrected
Action Required
Repeat
Not Inspected
Materials Properly Supported
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Ladders and Stairways
Ladders Inspected and Maintained
Compliant
Corrected
Action Required
Repeat
Not Inspected
Ladders Proper Length & Secured to Prevent Slipping, Sliding or Falling
Compliant
Corrected
Action Required
Repeat
Not Inspected
Extension Ladders Extend 36" Above Landing
Compliant
Corrected
Action Required
Repeat
Not Inspected
Extension Ladder Base Positioned 1/4 of the Vertical Distance
Compliant
Corrected
Action Required
Repeat
Not Inspected
Area Around Base and Top of Ladder Clear and Unobstructed
Compliant
Corrected
Action Required
Repeat
Not Inspected
Proper Maintenance and Storage
Compliant
Corrected
Action Required
Repeat
Not Inspected
Stepladders Fully Opened
Compliant
Corrected
Action Required
Repeat
Not Inspected
Job Made Ladders Constructed as Per Cal OSHA Regulations
Compliant
Corrected
Action Required
Repeat
Not Inspected
Metal Ladders Not Being Used Around Electrical Hazards
Compliant
Corrected
Action Required
Repeat
Not Inspected
Evidence of Unsafe Use of Ladders (Zero Tolerance Item)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Material Handling & Storage
Proper Lifting Techniques Being Used
Compliant
Corrected
Action Required
Repeat
Not Inspected
Stacks on Firm Footing & Not Too High
Compliant
Corrected
Action Required
Repeat
Not Inspected
Lay Down Areas Neat & Organized
Compliant
Corrected
Action Required
Repeat
Not Inspected
Passage Ways are Clear
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Personal Protective Equipment
Head Protection Hard Hat
Compliant
Corrected
Action Required
Repeat
Not Inspected
Safety Glasses
Compliant
Corrected
Action Required
Repeat
Not Inspected
Full Face Shield
Compliant
Corrected
Action Required
Repeat
Not Inspected
Hearing Protection
Compliant
Corrected
Action Required
Repeat
Not Inspected
Appropriate Hand Protection (Abrasion, Cut, Puncture, Chemical)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Foot Protection
Compliant
Corrected
Action Required
Repeat
Not Inspected
Respiratory Protection
Compliant
Corrected
Action Required
Repeat
Not Inspected
ANSI Class II or III High Visibility Garment or similar (Vest, Shirt, or Jacket)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Fall Protection
Full Body Harness
Compliant
Corrected
Action Required
Repeat
Not Inspected
Appropriate Connecting Device (Lanyard above 18', SRL below 18')
Compliant
Corrected
Action Required
Repeat
Not Inspected
Engineered Vertical or Horizontal Life Line
Compliant
Corrected
Action Required
Repeat
Not Inspected
Guard Rails in Place and Secure, Top Rail 42"-45" Mid Rail at 1/2 the Distance
Compliant
Corrected
Action Required
Repeat
Not Inspected
Controlled Access Zone Established
Compliant
Corrected
Action Required
Repeat
Not Inspected
Appropriate Anchorage (5000 lb. Capacity)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Warning Line Established
Compliant
Corrected
Action Required
Repeat
Not Inspected
Competent Trained Person(s) Onsite
Compliant
Corrected
Action Required
Repeat
Not Inspected
Employees Properly Trained
Compliant
Corrected
Action Required
Repeat
Not Inspected
Equipment in Good Condition and Inspected Semi Annually
Compliant
Corrected
Action Required
Repeat
Not Inspected
Rescue Plan In Place
Compliant
Corrected
Action Required
Repeat
Not Inspected
All Personnel Protected Against Fall Height Greater Than 6' (Zero Tolerance Item)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Aerial Lifts
Equipped with Outriggers
Compliant
Corrected
Action Required
Repeat
Not Inspected
Guard Rails in Good Condition
Compliant
Corrected
Action Required
Repeat
Not Inspected
Full Body Harness and Fall Restraint in Use
Compliant
Corrected
Action Required
Repeat
Not Inspected
Safety Chain Present and Connected
Compliant
Corrected
Action Required
Repeat
Not Inspected
Employees Properly Trained
Compliant
Corrected
Action Required
Repeat
Not Inspected
Employees Standing on Floor of Lift
Compliant
Corrected
Action Required
Repeat
Not Inspected
Documented Daily Inspection Completed
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Industrial Trucks
Roll Over Protective System (ROPS)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Documented Daily Inspection Performed
Compliant
Corrected
Action Required
Repeat
Not Inspected
Back-up Alarm and Horn Operational
Compliant
Corrected
Action Required
Repeat
Not Inspected
Fire Extinguisher
Compliant
Corrected
Action Required
Repeat
Not Inspected
Operator Trained and Authorized to Use
Compliant
Corrected
Action Required
Repeat
Not Inspected
Seatbelt Being Worn
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Cranes / Boom Trucks
Annual and Daily Inspections Complete
Compliant
Corrected
Action Required
Repeat
Not Inspected
Fire Extinguisher in Cab & Inspected
Compliant
Corrected
Action Required
Repeat
Not Inspected
Boom Angle Indicator and Load Charts Visible
Compliant
Corrected
Action Required
Repeat
Not Inspected
Proper Hand Signals in Use & Posted
Compliant
Corrected
Action Required
Repeat
Not Inspected
Swing Radius Barricaded
Compliant
Corrected
Action Required
Repeat
Not Inspected
Rigging Inspected Prior to Use & in Good Condition, All Tags Legible & Attached
Compliant
Corrected
Action Required
Repeat
Not Inspected
Rigging Properly Stored When Not In Use
Compliant
Corrected
Action Required
Repeat
Not Inspected
Seat Belt Being Used
Compliant
Corrected
Action Required
Repeat
Not Inspected
Qualified Rigger in Use
Compliant
Corrected
Action Required
Repeat
Not Inspected
Qualified Signal Person in Use
Compliant
Corrected
Action Required
Repeat
Not Inspected
Power Lines Deactivated, Removed or at a Minimum Safe Distance, Spotter in Use w/in 20'
Compliant
Corrected
Action Required
Repeat
Not Inspected
Tag Line(s) in Use For Load Control
Compliant
Corrected
Action Required
Repeat
Not Inspected
Equipment is Firmly Supported
Compliant
Corrected
Action Required
Repeat
Not Inspected
OutRiggers In Use
Compliant
Corrected
Action Required
Repeat
Not Inspected
Pre-Lift Meeting Conducted
Compliant
Corrected
Action Required
Repeat
Not Inspected
Critical Lift Plan Reviewed
Compliant
Corrected
Action Required
Repeat
Not Inspected
Operator Certified and Medical Card Current
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
General House Keeping
Orderly Storage of Material
Compliant
Corrected
Action Required
Repeat
Not Inspected
Orderly Storage of Equipmen
Compliant
Corrected
Action Required
Repeat
Not Inspected
Trash and Debris Picked Up
Compliant
Corrected
Action Required
Repeat
Not Inspected
Adequate Supply of Trash Receptacles
Compliant
Corrected
Action Required
Repeat
Not Inspected
Banding Material and Wire
Compliant
Corrected
Action Required
Repeat
Not Inspected
Protruding nails Removed or Bent Over
Compliant
Corrected
Action Required
Repeat
Not Inspected
Restrooms Clean and Supplies Adequate
Compliant
Corrected
Action Required
Repeat
Not Inspected
Hand Wash Stations Supplied & Stocked
Compliant
Corrected
Action Required
Repeat
Not Inspected
Dust Protection Observed
Compliant
Corrected
Action Required
Repeat
Not Inspected
Lighting is Adequate
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Heat Illness Prevention
Cool Drinking Water Supplied & Nearby
Compliant
Corrected
Action Required
Repeat
Not Inspected
Disposable Cups & Trash Receptacles Provided
Compliant
Corrected
Action Required
Repeat
Not Inspected
Adequate Shade Provided & Comfortable Seating
Compliant
Corrected
Action Required
Repeat
Not Inspected
Employees Properly Trained
Compliant
Corrected
Action Required
Repeat
Not Inspected
High Heat Requirements In Effect (95 degrees +)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Un-acclimatized Employees Monitored
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Confined Space
Permit Completed
Compliant
Corrected
Action Required
Repeat
Not Inspected
Verify Atmospheric Monitor Onsite & Calibrated w/in Last 30 Days
Compliant
Corrected
Action Required
Repeat
Not Inspected
Continuos Monitoring Required and Documented every 30 Minutes
Compliant
Corrected
Action Required
Repeat
Not Inspected
Ventilation of Space Adequate
Compliant
Corrected
Action Required
Repeat
Not Inspected
Pre-Task JSA Completed and Reviewed Prior to Entry
Compliant
Corrected
Action Required
Repeat
Not Inspected
Rescue Procedures in Place & Reviewed Prior to Entry
Compliant
Corrected
Action Required
Repeat
Not Inspected
Employees Involved Trained on Responsibilities (Supervisor, Attendant, Entrant)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Heavy Equipment and Vehicles
Operator Trained on Equipment Being Used
Compliant
Corrected
Action Required
Repeat
Not Inspected
Seatbelt Worn at All Times
Compliant
Corrected
Action Required
Repeat
Not Inspected
Inspection and Maintenance Logs Completed
Compliant
Corrected
Action Required
Repeat
Not Inspected
Safety Devices Functioning Properly (Brakes, Lights, Mirrors, Horn, Etc.,)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Back-up Alarm Installed and Audible
Compliant
Corrected
Action Required
Repeat
Not Inspected
All moving parts guarded
Compliant
Corrected
Action Required
Repeat
Not Inspected
Wheels Chocked on All Mobile Equipment When Standing Alone
Compliant
Corrected
Action Required
Repeat
Not Inspected
Fire Extinguisher Present and Inspection Tag Current
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Traffic Control
Traffic paths secures by reasonable equipment (Cones, hard barricade, tapes...etc)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Flaggers Are Trained & Wearing ANSI Class II or III High Visibility Garment
Compliant
Corrected
Action Required
Repeat
Not Inspected
Workers Exposed To Vehicular Traffic Wearing ANSI Class II or III High Visibility Garment
Compliant
Corrected
Action Required
Repeat
Not Inspected
Pre-Warning Signs In Place (Road Work Ahead, Flagger Ahead, Etc,.)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Sign Board(s) In Place To Warn of Lane Closure
Compliant
Corrected
Action Required
Repeat
Not Inspected
Approved Traffic Plan In Place and Followed
Compliant
Corrected
Action Required
Repeat
Not Inspected
Public (other employees) Protected from Work
Compliant
Corrected
Action Required
Repeat
Not Inspected
Spotter Used For Moving Of Equipment Near Or Through Traffic
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other;
Compliant
Corrected
Action Required
Repeat
Not Inspected
Welding and Cutting
Equipment Is In Good Condition
Compliant
Corrected
Action Required
Repeat
Not Inspected
Welders and Helpers Are Wearing Proper PPE
Compliant
Corrected
Action Required
Repeat
Not Inspected
Adjacent Workers Protected By Screens or Shields
Compliant
Corrected
Action Required
Repeat
Not Inspected
Electrical Equipment Is Grounded
Compliant
Corrected
Action Required
Repeat
Not Inspected
All Cables Are Protected And In Good Condition
Compliant
Corrected
Action Required
Repeat
Not Inspected
Fire Extinguisher Of Proper Type And Size In The Work Area
Compliant
Corrected
Action Required
Repeat
Not Inspected
Flammable Materials Removed From Work Area Or Protected
Compliant
Corrected
Action Required
Repeat
Not Inspected
Compressed Gas Cylinders Secured In Upright Position And Protective Caps In Place
Compliant
Corrected
Action Required
Repeat
Not Inspected
Backflow Preventer On Leads From Oxygen and Acetylene Cylinders
Compliant
Corrected
Action Required
Repeat
Not Inspected
Gas Lines Are Protected And In Good Condition
Compliant
Corrected
Action Required
Repeat
Not Inspected
Hot Work Permit Completed When Required
Compliant
Corrected
Action Required
Repeat
Not Inspected
Trained Fire Watch In Place (Min. Of 30 Minutes After Welding Task Completed)
Compliant
Corrected
Action Required
Repeat
Not Inspected
Other:
Compliant
Corrected
Action Required
Repeat
Not Inspected
Corrective Actions Taken / Inspection Summary
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Moses Randika
Ecocycle customer site health & safety inspection
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