EDI_SiteAudit

• Site conducted

  Select

EDI Weekly Site Inspection

• Conducted on

  Date

• Site Supervisor

• Inspection conducted by

• Number of employees on site

Site Office Administration:

• Project requires SSP?

  Yes

  No

• SSP complete, reviewed with supervisor, and saved in FieldFlo

  Yes

  No

• All controls in SSP in place

  Yes

  No

• Failure to implement general administrative tools

  Select FieldFlo docs not open before 9 am (Sign-in, PJS/JHA, Daily log) Designated provider letter not printed and/or available Emergency contact information not visibly posted Scope/drawings not readily available to supervisor Manifests not available for dumpsters on-site FD/PD notification not available in FieldFlo docs NO- All general administrative requirements are in compliance

  • FieldFlo docs not open before 9 am (Sign-in, PJS/JHA, Daily log)
  • Designated provider letter not printed and/or available
  • Emergency contact information not visibly posted
  • Scope/drawings not readily available to supervisor
  • Manifests not available for dumpsters on-site
  • FD/PD notification not available in FieldFlo docs
  • NO- All general administrative requirements are in compliance

• SDS for chemicals on site readily available to supervisor

  Yes

  No

  N/A

• Are all storage containers clearly marked in compliance with the HazCom standard?

  Yes

  No

  N/A

• Permits, notifications, and mods current and complete?

  Yes

  No

  N/A

• What must be done? (select one or more)

  Select Supervisor mod Start/end date mod Obtain/post original permit Obtain/post phase permit Other

  • Supervisor mod
  • Start/end date mod
  • Obtain/post original permit
  • Obtain/post phase permit
  • Other

• Specify

• All required employee records current and available to supervisor?

  Yes

  No

  N/A

• Missing tools from the supervisors phone?

  Select Noise meter FieldFlo Company email NONE: Device has all required tools

  • Noise meter
  • FieldFlo
  • Company email
  • NONE: Device has all required tools

• Weekly air monitoring results visibly posted

  Yes

  No

• Additional administrative observations?

  Yes

  No

• Explain

FieldFlo

• JHA complete and verified by all employees on site

  Yes

  No

• Does JHA include all present tasks and hazards with appropriate controls?

  Yes

  No

• Are all controls listed in JHA being implemented?

  Yes

  No

• All workers have required training listed in FieldFlo

  Yes

  No

Employee involvement

• Name(s) of worker(s) interviewed

Interview items

• Did worker participate in morning toolbox talk?

  Yes

  No

• Does worker's description of safety meeting match meeting log on daily field report?

  Yes

  No

• Does worker know and understand JHA process and content?

  Yes

  No

• Does worker understand incident reporting procedures?

  Yes

  No

• What is the most effective feature of our safety program?

• What do you think we can improve regarding worker safety?

• Additional observations regarding employee involvement?

  Yes

  No

• Explain

Health and hygiene

• Is there at least 1 bathroom for every 10 workers?

  Yes

  No

  N/A

• Are facilities available for washing hands and personal protective equipment?

  Yes

  No

  N/A

• Hazardous materials WIP

  Select Asbestos Lead Mold Environmental/Other No health exposures

  • Asbestos
  • Lead
  • Mold
  • Environmental/Other
  • No health exposures

• Describe other environmental or health hazards

• Has a regulated area been established with appropriate signage?

  Yes

  No

  N/A

• Are appropriate controls in place? (e.g. NAM's, material wetting, etc.)

  Yes

  No

  N/A

• Has appropriate PPE been selected and in use?

  Yes

  No

  N/A

• Are all relevant IH reports/documents available to supervisor for review?

  Yes

  No

  N/A

• Has a regulated area been established with appropriate signage?

  Yes

  No

  N/A

• Personal monitoring being conducted?

  Yes

  No

  N/A

• Are appropriate controls in place? (e.g. NAM's, material wetting, etc.)

  Yes

  No

  N/A

• Has appropriate PPE been selected and in use?

  Yes

  No

  N/A

• Are all relevant IH reports/documents available to supervisor for review?

  Yes

  No

  N/A

• TCLP all waste and dispose of properly?

  Yes

  No

  N/A

• Regulated work area and signage in place?

  Yes

  No

• PPE/Respirator selection sufficient to protect workers from exposure?

  Yes

  No

• Personal monitoring being conducted?

  Yes

  No

• Material being removed is adequately wet?

  Yes

  No

• Amended water in use?

  Yes

  No

• Visible emissions from work area?

  Yes

  No

• Project manager required?

  Yes

  No

• PM present or PM waiver aproved? (<1,000 lin. or 3,000 sq.)

  Yes

  No

• Material content

  Less than 1%

  Equal to or greater than 1 %

• Is waste material properly packaged and labeled for disposal?

  Yes

  No

• Manifest on-hand for materials to be disposed?

  Yes

  No

• Control level

  Select Minimal quantity, hand removal, component removal methods Secondary, mini-containment, glove-bag, other non-full containment Full containment

  • Minimal quantity, hand removal, component removal methods
  • Secondary, mini-containment, glove-bag, other non-full containment
  • Full containment

• Pre-cleaning conducted prior to setup/removal?

  Yes

  No

  N/A

• Decontamination unit setup and operational?

  Yes

  No

  N/A

• Critical barriers installed?

  Yes

  No

  N/A

• Glove-bag/containment installation meets minimal standard?

  Yes

  No

  N/A

• Smoke tubes attached to containment entrance?

  Yes

  No

  N/A

• Negative air machines in place and operating?

  Yes

  No

  N/A

• Sufficient Negative pressure established?

  Yes

  No

  N/A

• HEPA filters in working condition?

  Yes

  No

  N/A

• Exhaust to exterior or monitored by AMS?

  Yes

  No

  N/A

• All access to containment separated with z flaps?

  Yes

  No

  N/A

• Viewport in place?

  Yes

  No

  N/A

• Load-out, shower, and clean room clear of visible debris?

  Yes

  No

  N/A

• Materials remain non-friable for duration of work?

  Yes

  No

  N/A

• Yes

  No

  N/A

• Original permit posted visibly on-site

  Yes

  No

  N/A

• Project design signed and posted on-site?

  Yes

  No

  N/A

• Containment log at decon entrance/exit?

  Yes

  No

  N/A

• Pre-cleaning conducted prior to setup/removal?

  Yes

  No

  N/A

• Decontamination unit and load-out setup and operational?

  Yes

  No

  N/A

• Containment installation meets standard requirements? (critical barriers, 2 layers on floor/walls, fixed items covered, no seems on corners, 12 inch overlap, etc.)

  Yes

  No

  N/A

• 3 chamber decon and 2 chamber load-out separated with z flaps?

  Yes

  No

  N/A

• Smoke tubes attached to containment entrance?

  Yes

  No

  N/A

• 12x12 View-port in place?

  Yes

  No

  N/A

• Negative air machines in place and operating?

  Yes

  No

  N/A

• Negative pressure >-0.02 established and monitored with monometer?

  Yes

  No

  N/A

• Exhaust to exterior or monitored by AMS?

  Yes

  No

  N/A

• HEPA filters in working condition?

  Yes

  No

  N/A

• Airless sprayer present and in use?

  Yes

  No

  N/A

• Load-out, shower, and clean room clear of visible debris?

  Yes

  No

  N/A

• Material removed with hand methods only?

  Yes

  No

  N/A

• Material remains non-friable for duration of work?

  Yes

  No

  N/A

• Component removal: material adequately adhered to surface and/or wrapped in 2 layers of 6 mil. poly?

  Yes

  No

  N/A

• Has a regulated area been established with appropriate signage?

  Yes

  No

  N/A

• Personal monitoring being conducted?

  Yes

  No

  N/A

• Are appropriate controls in place? (e.g. NAM's, material wetting, etc.)

  Yes

  No

  N/A

• Has appropriate PPE been selected and in use?

  Yes

  No

  N/A

• Are all relevant IH reports/documents available to supervisor for review?

  Yes

  No

  N/A

Work site administration

• All required work area signage in place(caution, overhead, danger tape, etc.)

  Yes

  No

  N/A

• Is the site secure from non-authorized personnel and proper signage in place?

  Yes

  No

  N/A

• Are all working materials and equipment stored in a safe and secure location?

  Yes

  No

  N/A

• Are workers provided with a safe and secure place for storing personal items?

  Yes

  No

  N/A

• Additional worksite administration observations?

  Yes

  No

• Explain:

Management systems

• Supervisor understands incident response and reporting procedures

  Yes

  No

• Has supervisor report of injury form been filled out for all incidents?

  Yes

  No

  N/A

• Has the designated provider letter been signed by any person sent to the clinic for treatment and saved to project documents vault?

  Yes

  No

  N/A

• Management ratio < 5:1

  Yes

  No

  N/A

• What safety programs are applicable to this job?

  Select Aerial lifts Confined space Electrical safety Fall protection Fire protection Fork lift/industrial truck Hearing and noise expossure Ladder safety Lockout/Tag-out Respiratory protection Rigging and material handling Scaffold safety Trenching and excavations Welding/cutting/hotwork Other:

  • Aerial lifts
  • Confined space
  • Electrical safety
  • Fall protection
  • Fire protection
  • Fork lift/industrial truck
  • Hearing and noise expossure
  • Ladder safety
  • Lockout/Tag-out
  • Respiratory protection
  • Rigging and material handling
  • Scaffold safety
  • Trenching and excavations
  • Welding/cutting/hotwork
  • Other:

• What other applicable safety programs:

• Are there significant budget or schedule pressures on this job?

  Yes

  No

• Please explain:

• Additional observations regarding management systems?

  Yes

  No

• Explain

Work environment

• How well is the crew maintaining proper housekeeping in active work areas?

• Are all walkways and work areas clear, illuminated, and adequately marked?

  Yes

  No

  N/A

• Are all work materials and/or waste materials stored in a safe location and well organized?

  Yes

  No

  N/A

Equipment

• Are all tools and equipment in use in safe working condition, and all damaged/defective equipment red-tagged and removed from service?

  Yes

  No

  N/A

• Additional observations regarding equipment?

  Yes

  No

• Explain

Work operations

• Did any workers engage in any unsafe acts?

  Yes

  No

• Please explain:

• Were there any unsafe working conditions?

  Yes

  No

• Please explain:

• Any PPE issues? (wrong selection, wrong size, defective item in use, etc.)

  Yes

  No

• Please explain:

• Additional observations regarding work operations?

  Yes

  No

• Explain

• Is it apparent that a clear work plan is being executed?

  Yes

  No

  N/A

General safety

• What is the most LIKELY hazard on this site?

• What is the most SEVERE hazard on this site?

Confirmation

• Auditor - By signing I attest that to the best of my knowledge the information contained in this inspection report is current and correct, and I have reviewed this material with the site supervisor. I also confirm that I have/will fulfill my responsibility to work with the site supervisor and ensure prescribed corrections are implemented.

  Sign

• Supervisor - By signing I attest that I understand the information contained in this inspection report, and I have reviewed this material with the site auditor. I also confirm that I have/will fulfill my responsibility to implement the prescribed corrective actions contained in this report.

  Sign