EDI_SOSA_2.0

EDI Weekly Site Inspection

• Job Site Name

• Job Site Number

• Conducted on

  Date

• Site Supervisor

• Inspection conducted by

• Location
  Address

• Number of employees on site

• Names of all Supervisors/Crew Leaders on site

Site Office Administration:

• Are any job book items are missing?

  Select Containment logs Corrective action form Daily log Daily sign-in Designated provider letter Sample data sheets Emergency contact form Expossure assessment form Qualitative fit test form JHA forms Loadout forms Safety meeting sign-in sheets Cassette labels Supervisor accident report form T&M sheets Time cards Scope statement Manifests Red tags Map to nearest hospital FD/PD notification NONE- Job book is complete

  • Containment logs
  • Corrective action form
  • Daily log
  • Daily sign-in
  • Designated provider letter
  • Sample data sheets
  • Emergency contact form
  • Expossure assessment form
  • Qualitative fit test form
  • JHA forms
  • Loadout forms
  • Safety meeting sign-in sheets
  • Cassette labels
  • Supervisor accident report form
  • T&M sheets
  • Time cards
  • Scope statement
  • Manifests
  • Red tags
  • Map to nearest hospital
  • FD/PD notification
  • NONE- Job book is complete

• HazCom/administrative Postings: Select all MISSING items

  Select OSHA/DOL postings SDS binder Emergency contacts Scope statement and drawings/design Active worker state cards Air monitoring results or NEA NONE: HazCom and postings are complete

  • OSHA/DOL postings
  • SDS binder
  • Emergency contacts
  • Scope statement and drawings/design
  • Active worker state cards
  • Air monitoring results or NEA
  • NONE: HazCom and postings are complete

• Are all hazardous chemicals being used on the site clearly marked in the SDS binder?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Please explain:

• Are all 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

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

• All required employee records up to date, organized, and accessible?

  Yes

  No

  N/A

• Are any tools missing from the supervisors phone?

  Select iAuditor Noise meter Drop Box NONE: device has all required apps

  • iAuditor
  • Noise meter
  • Drop Box
  • NONE: device has all required apps

• Are there any other administrative observations and/or recommendations?

  Yes

  No

Employee involvement

• Names of worker(s) interviewed

Job Hazard Analysis

• Does worker know where work area JHA is located?

  Yes

  No

  N/A

• Does worker clearly understand the assigned tasks outlined on the JHA?

  Yes

  No

  N/A

• Does worker clearly understand the hazards outlined on the JHA?

  Yes

  No

  N/A

• Does worker clearly understand the controls outlined on the JHA?

  Yes

  No

  N/A

• Does worker know their responsibility to update JHA as necessary?

  Yes

  No

  N/A

• Does worker understand and participate in JHA program? (1= not at all 10= understands and participates completely)

• Please explain:

Toolbox talk

• What is noted as the focus of the toolbox talk

• Does worker's description of safety meeting match safety meeting notes?

  Yes

  No

  N/A

• Do safety meeting notes adequately describe meeting topics (i.e. site specific and detailed)

  Yes

  No

• Does daily focus apply to the workers assigned tasks?

  Yes

  No

  N/A

• How does worker rate toolbox talk? (1 = a waste of time, 5 = highly useful in creating a safe workplace)

• Worker recommendations to improve toolbox talk

• Additional observations regarding JHA?

  Yes

  No

• Additional observations regarding toolbox talk?

  Yes

  No

• What else is being done on this site to support worker participation in safety initiatives?

• Additional observations regarding employee involvement?

  Yes

  No

Health and hygiene

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

  Yes

  No

  N/A

• Are facilities available for washing hands and equipment (e.g. respirators)?

  Yes

  No

  N/A

• Identified health exposures

  Select Asbestos Lead Mold Environmental/Other Radiation No health exposures

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

• What other exposures are present on this job?

• Has an exposure assessment been conducted?

  Yes

  No

  N/A

• Air monitoring required?

  Yes

  No

  N/A

• Air monitoring results received and posted within 5 days of monitoring?

  Yes

  No

  N/A

Work site administration

• Site signage required?

  Yes

  No

  N/A

• What signage is required?

  Select Hearing protection required Authorized personnel only Fall protection required Overhead work Special equipment precautions Other:

  • Hearing protection required
  • Authorized personnel only
  • Fall protection required
  • Overhead work
  • Special equipment precautions
  • Other:

• What other signage is required?

• What signage is required (e.g. ram-set etc.)

• Is signage available and in place?

  Yes

  No

  N/A

• Is the site secure from non-authorized personnel?

  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

Training

• Does this site have posted minimum training requirements?

  Yes

  No

  N/A

• Does this site have posted 'House Rules'

  Yes

  No

  N/A

• What (if any) special equipment/task training is required at this site

  Select Abrasive blasting Aerial lift Confined space Fork lift Welding and cutting Equipment operator HAZWOPPER Other: No special training required

  • Abrasive blasting
  • Aerial lift
  • Confined space
  • Fork lift
  • Welding and cutting
  • Equipment operator
  • HAZWOPPER
  • Other:
  • No special training required

• What equipment?

• What other task/equipment specific training?

• Is documentation present that all special training has been administered? (e.g. certs, cards, etc.)

  Yes

  No

  N/A

• Are there any other training subjects you would recommend for this site?

• Any additional observations regarding training?

  Yes

  No

  N/A

Management systems

• Are the designated provider list and supervisor first report of injury forms available?

  Yes

  No

  N/A

• Has supervisor first 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?

  Yes

  No

  N/A

• Is management ratio at least 10:1 in all work areas?

  Yes

  No

  N/A

• If no, please explain.

• Has a weekly safety inspection been conducted in the past 5 business days?

  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

Work environment

• How well is the crew maintaining proper housekeeping?

• 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?

  Yes

  No

  N/A

• Is there a designated place for workers to take defective equipment?

  Yes

  No

  N/A

• Has all damaged equipment or equipment not fit for use been marked and returned to the warehouse?

  Yes

  No

  N/A

• Additional observations regarding equipment?

  Yes

  No

  N/A

Work operations

• Did any workers engage in any unsafe acts?

  Yes (-1)

  No (+1)

• Please explain:

• Were there any unsafe working conditions?

  Yes (-1)

  No (+1)

• Please explain:

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

  Yes (-1)

  No (+1)

• Please explain:

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

  Yes

  No

  N/A

• Please explain:

• Additional observations regarding work operations?

  Yes

  No

General safety

• What single program would you recommend be audited using this site?

  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 program would you recommend?

• What is the most LIKELY hazard on this site

• What is the most SEVERE hazard on this site?

Confirmation

• By signing I attest that to the best of my knowledge the information contained in this inspection report is current and correct. I also confirm that I have/will fulfill my responsibility to make corrections and/or work with the site supervisor to address any items contained in this report that would require corrective action.

  Sign