EFS Field Safety Inspection Report

• Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Add media

  Media

DESCRIPTION OF FACILITY AND SCOPE OF WORK

• Line Item Rating Information:
  2 - Meets Requirements
  1 - Needs Improvement
  0 - Totally Unacceptable
  NA - Not Acceptible

HEALTH AND WELFARE

• Location of nearest Emergency Room and Urgent Care Center

• First Aid supplies available

  0

  1

  2

  N/A

• Hand washing materials or facilities available

  0

  1

  2

  N/A

• Safety Data Sheets and Safe Work Practices Manual Available

  0

  1

  2

  N/A

• Emergency Preparedness: Evacuation route

  0

  1

  2

  N/A

• Safety Bulletin Board current and orderly

  0

  1

  2

  N/A

HOUSEKEEPING

• Good site layout of materials

  0

  1

  2

  N/A

• Site access/dust control

  0

  1

  2

  N/A

• Site Housekeeping/Controls

  0

  1

  2

  N/A

• Trash containers used, covered, and removed when necessary

  0

  1

  2

  N/A

• Material Stacked and stable

  0

  1

  2

  N/A

• Flammable - combustible stored/access clear

  0

  1

  2

  N/A

• All boards de-nailed and picked up

  0

  1

  2

  N/A

• Passageways/walkways clear at all times

  0

  1

  2

  N/A

• Holes covered, identified and secured

  0

  1

  2

  N/A

• Cords/cables routed properly out of walkway

  0

  1

  2

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Head protection worn at all times

  0

  1

  2

  N/A

• Eye protection appropriate for hazards

  0

  1

  2

  N/A

• Foot protection - hard soled rubber boots

  0

  1

  2

  N/A

• Hearing Protection appropriate for hazards

  0

  1

  2

  N/A

• Hand protection appropriate for hazards

  0

  1

  2

  N/A

• Respiratory protection as required for tasks

  0

  1

  2

  N/A

• Chemical Protection appropriate for hazards

  0

  1

  2

  N/A

• Fall protection and anchor points adequate

  0

  1

  2

  N/A

• Proper work clothing

  0

  1

  2

  N/A

• NFPA 70E PPE available/used

  0

  1

  2

  N/A

EMPLOYEE WORK OBSERVATIONS

• Employees wearing correct PPE for tasks

  0

  1

  2

  N/A

• Employees working on scissor lifts properly

  0

  1

  2

  N/A

• Fall protection available in all lifts

  0

  1

  2

  N/A

• Employee's were handling materials properly

  0

  1

  2

  N/A

• Workstations are at correct height

  0

  1

  2

  N/A

• Lifting and moving devices were available

  0

  1

  2

  N/A

• Employees observed using ladders properly

  0

  1

  2

  N/A

• No materials carried while ascending/descending ladder

  0

  1

  2

  N/A

• Employees are trained on operating equipment being used

  0

  1

  2

  N/A

• Employees using fall protection properly

  0

  1

  2

  N/A

SAFETY PROCEDURES

• Pre-Task planning form used before starting project

  0

  1

  2

  N/A

• Electrical Hazards identified

  Yes

  No

  N/A

• Hazardous Energy Control Program - Lock Out/Tag Out

  0

  1

  2

  N/A

• NFPA 70E Arc Flash Procedures involved,

  0

  1

  2

  N/A

• Confined Space Entry controls in place

  0

  1

  2

  N/A

• Hazard Communication labeling in use

  0

  1

  2

  N/A

• Machine guarding hazards identified

  Yes

  No

  N/A

HAND TOOLS

• Correct tools and use for task being observed

  0

  1

  2

  N/A

• Defective tool program in use

  0

  1

  2

  N/A

• Daily inspection

  0

  1

  2

  N/A

• No makeshift tools

  0

  1

  2

  N/A

POWERED HAND TOOLS

• Defective tool program in use

  0

  1

  2

  N/A

• Properly grounded or double insulated

  0

  1

  2

  N/A

• GFCI in use

  0

  1

  2

  N/A

• Properly guarded at all times

  0

  1

  2

  N/A

• Inspections of electrical cords and connectors

  0

  1

  2

  N/A

• Inspection and maintenance - daily/monthly

  0

  1

  2

  N/A

• Correct disc/speed/size/type

  0

  1

  2

  N/A

LADDERS, RAMPS, AND STAIRS

• Ladders inspected before use

  0

  1

  2

  N/A

• Ladder design and use correct for task

  0

  1

  2

  N/A

• Secure at top and/or base

  0

  1

  2

  N/A

• Side rails extend 3' above top platform

  0

  1

  2

  N/A

• Rungs not over 12" on center & regular spacing

  0

  1

  2

  N/A

• Ramps cleated

  0

  1

  2

  N/A

• Stairways completed for use

  0

  1

  2

  N/A

• Elevation changes of 19" - ramp or steps provided

  0

  1

  2

  N/A

• Handrails provided as required

  0

  1

  2

  N/A

ENVIRONMENTAL

• Universal wastes labeled, separated and stored properly

  0

  1

  2

  N/A

• Used lamps and ballasts

  0

  1

  2

  N/A

• Used batteries

  0

  1

  2

  N/A

• Used refrigerant oils

  0

  1

  2

  N/A

• Recovered refrigerant

  0

  1

  2

  N/A

• Used electronic circuit boards

  0

  1

  2

  N/A

• Used mercury switches

  0

  1

  2

  N/A

• Fluorescent Bulbs

  0

  1

  2

  N/A

• List other Universal wastes as needed at end of report

  0

  1

  2

  N/A

EMCOR TRUCK/VAN

• Good housekeeping evident

  0

  1

  2

  N/A

• Compressed gas cylinders are capped and secured

  0

  1

  2

  N/A

• Emergency road kit aboard

  0

  1

  2

  N/A

• Fire extinguisher on board

  0

  1

  2

  N/A

• Tools and materials tied down as needed.

  0

  1

  2

  N/A

• Ladders properly secured to roof rack, (no bungee/rubber cords)

  0

  1

  2

  N/A

• Hazardous chemicals labeled and properly stored

  0

  1

  2

  N/A

• Cab is clean and contents secured

  0

  1

  2

  N/A

FIRE PREVENTION/PROTECTION

• Adequate fire extinguishers for hazards

  0

  1

  2

  N/A

• Proper type and location

  0

  1

  2

  N/A

• Fire watches trained and posted where required

  0

  1

  2

  N/A

• No smoking signs posted

  0

  1

  2

  N/A

• Fire extinguisher use reported

  0

  1

  2

  N/A

• Flammable materials in approved containers

  0

  1

  2

  N/A

• Flammable distribution systems are grounded

  0

  1

  2

  N/A

SAFETY PERMITS

• Obtained as required/monitored, hot work, etc.

  0

  1

  2

  N/A

• Smoking control in areas of flammable material

  0

  1

  2

  N/A

• Fie extinguishers present as required by permit

  0

  1

  2

  N/A

WELDING/CUTTING

• Cylinders secured and upright

  0

  1

  2

  N/A

• Gauges removed during relocation (individual)

  0

  1

  2

  N/A

• Condition of hoses inspected daily

  0

  1

  2

  N/A

• Fire extinguishers present - 10lb ABC minimum within 50' of hot work operations

  0

  1

  2

  N/A

• PPE

  0

  1

  2

  N/A

• Welding shields in use

  0

  1

  2

  N/A

• Grounding - close to work station

  0

  1

  2

  N/A

• Cable condition inspected/rolled up not in use

  0

  1

  2

  N/A

• Hot work permit issued

  0

  1

  2

  N/A

• Equipment off when not in use.

  0

  1

  2

  N/A

• Machine Frame grounded

  0

  1

  2

  N/A

• Flash back arrestors installed

  0

  1

  2

  N/A

SCAFFOLDING

• Erected/Dismantled, supervised by a competent person

  0

  1

  2

  N/A

• Designed properly for height and weight

  0

  1

  2

  N/A

• Connections secured

  0

  1

  2

  N/A

• Platforms, full width - 2"x10" planks secured

  0

  1

  2

  N/A

• Scaffold tied to structure every 20 ft

  0

  1

  2

  N/A

• Platform free of debris

  0

  1

  2

  N/A

• Base pads/casters used, scaffolds are plumb and braced

  0

  1

  2

  N/A

• Scaffolds plumb and braced

  0

  1

  2

  N/A

• Gaurdrails 42" highly/stable

  0

  1

  2

  N/A

• Materials are in good condition

  0

  1

  2

  N/A

• Mobil scaffolds are stationary - no ride

  0

  1

  2

  N/A

• Safe access/fall protection provided/used

  0

  1

  2

  N/A

• Anchored, harness tied off

  0

  1

  2

  N/A

• Scaffold properly inspected

  0

  1

  2

  N/A

POWDER ACTUATED TOOLS

• Appropriate eye protection being used

  0

  1

  2

  N/A

• Ear protection used as required

  0

  1

  2

  N/A

• Control of cartridges

  0

  1

  2

  N/A

• Equipment used per manufacturer recommendation

  0

  1

  2

  N/A

• Trained and Qualified Operator

  0

  1

  2

  N/A

• Signs posted where being used

  0

  1

  2

  N/A

CRANES/LIFTING

• Operator qualified/certification

  0

  1

  2

  N/A

• Qualified rigger/signal person when required.

  0

  1

  2

  N/A

ADDITIONAL INFORMATION

• Inspector's Comments: (Document any critical observations, serious safety violations observed, employee(s) counseling required deficeincy training and/or disciplinary actions.

• Employee/Supervisor/Foreman Comments:

SGNATURES

• Inspector

  Sign

• Supervisor/Foreman

  Sign

• Employee

  Sign