Electronic CJSR

• Days Without A Recordable Incident (Day 34 as of August 20, 2023)

• Jobsite number and name

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Site Personnel Walking Project With

• Photos of Job Site/Facility/Plant

  Media

Overaa's Best Safety Practices, Progress on Past Observation and Documentation

• Any Safety Alert generated this week? (Please upload the picture of the alert)

  Overaa

  Sub-Contractor

  Both

• Please select the company name from the dropdown.

  Select

• Has the last safety inspection of this job site been reviewed and all previous recommendations completed?

  Yes

  No

  N/A

• Are safety inspections completed at least once a week?

  Yes

  No

  N/A

• Are safety tailgate meetings completed at least once a week?

  Yes

  No

  N/A

On Site Administrative Procedures

• Pink Incident Procedure posting posted on-site?

  Yes

  No

  N/A

• Are all necessary posters and permits (Cal/OSHA permit, Safety manual, Tailgate binder, USA ticket, Hot work, Confined Space permits posted or electronic, etc) in place?

  Yes

  No

  N/A

• Do all subcontractors (first and lower) tier provide safety talks and inspections to their employees on a weekly basis?

  Yes

  No

  N/A

• Are “Red Danger and Yellow Caution” Tape being used correctly throughout the job site? (Red tape means Red tape means….”Do not enter unless the entrant contacts the supervisor of the area and Yellow tape means, Enter, but proceed with caution.”)

  Yes

  No

  N/A

• Are portable emergency eye wash stations located throughout the job site, out of the direct sunlight and inspected monthly?

  Yes

  No

  N/A

Emergency Response

• Are all clinic and hospital information posted on site?

  Yes

  No

  N/A

• Are first aid kits and aid equipment on site up to date?

  Yes

  No

  N/A

• Are there formally trained First Aiders on site for all shifts? CPR/First Aid Certification?

  Yes

  No

  N/A

Job Hazard Analysis

• Have the JHAs been conducted for all the tasks?

  Yes

  No

  N/A

• Is the JHA available in the task area?

  Yes

  No

  N/A

• Have the Subs conducted their JHAs?

  Yes

  No

  N/A

Trenching and Excavation Safety

• Referance:

• Is there excavation at this project?

  Yes

  No

• Have we filled out the Daily Excavation/Trench checklist?

  Yes

  No

  N/A

• Who is the excavation/trench competent person on-site?

• What type of soil is it? A, B or C?

  A

  B

  C

• Are all Class "C" soils sloped at a 1 to 1-1/2 ratio with no benching?

  Yes

  No

  N/A

• Are all Class "B" soils sloped at a 1 to 1 ratio?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Are all excavations barricaded 6' back?

  Yes

  No

  N/A

• Are spoil piles or equipment set back at least 2' or more?

  Yes

  No

  N/A

• Are there adequate exits and enters leading into and out of the trench or excavation? Ladder every 25'?

  Yes

  No

  N/A

• Does the trench shield meet 18" extension from the edge of the excavation/trench? (18" is required if you have the potential of being struck by from soil pile or equipment/tools)

  Yes

  No

  N/A

• Are all excavations properly protected during breaks or when left unattended?

  Yes

  No

  N/A

• Who was the contributing factor to the violation(s) in this section?

  Overaa

  Sub-contractor

  Both

  N/A

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

Fall Protection/Prevention

• Reference:

• Has there been formal training on how and when to wear harnesses?

  Yes

  No

  N/A

• Do the workers using fall restraint (12.5') or fall arrest (18.5') have standard fall clearance?

  Yes

  No

  N/A

• Are all "D" rings, hooks/equipment compatible?

  Yes

  No

  N/A

• Are anchor point able to withstand 5000lbs force per person?

  Yes

  No

  N/A

• Are all potential fall risks of 6’ or more properly protected?

  Yes

  No

  N/A

• Are employees using fall protection equipment (rope grabs, tie offs, anchor points and lanyards) properly?

  Yes

  No

  N/A

• If roofing is being completed and are roofers following the 6' set back standard or do they have a designated competent person with different colored safety vest ?

  Yes

  No

  N/A

Respirable Silica

• Do we have respirable silica exposure on-site?

  Yes

  No

• Are we using dust control measures (engineering controls: HEPA Vaccum or Water Spray) to control dust?

  Yes

  No

  N/A

• Have we barricaded the task area to prevent exposure to other employees?

  Yes

  No

  N/A

• Is a respirator required for this task?

  Yes

  No

• Are respirators being worn/appropriate for job tasks, fit-tested, well maintained, and employees medically evaluated?

  Yes

  No

  N/A

• Who was the contributing factor to the violation(s) in this section?

  Overaa

  Sub-contractor

  Both

  N/A

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

Confined Space

• Reference:

• Do you have confined space on-site?

  Yes

  No

• Is it permit required or non-permit?

  Permit Required

  Non-permit Required

  Alternate Entry

• Do you have a confined space rescue plan?

  Yes

  No

  N/A

• Is the rescue equipment (Davit arm, Wrench, Gas monitors) set up the right way?

  Yes

  No

  N/A

• Do we have gas monitors to test atmospheric hazards?

  Yes

  No

  N/A

• All physical hazards eliminated?

  Yes

  No

  N/A

• Atmosphere being continually monitored?

  Yes

  No

  N/A

Scaffolds

• Reference:

• Do you have a scaffold on-site?

  Yes

  No

• Who is our Scaffold Competent Person on-site?

• Are all scaffold components compatible and does the labeling meet or exceed OSHA (Cal-OSHA) Standards?

  Yes

  No

  N/A

• Have we inspected the scaffold prior to use?

  Yes

  No

  N/A

• Are proper kick plates, mid rails, top rails and end rails in place?

  Yes

  No

  N/A

• Are scaffold footings level and secured?

  Yes

  No

  N/A

• Are all mobile scaffolds (bakers scaffolding) wheels locked when in use and guarded properly?

  Yes

  No

  N/A

• Is scaffolding being used above 6’ have the proper handrail system installed including outriggers?

  Yes

  No

  N/A

• Who was the contributing factor to the violation(s) in this section?

  Overaa

  Sub-contractor

  Both

  N/A

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

Personal Protective Equipment (PPE)

• Reference:

• Employees wearing all the required PPEs on-site?

  Yes

  No

  N/A

• Are heat illness procedures (water & shade) in place when temperatures exceed 85 degrees?

  Yes

  No

  N/A

• Who was the contributing factor to the violation(s) in this section?

  Overaa

  Sub-contractor

  Both

  N/A

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

Tools, Equipment, and Machinery

• Is all equipment/machinery properly guarded? Is there a handle on the grinder?

  Yes

  No

  N/A

• Are all tools and equipment being used for their intended purpose?(ex. grinding discs for grinding not cutting)

  Yes

  No

  N/A

• Is all equipment and machinery being used by qualified and competent persons? Trained operators?

  Yes

  No

  N/A

• Are all powder activated (HILTI/Milwaukee) tools being used properly and have the proper signage posted?

  Yes

  No

  N/A

• Are proper signs installed when Lasers are being used on job site?

  Yes

  No

  N/A

Lifting Equipment

• Are lifting plans reviewed prior to lifts occurring?

  Yes

  No

  N/A

• Are operators on all running equipment?

  Yes

  No

  N/A

• Are spotters being utilized during load lifting, load transferring and while reversing equipment/machinery?

  Yes

  No

  N/A

• Is lifting equipment, including ropes, slings, chains, hooks monitored on a daily basis?

  Yes

  No

  N/A

• Are air horns or other signals used during overhead lifts?

  Yes

  No

  N/A

• During lifts are tag lines being used properly?

  Yes

  No

  N/A

• Are riggers and crane operators properly certified and have proper licenses?

  Yes

  No

  N/A

• Is danger tape used around the swing radius of crane to keep unauthorized personnel from entering the area?

  Yes

  No

  N/A

Ladders

• Reference:

• Are all step ladders and extension ladders on the job site being used properly?

  Yes

  No

  N/A

• Are all ladders properly secured, labeled and in good structural condition?

  Yes

  No

  N/A

• Are extension ladders utilizing 4' to1' ratio?

  Yes

  No

  N/A

• Are three points of contact being used during all means of egress?

  Yes

  No

  N/A

• Are ladders extended over 3' of the landing area?

  Yes

  No

  N/A

• Is the ladder suitable for the job being completed? (ex. the metal ladder should not be used for electrical work, proper height for the job task being completed)

  Yes

  No

  N/A

• Are stored properly when not in use? (This includes whenever the ladder is unattended)

  Yes

  No

  N/A

Electrical Safety

• Reference:

• Are all portable power tools monitored for frayed or damaged cords?

  Yes

  No

  N/A

• Are electrical cords properly color coded using the (CalOSHA and OSHA) quarterly codes or Is there GFCI Protection in place?

  Yes

  No

  N/A

• Is the area in front of the electrical panel kept clear for 36"? Access?

  Yes

  No

  N/A

• Are proper LO/TO procedures being followed and enforced?

  Yes

  No

  N/A

• Are electrical cords located away from high traffic areas or where they could be damaged from contact with moving machinery?

  Yes

  No

  N/A

Traffic Management

• Reference:

• Is traffic control required on-site?

  Yes

  No

• Are there certified flaggers being used for traffic control?

  Yes

  No

  N/A

• Are there adequate traffic controls for TMP? (physical barriers, bollards, speed limits, flashing lights, spotters, etc)

  Yes

  No

  N/A

Hazardous Chemical Safety

• Are safety data sheets (SDS) accessible for all chemicals found on site?

  Yes

  No

  N/A

• Are all containers properly labeled and stored?

  Yes

  No

  N/A

• Is there adequate ventilation, PPE (safety glasses, face shield, gloves) and emergency eye wash station and showers on site?

  Yes

  No

  N/A

• Are all hazardous materials being properly stored and disposed of?

  Yes

  No

  N/A

• Are chemicals/flammables/combustibles stored in the grounded yellow flammable cabinets (as required)?

  Yes

  No

  N/A

Job Site Hazards

• Are "hot work" safety procedures being followed? (spotter, fire extinguisher, etc.)

  Yes

  No

  N/A

• Is general lighting throughout the job site 5 foot candles or more?

  Yes

  No

  N/A

• Are all walkways, stairwells, stairs and staging areas free of all slip, trip and fall hazards?

  Yes

  No

  N/A

• Are all floor openings greater than 2” properly marked and covered at all times?

  Yes

  No

  N/A

• Are all protrusions properly protected? (Rebar Caps, etc.)

  Yes

  No

  N/A

• Are all compressed gas cylinders properly secured and stored?

  Yes

  No

  N/A

• Are all oxygen and acetylene tanks on a portable cart separated by metal plate that has a fire rating of 1-1/2 hours?

  Yes

  No

  N/A

• Are all caught in and between hazards properly identified and controlled?

  Yes

  No

  N/A

• Are all walking and working surfaces free of clutter?

  Yes

  No

  N/A

• Are all struck by/ against hazards properly identified and controlled?

  Yes

  No

  N/A

• Are good housekeeping procedures being followed on site?

  Yes

  No

  N/A

Sign Off

• On site representative

• Auditor's Signature

  Sign