Epstein Daily Site Inspection

• Conducted on

  Date

• Prepared by

• Location
  Address

• Contractors on site

General

• Are all employees on site abiding by Epstein’s site policies for PPE?

  Yes

  No

  N/A

• Do employees on site have access to first aid?

  Yes

  No

  N/A

• Is there adequate access to restrooms and wash stations for employees on site?

  Yes

  No

  N/A

• Are doorways/exits kept clear?

  Yes

  No

  N/A

• How was this issue corrected?

• Do walkways have at least 3’ of clearance?

  Yes

  No

  N/A

• How was this issue corrected?

• Are there any positive notes for general site that you wish to make?

  Yes

  N/A

• What are the positive notes?

Hazard Communication

• Do employees on site have access to safety data sheets?

  Yes

  No

  N/A

• Are all containers properly marked?

  Yes

  No

  N/A

• Are all hazardous chemicals properly contained?

  Yes

  No

  N/A

• Are there any positive notes regarding hazard communication that you wish to make?

  Yes

  N/A

• What are the positive notes?

Electrical Safety

• Are cords free of damage?

  Yes

  No

  N/A

• Were damaged cords removed from service?

  Yes

  No

  N/A

• Why?

  Yes

  No

  N/A

• How were they removed from service?

• Are repaired cords repaired properly?

  Yes

  No

  N/A

• How was this issue corrected?

  Select Removed from service Repaired by electrician or other trained personnel

  • Removed from service
  • Repaired by electrician or other trained personnel

• Is there limited access electrical rooms?

  Yes

  No

  N/A

• How was this issue corrected?

• Do all live panels have covers that are installed and locked for limited access?

  Safe

  At Risk

  N/A

• How was this issue corrected?

• Is a proper LO/TO in place?

  Yes

  No

  N/A

• Are all tags properly labelled?

  Yes

  No

  N/A

• Is there any live work being performed?

  Yes

  No

  N/A

• Is the appropriate PPE in use?

  Yes

  No

  N/A

• What level of PPE is necessary for the electrical operations underway?

  Select Category 1 - 4cal Category 2 - 8cal Category 3 - 25cal Category 4 - 40cal

  • Category 1 - 4cal
  • Category 2 - 8cal
  • Category 3 - 25cal
  • Category 4 - 40cal

• Is a safe perimeter set up around the work area?

  Safe

  At Risk

  N/A

• Do you have any positive notes regarding electrical safety?

  Yes

  N/A

• What are the positive notes?

Hot work

• Is there any hot work underway?

  Yes

  No

  N/A

• Have hot work permits been signed by an Epstein representative prior to hot work operations?

  Yes

  No

  N/A

• How was this issue corrected?

• Are hot work permits in the area in which hot work operations are underway?

  Yes

  No

  N/A

• Was this issue corrected?

  Yes

  No

  N/A

• Is their a fire extinguisher within 25 feet of the hot work operations?

  Yes

  No

  N/A

• How was this issue corrected?

• Is there a fire watch available?

  Yes

  No

  N/A

• Was this issue corrected?

  Yes

  No

  N/A

• Are any combustible items, floors, or walls covered to prevent fires?

  Yes

  No

  N/A

• Was this issue immediately corrected?

  Yes

  No

  N/A

• Are flammable chemicals stored an appropriate distance from the hot work?

  Yes

  No

  N/A

• Was this issue immediately corrected?

  Yes

  No

  N/A

• Are there any positive notes you wish to make regarding hot work?

  Yes

  N/A

• What are your positive notes?

Fall protection?

• Are all necessary rails installed anywhere employees are exposed to falls? (i.e. balconies, lofts, roofs and other leading edge situations)

  Yes

  No

  N/A

• How was this issue corrected?

• Are all holes 2" or larger properly guarded?

  Yes

  No

  N/A

• How was this issue corrected?

• Is fall protection in use?

  Yes

  No

  N/A

• Are appropriate anchors in use?

  Yes

  No

  N/A

• What is the employee using as an anchor point?

• How was this issue corrected?

• Are retractables and lanyards being used correctly?

  Yes

  No

  N/A

• How are the lanyards/retractables being used incorrectly?

• How was this corrected?

• Are harnesses worn correctly? Check all that apply:

  Yes

  No

  N/A

• What is wrong with the harness in use?

  Select Leg straps are not on or are loose Harness back D ring is not in between the shoulder blades Harness appears to have damage Harness appears to be improperly fitted

  • Leg straps are not on or are loose
  • Harness back D ring is not in between the shoulder blades
  • Harness appears to have damage
  • Harness appears to be improperly fitted

• Was this issue immediately corrected?

  Yes

  No

  N/A

• Was this immediately corrected?

  Yes

  No

  N/A

• Has the harness been removed from service?

  Yes

  No

  N/A

• How was this corrected?

• Are there any positive notes you wish to make regarding fall protection?

  Yes

  N/A

• What are the positive notes?

Scaffold?

• Are there any scaffolds in use?

  Yes

  No

  N/A

• What kind of scaffold is in use?

  Select Baker Scaffold Frame Scaffold Hydro-Mobile Scaffold Tube and Clamp Scaffold

  • Baker Scaffold
  • Frame Scaffold
  • Hydro-Mobile Scaffold
  • Tube and Clamp Scaffold

• Is this scaffolding built correctly? Mark all that apply:

  Select Have a wide enough base to accommodate the height Have either base plates/castors Have all the necessary pins Has OSHA approved planking that is secured Has toe kicks and guard rails (if required) Is secured to a structure for stability (if required)

  • Have a wide enough base to accommodate the height
  • Have either base plates/castors
  • Have all the necessary pins
  • Has OSHA approved planking that is secured
  • Has toe kicks and guard rails (if required)
  • Is secured to a structure for stability (if required)

• Was the issue corrected?

  Yes

  No

  N/A

• Has the scaffold been tagged and inspected prior to use by a competent person?

  Yes

  No

  N/A

• Has scaffold been tagged and inspected prior to use?

  Yes

  No

  N/A

• Was this issue immediately corrected?

  Yes

  No

  N/A

• Was the scaffold built safely? Mark all that apply

  Select Scaffold has either base plates or castors Scaffold has all of the necessary pins Scaffolding has outriggers (if required) Scaffolding has all necessary cross bracing installed Employees have adequate access/egress All guardrails toe kicks are installed (if required) There is no large spacing or overlap with the planking. Scaffold is plumb, level, and square

  • Scaffold has either base plates or castors
  • Scaffold has all of the necessary pins
  • Scaffolding has outriggers (if required)
  • Scaffolding has all necessary cross bracing installed
  • Employees have adequate access/egress
  • All guardrails toe kicks are installed (if required)
  • There is no large spacing or overlap with the planking.
  • Scaffold is plumb, level, and square

• Have all scaffold defects been corrected?

  Yes

  No

  N/A

• Has the scaffold been tagged and inspected prior to use by a competent person?

  Yes

  No

  N/A

• Was this issue corrected?

  Yes

  No

  N/A

• Was scaffolding built safely?

  Select Scaffolding is on stable ground All necessary pins are used All rails are installed Employees shut the gates when necessary Scaffold is secured to the structure (when required) Bridges do not exceed the allowable length

  • Scaffolding is on stable ground
  • All necessary pins are used
  • All rails are installed
  • Employees shut the gates when necessary
  • Scaffold is secured to the structure (when required)
  • Bridges do not exceed the allowable length

• Were all scaffolding defects corrected?

  Yes

  No

  N/A

• Was the scaffolding tagged and inspected by a competent person?

  Yes

  No

  N/A

• Was this issue corrected?

  Yes

  No

  N/A

• Was the scaffold build safely?

  Select Scaffolding has baseplates or castors Scaffolding has all the necessary bracing All clamps/pins are tight enough/fully engaged. Employees have adequate access/egress Planks are all secured All guardrails and toe kicks are installed (if required) Scaffold is plumb, level, and square

  • Scaffolding has baseplates or castors
  • Scaffolding has all the necessary bracing
  • All clamps/pins are tight enough/fully engaged.
  • Employees have adequate access/egress
  • Planks are all secured
  • All guardrails and toe kicks are installed (if required)
  • Scaffold is plumb, level, and square

• Have all scaffold defects been corrected?

  Yes

  No

  N/A

Trenching/Excavating?

• Are digging operations underway?

  Yes

  No

  N/A

• Was utility locating services called prior to digging operations?

  Yes

  No

  N/A

• How was this issue corrected?

• Have at least two different tests been done to determine the soil type?

  Yes

  No

  N/A

• What types of soil tests?

  Select Visual Plasticity Test Dry Strength Test Thumb Penetration Test Pocket Penetrometer

  • Visual
  • Plasticity Test
  • Dry Strength Test
  • Thumb Penetration Test
  • Pocket Penetrometer

• Based on the soil tests, what type of soil are digging operations occurring in?

  Type A (slope - 3/4:1)

  Type B (slope - 1:1)

  Type C (slope - 1-1/2:1)

• If benched or sloped: Is the angle appropriate for the soil type?

  Safe

  At Risk

  N/A

• What is the plan to correct this hazard?

• If shoring is used: Are jacks properly spaced and at the correct pressure?

  Yes

  No

  N/A

• What is the plan to correct hazard?

• What type of access/egress is set in place for employees?

  Select Ramp Ladder Job Made Ladder Other None

  • Ramp
  • Ladder
  • Job Made Ladder
  • Other
  • None

• Does the job made ladder meet all necessary OSHA requirements?

  Yes

  No

  N/A

• What is wrong with the job made ladder and how was this issue corrected?

• Are there any notable issues with the access ramp?

  Yes

  No

  N/A

• Mark all issues that apply

  Select Not within 25' of employees Too steep to safely walk up

  • Not within 25' of employees
  • Too steep to safely walk up

• Was this issue immediately corrected?

  Yes

  No

  N/A

• Are there any issues with the ladder in use?

  Yes

  No

  N/A

• Mark all that apply:

  Select Not within 25' of employees Wrong type of ladder Ladder is not adequately set up/secured Damage to ladder Ladder is not tall enough to extend 3' past the working surface.

  • Not within 25' of employees
  • Wrong type of ladder
  • Ladder is not adequately set up/secured
  • Damage to ladder
  • Ladder is not tall enough to extend 3' past the working surface.

Equipment

• Are forklifts in use?

  Yes

  N/A

• If there is one in place, does the operator use the seatbelt?

  Yes

  No

  N/A

• Does the operator lower the forks down when the lift is not in use?

  Yes

  No

  N/A

• Was this issue corrected?

  Yes

  No

  N/A

• Is equipment in good operating condition?

  Yes

  No

  N/A

• What notable issues were spotted?

  Select No working back up alarms Cracked windshield Tires appear to be flat Seatbelt is inoperable There is a leak Labels are missing or difficult to read Does not appear to have a manual

  • No working back up alarms
  • Cracked windshield
  • Tires appear to be flat
  • Seatbelt is inoperable
  • There is a leak
  • Labels are missing or difficult to read
  • Does not appear to have a manual

• Was the foreman/supervisor of the company that the equipment belongs to notified of the necessary maintenance?

  Yes

  No

  N/A

• In your opinion, do operators appear to be well trained/competent?

  Yes

  No

  N/A

• Why have you come to this conclusion?

  Yes

  No

  N/A

• Have the above issues been reported to the operator's supervisor?

  Yes

  No

  N/A

• Are spotters in use when required?

  Yes

  No

  N/A

• Do the operators travel safely?

  Select Travel at a safe speed Alert pedestrians if they are coming around corners or entering gates by honking once Make eye contact and signal pedestrians

  • Travel at a safe speed
  • Alert pedestrians if they are coming around corners or entering gates by honking once
  • Make eye contact and signal pedestrians

• Was the unsafe behavior discussed with the operator?

  Yes

  No

  N/A

Hand/Power Tools

• Do all power tools have necessary guards/handles installed?

  Yes

  No

  N/A

• Was the issue immediately corrected?

  Yes

  No

  N/A

• Do hand tools have any damage (i.e. splintered handle, mushroom head, heat damage) that may require them to be removed from service?)

  Yes

  No

  N/A

• What actions were taken to remove the tools from service?

Silica

• Is there any work being performed that could expose employees to silica?

  Yes

  N/A

• Are appropriate measures taken to prevent the exposure?

  Yes

  No

  N/A

• What measures?

  Select Water-down Method Hepa Vacuum Respiratory protection

  • Water-down Method
  • Hepa Vacuum
  • Respiratory protection

• Do the vacuums appear to be working properly?

  Yes

  No

  N/A

• How was this issue corrected?

• Are masks worn correctly by employees that are exposed to the silica?

  Yes

  No

  N/A

Confine Space

• Is there any work being performed in confined spaces?

  Yes

  N/A

• Type of entry for confined space?

  Select Permit Required Confined Space Non-Permit Required Control Space

  • Permit Required Confined Space
  • Non-Permit Required Control Space

• Has a permit been signed by an Epstein Representative?

  Yes

  No

  N/A

• Was this issue immediately corrected?

  Yes

  No

  N/A

• Are dangers signs posted?

  Yes

  No

  N/A

• Was this corrected?

  Yes

  No

  N/A

• Are gas monitors in use?

  Yes

  No

  N/A

• Was this issue corrected?

  Yes

  No

  N/A

• Are employees aware and implementing their companies rescue protocols for the permit required space?

  Yes

  No

  N/A

• How was this issue corrected?

• We’re there any injuries on site today?

  Yes

  No

  N/A

• Give a brief description of the injury (describe injury, location on job, why the incident occurred)

• Were there any property damage incidents today?

  Yes

  No

  N/A

• Give a brief description of the incident: (describe damage, location on site, how the incident occurred)