EPTCON LTD. -- Health and Safety Site Inspection

• EPTCON Ltd.

  Media

• Project Name:

• Project #:

• Constructor:

• Conducted on

  Date

• Prepared by

• Location
  Address

• Weather

• YES = Compliant,
  NO = Non-Compliant,
  OFI = Opportunity for Improvement (Compliant),
  N/A = Not Applicable

  

EPTCON Ltd. PROJECT MANAGEMENT

• EPTCON Project Manager

• EPTCON Construction Manager

• # of EPTCON workers on site?

• Scope of Project

SUBCONTRACTORS

• Subcontractor #1:

• Scope of work:

• Supervisor:

• Number of Workers:

• Subcontractor #2:

• Scope of work:

• Supervisor:

• Number of Workers:

SAFETY SYSTEM PERFORMANCE

• Reporting Period

• First Aids

• Reported Near Misses

• Medical Aids

• Lost Time

• Critical Injuries

• Fatalities

• Property Damage

• Non-Occupational Incident

• Are incidents documented and corrective actions completed?

  Yes

  No

  N/A

• Has there been any government authority visits? (MOL, MOE)

  No

  Yes

POSTINGS / COMPLIANCE

• Emergency Telephone / Contacts Numbers (EPRP)

  YES

  NO

  N/A

• WSIB Accident Reporting Requirements Notice (form 82)

  YES

  NO

  N/A

• PPE Poster

  YES

  NO

  N/A

• Copy of O.H.S.A & Regs. Accessable

  YES

  NO

  N/A

• Notice of Project

  YES

  NO

  N/A

• H&S "Prevention Starts Here Poster"

  YES

  NO

  N/A

• Employment Standards Posting

  YES

  NO

  N/A

• Health and Safety Policy (signed)

  YES

  NO

  N/A

• Violence & Harassment Policy

  YES

  NO

  N/A

• Environmental Policy?

  YES

  NO

  N/A

• Health & Safety Rep Posting

  YES

  NO

  N/A

• Traffic Management Plan?

  YES

  NO

  N/A

• Risk Assessments?

  YES

  NO

  N/A

• Safety / Environmental Plans?

  YES

  NO

  N/A

• Orientation completed and documented for all site personnel (EPTCON and Subs)?

  YES

  NO

  N/A

• Sign-In Sheet

  YES

  NO

  N/A

• Daily Tailboards (EPTCON and Subs)?

  YES

  NO

  N/A

• Training Records (EPTCON and Subs)?

  YES

  NO

  N/A

• Equipment Inspections (EPTCON and Subs)?

  YES

  NO

  N/A

• Job Safety Analysis (EPTCON and Subs)?

  YES

  NO

  N/A

• Safety Talks (EPTCON and Subs)?

  YES

  NO

  N/A

• WSIB Clearance Certificates Valid for EPTCON and Subs

  YES

  NO

  N/A

• Subcontractors Form 1000 for EPTCON and Subs

  YES

  NO

  N/A

• Proof of Liability Insurance for EPTCON and Subs

  YES

  NO

  N/A

• Status Report?

  YES

  NO

  N/A

• First Aid Kit Easily Accessible?

  YES

  NO

  N/A

• First aid kit check list present and up to date?

  YES

  NO

  N/A

• Map to Hospital Posted?

  YES

  NO

  N/A

• Name(s) of First Aid Designate Posted with certifications

  YES

  NO

  N/A

• Valid, Properly trained First Aid Person(s) on site?

  YES

  NO

  N/A

• First Aid Requirements - Regulation 1101 posted?

  YES

  NO

  N/A

• First Aid treatment log present?

  YES

  NO

  N/A

• Vehicle first Aid kits?

  YES

  NO

  N/A

• Eye Wash Station?

  YES

  NO

  N/A

• Muster Point Identified?

  YES

  NO

  N/A

• Emergency Response Plan posted?

  YES

  NO

  N/A

• Emergency Sounding Device present?

  YES

  NO

  N/A

• Written WHMIS program available on site?

  YES

  NO

  N/A

• MSDSs available on site?

  YES

  NO

  N/A

• List of Hazardous Chemicals on site and accessible?

  YES

  NO

  N/A

• WHMIS symbol poster posted?

  YES

  NO

  N/A

• Employees trained in WHMIS?

  YES

  NO

  N/A

• Containers Properly Labeled?

  YES

  NO

  N/A

• Head Protection?

  YES

  NO

  N/A

• Foot Protection?

  YES

  NO

  N/A

• Eye Protection (safety glasses)?

  YES

  NO

  N/A

• High Visibility Clothing?

  YES

  NO

  N/A

• Fire Resistant Clothing?

  YES

  NO

  N/A

• Hearing Protection?

  YES

  NO

  N/A

• Fall Protection inspected and worn properly?

  YES

  NO

  N/A

• Respirators in use proper type and worn correctly?

  YES

  NO

  N/A

• Other PPE as required?

  YES

  NO

  N/A

• Entrance Clearly Identified?

  YES

  NO

  N/A

• Proper signage posted alerting to dangers present

  YES

  NO

  N/A

• PPE requirement sign posted at Gate?

  YES

  NO

  N/A

• Site Sign-in sign posted at gate or on trailer?

  YES

  NO

  N/A

• Pedestrian walkways clearly defined and separated for vehicle traffic?

  YES

  NO

  N/A

• Vehicle parking clearly identified?

  YES

  NO

  N/A

• Vehicle Back-in policy in effect?

  YES

  NO

  N/A

• Site Free of Debris?

  YES

  NO

  N/A

• Adequate Ramps?

  YES

  NO

  N/A

• Adequate number of facilities?

  YES

  NO

  N/A

• Facilities clean & maintained and positioned away from hazards (roads)?

  YES

  NO

  N/A

• Facilities heated for winter months?

  YES

  NO

  N/A

• Office and storage containment clean & maintained?

  YES

  NO

  N/A

• Potable water available for workers?

  YES

  NO

  N/A

• Aisles and access ways clear?

  YES

  NO

  N/A

• Clean / Dry location available for workers for lunch and breaks?

  YES

  NO

  N/A

• Garbage, scrap and debris removed regularly?

  YES

  NO

  N/A

• Flammable and explosive materials stored and properly labeled?

  YES

  NO

  N/A

• Required number of fire extinguishers properly sized, located and inspected?

  YES

  NO

  N/A

• All vehicles and mobile equipment equipped with fire extinguisher?

  YES

  NO

  N/A

• Fuel tanks properly labeled (type and "no smoking") signs?

  YES

  NO

  N/A

• Tanks properly barricaded?

  YES

  NO

  N/A

• Compressed gas tanks properly secured and stored?

  YES

  NO

  N/A

• Is spill containment and response equipment present?

  YES

  NO

  N/A

• Ladders adequate for task?

  YES

  NO

  N/A

• Ladders inspected and in good condition and properly stored?

  YES

  NO

  N/A

• Ladders properly secured during use?

  YES

  NO

  N/A

• Lifting devices adequate for work?

  YES

  NO

  N/A

• Scaffolds or access ramps adequate?

  YES

  NO

  N/A

• Rebar caps used when risk of injury present?

  YES

  NO

  N/A

• Forms and structures properly secured?

  YES

  NO

  N/A

• Electrical dangers posted?

  YES

  NO

  N/A

• All electrical equipment grounded including generators and portable hand tools?

  YES

  NO

  N/A

• Extension cords in good condition?

  YES

  NO

  N/A

• Ground fault circuit interrupters in use?

  YES

  NO

  N/A

• Temporary lighting adequate?

  YES

  NO

  N/A

• Isolation of Apparatus?

  YES

  NO

  N/A

• Limits of Approach?

  YES

  NO

  N/A

• Work Protection?

  YES

  NO

  N/A

• Tools/equipment inspected regularly to ensure they are safe to operate?

  YES

  NO

  N/A

• Slings in good condition, properly stored and manintained

  YES

  NO

  N/A

• Guards and cords in good condition?

  YES

  NO

  N/A

• Vehicle Circle Check completed?

  YES

  NO

  N/A

• Red Tag Program in use/available?

  YES

  NO

  N/A

• Valid locate documents posted (30 days) ?

  YES

  NO

  N/A

• Soil testing complete?

  YES

  NO

  N/A

• All trenches properly shored or sloped as required?

  YES

  NO

  N/A

• Spoil placed 1 meter min. from sides of excavation?

  YES

  NO

  N/A

• Access and /or ladders present as required?

  YES

  NO

  N/A

• Trench or Excavation properly identified?

  Yes

  No

  N/A

• Water removed daily from open excavations?

  YES

  NO

  N/A

• Competent person performing tasks?

  YES

  NO

  N/A

• Monitoring equipment properly calibrated?

  YES

  NO

  N/A

• Written program on site?

  YES

  NO

  N/A

• Confined space properly tested before entry?

  YES

  NO

  N/A

• Workers properly trained on their duties?

  YES

  NO

  N/A

• Entry worker advised of hazards?

  YES

  NO

  N/A

• Permits obtained?

  YES

  NO

  N/A

• Rescue equipment/plans in place?

  YES

  NO

  N/A

• Additional Comments:

• Inspector Signature:

  Sign