Extreme Steel Inc.

Job Information

• Conducted on

  Date

• Job Name

• Job Number

• Foreman

  Select Cory Newman Nick Pugh Kapildeo Daitnarayan William Graves Jose Cruz Charlie Mull Jacob Shoemaker Ricky Russell Michael Myers Thomas Fraley Jeff Nester Steve Segal Mario Rodriguez Rene Hernandez Aaron Bennett Sixtoe Cubias Edmar Fonseca Mike Finamore

  • Cory Newman
  • Nick Pugh
  • Kapildeo Daitnarayan
  • William Graves
  • Jose Cruz
  • Charlie Mull
  • Jacob Shoemaker
  • Ricky Russell
  • Michael Myers
  • Thomas Fraley
  • Jeff Nester
  • Steve Segal
  • Mario Rodriguez
  • Rene Hernandez
  • Aaron Bennett
  • Sixtoe Cubias
  • Edmar Fonseca
  • Mike Finamore

• Number of employees on site

• Inside Conditions:

  Select N/A Hot Moderate Cold Bright Dark Dusty Dirty Mudy Standing water Ice

  • N/A
  • Hot
  • Moderate
  • Cold
  • Bright
  • Dark
  • Dusty
  • Dirty
  • Mudy
  • Standing water
  • Ice

• Outside Conditions:

  Select Hot Cold Moderate Snow Rain Wind Dark Bright Clear Cloudy Dirty Muddy Ice

  • Hot
  • Cold
  • Moderate
  • Snow
  • Rain
  • Wind
  • Dark
  • Bright
  • Clear
  • Cloudy
  • Dirty
  • Muddy
  • Ice

Personal Protective Equipment

• Hard Hat is warn at all times while working on site?

  Yes

  No

  N/A

• Safety Glasses are worn at all times while working on site?

  Yes

  No

  N/A

• Gloves are warn while handling material?

  Yes

  No

  N/A

• High-visibility vest warn around equipment and exposed infrastructure?

  Yes

  No

  N/A

• Appropriate footwear and apparel warn on site?

  Yes

  No

  N/A

• Face shield is applied for heavy carbide cutting activities?

  Yes

  No

  N/A

• Shade 3 or greater sealed eye protection or face shield is applied for Oxyfuel Gas Cutting activities?

  Yes

  No

  N/A

• Correct PPE applied for back welding activities?

  Yes

  No

  N/A

• Respirator used for required task?

  Yes

  No

  N/A

Fall Protection

• Safety Railing / Perimeter cable are maintained at areas that produce a fall hazard within the work area?

  Yes

  No

  N/A

• 100% tie off is established for accessing greater than 6' fall exposures?

  Yes

  No

  N/A

• Fall Arrest System used is correct to prevent failure?

  Yes

  No

  N/A

• Exclusion zone established to prevent exposed fall hazards?

  Yes

  No

  N/A

• Materials stored to prevent displacement?

  Yes

  No

  N/A

Tools / Equipment

• Angle grinders are supplied with Guards?

  Yes

  No

  N/A

• All hammer drilling activities comply with OSHA's Table 1 for silica exposure control?

  Yes

  No

  N/A

• Welding machines are in good mechanical condition with proper maintenance performed?

  equipment is mechanicaly operating in good condition

  Mechanical condition is poor

• All power tools / Equipment are properly functioning?

  Yes

  No

  N/A

• Power tools / Equipment are properly insulated from electrical hazards?

  Yes

  No

  N/A

• Electrical cords are inspected and safe from exposed wiring?

  Yes

  No

  N/A

• Tools/Equipment in use are designed for applied tasks?

  Yes

  No

  N/A

• G.F.C.I. is established at all non temporary power supply?

  Yes

  No

  N/A

• Welding lead is in good working condition? (no exposed wiring, insulators in place)

  Yes

  No

  N/A

• Oxyfuel Gas Cutting system is free from damage and in working condition?

  Yes

  No

  N/A

Material Handling

• Material is delivered / stored to limit the amount of handling and distance to installation?

  Yes

  No

  N/A

• Appropriate manpower / mechanical means are supplied for weight and location?

  Yes

  No

  N/A

• Material carts are free from damage and not overloaded?

  Yes

  No

  N/A

• Duct hoist / Roust-About are free from damage and not overloaded?

  Yes

  No

  N/A

Fire Protection

• Supplied / Inspected fire extinguisher is within 50' of hot work being performed?

  Yes

  No

  N/A

• Hot work permit is filed for activity / location?

  Yes

  No

  N/A

• Fire watch personnel is present?

  Yes

  No

  N/A

• Fuel containers are labeled with no sign of leaks or damage.

  Yes

  No

  N/A

• Fuel containers are properly stored away from hot work / accelerants with supplied fire extinguisher at storage location?

  Yes

  No

  N/A

• Oxygen and Acetylene Cylinders are properly stored with fire extinguisher at storage location?

  Yes

  No

  N/A

Ladders

• Ladders in use?

  Off

  On

• Employee is working with ESI supplied ladder?

  Yes

  No

  N/A

• Ladders are inspected and in safe working condition? (no damage)

  Yes

  No

  N/A

• Employees are properly using selected ladder to access the work area?

  Yes

  No

  N/A

• Ladders are properly stored when not in use?

  Yes

  No

  N/A

Scaffolding

• Scaffolding in use

  Off

  On

• Scaffolding has been inspected and Tagged?

  Yes

  No

  N/A

• Working Platform is fully Planked?

  Yes

  No

  N/A

• Pins and braces are supplied and in place?

  Yes

  No

  N/A

• Safety Railing is supplied and completely surrounding working platform?

  Yes

  No

  N/A

• Fall arrest system is applied for access to unprotected platform above 6' in elevation?

  Yes

  No

  N/A

Forklift

• Forklift in use

  Off

  On

• Is the operator certified in the use of the equipment?

  Yes

  No

  N/A

• Safety restraint is warn during forklift operation?

  Yes

  No

  N/A

• Are forks fully engaged under load / loads appropriately fastened to mast?

  Yes

  No

  N/A

• Is the forklift appropriately rated for the load?

  Safe

  At Risk

  N/A

• Does the forklift have signs of damage or leaks?

  Equipment Safe for operation

  Equipment at risk for operation

Aerial Lift / Scissor lift

• Aerial / Scissor lift in use

  Off

  On

• Is the operator certified in the use of the equipment?

  Yes

  No

  N/A

• All safety rails latches and chains in place during lift operation?

  Yes

  No

  N/A

• Full body harness and form of fall arrest are applied for lift operation?

  Yes

  No

  N/A

• Personnel are correctly using the working platform and not standing on the side rails?

  Yes

  No

  N/A

• Personnel are correctly tied off to the manufacturers tie off point?

  Yes

  No

  N/A

• Does the personnel lift have signs damage and leaks?

  Equipment Safe for operation

  Equipment at risk for operation

Rigging

• Is rigging in use?

  Off

  On

• Riggers involved in operation are certified riggers / signalman?

  Yes

  No

  N/A

• Chain-falls / Come-alongs are free from damage and rated for the applied load?

  Yes

  No

  N/A

• Anchorage point can sustain the load with a safety factor applied?

  Yes

  No

  N/A

• Wire rope chokers / Synthetic slings are free from damage and tagged for the applied load?

  Yes

  No

  N/A

• Rigging is stored properly?

  Yes

  No

  N/A

Housekeeping

• Is Extreme Steel Inc. controlling housekeeping appropriate and professional?

  Housekeeping is good

  Housekeeping needs work

  Housekeeping is poor

• Has all material drops and debris produced by Extreme Steel Inc. been removed in completed work areas?

  Yes

  No

  N/A

• Has any ESI equipment been left behind in completed / vacant work areas?

  All equipment is in an active work area

  Equipment is not in an active work area

Sub-Par Craftsmanship

• Was a sub-par installation performed?

  Off

  On

• Pictures / Location

  Media

Supplies delivered

• PPE consumables supplied

  Select N/A Clear safety glasses Dark safety glasses Amber safety glasses Clear face shield IR3 face shield Face shield frame Work gloves Welding gloves Ear plugs Safety vests Dust masks

  • N/A
  • Clear safety glasses
  • Dark safety glasses
  • Amber safety glasses
  • Clear face shield
  • IR3 face shield
  • Face shield frame
  • Work gloves
  • Welding gloves
  • Ear plugs
  • Safety vests
  • Dust masks

• Was tracked safety equipment supplied or removed from site?

  Supplied

  Removed

  Neither

• Equipment

Comments

• Crew was working on?

• Additional notes / information: