Foreman Daily Report - M1028

Safety Huddle (Part I & Part II) Reporting Requirements

• The Safety Huddle (Part I and Part II) portion of this report must be completed with the field crews prior to the start of work activities each day.
  
  If tasks change from initial huddle, please perform additional Foreman Daily Safety Huddle(s) as required. Please perform these huddles with all crew members working on a new task.
  
  Please forward these completed portions (exported as an emailed PDF) to the Project Manager, Superintendent, and Mike Hiatt, immediately upon completion.
  
  THANK YOU FOR YOUR CONTRIBUTIONS TO THE SAFETY OF OUR EMPLOYEES, AND YOUR EFFORTS IN MAINTAINING SAFETY AS OUR GREATEST PRIORITY.
  
  Have a safe day!

• My Pledge

Safety Huddle (Part III) & Foreman Daily Report - Reporting Requirements

• Safety Huddle (Part III) shall be completed and submitted by the end of the work day (along with the remaining portions of this report) - However, please engage your crew for input during the discussion of work planned and identified hazards.
  
  The remaining portions of this report are critical in capturing a variety of project events. Please answer all questions and add additional information as you see fit.
  
  This report, in its entirety, shall be completed and submitted (exported in an emailed PDF) to the Project Manager, Superintendent, and Mike Hiatt by the end of the work day.
  
  Thank you for your contributions to a successful project!
  
  

SAFETY HUDDLE - PART I (JOB INFORMATION)

• Foreman:

  Select Cameron Samuelson Oscar Virrey

  • Cameron Samuelson
  • Oscar Virrey

• Job Number:

  M-1028
• Location:
  Address

• Employees Fit for Duty? (If No, Explain):

  Yes

  No

• Date:

  Date

SAFETY HUDDLE - PART II (WORK PLANNED & IDENTIFIED HAZARDS)

• List Activities Planned for Today
  
  *Add multiple activities to properly identify all work to be performed today.

Activity

• Description of Activity:

• Select Hazards Identified for Activity

  Select Overhead Utilities Underground Utilities Excavations

  • Overhead Utilities
  • Underground Utilities
  • Excavations

• Explain "Other Identified Hazards"

• Discussion of Preventative Actions Required to Control Identified Hazards:

SAFETY HUDDLE - PART III (RECOGNITION & REPORTING)

• Safety Observations / Suggestions Received from Field Employees Today?

  Yes

  No
Observation / Suggestion

• Name:

• Concern:

• Corrective Actions Taken:

• Photos:

  Media

• Near Miss or Close-Call Events Today? <br><br>*Fill out Incident Report if required.

  Yes

  No
Near Miss / Close Call

• Name:

• Description:

• Further Discussions or Corrective Actions:

• Photos:

  Media

• Field Employees Recognized for Safe Work Practices / Attitude Today?

  Yes

  No
Employee

• Employee Name:

• Reason for Recognition:

• Recognition Given:

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Conducted or Participated in Weekly Tailgate Meeting Today (If No, Explain)?

  Yes

  No

  Previously Conducted

• "Take 2" End of Day Debriefing Completed (If No, Explain):

  Yes

  No

• Reported Injuries (If Yes, Explain):

  Yes

  No

FOR OFFICE USE ONLY

• Safety Observation/Suggestion

• Appropriate Employee Recognition

• Near Miss/Close Call Reporting

• Approving Manager Signature

DAILY REPORT - PART I (WEATHER & WORKFORCE)

• Today's Weather

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Explain "Other" from Selection Above

• Recorded High Temperature (F)

• Recorded Low Temperature (F)

• Did the Weather Create an Impact on Today's Work (If Yes, Explain and Attach Relevant Photos)

  Yes

  No

• Define Today's Work Force (check off included classification and indicate quantity)

• Foreman

• Quantity

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Journeyman

• Quantity

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Apprentice

• Quantity

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Other

• Please define "Other"

• Quantity

  Select Yes No N/A

  • Yes
  • No
  • N/A

DAILY REPORT - PART II (WORK PERFORMED)

• List Items of Work Performed Today
  
  *Add multiple activities to properly identify all work performed today.

Activity

• Select Area Work Was Performed

  Select Process Building Dewatering Building Existing Plant Site Work

  • Process Building
  • Dewatering Building
  • Existing Plant
  • Site Work

• Description of Area (not listed)

• Activity Performed:

DAILY REPORT - PART III (CONTRACTOR ACTIVITY)

• Any LMC SUBCONTRACTORS on Site Today?

  Yes

  No

• Add Each LMC Subcontractor on Site Today

Subcontractor

• Select Subcontractor

  Insulator

  Iron Worker

  Painter

  Electrician

  Masonry

• Subcontractor's Name (not listed)

• Activity Performed:

• Select Area Activity Was Performed

  Select Process Building Dewatering Building Existing Plant Site Work

  • Process Building
  • Dewatering Building
  • Existing Plant
  • Site Work

• Description of Area (not listed):

• Any OTHER CONTRACTORS on Site Today?

  Yes

  No

• Add Each Contractor (other than LMC Subcontractors) on Site Today

Contractor

• Select Contractor

  Insulator

  Iron Worker

  Painter

  Electrician

  Masonry

• Contractor's Name (not listed)

• Brief Description of Activity Performed:

DAILY REPORT - PART IV (REPRESENTATIVES & VISITORS)

• Are Representatives of the General Contractor on Site Today?

  Yes

  No

  N/A

• Select GC's Representative(s)

  Select Juan Castillo Jonathan Quezada Mike Dragoon Steven Bell

  • Juan Castillo
  • Jonathan Quezada
  • Mike Dragoon
  • Steven Bell

• Representative(s) (not listed):

• Are Inspectors Of Record on Site Today?

  Yes

  No

  N/A

• Select Inspector(s)

  Select Kelli O'Conner Bart Crawford

  • Kelli O'Conner
  • Bart Crawford

• Inspector(s) (not listed):

• Are Representatives from the Design Team on Site Today?

  Yes

  No

  N/A

• Select Design Team Representative(s)

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Representative(s) (not listed):

• Are Owner Representatives on Site Today?

  Yes

  No

  N/A

• Select Owner Representative(s)

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Representative(s) (not listed):

• Other Visitors (not listed above) to the Project Site Today (If Yes, Add Below):

  Yes

  No
Visitor

• Name:

• Company:

• Purpose of Visit:

DAILY REPORT - PART V (EQUIPMENT)

• LMC Owned Equipment on Site Today?

  Yes

  No

• Add LMC Equipment

LMC Equipment Item

• Select Equipment Item

  Truck (15-017)

  Scissor Lift (77-002)

• Equipment Item Not Listed

• Is Equipment in Need of Service or Repair?

  Yes

  No

  Not Inspected

• Comments Regarding Equipment Condition:

• Attach Photo(s) of Equipment Condition (if applicable)

  Media

• Rental Equipment on Site Today?

  Yes

  No

• Add Rental Equipment

Rental Equipment Item

• Description of Rental Equipment:

• Rental Equipment Called Off-Rent Today?

  Yes

  No

• Add Called-Off Equipment

Called-Off Equipment

• Description of Equipment:

• Name of Rental Company:

• Cancellation Number Provided By Rental Company:

DAILY REPORT - PART VI (DELIVERIES)

• Any DELIVERIES Received Today (If Yes, Add Each Below)?

  Yes

  No
Delivery

• Description of Delivery:

• Name of Freight Company:

• Name of Supplier:

• Select Stored Location of Delivered Items

  Select Office Sea Container West Sea Containers Process building Dewatering Building North of House West of House South of House

  • Office Sea Container
  • West Sea Containers
  • Process building
  • Dewatering Building
  • North of House
  • West of House
  • South of House

• Storage Location (not listed):

• Was Order Delivered Complete (If No, Explain and Attach Photos / Documents as Necessary)?

  Yes

  No

• Was Order Delivered Free from Damage (If No, Explain and Attach Photos / Documents as Necessary) ?

  Yes

  No

DAILY REPORT - PART VII (RESTING & INSPECTIONS)

• TESTING Performed Today?

  Yes

  No

• Add Each Testing Activity Performed Today

Testing Activity

• Description:

• Company:

• Representative:

• Results:

• Direction Provided (include who gave direction):

• Comments Associated with Testing Performed:

• Attach Scanned Image of Testing Documents

  Media

• Photos Associated with Testing Performed:

  Media

• INSPECTIONS Performed Today?

  Yes

  No

• Add Each Inspection Performed Today

Inspection

• Description:

• Select Inspector(s)

  Select Kelli O'Conner Bart Crawford

  • Kelli O'Conner
  • Bart Crawford

• Name of Inspector (not listed):

• Results:

• Direction Provided (include who gave direction):

• Comments Associated with Inspection Performed:

• Attach Scanned Image of Inspection Documents

  Media

• Photos Associated with Inspection Performed

  Media

DAILY REPORT - PART VIII (EXTRA WORK)

• All extra work, or potentially disputed work, must receive prior Project Manager approval.
  
  

• EXTRA WORK Performed Today (If Yes, Add Each Work Item Below)?

  Yes

  No
Extra Work Item

• GC Assigned PCO Number for Extra Work:

• Description of Extra Work:

• Select Individual Providing Direction To Proceed with Extra Work

  Select Kelli O'Conner Bart Crawford

  • Kelli O'Conner
  • Bart Crawford

• Name (not listed):

• Other Comments Associated With Extra Work:

• Attach Scanned Documentation (GC Signed T&M Timesheet, etc.)

  Media

• Attach Photos Associated With Extra Work

  Media

DAILY REPORT - PART IX (ADDITIONAL DOCUMENTATION)

• Please add any additional information regarding items of CONCERN or COMMENTS occurring today.
  
  This information may include (but is not limited to) conversations, direction provided, field decisions, potential impacts, schedule delays, etc.
  
  Please contact the LMC Project Manager regarding any questions about this additional project documentation.

Item

• Description of Item

• Associated Photos

  Media