GCI SAFETY REPORT

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

JOB INFORMATION

• OSHA 300 forms complete and posted from February 1 - April 30?<br>

  Yes

  No

  N/A

• OSHA and DOL posters posted?

  Yes

  No

  N/A

• Emergency phone numbers posted?

  Yes

  No

  N/A

• Safety meeting completed?

  Yes

  No

  N/A

• MSDS on site ?

  Safe

  At Risk

  N/A

• Have JSA's been completed?

  Yes

  No

  N/A

• Work areas properly signed and barricaded?

  Safe

  At Risk

  N/A

• Subcontractors on site?

List subcontractors.

HOUSEKEEPING

• Work areas neat?

  Safe

  At Risk

  N/A

• Projecting nails or screws bent over or removed?

  Safe

  At Risk

  N/A

• Waste containers provided and used?

  Safe

  At Risk

  N/A

• Passageways and walkways clear?

  Safe

  At Risk

  N/A

• Cords and leads off the floor?

  Safe

  At Risk

  N/A

SLIPS, TRIPS, FALLS

• Proper guard rails in place (top, mid, toe board)?

  Safe

  At Risk

  N/A

• Are open holes properly covered?

  Safe

  At Risk

  N/A

• Are there trip hazards?

  Safe

  At Risk

  N/A

FIRE PREVENTION

• Adequate fire extinguishers, checked and accessible?

  Safe

  At Risk

  N/A

• Phone no. of Fire Department posted?

  Yes

  No

  N/A

• "No Smoking" posted and enforced near flammables? (Smoking is not permitted in buildings)

  Yes

  No

  N/A

• Are combustible materials stored away from spark producing tasks?

  Safe

  At Risk

  N/A

• Proper fuel cans being used?

  Safe

  At Risk

  N/A

ELECTRICAL

• Extension cords with bare wires or missing ground prongs taken out of service?

  Safe

  At Risk

  N/A

• Proper grounding on extension cords?

  Safe

  At Risk

  N/A

• Ground fault interrupters being used?

  Safe

  At Risk

  N/A

• Terminal boxes equipped with required covers?

  Safe

  At Risk

  N/A

HAND, POWER & POWDER ACTUATED TOOLS

• Hand tools inspected regularly?

  Safe

  At Risk

  N/A

• Tools not in proper condition tagged and taken out of service?

  Safe

  At Risk

  N/A

• Guards in place?

  Safe

  At Risk

  N/A

• Operators of powder actuated tools licensed?

  Safe

  At Risk

  N/A

• Correct tool being used for job at hand?

  Yes

  No

  N/A

FALL PROTECTION

• Working at heights 6' or above?

  Safe

  At Risk

  N/A

• Working at heights 4' or above (general industry)

  Safe

  At Risk

  N/A

• Are there proper guard rails in place?

  Yes

  No

  N/A

• Safety harnesses?

  Safe

  At Risk

  N/A

• Proper anchor point?

  Safe

  At Risk

  N/A

• Properly lanyard?

  Safe

  At Risk

  N/A

• Employees below protected from falling objects?

  Safe

  At Risk

  N/A

LADDERS

• Ladders extended at least 36" above landing?

  Safe

  At Risk

  N/A

• Ladders are secured?

  Safe

  At Risk

  N/A

• Damaged ladders tagged and taken out of service?

  Safe

  At Risk

  N/A

• All ladders used for their intended purpose?

  Safe

  At Risk

  N/A

SCAFFOLDING

• All scaffolding inspected daily?

  Yes

  No

  N/A

• Erected on sound rigid footing?

  Safe

  At Risk

  N/A

• Tied to structure as required?

  Yes

  No

  N/A

• Guardrails, intermediate rails, toe boards and screens in place?

  Safe

  At Risk

  N/A

• Planking is sound and sturdy?

  Safe

  At Risk

  N/A

• Proper access provided?

  Safe

  At Risk

  N/A

TRENCHES, EXCAVATION & SHORING

• Competent person? If yes who?

  Yes

  No

  N/A

• Excavations are shored and sloped back?

  Safe

  At Risk

  N/A

• Materials are stored at least 2' away from trench?

  Safe

  At Risk

  N/A

• Ladders provided every 25' in trench?

  Safe

  At Risk

  N/A

• Equipment is at a safe distance from edge of trench or excavation?

  Safe

  At Risk

  N/A

CONFINED SPACES

• Are workers trained in proper procedures for working in confined spaces?

  Safe

  At Risk

  N/A

• Is confined space permit properly completed? Posted?

  Yes

  No

  N/A

• Is gas monitor being used?

  Yes

  No

  N/A

• Is there an attendant outside space at all times?

  Yes

  No

  N/A

• Any other confined space issues?

  Safe

  At Risk

  N/A

• Proper rescue equipment on hand and ready for use?

  Yes

  No

  N/A

• Does everyone know their duties/responsibilities?

  Yes

  No

  N/A

MATERIAL HANDLING

• Materials properly stored or stacked?

  Safe

  At Risk

  N/A

• Employees using proper lifting techniques?

  Safe

  At Risk

  N/A

• Walkways clear?

  Safe

  At Risk

  N/A

WELDING AND BURNING

• Compressed gas cylinders stored properly?

  Safe

  At Risk

  N/A

• Proper eye and face protection?

  Safe

  At Risk

  N/A

• Fire extinguishers readily available?

  Yes

  No

  N/A

• Hoses in good condition?

  Yes

  No

  N/A

CRANES

• Outriggers extended and swing radius barricade in place?

  Safe

  At Risk

  N/A

• Operator is familiar with load charts?

  Safe

  At Risk

  N/A

• Hand signal charts on crane?

  Safe

  At Risk

  N/A

• Crane operator logs up to date?

  Safe

  At Risk

  N/A

• Employees kept from under suspended loads?

  Safe

  At Risk

  N/A

RIGGING EQUIPMENT

• All rigging equipment in proper condition?

  Safe

  At Risk

  N/A

• All rigging equipment properly tagged?

  Safe

  At Risk

  N/A

• Are tag lines being used?

  Safe

  At Risk

  N/A

• Safety latches on all hooks where required?

  Safe

  At Risk

  N/A

CONCRETE CONSTRUCTION

• Employees are protected from cement dust?

  Safe

  At Risk

  N/A

• Exposed skin covered?

  Safe

  At Risk

  N/A

• Proper PPE for this task?

  Safe

  At Risk

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Hard hats?

  Safe

  At Risk

  N/A

• Safety glasses?

  Safe

  At Risk

  N/A

• Respirators used when required? Proper respirator documentation available?

  Yes

  No

  N/A

• Hearing protection being worn when required?

  Safe

  At Risk

  N/A

• Traffic vests or high visibility clothing material being worn?

  Safe

  At Risk

  N/A

• Proper footwear?

  Safe

  At Risk

  N/A

TRAFFIC CONTROL

• Is proper traffic control in place

  Safe

  At Risk

  N/A

• Is high visibility clothing being worn?

  Safe

  At Risk

  N/A

EQUIPMENT

• Fork truck operators certified?

  Yes

  No

  N/A

• Proper training for aerial/platform lifts?

  Yes

  No

  N/A

• Has all equipment been properly inspected?

  Safe

  At Risk

  N/A

• Does equipment appear to be in good condition?

  Safe

  At Risk

  N/A

• Roll over protection?

  Safe

  At Risk

  N/A

COMPLETION

• Is there anything else that must be mentioned?

  Yes

  No

  N/A

• Safety Manager

  Sign

• Superintendent

  Sign