Habitat Wake 10/16/17

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

PPE

• Hardhats worn by all personnel?

  Yes

  No

  N/A

• Hard hats inspected free of defects?

  Yes

  No

  N/A

• Proper foot wear worn by all personnel?

  Yes

  No

  N/A

• Eye protection worn by all personnel?

  Yes

  No

  N/A

• Hearing protection worn when necessary?

  Yes

  No

  N/A

• Proper breathing apparatus used when necessary?

  Yes

  No

  N/A

• Shirts worn at all times?

  Yes

  No

  N/A

INDIVIDUAL SITE REQUIRMENTS

• Site clearly marked with address and lot number?

  Yes

  No

  N/A

• Site clearly marked with C.A.Z.?

  Yes

  No

  N/A

• Drop zone clearly marked on two story homes?

  Yes

  No

  N/A

• Porches more than six feet above grade marked to limit access?

  Yes

  No

  N/A

• Fire extinguisher on site and readily available. Inspected monthly?

  Yes

  No

  N/A

• First aid kit on site and fully stocked?

  Yes

  No

  N/A

• Rebar and anchor bolts capped?

  Yes

  No

  N/A

• Site free of trip hazards?

  Yes

  No

  N/A

• Electric cords crossing streets protected by channel?

  Yes

  No

  N/A

• GFCI at temp pole provided and tested prior to each shift?

  Yes

  No

  N/A

• Competent person on site for each sub contractor/ Volunteer team?

  Yes

  No

  N/A

• Subcontractor framing crew Competent person identified? List names.

  Yes

  No

  N/A

• Copy of Habitat Wake Written Health and Safety Program on site?

  Yes

  No

  N/A

POWER TOOLS

• Instruction given to each Volunteer user on proper use of tool?

  Yes

  No

  N/A

• All power tools equipped with operable guards?

  Yes

  No

  N/A

• All power tools equipped with proper cords?

  Yes

  No

  N/A

• Powder actuated tools used by certified personnel?

  Yes

  No

  N/A

LADDERS

• Proper ladder length for task at hand?

  Yes

  No

  N/A

• Step ladders used in open and locked position?

  Yes

  No

  N/A

• Extension ladders set up properly?

  Yes

  No

  N/A

• Extension ladders extend 3 foot above landing point?

  Yes

  No

  N/A

• All ladders on job site free from defects?

  Yes

  No

  N/A

• Proper ladder climbing technique used

  Yes

  No

  N/A

SCAFFOLDING

• Masons scaffolding/ Pipe scaffolding in use?

  Yes

  No

  N/A

• Proper base, feet?

  Yes

  No

  N/A

• All required bracing in place?

  Yes

  No

  N/A

• Fully decked working / walking surface?

  Yes

  No

  N/A

• Like and kind parts?

  Yes

  No

  N/A

• Guard rails and end rails in place?

  Yes

  No

  N/A

• Scaffolding set proper distance from work surface?

  Yes

  No

  N/A

• Scaffolding set 10' from over head electrical lines?

  Yes

  No

  N/A

• Wall Walker in use?

  Yes

  No

  N/A

• Wall Walkers installed per manufacturers specs?

  Yes

  No

  N/A

• Access provided to working platform?

  Yes

  No

  N/A

GUARD RAILS

• Stairs set with guardrails prior to any work starting on second floor?

  Yes

  No

  N/A

• Bars on windows or door openings at 42" above floor area when more than 6' above lower level

  Yes

  No

  N/A

FALL PROTECTION

• Hazardous work area clearly marked at 6 ft. from leading edge?

  Yes

  No

  N/A

• PFAS used when no other form of fall protection is provided?

  Yes

  No

  N/A

• PFAS properly used?

  Yes

  No

  N/A

• PFAS inspected before use?

  Yes

  No

  N/A

EXCAVATIONS

• Ditch depth 5 ft. Or deeper sloped or sheilded?

  Yes

  No

  N/A

• Escape ladder less than 25 ft. From worker in ditch?

  Yes

  No

  N/A

• Spoils 2 ft. Or greater back from edge of ditch?

  Yes

  No

  N/A

• All trenches clearly marked as hazardous areas?

  Yes

  No

  N/A

• Utilities located prior to digging?

  Yes

  No

  N/A

• Traffic controled?

  Yes

  No

  N/A

HAZ COM

• Flammable liquids stored in metal cans and marked as to contents?

  Yes

  No

  N/A

• All flammable and toxic materials properly labeled

  Yes

  No

  N/A

• SDS notebook on site?

  Yes

  No

  N/A

MATERIAL HANDLING

• Fork lift operators certified?

  Yes

  No

  N/A

• Boom truck operators certified?

  Yes

  No

  N/A

• Boom truck operators check list complete?

  Yes

  No

  N/A

• Back up alarms functioning on all equipment?

  Yes

  No

  N/A

• Swing radius of boom truck blocked off?

  Yes

  No

  N/A

• Proper hoisting equipment inspected and used?

  Yes

  No

  N/A

• Signal person competent in task?

  Yes

  No

  N/A

• Rigger competent in task?

  Yes

  No

  N/A

• Boom truck set up on stable ground?

  Yes

  No

  N/A

• Proper truss setting techniques used per Habitat Wale Written Fall protection Plan?

  Yes

  No

  N/A

VOLUNTEERS BREFING

• Each group breifed on Safety Procedures for their tasks?

  Yes

  No

  N/A

• PPE provided to each volunteer?

  Yes

  No

  N/A

• All volunteers have signed in and provided emergency phone number?

  Yes

  No

  N/A

• All volunteers have signed Release Agreement?

  Yes

  No

  N/A

• Parental or Guardian Consent Form signed for volunteers under the age of 16?

  Yes

  No

  N/A

INJURY, INCIDENT OR NEAR MISS REPORT

• Were there any near misses reported?

  Yes

  No

  N/A

• were there any injuries reported?

  Yes

  No

  N/A

• Were there any incidents reported?

  Yes

  No

  N/A

• Give short description, with names.