Hagerman Jobsite Audit

• Project Name

• Project Number

• Owner Name

• Conducted on

  Date

• Prepared by

• Location
  Address

• Hagerman Project Supervisor(s)

• Subcontractors On Site

PROGRAM ADMINISTRATION

• 1.1 OSHA POSTINGS

  Yes

  No

  N/A

• 1.2 Medical provider posted

  Yes

  No

  N/A

• 1.3 Safety manual - Hagerman

  Yes

  No

  N/A

• 1.4 Safety manual -subcontractors

  Yes

  No

  N/A

• 1.5 Field Safety Training - Hagerman

  Yes

  No

  N/A

• 1.6 Weekly toolbox talks - subcontractors

  Yes

  No

  N/A

• 1.7 First aid kits - job trailer - inspected

  Yes

  No

  N/A

• 1.8 First aid kits - field - inspected

  Yes

  No

  N/A

• 1.9 Emergency action plan posted / up to date

  Yes

  No

  N/A

• 1.10 Fire extinguisher - trailer(s)

  Yes

  No

  N/A

• 1.11 MSDS received by subcontractors

  Yes

  No

  N/A

• 1.12 MSDS / 3E posted

  Yes

  No

  N/A

HOUSEKEEPING

• 2.1 Work areas orderly

  Yes

  No

  N/A

• 2.2 Adequate lighting

  Yes

  No

  N/A

• 2.3 Job site free of slips, trips and fall hazards

  Yes

  No

  N/A

• 2.4 Stairways / walkways clear

  Yes

  No

  N/A

• 2.5 Trash picked up

  Yes

  No

  N/A

• 2.6 Break areas orderly

  Yes

  No

  N/A

• 2.7 Sharp metal scrap contained in area by container / trash can or other?

  Yes

  No

  N/A

ELECTRICAL / UTILITY

• 3.1 Insulation intact on cords and wiring

  Yes

  No

  N/A

• 3.2 Temporary lighting guarded

  Yes

  No

  N/A

• 3.3 Electrical panels labeled HOT and covered

  Yes

  No

  N/A

• 3.4 GFCI protection utilized

  Yes

  No

  N/A

• 3.5 Underground electrical lines marked

  Yes

  No

  N/A

• 3.6 Underground gas lines marked

  Yes

  No

  N/A

• 3.7 Lockout procedures utilized

  Yes

  No

  N/A

• 3.8 Electrical cords not exposed to sharp edges?

  Yes

  No

  N/A

• 3.9 All live electrical components are covered and protected from exposed, (i.e. receptacles, switches and exposed wiring) or missing knockouts.

  Yes

  No

  N/A

HAND AND POWER EQUIPMENT

• 4.1 Hand tools in good working order

  Yes

  No

  N/A

• 4.2 Electrical cords in good working order

  Yes

  No

  N/A

• 4.3 All mechanical safeguards in use

  Yes

  No

  N/A

• 4.4 Handles not broke / splinter free

  Yes

  No

  N/A

EQUIPMENT

• 5.1 Breaks, lights, signals and alarms operative

  Yes

  No

  N/A

• 5.2 Daily log book filled out

  Yes

  No

  N/A

• 5.3 Seat belts worn - LULL

  Yes

  No

  N/A

• 5.4 Aerial lift - PPE being used

  Yes

  No

  N/A

• 5.5 Cranes- swing radius protected - level

  Yes

  No

  N/A

• 5.6 Rigging equipment inspected - tag showing

  Yes

  No

  N/A

• 5.7 Cranes - swing radius protected / level?

  Yes

  No

  N/A

• 5.6 Rigging equipment inspected - tag showing - legible

  Yes

  No

  N/A

• 5.7 Crane has proper clearance from overhead electrical?

  Yes

  No

  N/A

• 5.8 All signal and rigging personnel are qualified?

  Yes

  No

  N/A

BARRICADES AND FENCING

• 6.1 Roadways and sidewalks protected

  Yes

  No

  N/A

• 6.2 Floor openings planked or barricaded

  Yes

  No

  N/A

• 6.3 Wall, roof openings covered or barricaded

  Yes

  No

  N/A

• 6.4 Leading edges guarded

  Yes

  No

  N/A

• 6.5 Red barrier tape or other devices being used to warn of overhead work when exposing other workers?

  Yes

  No

  N/A

• 6.6 Top heights of top rails shall be 42 inches +/- 3 inches on walking surface?

  Yes

  No

  N/A

• 6.7 Top rail must be able to withstand 200 pounds in downward direction without deflecting more than 3 inches or fall below 39 inches.

  Yes

  No

  N/A

• 6.8 Wire rope top rail is flagged every 6 feet.

  Yes

  No

  N/A

EXCAVATION

• 7.1 Necessary ladders provided

  Yes

  No

  N/A

• 7.2 Spoil set back at least 2 feet

  Yes

  No

  N/A

• 7.3 Rebar impalement protection

  Yes

  No

  N/A

LADDERS

• 8.1 Ladders in good condition

  Yes

  No

  N/A

• 8.2 Side rails extend 36 inches above landing

  Yes

  No

  N/A

• 8.3 Proper for job and secure

  Yes

  No

  N/A

• 8.4 Step ladders fully open when in use

  Yes

  No

  N/A

• 8.5 Placement of ladder safe

  Yes

  No

  N/A

INFECTION CONTROL

• 9.1 Daily inspection checklist completed

  Yes

  No

  N/A

• 9.2 ILSM current

  Yes

  No

  N/A

• 9.3 Debris covered

  Yes

  No

  N/A

• 9.4 Walk off mats in place / in use

  Yes

  No

  N/A

SCAFFOLDING

• 10.1 All scaffolds plumbed and leveled as erection proceeds

  Yes

  No

  N/A

• 10.2 Are adequate sills and base plates being used

  Yes

  No

  N/A

• 10.3 If electrical power lines are near the scaffold, are necessary precautions being taken

  Yes

  No

  N/A

• 10.4 Do scaffold planks extend past their end supports not less than 6 inches and no more than 12 inches

  Yes

  No

  N/A

• 10.5 Are guardrails and end rails in place

  Yes

  No

  N/A

• 10.6 To protect from falling objects, are toe boards or area barricaded below

  Yes

  No

  N/A

• 10.7 Are frames and panels braced by cross, horizontal or diagonal braces

  Yes

  No

  N/A

• 10.8 Are scaffolds with a (4:1) base to height ratio

  Yes

  No

  N/A

• 10.9 Is fall protection being used in areas where required

  Yes

  No

  N/A

• 10.10 Are scaffolds securely anchored at lease every 30 feet of length and 25 feet in height

  Yes

  No

  N/A

• 10.11 Is their an assess ladder, steps or equivalent safe access to scaffold

  Yes

  No

  N/A

• 10.12 Is the scaffold within its weight capacity

  Yes

  No

  N/A

• 10.13 Scaffold tagging system is in place (RED and GREEN tags) on all scaffolding systems on site. (includes stair towers)

  Yes

  No

  N/A

ENVIRONMENTAL CONTROLS

• 11.1 Silt fence installed and maintained

  Yes

  No

  N/A

• 11.2 Hazardous materials properly stored

  Yes

  No

  N/A

• 11.3 Spill containment kit adequate / on site

  Yes

  No

  N/A

FIRE PREVENTION

• 12.1 Are safety cans being used and properly labeled

  Yes

  No

  N/A

• 12.2 Propane tanks - barricade installed - labeled -( flammable,no smoking, fuel type)

  Yes

  No

  N/A

• 12.3 Compressed gas cylinders secured- upright- protected from damage

  Yes

  No

  N/A

• 12.4 Fire extinguishers immediately available and inspection current

  Yes

  No

  N/A

PPE

• 13.1 Hard hats worn

  Yes

  No

  N/A

• 13.2 Gloves available - cut resistant for demo

  Yes

  No

  N/A

• 13.3 Face shields being used - mason saw or other operations

  Yes

  No

  N/A

• 13.4 Eye protection

  Yes

  No

  N/A

• 13.5 Hearing protection

  Yes

  No

  N/A

• 13.6 Safety harness and lanyards utilized with adequate anchorage points

  Yes

  No

  N/A

• 13.7 Respirators and masks utilized

  Yes

  No

  N/A

• 13.8 High visible clothing in use

  Yes

  No

  N/A

HAGERMAN VIOLATIONS

• Hagerman Violations

  Corrected

  Still needs corrected

• Hagerman Violations

  Corrected

  Still needs corrected

SUBCONTRACTOR VIOLATIONS

• Subcontractor Audit Violations

  Corrected

  Still needs corrected

• Subcontractor Audit Violations

  Corrected

  Still needs corrected

• Subcontractor Audit Violations

  Corrected

  Still needs corrected

• Notes

  Corrected

  Still needs corrected

• Drawing area

  Drawing