Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Daily Paperwork & General Safety

  • Daily JHA/Toolbox Talk completed

  • Daily Crane & Equipment Inspection completed

  • Safety Manual & MSDS on site

  • Job specific paperwork available (AHA and/or SSJHA)

  • Federal, Ethics and EEO Statement Posted

  • No Cuts Locate number(s) available

  • Emergency numbers and facilities identified

  • Proper First Aid Kit on site

  • Fresh drinking water available on site

Personal Protective Equipment (PPE)

  • Employee(s) dressed properly for work (shirts w/ 4" sleeves, long pants and sturdy work boots (safety-toe if reuired)

  • Hardhats

  • Safety Glasses

  • Gloves (if required)

  • High Visibility Clothing and/or Reflective Vest

  • Hearing Protection

  • Type:

  • Face Sheild

  • Activity:

  • Buoyant Work Vest (if near water i.e. tremie work)

  • Respiratory Protection (if required, fit test needed)

  • Type:

  • All suppliers and sub contractors involved with HJ Foundation are in compliance w/ PPE requirements

Fall Protection

  • Competent Person(s)

  • Hazard(s)

  • Proper System/Equipment used

  • Type:

  • Full Body Harness and lanyards in good working condition

  • (SRL) Self Retracting Lifeline tested

  • Proper Anchorage/Tie-Off

  • Rebar Caps in use

Crane(s)

  • Certified Operator(s)

  • Set up:

  • Inspection Certificate up to date

  • Expires:

  • Operator's Manual in crane

  • Lift Plan and Weight Sheet in crane

  • Anti 2-Block(s) Operational

  • Line(s) installed on

  • E-Stop(s) Operational

  • Swing Radius

  • Swing Alarm Operational

  • Back Up Alarm Operational

  • Boom Angle Indicator Operational

  • Type:

  • Fire Extinguisher (5lb ABC)

  • Warning and/or Operational Decals

  • Steps and/or Ladder

  • Mirrors & Windows in good condition

  • Mechanical deficiencies reported

  • Catwalks (clear of debris)

Drill Rig//Low Headroom Rig

  • Qualified Operator(s)

  • Operator's Manual in drill rig

  • Anti 2-Block Operational

  • E-Stop(s) Operational

  • Swing Alarm Operational

  • Back Up Alarm Operational

  • Fire Extinguisher (5lb ABC)

  • Warning and/or Operational Decals

  • Steps and/or Ladder

  • Mirrors & Windows in good condition

  • Mechanical deficiencies reported

  • Catwalks (clear of debris)

Rigging

  • Certified Rigger(s)/Signal Person(s)

  • Nylon Straps

  • Wire Rope Slings

  • Chains

  • Spreaders

  • Type:

  • Blocks, Hooks & Latches

  • Shackles

  • Other

Material Handling

  • Proper Lifting

  • Hands free of Pinch Points

  • Mechanical Assist or 2-Man Lift when too heavy

Heavy Equipment

  • Qualified Operator(s)

  • Machine Type:

  • Operator's Manual in machine

  • E-Stop(s) Operational

  • Swing Alarm Operational

  • Back-Up Alarm Operational

  • Mirrors and Windows in good condition

  • Tracks Clean

  • Mechanical deficiencies reported

Grout Pump (Operator & Surrounding Area)

  • Operator wearing Hearing Protection

  • Operator Position (Caught-In-Between, etc)

  • E-Stop(s) Operational

  • Clamps properly secured

  • 1st Grout Hose properly secured

  • Gray Cover on 1st Grout Hose

  • Machine kept clean

  • Mechanical deficiencies reported

Confined Spaces/Excavations

  • Competent Person(s)

  • Permit Required

  • Air Monitoring completed

  • Decibel Monitoring completed

  • Access/Egress

  • Type:

  • Proper Excavation Protection

  • Type:

  • Soil Type (if known)

Cutting & Welding

  • Hot Work Permit Pulled

  • Fire Watch

  • Area clear of combustibles

  • Compressed Gas Cylinders properly stored

  • Storage Type:

  • Striker used for ignition

  • Hoses in good condition

  • Leads in good condition

  • Gauges in good condition

  • Caps on Compressed Gas Cylinders if Gauges are removed

  • Chop Saw Disc in good condition

Fire Safety

  • Fire Extinguisher(s) are charged and in good condition

  • Fire Extinguisher(s) have up-to-date tag(s)

  • All Equipment has an accessible Fire Extinguisher

  • 20lb Fire Extinguisher 25' to 75' from Fuel Containment

  • Combustibles properly stored

  • Fuel Containers labeled

Electrical

  • GFCI working properly

  • Power Tools in good working condition

  • Extension Cords free from defects

  • Overhead Power Lines (proper distance indicated and observed)

  • Under Ground Utilities (properly identified and marked)

Company Vehicle/Conex Box

  • Truck/Conex is reasonably clean

  • Truck/Conex is well organized

  • Back-Up Alarm Operational

  • Mirrors, Seat Belts & Windows in good condition

  • Mechanical deficiencies reported

Other

  • Guards provided for rotating parts

  • Grout Hoses have Whip-Checks

  • Laser Sign visible

  • Tag Lines in use when unloading or flying materials

  • Sheet Shackles in good condition

  • Housekeeping (trash & debris) controlled

  • Other Essential Findings

Signatures

  • Superintendent

  • Inspector

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