HSE Jobsite Evaluation - FREEDOM IND.

• Project Location

• Job Number

• Project Name

• Conducted on

  Date

• Prepared by

Housekeeping

• Project work areas are clean and free of trash or debris

  Safe

  At Risk

  N/A

• Walkways and passageways clear of tripping hazards.

  Safe

  At Risk

  N/A

• Material or equipment properly stored?

  Safe

  At Risk

  N/A

• Scrap metal/wood free of protruding nails or other puncture hazards

  Safe

  At Risk

  N/A

• Warning signs posted, work areas barricaded as required.

  Safe

  At Risk

  N/A

• Drinking water containers labeled properly

  Yes

  No

  N/A

• Other

Personal Protective Equipment (PPE)

• Hard hats

  Safe

  At Risk

  N/A

• Proper footwear

  Safe

  At Risk

  N/A

• Ear protection

  Safe

  At Risk

  N/A

• Eye protection

  Safe

  At Risk

  N/A

• Hand protection

  Safe

  At Risk

  N/A

• Safety Vests

  Safe

  At Risk

  N/A

• Other

Fall Protection

• Guardrails in place.

  Safe

  At Risk

  N/A

• Safety harness/lanyards worn in a proper manner

  Safe

  At Risk

  N/A

• Floor openings guarded

  Safe

  At Risk

  N/A

• Proper fall protection used

  Safe

  At Risk

  N/A

• Fall protection equipment maintained and has current inspection

  Safe

  At Risk

  N/A

• Other

Motor Vehicles and Equipment

• Daily inspections of lifts

  Safe

  At Risk

  N/A

• Fire extinguisher in place and fully charged

  Safe

  At Risk

  N/A

• Equipment in good condition

  Safe

  At Risk

  N/A

• Spotters present

  Safe

  At Risk

  N/A

• Other

Excavations

• Support systems in place for adjacent structures.

  Safe

  At Risk

  N/A

• Ladders provided

  Safe

  At Risk

  N/A

• Competent person on site

  Safe

  At Risk

  N/A

• Underground utilities located and marked

  Safe

  At Risk

  N/A

• Soil bank and equipment sufficient distance from excavation

  Safe

  At Risk

  N/A

• Sharing adequate for soil type and depth

  Safe

  At Risk

  N/A

• Access and egress provided ever 25ft.

  Safe

  At Risk

  N/A

• Other

Welding And Cutting

• Qualified personnel performing task

  Safe

  At Risk

  N/A

• Screens, shields, goggles, gloves

  Safe

  At Risk

  N/A

• Gas cylinders secured in upright position

  Safe

  At Risk

  N/A

• Fire extinguisher available

  Safe

  At Risk

  N/A

• Electrical equipment properly grounded

  Safe

  At Risk

  N/A

• Valve protection caps in place when not in use

  Safe

  At Risk

  N/A

• Fire watch present

  Safe

  At Risk

  N/A

• Other

Electrical

• GFCIs in use

  Safe

  At Risk

  N/A

• Terminal boxes equipped with required covers

  Safe

  At Risk

  N/A

• Extension cords are 3-wire with ground pin

  Safe

  At Risk

  N/A

• Electrical tool are 3-wire with ground pin

  Safe

  At Risk

  N/A

• Extension cords inspected with monthly color code

  Safe

  At Risk

  N/A

• Other

Scaffolding

• Supervised properly by a competent person

  Safe

  At Risk

  N/A

• Daily inspection performed and available for review

  Safe

  At Risk

  N/A

• Scaffolding tied to structure

  Safe

  At Risk

  N/A

• Ladder access provided

  Safe

  At Risk

  N/A

• Fall protection in use while working from elevated scaffolding

  Safe

  At Risk

  N/A

• Base plates used

  Safe

  At Risk

  N/A

• Other

Stairways and Ladders

• Inspected and in good condition

  Safe

  At Risk

  N/A

• Properly secured

  Safe

  At Risk

  N/A

• 3 point contact method used

  Safe

  At Risk

  N/A

• Extension ladder used on 4 to 1 pitch

  Safe

  At Risk

  N/A

• Employees not exceeding max rung height

  Safe

  At Risk

  N/A

• Guardrails provided for stairways

  Safe

  At Risk

  N/A

• Other

Fire Protection

• Approved gas cans in use.

  Safe

  At Risk

  N/A

• No smoking in undesignated areas

  Safe

  At Risk

  N/A

• Proper number of extinguishers provided and charged

  Safe

  At Risk

  N/A

• Combustibles >10’ from structures

  Safe

  At Risk

  N/A

• Other

First Aid and Emergency

• First aid kits fully stocked

  Safe

  At Risk

  N/A

• Employees aware of emergency procedures

  Safe

  At Risk

  N/A

• Employees aware of evacuation procedures and meeting points

  Safe

  At Risk

  N/A

• Other

Administration

• Pre-construction meetings (tailgate) (Tool Box topic)

  Yes

  No

  N/A

• Emergency phone numbers posted

  Yes

  No

  N/A

• SDS on site

  Yes

  No

  N/A

• SPAs completed

  Yes

  No

  N/A

• SORs completed

  Yes

  No

  N/A

• Other

Comments

Worker Training and Performance

• Employees following all safety practices

  Yes

  No

• Employees need retraining

  Yes

  No

• Supervisors informed of audit results

  Yes

  No

Signatures

• Supervisor

  Sign

• Supervisor

  Sign

• Inspected by

  Sign