James McHugh Construction Concrete SSSP Survey

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

2. Safety Responsibilities

• 2a. Please list Project Team and their responsibilities

  Yes

  No

  N/A

• Project Manager

• Superintendent

• Safety Manager

• Other

• 2b. Please list the General Foremen on site and their safety responsibilities

  Yes

  No

  N/A

• Carpenter General Foreman

• Deck Foreman

• Vertical Foreman (besides core)

• Core Foreman

• Carpenter Union Steward

• Safety Carpenter

• Laborer General Foreman?

• Stripping Foreman

• Sub Foreman

• Ground man

• Deck Laborer

• Laborer Union steward

• Safety Laborer

• Ironworker General Foreman?

• Deck Foreman (rebar decks)

• Deck Foreman (PT slabs)

• Vertical Foreman

• Core foreman

• Ironworker Union Steward

• Safety Ironworker

• Cement Mason General Foreman?

• Sub Foreman

• Cement Mason Union Steward

• Safety Cement Mason

• Engineer Foreman

• Safety Tech. Engineer

• Operators

• Crane Operators

• Oiler

• Crane Operator

• Oiler

• Pump Operator

• Placing Boom Operator

• 2c. Are there any site safety contractual requirements above and beyond McHugh's requirements? If so pease list

  Yes

  No

  N/A

• Please list

• 2d. List any additional Safety Comments

  Yes

  No

  N/A

3. Emergency Action Plans

• 3a. Have you designated an emergency evacuation meeting area?

  Yes

  No

  N/A

• Please enter the location

• 3b. Severe Weather-preventative measures?

  Yes

  No

  N/A

• List any site specific potential safety hazards

• 3c. Please list emergency contact numbers of Project Team.

  Yes

  No

  N/A

• Home Phone Number

• Cellular Phone Number

• Other Phone Number

• 3d. Please list the operational plans that will be provided for the project.

  Yes

  No

  N/A

• Locations of Safety straps

• Location plan for fire extinguishers

• Location plan of exits

• Location Plan of other (please list)

4. Training and Education, New Employee Orientation

• 4a. Please ensure the following requirements are met prior to employee beginning work

  Yes

  No

  N/A

• Fit for duty for new employees

  Yes

  No

  N/A

• Drug and alcohol test

  Yes

  No

  N/A

• Safety Orientation

  Yes

  No

  N/A

• Proper documentation

  Yes

  No

  N/A

• Copy of special certifications, if applicable

  Yes

  No

  N/A

• 4b. Is there anyone on site that is trained in CPR or First Aid? If not, there should be an effort made to provide training

  Yes

  No

  N/A

• Please list employees who are trained in CPR or First Aid

• Please list employees you recommend to be trained in CPR or First Aid

• Please list employees you recommend to be trained in CPR or First Aid

• 4c. Please list any planned training that will take place

  Yes

  No

  N/A

• 4d. Is there any task specific training that will be necessary for this project?

  Yes

  No

  N/A

• Confined Space? If so please explain

  Yes

  No

  N/A

• Trenching? If so, please explain

  Yes

  No

  N/A

• Post tensioned slabs/beams? If so, please explain

  Yes

  No

  N/A

• High Decks? If so, please explain

  Yes

  No

  N/A

• Any other task specific training that will be necessary for this project?

  Yes

  No

  N/A

5. Pre-task Planning and Job Hazard Analysis

• 5a. Please list any areas that need extensive long term planning with pre-construction safety meeting required

  Yes

  No

  N/A

• Confined Space?

  Yes

  No

  N/A

• Please list Responsible person

• Please select date of scheduled work

  Date

• Please enter the meeting date

  Date

• Trenching?

  Yes

  No

  N/A

• Please list Responsible person

• Please select date of scheduled work

  Date

• Please enter the meeting date

  Date

• Post-Tensioning?

  Yes

  No

  N/A

• Please list Responsible person

• Please select date of scheduled work

  Date

• Please enter the meeting date

  Date

• High Decks?

  Yes

  No

  N/A

• Please list Responsible person

• Please select date of scheduled work

  Date

• Please enter the meeting date

  Date

• Other?

  Yes

  No

  N/A

• Please list Responsible person

• Please select date of scheduled work

  Date

• Please enter the meeting date

  Date

• 5b. Please list those on your Team who will be performing the Take 5 meetings, and their titiles

  Yes

  No

  N/A

6. Safety Inspection Procedures

• 6a. Please list inspection procedures besides the regular safety audits that will be performed

  Yes

  No

  N/A

• Please list the plans that will be provided regulating fire extinguishers

• Please list the plans that will be provided for checking PPE

• 6b. Please list whom will perform the regular Safety Audits

  Yes

  No

  N/A

• 6c. What processes are in place to make employees aware of potential hazards?

  Yes

  No

  N/A

• Site Orientation?

  Yes

  No

  N/A

• JHAs?

  Yes

  No

  N/A

• Take 5 meetings?

  Yes

  No

  N/A

• Weekly coordination meetings?

  Yes

  No

  N/A

• Tool box talks?

  Yes

  No

  N/A

• Other (Please list)?

  Yes

  No

  N/A

7. Personal Protective Equipment

• 7a. Are there any Protective Equipment requirements above and beyond the standard?

  Yes

  No

  N/A

• Please list

• 7b. Is there any special equipment required for the project?

  Yes

  No

  N/A

• Please list

• 7c. Has the project required PPE signage locations been determined?

  Yes

  No

  N/A

• Please list signage and locations

8. Respiratory Protection Program

• 8a. Employees on site using respirators?

  Yes

  No

  N/A

• 8b. Employees Medical and Fit tested?

  Yes

  No

  N/A

• 8c. Records on site?

  Yes

  No

  N/A

• 8d. Respirators in sealed container when not in use?

  Yes

  No

  N/A

• 8e. Only McHugh Construction respirators used on site?

  Yes

  No

  N/A

• 8f. Confined spaces?

  Yes

  No

  N/A

• 8g. Hazardous gases/dust?

  Yes

  No

  N/A

• 8h. Have the Silica Hazard signs en posted if applicable?

  Yes

  No

  N/A

9. Fire Prevention and Protection

• 9a. Will flammables be stored on site?

  Yes

  No

  N/A

• 9b. Are flammables located in a safe area, away from sparks, flames and traffic?

  Yes

  No

  N/A

• 9c. Are flammables stored in an enclosure that is labeled?

  Yes

  No

  N/A

• 9d. Will torches be used on site?

  Yes

  No

  N/A

• 9e. Do the gauges have flash back arrestors?

  Yes

  No

  N/A

• 9f. Required separation and storage area's provided for oxygen and acetylene?

  Yes

  No

  N/A

• 9g. Storage area's labeled and warning signs posted?

  Yes

  No

  N/A

• 9h. Has the local Fire Dept. been notified of the type of construction taking place?

  Yes

  No

  N/A

• 9i. Has a drawing of the site and hazardous area's been provided to the Fire Dept.?

  Yes

  No

  N/A

• 9j. Evacuation Area designated?

  Yes

  No

  N/A

• 9k. Special hot work needs, neighboring fuel storage/flammables?

  Yes

  No

  N/A

• 9l. Deck heaters being used on site?

  Yes

  No

  N/A

• 9m. Extra fire extinguishers placed near heated areas?

  Yes

  No

  N/A

• 9n. Has the appropriate number of fire extinguishers and signage been addressed for the project formwork?

  Yes

  No

  N/A

10. Fall Prevention and Protection

• 10a. Decking over 10'?

  Yes

  No

  N/A

• 10b. Deck monitor on site?

  Yes

  No

  N/A

• 10c. Full time tie off on floors over 10'?

  Yes

  No

  N/A

• 10d. Briefings/Safety Meetings prior to 10'+ decking operation?

  Yes

  No

  N/A

• 10e. Procedures in place for stripping elevated decks - scissor lifts, boom lifts, ladders, tie off straps?

  Yes

  No

  N/A

• 10f. Scaffolds on site?

  Yes

  No

  N/A

• 10g. Employee's trained and proof of training on site?

  Yes

  No

  N/A

• 10h. Type of exterior fall protection - cables, wood rails, mesh?

  Yes

  No

  N/A

• 10i. Boom lifts being used on site?

  Yes

  No

  N/A

• 10j. Scissor lifts used on site?

  Yes

  No

  N/A

• 10k. Employees trained in use of boom and scissor lifts?

  Yes

  No

  N/A

• 10l. Deck monitor on site?

  Yes

  No

  N/A

• 10m. Plan for full time tie off on floors over 10' in elevation?

  Yes

  No

  N/A

• 10n. Life lines, retractables, d-ring anchors and column straps inspected prior to use?

  Yes

  No

  N/A

• 10o. Will the control zone and 100% tie-off signs be posted?

  Yes

  No

  N/A

11. Housekeeping and Material Storage

• 11a. All material will be stored to not block aisle ways and passageways, both interior and exterior?

  Yes

  No

  N/A

• 11b. All fuel tanks to be properly stored and removed from building ASAP?

  Yes

  No

  N/A

• 11c. All work areas to be kept as free of waste materials that may cause tripping, fire, or other hazards?

  Yes

  No

  N/A

• 11d. Materials will be stacked, racked, and blocked in such a way as to prevent the accidental displacement or collapse?

  Yes

  No

  N/A

• 11e. Nails will be removed from lumber that is to be re-used?

  Yes

  No

  N/A

12. Electrical Safety

• 12a. Are all electrical tools protected by Ground Fault Circuit Interrupters (GFCIs)?

  Yes

  No

  N/A

• 12b. Will electrical tools be inspected for visible defects daily?

  Yes

  No

  N/A

• 12c. Electrical cords will be positioned to not cause tripping hazards?

  Yes

  No

  N/A

• 12d. Crane electrical & boxes will be marked with the operating voltage?

  Yes

  No

  N/A

• 12e. If temporary generators are used there will be proper ventilation and electrical cords will be checked daily?

  Yes

  No

  N/A

• 12f. Will the electrical boxes and disconnects be labelled for the crane?

  Yes

  No

  N/A

13. Cranes, Rigging, and Heavy Equipment

• 13a. Type of crane/cranes on site - Hammerhead, luffing boom, crawler, rubber tire mobile.

  Yes

  No

  N/A

• 13b. Copy of annual inspections on site?

  Yes

  No

  N/A

• 13c. Inspection sheets for each type of crane being used?

  Yes

  No

  N/A

• 13d. Procedures in place for swing radius protection for crawler cranes?

  Yes

  No

  N/A

• 13e. Communication to Crane operators - radios, hand signals, hardline speaker?

  Yes

  No

  N/A

• 13f. Signal and rigging training certification for employees on site?

  Yes

  No

  N/A

• 13g. Copy of City of Chicago Crane License if necessary on site?

  Yes

  No

  N/A

• 13h. Signal and rigging training certification for employees on site?

  Yes

  No

  N/A

• 13i. Will the "Authorized Personnel Only" sign be posted at the bottom of crane ladder?

  Yes

  No

  N/A

14. Truck and Auto Fleet Safety

• 14a. List of vehicles used on site available?

  Yes

  No

  N/A

• 14b. Copy of Drivers Licenses of employees using vehicles on site?

  Yes

  No

  N/A

• 14c. Fire extinguishers and First Aid kits in company vehicles (infrastructure)?

  Yes

  No

  N/A

• 14d. Mars lights/ four way flashers required?

  Yes

  No

  N/A

15. Confined Space Entry

• 15a. If there will be CSE work, has the CSE procedure been developed by Corporate Safety?

  Yes

  No

  N/A

• 15b. Are concrete subcontractors of McHugh planning to use CSE with their work?

  Yes

  No

  N/A

• 15c. CSE safety procedures for subs need to be approved by Corporate Safety?

  Yes

  No

  N/A

• 15d. Will confined Space sign be posted if applicable?

  Yes

  No

  N/A

16. Scaffold, Aerial Lift, and Ladder Safety

• 16a. Are any scaffolds or aerial lifts (scissor or booms) planned to be used for the concrete work?

  Yes

  No

  N/A

• 16b. Will there be daily records kept for each days inspection?

  Yes

  No

  N/A

• 16c. Will there be training records for each employee that is trained on booms or other?

  Yes

  No

  N/A

• 16d. Will there be ladder safety training done and recorded?

  Yes

  No

  N/A

17. Trenching and Excavation

• 17a. If trenching is done to do concrete work, have the employees working in the trench been trained and has this training been recorded?

  Yes

  No

  N/A

• 17b. Will the excavator be following the McHugh process trench safety?

  Yes

  No

  N/A

18. Portland Cement/Concrete Safety

• 18a. Have the employee been trained regarding Cement/Concrete safety?

  Yes

  No

  N/A

• 18b. Will employees be wearing proper PPE, fitted masks, and other?

  Yes

  No

  N/A

• 18c. Are mask fit test records being kept for each affected employee?

  Yes

  No

  N/A

• 18d. Has the "Silica Hazard" signage been posted if applicable?

  Yes

  No

  N/A

19. Cable Post Tensioning/Safety Traffic Control

• 19a If there is concrete post tensioning on the project, have the employees been trained?

  Yes

  No

  N/A

• 19b. Are the records of the employee training being kept?

  Yes

  No

  N/A

• 19c. Has there been a procedure for disposing of the cut-off tails?

  Yes

  No

  N/A

• 19d. Has the "Post Tensioning in Progress" signage been posted if applicable?

  Yes

  No

  N/A

20. Traffic Control

• 20a. Has the site logistics plan used for the bid been reviewed for more project specific information?

  Yes

  No

  N/A

• 20b. Has the site logistics plan included auto, truck, and pedestrian traffic control?

  Yes

  No

  N/A

• 20c. If there is specific training for traffic control, like for flaggers, has this training been planned?

  Yes

  No

  N/A

• 20d. Has the "Truck Crossing" and "Sidewalk Traffic Control" signage been posted if applicable?

  Yes

  No

  N/A

21. Work Over, On, or Near Water

• 21a. will there be any work over, on, or near water?

  Yes

  No

  N/A

• 21b. Has there been a JHA for this work item?

  Yes

  No

  N/A

• 21c. Has the "Life Jackets Required" signage been posted if applicable?

  Yes

  No

  N/A

22. Demolition

• 22a. Will there be any demolition on this project? If yes, describe locations and methods plan.

  Yes

  No

  N/A

• 22b. Are existing utilities (gas, water, electric, sewer) anticipated?

  Yes

  No

  N/A

• 22c. Hazardous materials (gases, explosives, flammable materials, lead, asbestos)?

  Yes

  No

  N/A

• 22d. Testing for hazardous materials?

  Yes

  No

  N/A

• 22e. Has the "Demolition Hazard" signage been posted if applicable?

  Yes

  No

  N/A

23. Public Protection and Site Security

• 23a Does site logistics plan address public safety?

  Yes

  No

  N/A

• 23b. Are noise, vibrations, fumes, dust, falling debris concerns?

  Yes

  No

  N/A

• 23c. Will overhead protection canopies be required?

  Yes

  No

  N/A

• 23d. Does construction traffic cross pedestrian routes safely?

  Yes

  No

  N/A

• 23e. Will perimeter wind screens be needed?

  Yes

  No

  N/A

• 23f. Has "Construction Site Public Protection Plan Checklist been reviewed" (ref. Section 23 of Corp. Safety Plan

  Yes

  No

  N/A

• 23g. Will Logistics/Site Security plans be included in tool box talks and orientations?

  Yes

  No

  N/A

• 23h. Will Logistics/Site Security plans be posted? Where?

  Yes

  No

  N/A

• 23i. Have the "Danger Truck Traffic" signs been displayed?

  Yes

  No

  N/A

24. Employee Safety Violation and Penalty Program

• 24a. Does this project require stricter standards than what is included in McHugh's corporate plan section 24?

  Yes

  No

  N/A

25. Subcontractor Information and Requirements

• 25a. Will there be any subcontractors working for McHugh on this project?

  Yes

  No

  N/A

• 25b. Does their contract include safety requirements and schedule of violation fines?

  Yes

  No

  N/A

• 25c. Are there any special job site requirements for this project and are they included in their subcontract? i.e. no smoking, 100% tie-off...

  Yes

  No

  N/A

• 25d. Is this an OCIP or CCIP job? If so, do we have a copy of the OCIP/CCIP Plan Requirements?

  Yes

  No

  N/A

26. Substance Abuse and recovery Program

• 26a. Does this project require stricter standards than what is included in McHugh's corporate plan section 26?

  Yes

  No

  N/A

27. Blood Borne Pathogens Information

28. Accidental

• 28a. Has the person been assigned that will lead all accident investigations?

  Yes

  No

  N/A

• 28b. Are there any reports or procedures required for this project different from what is in McHugh's Corporate Plan section 28?

  Yes

  No

  N/A

29. Sexual Harassment and Unlawful Acts Policy

• 29a. Does this project require stricter standards than what is included in McHugh's corporate plan section 29?

  Yes

  No

  N/A

• 29b. Where will McHugh Hotline posters be displayed?

  Yes

  No

  N/A

30. OSHA Inspections

• 30a. Are there any procedures required for this project different from what is in McHugh's Corporate Plan section 30?

  Yes

  No

  N/A

31. Crisis Management Plan

• 31a. Are there any procedures required for this project different from what is in McHugh's Corporate Plan section 31?

  Yes

  No

  N/A

• Sign off (Print Name)

• Signature

  Sign

• Title