James McHugh Construction Concrete SSSP Survey

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

2. Safety Responsibilities

• 2a. Has a project team been assigned? If so please list who and their responsibilities

  Yes

  No

  N/A

• Superintendent

• Safety Manager

• Other

• 2b. Have the General Foremen been assigned for the project? If so please list their names 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

• Deck Laborer

• Stripping Foreman

• Sub Foreman

• Ground man

• 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

• Safety Cement Mason

• Cement Mason Union Steward

• 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. Arethere any additional Safety Comments?

  Yes

  No

  N/A

• Please explain

3. Emergency Action Plans

• 3a. Has an emergency evacuation meeting area been designated?

  Yes

  No

  N/A

• Please enter the location

• 3b. Are there any Severe Weather-preventative measures?

  Yes

  No

  N/A

• Please List any site specific severe weather hazards

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

• Superintendent

• Cellular Phone Number

• Home Phone Number

• Other Phone Number

• Project Manager

• Cellular Phone Number

• Home Phone Number

• Other Phone Number

• Safety Manager

• Cellular Phone Number

• Home Phone Number

• Other Phone Number

• 3d. Are there operational safety 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. Are the following requirements met prior to employee beginning work?

  Yes

  No

  N/A

• Fit for duty for new employees?

• Drug and alcohol test?

• Safety Orientation?

• Proper documentation i.e. drivers license, ID card etc.?

• Copy of special certifications, if applicable?

• 4b. Is there anyone that will be 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. Is there any planned safety training that will take place? If so, please list...

  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. Are there 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 titles

  Yes

  No

  N/A

6. Safety Inspection Procedures

• 6a. Are there safety 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 inspecting PPE i.e. Harnesses, dust masks, lanyards etc.

• Please list the plans that will be provided for inspecting other (please specify)

• 6b. Will there be a daily safety audit?

  Yes

  No

  N/A

• Who will perform it?

• What is the frequency of safety audits, and who will perform them?

• 6c. Are there processes 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 Personal Protective Equipment requirements for your project that are above and beyond the standard?

  Yes

  No

  N/A

• Please list

• 7b. Is there any special PPE 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. Have employees who will be using respirators on site been identified?

  Yes

  No

  N/A

• Who will be responsible to prepare and by when?

• 8b. Will employees be Medical and Fit tested with records on site?

  Yes

  No

  N/A

• 8c. Respirators will be stored in sealed container when not in use?

  Yes

  No

  N/A

• 8d. Only McHugh Construction supplied respirators used on site?

  Yes

  No

  N/A

• 8e. Will subcontractors be using respirators?

  Yes

  No

  N/A

• Employee Fit Tests and Medical Records must be submitted to Mchugh Construction.

• 8f. Will there be an exposure to neighboring buildings or public from concrete dust?

  Yes

  No

  N/A

• What procedures will be implemented to reduce exposure?

• 8g. Are there any hazardous gases known, or expected?

  Yes

  No

  N/A

• Please explain

• 8h. Will the "Silica Hazard" signs be posted if applicable?

  Yes

  No

  N/A

9. Fire Prevention and Protection

• 9a. Will flammables be stored on site?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Please list the location(s) of enclosures

• 9d. Will torches be used on site?

  Yes

  No

  N/A

• 9e. Will the gauges on the torches have flash back arrestors?

  Yes

  No

  N/A

• Please explain

• 9f. Are required separation and storage areas provided for oxygen and acetylene?

  Yes

  No

  N/A

• 9g. Will flammables' storage areas be 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. Has an emergency evacuation area been designated?

  Yes

  No

  N/A

• Location of the Evacuation area?

• 9k. Are there special hot work needs, neighboring fuel storage/flammables?

  Yes

  No

  N/A

• Explain procedures to eliminate hazards.

• 9l. Will deck heaters be used on site?

  Yes

  No

  N/A

• 9m. Will extra fire extinguishers be 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. Is there any decking over 10' high?

  Yes

  No

  N/A

• Is there a tie-off plan in place?

  Yes

  No

  N/A

• 10b. Is there or will there be a deck monitor on site?

  Yes

  No

  N/A

• 100% Tie-Off is required while working on all decks

• 10c. Are there briefings/Safety Meetings planned for 10'+ decking operation?<br>

  Yes

  No

  N/A

• 10d. Are there procedures in place for stripping elevated decks- scissor lifts, boom lifts, ladders, tie-off straps etc.?

  Yes

  No

  N/A

• 10e. Will scaffolds be used on site?

  Yes

  No

  N/A

• Employees trained and records on site?

  Yes

  No

  N/A

• 10f. What types of exterior fall protection are required to be used on site?

  Yes

  No

  N/A

• Cables?

• Wood Handrails?

• Mesh?

• Other?

• Please list other

• 10g. Will boom lifts be used on site?

  Yes

  No

  N/A

• Are employees trained and records on site?

  Yes

  No

  N/A

• 10h. Will scissor lifts be used on site?

  Yes

  No

  N/A

• Are employees trained and records on site?

  Yes

  No

  N/A

• 10i. Is there a plan for full time tie off on floors over 10' in elevation?

  Yes

  No

  N/A

• 10j. Will life lines, retractables, d-ring anchors and column straps inspected prior to use?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

11. Housekeeping and Material Storage

• 11a. Will all materials 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. Will all work areas be kept 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

• 11f. Is the Material Storage-Location, within reach of crane, away from overhead power lines, and a safe distance from jobsite traffic?

  Yes

  No

  N/A

• 11g. Will materials be store a minimum of 6' from the edge of the deck?

  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. GFCI inspections performed bi-weekly?

  Yes

  No

  N/A

• 12d. Temporary lighting under decks by sub-contractor?

  Yes

  No

  N/A

• Please name Contractor

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 12h. 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

• Please specify types & model #'s

• 13b. Copy of annual inspections on site?

  Yes

  No

  N/A

• 13c. Daily Inspections 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. 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

• Who will be responsible to prepare, and by when?

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

  Yes

  No

  N/A

• CSE safety procedures for subs need to be approved by corporate safety.

  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

• Safety procedures need to be identified for each type by Site Safety Manager and by when?

• 16b. Will there be daily records kept for each days inspection of (scaffolds/lifts/ladders)?

  Yes

  No

  N/A

• Daily inspection records will be collected for each item by Site Safety Manager?

  Yes

  No

  N/A

• Lift equipment training records will be collected for each employee by the Site Safety Manager?

  Yes

  No

  N/A

• Ladder safety training records will be collected for each employee by the Site Safety Manager?

  Yes

  No

  N/A

17. Trenching and Excavation

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Safety procedures need to be identified for each type of excavation by Site Safety Manager and by when?

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

• Training for Cement/Concrete Safety needs to be done and recorded by the Site Safety Manager and by when?

• 18c. Will mask fit test records be kept for each affected employee?

  Yes

  No

  N/A

• 18d. Will the "Silica Hazard" signage be posted where applicable?

  Yes

  No

  N/A

19. Cable Post Tensioning

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

  Yes

  No

  N/A

• Training for Cable Post Tensioning needs to be done and recorded by the Site Safety Manager and by when?

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

  Yes

  No

  N/A

• 19c. Will the "Post Tensioning in Progress" signage be posted where 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

• Who will prepare and by when? (Note: also reference "Construction Site Public Protection Plan Checklist" and McHugh Way Logistics template)

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

  Yes

  No

  N/A

• Training for Traffic Control needs to be performed and recorded by the Site Safety Manager and by when?

• 20c. Will the "Truck Crossing" and "Sidewalk Traffic Control" signage be posted where 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

• Safety hazards and safe work procedures need to be identified by the Site Safety Manager and by when?

• Training for work over or near water to be performed and recorded by the site safety manager and by when?

• 21b. Will the "Life Jackets Required" signage be posted where applicable?

  Yes

  No

  N/A

22. Demolition

• 22a. Will there be any major demolition on this project?

  Yes

  No

  N/A

• Has a detailed demo plan been prepared?

  Yes

  No

  N/A

• Briefly describe the demo to take place.

• Who will be responsible to prepare and by when?

• Are there no existing utilities (gas, water, electric, sewer) anticipated?

  Yes

  No

  N/A

• Are there no hazardous materials (gases, explosive materials, flammable materials, lead, asbestos) anticipated?

  Yes

  No

  N/A

• Has testing for hazardous materials been performed?

  Yes

  No

  N/A

23. Public Protection and Site Security

• 23a. Has a site logistics plan been prepared?

  Yes

  No

  N/A

• Who will prepare and by when?

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

  Yes

  No

  N/A

• Does the site logistics plan indicate locations of pedestrian canopies?

  Yes

  No

  N/A

• Are there areas not protected by pedestrian canopies where other means of protection is required?

  Yes

  No

  N/A

• Please list locations.

• 23b. Will construction traffic cross pedestrian routes?

  Yes

  No

  N/A

• Please check means that will be implemented to protect pedestrians from construction traffic.

• Flaggers?

• Whistles or alarms?

• Signs?

• Barricades?

• Swing gates?

• Other?

• 23c. Will perimeter wind screens be needed?

  Yes

  No

  N/A

• Has a plan been prepared showing locations of wind screens?

  Yes

  No

  N/A

• Will netting be installed at all perimeter conditions not covered by wind screens including top working surface?

  Yes

  No

  N/A

• Will netting be installed at all perimeter conditions including top working surface?

  Yes

  No

  N/A

• 23d. What are the guardrail height requirements for this project?

• 23e. Will construction workers and haul routes be separated by a physical barrier?

  Yes

  No

  N/A

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

  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

• Please list or provide reference to where these standards can be found.

25. Subcontractor Information and Requirements

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

  Yes

  No

  N/A

• Please list anticipated subs/trades.

• 25b. Are there any special job site requirements for this project and are they included in their subcontract? i.e. no smoking, ladders, etc.?

  Yes

  No

  N/A

• Please list or provide reference where they can be found.

• 25c. 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

28. Accidental

• 28a. Who will lead accident investigations?

  Yes

  No

  N/A

• Please list

29. Sexual Harassment and Unlawful Acts Policy

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

  Yes

  No

  N/A

30. OSHA Inspections

31. Crisis Management Plan

• Sign off (Print Name)

• Signature

  Sign

• Title