1a. Have all employees, sub-contractor employees, & visitors completed orientation specifically to project and job sticker issued?
1b. Are all required Job Posters, Ethics Notifications, and Emergency Numbers conspicuously posted?
1c. Is the Site Safety Program and SDS Manuals readily available?
1d. Has the First Aid kit been inspected and all contents current (not expired)?
1e. Is site entrance and exit clearly identified with warning / informational signs posted?
(i.e. PPE Requirements, office location, etc..)
1f. Do the amount of Facilities / Port-a-potties on project meet requirements & OSHA standards? (i.e. 1 unit per 10 workers for 40 hrs.)
List any Schedule, Progress, Staff, Owner or Sub-Contractor meetings attended today:
General description of tasks to be performed for shift work today:
2a. Are there employees on site that have current First Aid / CPR training? (please list)
2b. Have all employees been trained to use tools required for tasks assigned?
2c. Are Pre-Task / Take 5 meetings held daily or as tasks change?
2d. Are weekly safety briefings / tool box talks provided, and documented?
2e. List person or persons and job title conducting meeting:
2g. Were any disciplinary actions taken and or documented for shift work today?
List Person or entity issuing discipline:
Discipline issued to JMCC Employee? (List Name and Action)
Discipline Issued to Sub-Contractor Employee? (List Name & Action)
3a. Are SUB-CONTRACTORS working on site today?
3b. Are all insurance requirements current and in place?
3c. Is Sub-Contractor Supervision on site? (If yes list)
3d. Did Sub-Contractor provided copies of Documented Safety Training?
(I.e. Pre-Task, Take 5, Weekly Safety Briefing/Tool Box Talk)
List person conducting meeting and topic:
3e. If Sub-Contractor is using any kind of equipment, are all inspections available & all employees have proof of training for equipment being used?
3f. Is Sub-Contractor following PPE Requirements? (ie. Stock, Provide to employees, utilized by employee's)
4a. Is all company supplied PPE on site (stocked) and readily available?
4b. Is personal protective equipment (PPE) provided, utilized and are all employees trained to use PPE as needed to protect against injury?
4c. Are gloves provided for hand protection utilized?
4d. Are reflective vests / clothing being worn at all times?
5a. Will work that requires use of a respirator be performed today?
5b. Do you conduct assessments of the workplace to ensure that the written respiratory protection program is being properly implemented, and consult employees to ensure that they are using respirators properly?
5c. Do you have a written respiratory protection program with required worksite-specific procedures and elements for required respirator use?
5d. Is training provided for use, cleaning and hygiene (no facial hair) to employees who are required to use respirators?
5e. Are all employee's that are assigned respirators medically cleared & FIT tested?
5f. Are all respirators used in routine situations inspected before each use, and during cleaning?
5g. Is a written industrial hygiene plan in place?
5h. Is Industrial Hygiene testing being performed as required, Including retesting when applicable.
5i. Are record keeping documents and corrective actions up to date?
6a. Are Look-out platforms utilized on project?
6bI. Have all structural installation plans been reviewed, approved and followed for installation?
6bII. Are all guard rails, toe-boards, and debris netting in place and meet Corporate Policy requirements?
6bIII. Are retractibles in place on all LOOK-OUTS?
6bIIII. Are LOOK-OUT platforms clean and clear of any loose debris?
6bV. Are all WARNING, CAPACITY, AND ALLOWABLE ACCESS signs posted, secured, and in good condition?
7a. Are all employee's familiar with the JMCC Fall Prevention / Protection section of the Corporate Safety Manual?
7b. Is all fall arrest equipment, such as harnesses, in good working condition
7c. Have all Harness', Lanyards, SRL's (Self Retracting Lifelines), and Anchor points been inspected and documentation retained?
7d. Have all "FALL FROM HEIGHT" hazards been identified and addressed?
7e. Have all necessary FALL ARREST Anchorage points been installed where needed?
7f. Is perimeter protection (guard rails, netting, cables, & flagging) devices in place and built according to standard requirements?
7g. List person (s) working on, or assigned to maintain guard rail system / perimeter protection:
7h. Are all holes that are greater than 2" securely covered, & clearly marked 'HOLE'?
8a. Is scaffolding being used on this project?
8b. List scaffold type and purpose:
8c. Was scaffold system erected according to manufacturer specification by a Competent Person?
8d. Have all employee's that are using scaffold to perform work been trained with valid certification card readily available? (Copies on file)
List person whom provided daily inspection
8e. Will swing stage scaffold be utilized?
8e I. Has scaffolding and components been inspected by the competent person regularly and prior to use?
8e II. Has all SWING STAGE scaffolding been inspected?
8e III. Are all VERTICAL LIFE LINES properly installed, correctly anchored?
8e IV. Are all TIE-BACKS properly anchored and secured?
9a. Is this project a building?
9b. Is perimeter fence in place, with clear and identified entrance and exit points?
9c. Are all entries and exits clearly marked, and have sufficient lighting?
9d. Is lighting sufficient through out building and work areas?
9e. Are shanties provided for work force, properly ventilated, and clean?
9f. Have all holes greater than 2" been securely covered and marked HOLE?
9g. Has all vertical rebar been capped to avoid impalement?
9h. Have any other sources of an impalement hazard been identified and corrected?
(ie. conduit, plumbers pipe, threaded rod etc..)
9i. Have all fire prevention and protection measures been taken?
9j. Is debris netting installed, maintained and in good condition?
9k. Are there hand wash stations available through out project to meet standards & requirements?
9l. Have all exterior RE-SHORING DEVICES (pole shores) been secured, tied back, and tightened?
9m. Are all access to ladders / stairs clean and clear of materials and debris?
9n. Are Certified Flaggers posted at entrance & exit to assist with concrete and other misc. deliveries?
9o. Have all framing forms been cleaned of loose debris before hoisting to work location?
9p. Are Self Climbing Wall forms / decks clean and clear of debris?
9q. Is all decking on CORE STRUCTURE installed and perimeter protected?
9r.Are all elevator shaft covers secured and in good condition?
9s. Are exits marked by readily visible signage?
9t. Are all means of access / egress clearly identified with signage or similar notification?
List corrective actions taken for this section:
10a. Is there hoisting equipment including cranes on site today?
10b. Is communication system in place and in good working order?
10c. Are there any critical or multiple crane lifts scheduled for the day? ie .. In excess of 75% of crane capacity?
10c I. Will outrigger experience more than 48,000 lbs of force?
10c II. Has ground penetrating radar been performed (GPR)? If YES, by whom?
10d. Have all critical lift plans been submitted to safety department for review?
10e. Are inspections current and a copy obtained daily?
10f. Are signal persons and riggers qualified with proof readily available?
10g. Are all 'HOOK SAFETY LOCKS' in working order?
10h. Are Navigation lights required, and functioning? (Boom Lights)
10i. Is crane positioned at the REQUIRED Safe distance from over-head power lines?
10j. Are the out-riggers correctly cribbed & padded? (ground bearing pressure addressed)
10k. Are access ladders and steps protected, in good condition and easily accessible?
10l. Is the Operator licensed according to Job, City, Federal & State requirements?
10m. Is all rigging tagged, with legible tags, and regularly inspected?
10n. Have chain falls been inspected for defects, deformed chains and hooks?
10o. Have all safety mechanisms been inspected? (ie. directional locks, anchor points etc...?
10p. Is Load Chart in Cab or on Equipment?
11a. Will motorized equipment be used?
11b. Was equipment inspected prior to use?
List equipment that is used and operator:
11c. Are all employees that intend to use equipment trained? Are records readily available, with copies obtained?
11d. Do all motion alarms function?
11e. Are Safety Zones around equipment established and communicated?
11f. Are areas free of holes, debris and obstructions for safe movement of equipment?
11g. Is machine shut off, keys removed and secure when unattended?
11h. Are safety restraint belts in place and being used?
11i. Are load capacities being observed and followed?
11j. Will equipment have to travel outside of the project perimeter? (List Operator)
11j I. Has travel route been verified?
11j II. Have all LOW-CLEARANCE or other obstructions been identified, and travel route designed to avoid them?
11j III. Is spotter, flagger, or escort in place at time of movement? (List individually)
12a. Does this project consist of infrastructure work?
12b. Have all required permits been acquired and valid?
(ie.. Construction, Hot Works, Confined Space Ground Disturbance)
12c. Are all employees and sub contractors assigned to the project, familiar with project limits prior to starting work?
12d. All personnel have completed Railroad Specific Training if required? (i.e. BNSF, CN, Metra, UPRR Contractor Orientation)
12e. Has all demolition work been identified?
12f. Have all soils to be removed been tested for foreign contaminants?
12g. Have all painted metals been tested for LEAD?
12h. All piping and insulation tested for ASBESTOS?
12i. Any work beyond contract scope of work?
12j. Have these areas been tested for suspect contaminants?
12k. Is there an abatement plan in place for removal of contaminants prior to start of project?
12l. All traffic control devices in place according to TRAFFIC CONTROL PLAN and in compliance with MUTCD?
12m. List responsible parties fro Traffic Control Devices: Placement, maintenance, inspections & corrective actions.
12n. All construction equipment and vehicles kept inside of barricades?
12o. Does all moving equipment have MOTION ALARMS (back-up beepers)?
12p. Will there be work over water?
12p I. Is work being performed on navigable waters? (Boat traffic commercial or recreational)
12p II. Are work area protection devices required and in place? (if yes, describe)
12p III. Are rescue buoys in place?
12p IV. Is rescue boat on site, in water, and supplied with correct equipment to perform rescue?
12p V. Are floatation devices supplied, inspected and used correctly? (zipped up, straps connected etc..)
12q. Will work be performed within 25' of Rail road track?
12q I. All personnel have completed Railroad Specific Training if required? (i.e. BNSF, CN, Metra, UPRR Contractor Orientation)
12q Ia. All personnel have a valid e-RAILSAFE ID?
12q II. Is Rail Road Flagger & EIC (Employee In Charge) on site, & Safety Briefing Given?
Identify Rail Road Provided Flagger:
12q III. Have all workers specific to Rail Road attended the job briefing?
12q IV. Were any hazards communicated during on track safety briefing? If yes please describe:
12q V. Are the Rail Road tracks live while work is being performed?
Define all track protection provided for workers.
List limits, time and verification:
12q VI. Are Flaggers and look-outs positioned according to requirements for task at hand?
12q VII. Has a method of communication or warning been established with EIC and / or flagger?
12q VIII. Is the Rail Road track INACTIVE, if yes, are all LOCK OUT - TAG OUT methods in place?
12q VIIII. Are Job Briefings updated as personnel or conditions change?
13a. Will excavation work be performed today?
13b. Has an excavation Corporate Safety Program been submitted to Superintendent?
Name the Competent Person for excavation work?
13c. Is there an excavation plan with associated 'DIG' numbers reviewed and approved?
13d. Are safety restraint belts in place on mobile equipment and being used?
13e. Are "BACK UP or other motion alarms in place and functioning at 90 decibels or greater?
13f. Is traffic control required, and in place according to traffic control plan?
13g. Will Flagger or Spotter be required for task? (If yes, please list)
13h. Have all OPEN excavations been protected?
13i. Is contaminated material being handled according to plan and disposed of properly in accordance with EPA requirements?
13j. Is erosion control in place? ie.. silt fence, drain screen, pump sock, filter bag etc...
13k. Has all earth work been inspected by the Competent Person prior to entering?
13l. Are precautionary measures in place for dewatering excavations?
13m. Have ALL proper permits been acquired prior to digging?
13n. Has the soil been tested by the competent person to determine classification? What means of testing was used?
13o. Is benching, shoring, sloping, or shielding required?
13p. Is shoring designed by structural engineer?
13q. Is any special insurance required, if so, has it been obtained? (RR Protective, etc..)
13r. Are measures in place to control dust, excessive tracking, mud accumulation etc.?
13s. Have any atmospheric hazards been identified?
13t. Are access & egress points in place no further than 25 feet of travel, and clear of material & debris according to standards?
14a. Is this project Interior Rehab / Addition?
14b. Have all Employee's, Sub-Contractors, & Owners / Reps been orientated to work area and expectations?
14c. Are all work areas contained / sealed off as to not affect adjacent or existing public operations?
14d. Have all suspect contaminants been tested, identified, and removed by qualified personnel?
14e. Do public walkways go through work area?
14f. Are public walkways through area properly barricaded and clearly marked as such?
14g. Any work beyond contract scope of work?
14h. Have all painted metals been tested for LEAD?
14i. All piping and insulation tested for ASBESTOS?
14j. Has all demolition work been identified?
14k. Is there an abatement plan in place for removal of contaminants prior to start of project?
15a. Will confined space work be performed on project today?
15b. Has the Safety Dept. been notified of intended Permit Required Confined Space Work?
15c. Have Permit Required Confined Spaces been identified in the written Confined Space Plan?
15d. Has a rescue plan been developed, communicated and distributed to all parties involved?
15e. Has the atmosphere been tested and accepted by the competent person?
15f. Does the attendant stationed at the space have the ability to keep in communication with those in the confined space at all times?
15g. Has the space been "declassified" to NON-PERMIT REQUIRED prior to entry using such techniques as lockout or forced air?
15h. Has the gas meter been calibrated according to manufacturer instructions?
15i. Is the meter used during the entry and re-entry (breaks & lunch) to work area assuring that the conditions remain safe?
15j. Is the person using the gas meter well trained in its use?
15k. Has the training been provided in the past 12 months for those that work with the confined spaces?
15l. Is all record keeping documentation, including corrective actions available?
15m. Are danger signs posted (or other equally effective means of communication) and maintained to inform employees about the existence, location, and dangers of permit-required confined spaces?
16a. Have all extension cords been inspected for faults in insulation, missing pins, or deformity?
16b. Have all power tools been inspected at beginning of shift for faulty triggers, guards, cords, and physical damage?
16c. Do all breaker boxes have secure doors and clearly marked / labeled with voltage contents?
16e. Are all "Knock outs" in electrical boxes covered, protected or sealed?
16e. Have all exposures to high voltage equipment been eliminated?
16f. Are switches, receptacles, etc., provided with tight-fitting covers or plates?
16g. Are all electrical outlets GFCI protected and tested according to standard?
16h. Are all power cords / lines for temp lighting secured, contiguous, and above 8 feet from walking surface?
16i. Are LOTO procedures in place and utilized for shift work at time of observation? If answer is yes, list procedures and contact persons.
17a. Inventory: Flammable Liquids are kept to a 1 day supply in production areas.
17b. Are "NO SMOKING" signs posted?
17c. Are Hot Work Permits completed correctly and valid?
17d. Is there a designated 'fire watch person' for all hot work operations?
17e. Is an annual maintenance check performed on fire extinguishers?
17f. Do Flammable Liquid Containers have a spring loaded closure device and flame arresters?
17g. Are Flammable Liquids stored in an approved flammable storage cabinet when not in use?
17h. Are the storage cabinets used to hold flammable liquids labeled "Flammable--Keep Fire Away"?
17i. Are fire extinguishers placed according to plan through out project and inspected regularly?
17j. Are Temporary Heaters being used on project, at this time?
17j I. Are all Gas Line connections secure and lines / hoses off floor?
17j II. Have all power supply cords been inspected and in good working condition?
17j III. Are heaters placed far enough away from form work and materials to avoid starting fire?
17j IIII. Were any articles of clothing placed near heaters for drying purposes? (gloves, boots, cover-alls etc..)
17j V. Are all heaters are clear of debris or any other potential fire risk?
17j VI. Is heated area enclosure materials secure? (tarps, etc..)
17j VII. Does heated area have sufficient ventilation?
17j VIII. Is the air quality of heated area measured, and documented? (list method and tool used)
17j VIIII. Is there a method of communication to repot a Fire that could potentially occur during OFF HOURS?
18a. Will welding or torch work be performed today?
18b. Are only authorized and trained personnel permitted to use welding, cutting, or brazing equipment?
18c. Is a check made for adequate ventilation in and where welding or cutting is performed?
18d. Is grounding of the machine frame and safety ground connections of portable machines checked periodically?
18e. Are compressed gas cylinders kept away from sources of heat?
18f. Are fire watchers assigned when welding or cutting is performed in locations where a serious fire might develop?
18g. Are warning signs posted around affected area?
18h. All fire extinguishing equipment that is available in work areas where welding, cutting, or heating is being performed maintained in a state of readiness for instant use?
19a. Are cylinders legibly marked to clearly identify the gas contained?
19b. Are all valve protectors always placed on cylinders when the cylinders are not in use or connected for use?
19c. Are cylinders located or stored in a manner to prevent them from creating a hazard by tipping, falling, or rolling?
19d. Are valves closed off before a cylinder is moved, when the cylinder is empty, and at the completion of each job?
19e. Do the high pressure compressed gas cylinders have the correct pressure relief valves (I.e....with relief holes)?
19f. Are Oxygen bottles stored at least 20' (minimum) away from other combustible / flammable liquids or gases?
19g. Are all gas cylinders transported in an upright position?
20a. Are stretch & flex exercises conducted at beginning of shift?
20b. We're correct lifting techniques utilized, and observed?
21a. Do you have safety data sheet for each hazardous material that you use?
21b. Are SDS available to all employees at all times?
22a. Were any House Keeping issues observed?
22b. Are there any specific areas that need continuous House Keeping Attention?
22c. Are all materials neatly stacked away from walkways?
22d. Is all debris removed from walkways, ladder access', work areas and placed in appropriate trash containers?
22e. Have all nails been removed from stripped form work, wood and other areas as to avoid puncture wounds and other potential injuries?
22f. Are walk ways designated, conspicuously marked, and kept clear to allow unhindered passage?
22g. Describe all corrective actions taken for house keeping improvements and to whom the actions were reported:
22h. List person or persons responsible for corrections and completion Date / Time:
23. Are Ladders present and being used on project?
23a. Are all ladders inspected prior to use, for damage, defects, or unusual wear?
23b. Are unsafe or damaged ladders destroyed, discarded and removed from site?
23c. Are all ladders that are in use correctly positioned and secured?
23e. Are INSTRUCTIONS, WARNING LABLES & CAPACITIES conspicuously located and legible on Extension and Step Ladders?
23f. Are all ladder access points corralled, or protected from unintentional entry?
23d. Are job made ladders built according to ANSI standard?
24a. Is site fenced in to prevent unauthorized entry?
24b. Are entry locations clear of equipment, material and debris?
24c. Are "NO TRESPASSING" and other applicable warning signs posted?
24d. Do public pathways be it road or side walk, have correct signage and barricades in place to identify designated routes?
25a. Any incidents, accidents, near misses or injuries to report today?
25c. List all NEAR MISSES, INCIDENTS, ACCIDENTS, INJURIES and any EMERGENCY RESPONSES ASSOCIATED with the project.
25d. Have all injuries been reported in 24 hours or less - initial.
25e. View Point Reference Number:
26a. Were there any issues of concern that are not listed above? (If "Yes" please describe, include corrective measures and photo's)
26b. List Corrective Actions taken for shift work today: