JMCC Safety Audit 5.0

• Date (yyyymmdd Format)

• Job Number:

• Job Name:

• Site Supervision:

• Site Safety Manager:

• Weather Conditions:

• Location
  Address

1. Site Administration

• 1a. Have all employees, subcontractor employees, and visitors completed the site orientation process and been issued a job sticker?

  YES

  NO

• Corrective Action Taken:

• 1b. Are all required Job Posters (OSHA, IDOT, DOL, etc), Ethics Notifications, and Emergency Numbers conspicuously posted?

  YES

  NO

• Corrective Action Taken:

• 1c. Are the Site Safety Manual and SDS/Hazcom Book current and readily available?

  YES

  NO

• Corrective Action Taken:

• 1d. Are First-Aid Kits readily available, stocked, and contents not expired?

  YES

  NO

• Corrective Action Taken:

• 1e. Are First-Aid/CPR trained personnel available on-site?

  YES

  NO

• Corrective Action Taken:

• 1f. Are Pre-Task Plans and/or Take-5 Books being completed on a daily and as necessary basis?

  YES

  NO

• Corrective Action Taken:

• 1g. Are weekly Toolbox Talks/Safety Trainings being held and documented?

  YES

  NO

• Corrective Action Taken:

• 1h. Are stretch and flex exercises being performed prior to the start of work and as necessary daily?

  Yes

  No

  N/A

• Corrective Action Taken:

• 1i. Is the site entrance/exit clearly identified and all informational signage(i.e. No Trespassing, PPE requirements, Office Location, etc.) in place?

  YES

  NO

• Corrective Action Taken:

• 1j. Is required informational and warning signage in place throughout the project? (i.e. EXIT, NO EXIT, Fire Extinguisher, Floor Numbers, etc)

  YES

  NO

• Corrective Action Taken:

2. Personal Protective Equipment

• 2a. Is all required company supplied PPE stocked on-site and readily available?

  YES

  NO

• Corrective Action Taken:

• 2b. Were all observed personnel wearing the required PPE at time of audit?

  YES

  NO

• Corrective Action Taken:

3. Fall Protection

• 3a. Have all identified fall from height hazards been controlled?

  YES

  NO

• Corrective Action Taken:

• 3b. Was all observed fall arrest equipment, such as, harnesses, SRLs, lanyards, and anchorages free from obvious damage and appear to be in working order?

  YES

  NO

• Corrective Action Taken:

• 3c. Were all observed guard rails (wood or cable) in place, built, and maintained according to standards?

  YES

  NO

• Corrective Action Taken:

• 3d. Were all observed holes 2" or greater in their smallest dimension securely covered and clearly marked "HOLE"?

  YES

  NO

• Corrective Action Taken:

• 3e. Are Look-out Platforms being utilized on this site?

  YES

  N/A

• 3e-1. Have all structural installation plans bee reviewed, approved, and followed for Look-out installation?

  YES

  NO

• Corrective Action Taken:

• 3e-2. Has the Look-out been maintained in accordance with JMCC policy?<br> 1. All guard rails, toe boards, and netting are in place<br> 2. SRL's are in place<br> 3. Warning, Capacity, and Allowable Access signs are posted secured and in good condition

  YES

  NO

• Corrective Action Taken:

• 3f. Were all observed impalement hazards both vertical and horizontal protected?<br> (rebar, conduit, pipe, nails, etc)

  Yes

  No

  N/A

• Corrective Action Taken:

4. Electrical

• 4a. Have all known exposures to high voltage been controlled?

  Yes

  No

  N/A

• Corrective Action Taken:

• 4b. Did all observed breaker boxes have secure doors and were clearly marked/labeled with voltage present?

  Yes

  No

  N/A

• Corrective Action Taken:

• 4c. Were all observed extension cords and power tools free from physical damage such as faults in insulation, missing grounds, missing guards, faulty triggers, etc?

  Yes

  No

  N/A

• Corrective Action Taken:

• 4d. Did all observed electrical boxes, switches, and receptacle have tight fitting cover or plates, have all "Knock Outs" or holes covered protected or sealed, and have weatherproofing where needed?

  Yes

  No

  N/A

• Corrective Action Taken:

• 4e. Were all observed electrical receptacles protected by GFCI?

  Yes

  No

  N/A

• Corrective Action Taken:

• 4f. Did all observed electrical rooms have doors, signage, and were secured to prevent unauthorized access?

  YES

  NO

• Corrective Action Taken:

• 4g. Have measures been taken to prevent exposure to and contact with overhead power lines if present? (i.e. warning signs, markers, insulators)

  Yes

  No

  N/A

• Corrective Action Taken:

5. HOT Work (Welding, cutting, burning, torch)

• 5a. Was there any work requiring a "Hot Work Permit" being performed?

  YES

  N/A

• 5a-1. Were proper permits obtained before starting the work?

  YES

  NO

• Corrective Action Taken:

• 5a-2. Was the observed hot work being performed being done in accordance with the terms of the permit? (Permit posted, fire extinguishing meathod present, fire watch utilized, area clean and flammables protected if present)

  YES

  NO

• Corrective Action Taken:

6. Fire Prevention

• 6a. Were fire extinguishers on site clearly visible and being maintained?

  YES

  NO

• Corrective Action Taken:

• 6b. Were all observed flammable liquids in approved containers such as gas cans with spring loaded closures and flame arresters, and stored in an acceptable manner when not in use?

  Yes

  No

  N/A

• Corrective Action Taken:

• 6c. Were all observed compressed gas cylinder being stored, handled, used, and transported correctly?<br>

  Yes

  No

  N/A

• Corrective Action Taken:

7. Ladders and Scaffold

• 7a. Were any ladders observed to be in use or available for use on site?

  YES

  N/A

• 7a-1. Were ladders in use or available for use observed to be free of any obvious defects, damage, or excessive wear; have all warning, instruction and capacity labels visible and legible; and be positioned, used, secured, and stored correctly?

  YES

  NO

• Corrective Action Taken:

• 7a-2. Were any observed job built ladders built in accordance with ANSI standards?

  Yes

  No

  N/A

• Corrective Action Taken:

• 7a-3. Are ladder access and landing areas free from debris and other hazards?

  YES

  NO

• Corrective Action Taken:

• 7b. Was any supported or suspended scaffold observed to be in use or available for use on site?

  YES

  N/A

• 7b-1. Was the scaffold observed to be free of any obvious defects or deficiencies?

  YES

  NO

• Corrective Action Taken:

• 7b-2. Was the scaffold built by, being inspected by, and being used by qualified persons with valid scaffold certifications?

  YES

  NO

• Corrective Action Taken:

8. Housekeeping

• 8a. Were all walkways, stairways, ladder accesses, and work areas observed to be maintained in a clean and passable fashion?

  YES

  NO

• Corrective Action Taken:

• 8b. Were stored materials observed to be neat, orderly, and secured from displacement ?

  YES

  NO

• Corrective Action Taken:

• 8c. Were there an adequate number of maintained Facilities/Porta-potties and personal hygiene/wash stations on site and accessible to meet requirements and standards?

  YES

  NO

• Corrective Action Taken:

• 8d. Have perimeter protection controls been put into place to prevent the dislodgment of materials, tools and debris?

  YES

  NO

• Corrective Action Taken:

• 8e. Are trash container readily available and maintained?

  YES

  NO

• Corrective Action Taken:

9. Cranes (Tower and Mobile)

• 9a. Were cranes observed to be in use on site?

  Select N/A Tower Mobile

  • N/A
  • Tower
  • Mobile

9a-1. Tower Crane

• 9a-1a. Have all crane planning and pre-assembly meetings taken place and been documented?

  YES

  NO

• Corrective Action Taken:

• 9a-1b. Was the crane assembled and inspected by competent and qualified personnel per governing regulations and guidelines?

  YES

  NO

• Corrective Action Taken:

• 9a-1c. Is the crane being inspected and maintenance being performed per manufacturers specification?(Daily, Periodic, Annual)

  YES

  NO

• Corrective Action Taken:

• 9a-1d. Are crane communications systems in use and functioning for all foreseen tasks?

  YES

  NO

• Corrective Action Taken:

• 9a-1e. Have security measure been taken to prevent unauthorized access and secure the crane when not in use?

  YES

  NO

• Corrective Action Taken:

9a-2. Mobile Crane

• 9a-2a. Have all crane planning and pre-assembly meetings taken place and been documented?

  YES

  NO

• Corrective Action Taken:

• 9a-2b. Was the crane assembled and inspected by competent and qualified personnel per governing regulations and guidelines?

  YES

  NO

• Corrective Action Taken:

• 9a-2c. Is the crane being inspected and maintenance being performed per manufacturers specification?(Daily, Periodic, Annual)

  YES

  NO

• Corrective Action Taken:

• 9a-2d. Are crane communications systems in use and functioning for all foreseen tasks?

  YES

  NO

• Corrective Action Taken:

• 9a-2e. Have security measure been taken to prevent unauthorized access and secure the crane when not in use?

  YES

  NO

• Corrective Action Taken:

• 9b. When observed did the crane appear to be in good operating condition and being operated in a safe manner with all safety devices in place and with due regard to personnel and surroundings?

  YES

  NO

• Corrective Action Taken:

• 9c. Are any critical lifts being performed?

  YES

  N/A

• 9c-1. Have all critical lift plans been submitted to and reviewed by all appropriate parties?

  YES

  NO

• Corrective Action Taken:

• 9c-2. Is the lift being performed in accordance with the submitted and reviewed plan?

  YES

  NO

• Corrective Action Taken:

10. Mobile and Heavy Equipment (Man Lifts, Telehandlers, Motorized Heavy Equipment)

• 10a. Was any mobile or heavy equipment observed in use on site today?

  YES

  N/A

• 10b. Is the equipment being inspected daily by a trained user/competent person and records of those inspections available?

  YES

  NO

• Corrective Action Taken:

• 10c. When observed did the equipment appear to be free from any obvious damage or defects, appear to operating correctly, and appear to be being operated with due regard to personnel and surroundings?

  YES

  NO

• Corrective Action Taken:

11. Confined Space

• 11a. Have all confined spaces on site been identified and their locations made known to all on site personnel?

  Yes

  No

  N/A

• Corrective Action Taken:

• 11b. Is any work requiring confined space entry being performed at this time?

  YES

  N/A

• 11b-1. Have all entry and other required permits been acquired prior to entry?

  YES

  NO

• Corrective Action Taken:

• 11b-2. Is the entry being performed in accordance with the terms and requirements of the permit?

  YES

  NO

• Corrective Action Taken:

12. Site Specific Conditions

• Was any work having circumstances or considerations from the response list observed?

  Select Lead Containing Substances Asbestos Containing Substances Silica Containing Substances Steel Erection Concrete Placement Excavation Work Over/Adjacent to Water Form Work and Decking Temporary Heat Rigging Demolition Post-Tensioning General Public Protection N/A Storm Water Pollution Prevention Plan

  • Lead Containing Substances
  • Asbestos Containing Substances
  • Silica Containing Substances
  • Steel Erection
  • Concrete Placement
  • Excavation
  • Work Over/Adjacent to Water
  • Form Work and Decking
  • Temporary Heat
  • Rigging
  • Demolition
  • Post-Tensioning
  • General Public Protection
  • N/A
  • Storm Water Pollution Prevention Plan

12a. Lead Containing Substances

• 12a-1. Has formal testing been performed to determine the presence of and level of lead present; and is there a written lead compliance plan in place for the project?

  YES

  NO

• Corrective Action Taken:

• 12a-2. Is all work being performed in accordance with the site lead compliance plan?

  YES

  NO

• Corrective Action Taken:

• 12a-3. Have all personnel been trained on the hazards associated with, health effects of, and the prevention of exposure lead hazards?

  YES

  NO

• Corrective Action Taken:

12b. Asbestos Containing Substance

• 12b-1. Is work on asbestos containing materials being performed by properly trained and qualified personnel?

  YES

  NO

• Corrective Action Taken:

• 12b-2. Is signage in place warning of the asbestos hazard in the area?

  YES

  NO

• Corrective Action Taken:

• 12b-3. Has proper containment with required signage been set up for asbestos work areas?

  YES

  NO

• Corrective Action Taken:

• 12b-4. Have provisions been made for proper disposal of generated waste? (waste properly bagged and in special waste/waste specific containers)

  YES

  NO

• Corrective Action Taken:

12c. Silica Containing Substances

• 12c-1. Is there a silica exposure control plan in place, has that plan been reviewed by all involved parties, and is work being performed in accordance with the plan?

  YES

  NO

• Corrective Action Taken:

• 12c-2. Are barricades and signage in place warning of the presence of a silica hazard?

  YES

  NO

• Corrective Action Taken:

• 12c-3. Are dust control measure such as wetting, HEPA vaccuum, and respiratory protection in place and appear to be functioning?

  YES

  NO

• Corrective Action Taken:

12d. Steel Erection

• 12d-1. Has a written steel erection plan been provided and a pre-erection plan review meeting been held?

  YES

  NO

• Corrective Action Taken:

• 12d-2. Have required concrete strength results been provided to the steel erector prior to the start of erection?

  YES

  NO

• Corrective Action Taken:

• 12d-3. Have any anchor bolts been repaired or modified?

  YES

  N/A

• 12d-4. Have repairs or modifications been approved by the structural engineer of record?

  YES

  NO

• Corrective Action Taken:

• 12d-5. Has the area beneath the erection been outfitted with signage and barriers to prevent entry and overhead protection provided to prevent falling objects and fire?

  YES

  NO

• Corrective Action Taken:

12j. Form Work and Decking

• 12j-1. Is there a plan in place for form and decking work, has that plan been reviewed by all involved parties, and is work being performed in accordance with the plan?

  YES

  NO

• Corrective Action Taken:

• 12j-2. Were all deck panels observed to be in place and secure? (no open holes or unsecured patches)

  Yes

  No

  N/A

• Corrective Action Taken:

• 12j-3. Were observed tables, framing, forms and panels clean and free of loose debris prior to hoisting?

  Yes

  No

  N/A

• Corrective Action Taken:

• 12j-4. Were observed re-shore devices secured, tied back, and tight?

  Yes

  No

  N/A

• Corrective Action Taken:

• 12j-5. Were self climbing forms observed to be clean and power cables managed and protected?

  Yes

  No

  N/A

• Corrective Action Taken:

• 12j-6. Were core and shear wall perimeter protection and anchor points observed to be in place?

  Yes

  No

  N/A

• Corrective Action Taken:

12e. Concrete Placement

• 12e-1. Is there a plan in place for concrete placement, has the plan been reviewed by all involved parties, and is work being performed in accordance with the plan?

  YES

  NO

• Corrective Action Taken:

• 12e-2. Are personnel placing concrete wearing additional required PPE to prevent exposure to concrete? (gloves, splash protective apparel, rubber boots)

  YES

  NO

• Corrective Action Taken:

• 12e-3. Are adequately supplied wash stations and eye wash available?

  YES

  NO

• Corrective Action Taken:

12f. Excavation, Trenching, Ground Displacement

• 12f-1. Has a ground disturbance permit been submitted, reviewed and the excavation being performed in accordance with the provisions of that permit?<br>

  YES

  NO

• Corrective Action Taken:

• 12f-2. Will personnel be entering the excavation?

  YES

  N/A

• 12f-3. Has the excavation been properly protected by benching, sloping, shielding or shoring?

  YES

  NO

• Corrective Action Taken:

• 12f-4. Is the excavation dry and/or precautionary measures are in place for dewatering?

  YES

  NO

• Corrective Action Taken:

• 12f-5. Are access and egress points present and in accordance with standards?

  YES

  NO

• Corrective Action Taken:

• 12f-3. Is there a plan in place to protect open excavations? (immediate backfill, fence, barricades, handrail, etc)

  YES

  NO

• Corrective Action Taken:

12g. Storm Water Pollution Prevention Plan (SWPPP)

• 12g-1. Is there a written SWPPP and is it readily available for review?

  YES

  NO

• Corrective Action Taken:

• 12g-2. Are require inspections being preformed in accordance with the SWPPP? (weekly, monthly, rain fall event)

  YES

  NO

• Corrective Action Taken:

• 12g-3. Are required BMP's and devices(straw logs, socks, silt fence, catch bags, etc) in place and not in need of maintenance?

  YES

  NO

• Corrective Action Taken:

12h. Work Over or On Water

• 12h-1. Is there a plan in place for work on and over water, has that plan been reviewed by all involved parties, and is work being performed in accordance with that plan?

  YES

  NO

• Corrective Action Taken:

• 12h-2. Are rescue buoys and/or rescue boats on site, in place, and in working order (supplied with rescue equipment for boats)?

  YES

  NO

• Corrective Action Taken:

• 12h-3. Are floatation devices being supplied, inspected, and used correctly?

  YES

  NO

• Corrective Action Taken:

12i. Temporary Heat

• 12i-1. Are gas and power lines and connections in good condition and laid out in a manner which protects both the lines from damage as well as maintains clear access and egress?

  Yes

  No

  N/A

• Corrective Action Taken:

• 12i-2. Do heaters have sufficient air supply and are atmospheric conditions being monitored to insure so?

  YES

  NO

• Corrective Action Taken:

• 12i-3. Are heaters guarded and positioned far enough from materials, debris and work to prevent fires or damage?

  YES

  NO

• Corrective Action Taken:

12m. Rigging

• 12m-1. Are all personnel performing rigging operations trained in accordance with applicable standards and requirements and have proof of that training on hand?

  YES

  NO

• Corrective Action Taken:

• 12m-2. Did all observed slings and lifting appliances appear to be in good shape and have load limit tags in place and legible?

  YES

  NO

• Corrective Action Taken:

• 12m-3. Were all observed hooks free from obvious deformities and have safety latches as required?

  YES

  NO

• Corrective Action Taken:

12k. Demolition

• 12k-1. Is there a demolition plan in place, has the plan been reviewed by all required parties, and has a pre-demolition meeting been held with all involved parties?

  YES

  NO

• Corrective Action Taken:

• 12k-2. Are dust control measures in place (wetting, negative air filter, etc) and do the measure appear to be effective?

  YES

  NO

• Corrective Action Taken:

12l. Post-Tensioning

• 12l-1. Is there a post-tensioning plan in place and has the plan been reviewed with all involved parties?

  YES

  NO

• Corrective Action Taken:

• 12l-2. Have all required signs, barricades, and warning devices been put in place prior to the start of operations?

  YES

  NO

• Corrective Action Taken:

12n. General Public Protection

• 12n-1. Does work intersect the public side walk?

  YES

  N/A

• 12n-1a. Are required signage and barricades in place? (Sidewalk Closed, Warning Overhead Work, Uneven Pavement, etc)

  YES

  NO

• Corrective Action Taken:

• 12n-1b. Are sidewalk canopies in place and maintained (clear walk area, overhead protection complete, lights where required)?

  YES

  NO

• Corrective Action Taken:

• 12n-2. Does work effect the public roadway?

  YES

  N/A

• 12n-2a. Are required signage and barricades in place?

  YES

  NO

• Corrective Action Taken:

• 12n-2b. Are flaggers in use as required trained and equipped to applicable standards and requirements?

  YES

  NO

• Corrective Action Taken:

13. General Duty Safety Observations

• 13a. Were other observations or miscellaneous findings that pose a potential hazard discovered during the audit process?

  YES

  N/A

• Note Observed Condition or Action:

• Corrective Action Taken:

14. Incidents

• 14a. Were there any near miss, property damage or personal injury incidents to report today?

  YES

  N/A

• Viewpoint Reference Number:

• Incident Description:

15. Preventative, Corrective, and Disciplinary Actions

• 15a. Were there any preventative, corrective, or disciplinary actions not previously noted taken today?

  YES

  N/A

• Description of Action Taken:

Audit Conducted By

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