1. Working at Heights

  • 1.1. Is there a fall risks of 6 feet or more? (including voids, pits, and trenches)

  • 1.2. Is there edge protection?

  • 1.3. Is the edge protection unsafe or incomplete?

2. Equipment

  • 2.1. Is there any unsafe or damaged equipment? (missing or damaged guards, etc.)

  • 2.2. Is the right or correct equipment on hand?

  • 2.3. All attachments used with equipment are approved and correct?

  • 2.4. Are all operators licensed or designated (properly trained and documented)?

  • 2.5. Are all required inspection regimes followed?

3. Scaffolds

  • 3.1. Are qualified persons erecting scaffold above 12 feet?

  • 3.2. Are all scaffold inspected and tagged before use?

  • 3.3. Is there procedures in affect to insure incompatible scaffold components are not used together?

  • 3.5. Is the Safe Work Load (SWL) for the scaffold exceeded? (tools, stored materials, number of persons)

4. Lifting Equipment

  • 4.1. Is any of the equipment unsafe, damaged or unlabeled?

  • 4.2. Are loads lifted over persons or close proximity to obstacles incl. overhead power lines?

  • 4.3. Is the maintenance, testing or inspection documentation available?

  • 4.4. Is Safe Working Load (SWL) information displayed?

  • 4.5. Is daily inspection worksheet available and current for equipment requiring it?

  • 4.6. Are unsafe or damaged lifting equipment, including ropes, slings, chains, hooks disposed of as soon as they are discovered?

  • 4.7. Are all operators licensed, trained and documented?

5. Harness and Equipment

  • 5.1. Is there any unsafe or damaged fall protection equipment?

  • 5.2. Is there any incompatible hooks/equipment being used?

  • 5.3. Is all fall protection properly marked, labeled and does it meet ANSI Standards?

  • 5.4. Are only safe anchor points being used?

  • 5.5. Are monthly inspection for equipment being completed and documented?

6. Ladders

  • 6.1. Any unsafe or damaged ladders on the job site?

  • 6.2. Is the positioning of ladders safe?

  • 6.3. Is the ladder properly secured or held when in use?

  • 6.4. Is the ladder unsuitable for job? (e.g. metal ladder used for electrical work)

7. Hazardous Manual Tasks

  • 7.1. After the identification of a hazardous manual task, is there a crew assessment and discussion of how to do it safely?

  • 7.2. Is the hazardous manual task identified on the PTP (Pre task plan) ?

  • 7.3. Are there adequate risk controls? (examples: job rotation, lighter loads, trolleys, lifting equipment, etc)

  • 7.4. Has the crew received training in risk controls and safe lifting/ team lifting techniques?

8. Hazardous Communication

  • 8.1. Are flammables and combustibles placed in a safe storage location? (e.g. flammables near ignition sources, spills could enter stormwater drains, etc)

  • 8.2. Are incompatible chemicals stored near each other?

  • 8.3. Is there adequate spill containment materials and equipment readily available?

  • 8.4. Are Material Safety Data Sheets accessible on site?

  • 8.5. Are there established emergency procedures for injury/spills/fire etc?

  • 8.6. Are there excessive quantities stored on site or in vehicles?

  • 8.7. Is there sufficient ventilation around the work and storage area for the material being used?

  • 8.8. Is the correct PPE being used for the chemicals in use?

  • 8.9. Are all storage containers correctly labeled?

9. Emergency Response

  • 9.1. Is there an emergency plans for site?

  • 9.2. Are the emergency procedures displayed at site?

  • 9.3. Is there adequate training and rehearsal of emergency plans?

  • 9.4. Is there adequate first aid kits aid equipment for site? (To include AED's)

  • 9.5. Are there sufficient and good access to formally trained First Aiders for all shifts?

  • 9.6. Is there suitable or adequate communication equipment?

10. Personal Protective Equipment (PPE)

  • 10.1. Is there adequate PPE (including sun protection) for the job task(s)?

  • 10.2. Is there an established system to issue, inspect, replace and monitor PPE?

  • 10.3. Is there training in safe use, clean-up and inspection of PPE?

11. Work Environment

  • 11.1. Are there adequate amenities? (toilets, wash areas, lunch rooms, etc)

  • 11.2. Is there sufficient lighting for the work to be accomplished?

  • 11.3. Adequate housekeeping?

  • 11.4. Adequate noise/ vibration control?

12. Electrical Hazards

  • 12.1. Safe electrical cords? (None damaged, out of test date or untested)

  • 12.2. No overloading outlets?

  • 12.3. Are cords placed on working surfaces or on metal structures?

  • 12.4. At the job site can any electrical cords be damaged from contact with moving machinery parts?

  • 12.5. Are there Lock-out/Tag-out (LOTO) procedures for electrical equipment?

13. Administrative Procedures

  • 13.1. Adequate Site Safety Plan?

  • 13.2. Crew obtain required permits (PTP, Hot Works, Confined Space etc)

  • 13.3 Orientation for workers, contractors, visitors?

  • 13.4. Adequate, supervisory arrangements?

  • 13.5. Adequate training, licenses, skills, experience?

  • 13.6. Adequate Pre-Task Plan (PTP) or Job Safety Analysis (JSA) for high- risk work?

Corrective Actions

  • Comments:

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