Jobsite Safety Assessment

• Job Number

• Job Name

• Job Location
  Address

• Project Superintendent

• Project Foreman

• Subcontractors

• Conducted on

  Date

• Conducted by

• Additional Attendees:

A. Posters and Records

• A1. OSHA and EEO posters appropriate and current

  Safe

  At Risk

  N/A

• A2. Emergency numbers posted with directions

  Safe

  At Risk

  N/A

• A.3. OSHA regulations and blank accident reports on site

  Safe

  At Risk

  N/A

• A.4. MSDS accessible and inclusive of job materials

  Safe

  At Risk

  N/A

• A.5. Supervisors holding daily & weekly safety meetings

  Safe

  At Risk

  N/A

• A.6. Site specific reviewed and signed by each employee

  Safe

  At Risk

  N/A

B. Housekeeping and Sanitation

• B.1. General Housekeeping of Jobsite

  Safe

  At Risk

  N/A

• B.2. Is area provided for waste and trash?

  Safe

  At Risk

  N/A

• B.3. Is waste/trash regularly removed from Jobsite?

  Safe

  At Risk

  N/A

• B.4. Materials of all types properly stacked

  Safe

  At Risk

  N/A

• B.5. Hoses, cables, and cords routed away from traveled routes

  Safe

  At Risk

  N/A

• B.6. Nails removed from scrap lumber

  Safe

  At Risk

  N/A

• B.7. Toilet facility adequate and clean

  Safe

  At Risk

  N/A

• B.8. Adequate supply of drinking water

  Safe

  At Risk

  N/A

C. Fire Protection

• C.1. Are "No Smoking" and "Flammable" signs posted?

  Safe

  At Risk

  N/A

• C.2. Fire extinguishers present in trailers, vehicles, fueling stations, and equipment. Are they current?

  Safe

  At Risk

  N/A

• C.3. Are approved containers used for flammables

  Safe

  At Risk

  N/A

• C.4. Are containers / cylinders properly labeled

  Safe

  At Risk

  N/A

• C.5. Are containers stored in approved fuel boxes

  Yes

  No

  N/A

• C.6. Fuel tanks doubled walled / diked and protected from collision?

  Safe

  At Risk

  N/A

• C.7. Fire extinguisher stored at least 25' but no further than 75' from fueling stations

  Safe

  At Risk

  N/A

D. First Aid / CPR

• D.1. First aid kits available in all trailers and company vehicles

  Safe

  At Risk

  N/A

• D.2. First aid kits well stocked

  Safe

  At Risk

  N/A

• D.3. Supervisor on site trained in first aid / CPR

  Safe

  At Risk

  N/A

E. Personal Protective Equipment

• E.1. Safety glasses with side shields being worn by all employees, subcontractors, and suppliers on site

  Safe

  At Risk

  N/A

• E.2. Approved hard hats, with bill facing forward, being worn by all employees, subcontractors, and suppliers on site.

  Safe

  At Risk

  N/A

• E.3. Safety-toe boots worn by all supervisors and employees employed for one year or longer

  Safe

  At Risk

  N/A

• E.4. Face shield being worn when needed (chipping, grinding, chop saw, chain saw, blow pipe, etc.)

  Safe

  At Risk

  N/A

• E.5. Chaps used when running chainsaw

  Safe

  At Risk

  N/A

• E.6. Metatarsal guards used with whackers and air tampers

  Safe

  At Risk

  N/A

• E.7. Respiratory protection used when appropriate

  Safe

  At Risk

  N/A

• E.8. Appropriate gloves worn when working with hazardous chemicals, temperatures, and materials

  Safe

  At Risk

  N/A

• E.9. Hearing protection used when working with, or in the vicinity of, loud tools and equipment

  Safe

  At Risk

  N/A

• E.10. Is clothing appropriate (4" sleeves, long pants, etc.)

  Safe

  At Risk

  N/A

F. Tools and Equipment

• F.1. All tools properly inspected before use

  Safe

  At Risk

  N/A

• F.2. Damaged or broken tools tagged out of service

  Safe

  At Risk

  N/A

• F.3. Appropriate tools being used, tools being used as intended

  Safe

  At Risk

  N/A

• F.4. Operative guards on all power tools

  Safe

  At Risk

  N/A

• F.5. Air hose connections properly fastened and secured with whip checks, clips, or wire

  Safe

  At Risk

  N/A

• F.6. Air compressors equipped with safety check valve

  Safe

  At Risk

  N/A

• F.7. All portable equipment secured (tongue lock, wheel removed)

  Safe

  At Risk

  N/A

• F.8. Tow chains adequate on trailers, compressors, etc. Do the hooks have safety latches?

  Safe

  At Risk

  N/A

G. Electrical and Utilities

• G.1. Assured Grounding Program implemented and current

  Safe

  At Risk

  N/A

• G.2. Cords and tools properly used and protected

  Safe

  At Risk

  N/A

• G.3. GFCIs on outlets and generators functioning properly

  Safe

  At Risk

  N/A

• G.4. Overhead and underground utilities identified with warning signs

  Safe

  At Risk

  N/A

• G.5. Proper distance maintained from electrical lines - 10' min 50kV or less and 4" for each additional 10kV (Non Crane Operations)

  Safe

  At Risk

  N/A

• G.6. Distribution boxes covered and marked

  Safe

  At Risk

  N/A

H. Access and Walking / Working Surfaces

• H.1. Stairs, ramps, or ladders installed at breaks in elevation greater than 19"

  Safe

  At Risk

  N/A

• H.2. Stair riser height and tread depth uniform within 1/4"

  Safe

  At Risk

  N/A

• H.3. Handrails provided on each unprotected edge of stairways having 4 or more risers or rising more than 30"

  Safe

  At Risk

  N/A

• H.4. Handrails installed 36" high from the face of the tread

  Safe

  At Risk

  N/A

• H.5. 20" provided beyond swing of door on stairway platforms (when door opens directly over stairs)

  Safe

  At Risk

  N/A

• H.6. Stairs free from debris and slippery surfaces

  Safe

  At Risk

  N/A

• H.7. Ladders properly constructed and free of defects

  Safe

  At Risk

  N/A

• H.8. Ladders installed on level surfaces at a 4 to 1 ratio vertical / horizontal and secured from movement

  Safe

  At Risk

  N/A

• H.9. Ladders extend 3' above landing or grab rail provided

  Safe

  At Risk

  N/A

• H.10. Stepladders level and used with spreader locks engaged

  Safe

  At Risk

  N/A

• H.11. 3-points of contact maintained when using all ladders

  Safe

  At Risk

  N/A

• H.12. Job-made ladders constructed properly and with filler blocks

  Safe

  At Risk

  N/A

• H.13. Ramps installed no steeper than 3 horizontal to 1 vertical

  Safe

  At Risk

  N/A

• H.14. Cleats provided every 14" on ramps steeper than 8 to 1

  Safe

  At Risk

  N/A

• H.15. Walking / working surfaces free of trip and slip hazards

  Safe

  At Risk

  N/A

• H.16. Hazards such as plastic sheeting, burlap, concrete blankets, etc. removed from walking / working surfaces as necessary

  Safe

  At Risk

  N/A

• H.17. Adequate lighting in walkways and work areas

  Safe

  At Risk

  N/A

• H.18. Walkways, platforms, and ramps at least 18" wide

  Safe

  At Risk

  N/A

• H.19. Walkway holes / openings properly covered and marked "Hole" or "Cover". Are covers adequately secured?

  Safe

  At Risk

  N/A

I. Fall Protection

• I.1. Employees donning fall protection equipment have been trained in accordance with OSHA standards

  Safe

  At Risk

  N/A

• I.2. 100% fall protection being utilized at 6'

  Safe

  At Risk

  N/A

• I.3. Fall protection systems and equipment properly inspected and maintained

  Safe

  At Risk

  N/A

• I.4. Equipment being worn properly. D-ring between shoulder blades, chest strap 6-8" below trachea, etc.

  Safe

  At Risk

  N/A

• I.5. Fall protection anchorages meet 5,000 lbs.

  Safe

  At Risk

  N/A

• I.6. Guardrail systems installed between 39-45" with no gaps between rails (top, mid, toe) greater then 19"

  Safe

  At Risk

  N/A

• I.7. Warning lines installed 6' from edge, at 34-39" high and flagged or painted every 6' with highly visible material

  Safe

  At Risk

  N/A

• I.8. Employees anchored to prevent free fall greater than 6'

  Safe

  At Risk

  N/A

• I.9. Are wire rope clips installed properly on cable systems

  Safe

  At Risk

  N/A

• I.10. Protection provided on projection hazards (rebar, all-thread, etc.)

  Safe

  At Risk

  N/A

• I.11. Toe boards 3-1/2" high installed for falling object protection

  Safe

  At Risk

  N/A

J. Traffic Control

• J.1. Certified Traffic Control Supervisor on site

  Safe

  At Risk

  N/A

• J.2. Flagger(s) certified (training card present) and performing duties properly

  Safe

  At Risk

  N/A

• J.3. All construction signage visible and properly secured

  Safe

  At Risk

  N/A

• J.4. All workers wearing min. class 2 vest, shirt, or jacket. Are they in good condition?

  Safe

  At Risk

  N/A

• J.5. Employees protected by crash trucks where needed

  Safe

  At Risk

  N/A

K. Welding and Cutting

• K.1. Proper IR eye protection in use, #5 min. face shield, glasses, or goggles for cutting, #10 shade min. for arc welding

  Safe

  At Risk

  N/A

• K.2. Gauges, valves, torches, and lines in good condition and free from grease and oil

  Safe

  At Risk

  N/A

• K.3. Cylinders (oxygen, acetylene, propane, etc.) not in use capped and secured upright

  Safe

  At Risk

  N/A

• K.4. Anti-flashback valves installed at gauges. Are covers in place on gauge faces?

  Safe

  At Risk

  N/A

• K.5. Is stored oxygen separated from fuel / gas / oil by 20' or a 5' fire barrier

  Safe

  At Risk

  N/A

• K.6. Fire extinguishers at welding or cutting areas, are they current?

  Safe

  At Risk

  N/A

• K.7. Flammable materials removed from the hot work area

  Safe

  At Risk

  N/A

• K.8. Welding leads undamaged within 10' of cable end

  Safe

  At Risk

  N/A

• K.9. Acetylene operated at no greater than 15 psi

  Safe

  At Risk

  N/A

• K.10. Fuel gas cylinder valves opened no more than 1-1/2 turns

  Safe

  At Risk

  N/A

• K.11. Adequate ventilation provided

  Safe

  At Risk

  N/A

L. Heavy Equipment and Vehicles

• L.1. Are all operators qualified / competent for the piece of equipment / machinery being used

  Safe

  At Risk

  N/A

• L.2. Seat belts being utilized

  Safe

  At Risk

  N/A

• L.3. Is equipment being operated at safe speeds

  Safe

  At Risk

  N/A

• L.4. Equipment used per manufacturers specifications

  Safe

  At Risk

  N/A

• L.5. All loads, buckets, forks, blades lowered to ground or other surface when the operator is not present in the equipment

  Safe

  At Risk

  N/A

• L.6. Horns and back-up alarms working properly

  Safe

  At Risk

  N/A

• L.7. Spotters utilized, as needed

  Safe

  At Risk

  N/A

• L.8. Engines off when refueling / lubricating

  Safe

  At Risk

  N/A

• L.9. Vehicle / equipment cabs free of excessive trash, dirt, and debris

  Safe

  At Risk

  N/A

• L.10. Windows clean and undamaged

  Safe

  At Risk

  N/A

• L.11. Equipment in good working order and operated safely

  Safe

  At Risk

  N/A

• L.12. Manuals in all equipment or on site

  Safe

  At Risk

  N/A

• L.13. Owners card, insurance card, accident report, camera, first aid kit, and fire ext. in each registered vehicle

  Safe

  At Risk

  N/A

• L.14. Security club being used on all vehicles parked overnight

  Safe

  At Risk

  N/A

• L.15. All drivers have approved MVR

  Safe

  At Risk

  N/A

• L.16. Company Vehicle Policy being followed

  Safe

  At Risk

  N/A

• L.17. Orange beacon light and construction sign on company vehicles entering and exiting highway work zones

  Safe

  At Risk

  N/A

M. Trenches and Excavations

• M.1. Excavation checklist completed by competent person

  Safe

  At Risk

  N/A

• M.2. Utilities contacted and located prior to digging

  Safe

  At Risk

  N/A

• M.3. 24" tolerance zone being observed around all suspected utilities, no mechanical digging performed within zone.

  Safe

  At Risk

  N/A

• M.4. Trenches deeper than 5' properly sloped, benched, or protected

  Safe

  At Risk

  N/A

• M.5. Access / egress provided in excavations deeper than 4' and within 25' of employee travel

  Safe

  At Risk

  N/A

• M.6. Spoil piles, tools, and equipment placed at least 2' from excavation

  Safe

  At Risk

  N/A

• M.7. Trench box no greater than 2' from bottom of trench and extending at least 18' above ground, when required

  Safe

  At Risk

  N/A

• M.8. Walkways used when crossing over excavations greater than 30"

  Safe

  At Risk

  N/A

• M.9. Walkways equipped with approved guardrails when crossing over excavations deeper than 6'

  Safe

  At Risk

  N/A

• M.10. Tabulated data sheets on site for trench box

  Safe

  At Risk

  N/A

• M.11. Excavation free of hazardous atmospheres and standing water

  Safe

  At Risk

  N/A

N. Crane and Rigging

• N.1. Daily and annual inspection current

  Safe

  At Risk

  N/A

• N.2. Operator qualified, CCO

  Safe

  At Risk

  N/A

• N.3. Crane set up level within 1 degree

  Safe

  At Risk

  N/A

• N.4. Blocking / cribbing adequate size min. 4" thick with no span blocking > 1"

  Safe

  At Risk

  N/A

• N.5. Swing radius barricaded from entry and free from personnel / equipment while crane is in operation

  Safe

  At Risk

  N/A

• N.6. Tires completely free of ground when outriggers are used

  Safe

  At Risk

  N/A

• N.7. Operation manual and load chart in cab

  Safe

  At Risk

  N/A

• N.8. Rigging equipment in a safe condition and stored properly

  Safe

  At Risk

  N/A

• N.9. Rigging equipment of sufficient capacity for lift

  Safe

  At Risk

  N/A

• N.10. Safe rigging techniques being used to prevent loss of load

  Safe

  At Risk

  N/A

• N.11. Taglines used on all overhead loads

  Safe

  At Risk

  N/A

• N.12. Sharp edges protected to prevent sling damage

  Safe

  At Risk

  N/A

• N.13. Is material rigged to center of gravity

  Yes

  No

  N/A

• N.14. Are working safety latches installed on all hooks

  Safe

  At Risk

  N/A

• N.15. Are employees kept clear of suspended loads

  Safe

  At Risk

  N/A

• N.16. Proper hand signals / communication being used to control cranes movement

  Safe

  At Risk

  N/A

• N.17. Proper distances maintained from all overhead obstructions

  Safe

  At Risk

  N/A

• N.18. 20' maintained on all lines < 350kV and 50' on all lines >350kV

  Safe

  At Risk

  N/A

O. Marine Activities and Working Over or Near Water

• O.1. 30" ring buoy provided every 200' with at least 90' of line

  Safe

  At Risk

  N/A

• O.2. Air horns located with ring buoys

  Safe

  At Risk

  N/A

• O.3. Life saving skiff available and readily accessible

  Safe

  At Risk

  N/A

• O.4. Does skiff contain a fire ext., ring buoy, air horn, life jackets, anchor, retrieval hook, first aid kits, and oars?

  Safe

  At Risk

  N/A

• O.5. Skiff operator properly trained and daily inspection completed.

  Safe

  At Risk

  N/A

• O.6. Life jackets / work vests worn by all employees where there is a potential for downing. Are they properly zipped / fastened?

  Safe

  At Risk

  N/A

• O.7. 3' clear area maintained on the outer perimeter of all floating plants

  Safe

  At Risk

  N/A

• O.8. All barge obstructions painted with high-visibility paint

  Safe

  At Risk

  N/A

• O.9. Spud holes and deck hatch covers properly covered and secured

  Safe

  At Risk

  N/A

• O.10 Barges free of water and loaded adequately

  Safe

  At Risk

  N/A

• O.11. Man-overboard drills completed as needed

  Safe

  At Risk

  N/A

• O.12. Jacobs ladder extending to water level provided on each floating plant

  Safe

  At Risk

  N/A

• O.13. All floating equipment properly secured, ropes in good condition

  Safe

  At Risk

  N/A

P. Pile Driving and Drilling

• P.1. Hammer lowered while leads / crane being moved

  Safe

  At Risk

  N/A

• P.2. Hammer blocked or secured when working under it

  Safe

  At Risk

  N/A

• P.3. Personnel clear of piles being hoisted into leads

  Safe

  At Risk

  N/A

• P.4. Pile heads cut square and free of frozen material or debris

  Safe

  At Risk

  N/A

• P.5. Lead feet securely anchored during battered pile installation

  Safe

  At Risk

  N/A

• P.6. Lead gates or template being provided to control pile in leads

  Safe

  At Risk

  N/A

• P.7. Hearing protection worn while driving piles

  Safe

  At Risk

  N/A

• P.8. Fall protection provided around drilled holes / caissons

  Safe

  At Risk

  N/A

• P.9. Surrounding area / excavation safe against vibration hazards

  Safe

  At Risk

  N/A

Q. Silica and Concrete Work

• Q.1. Engineering controls being used to minimize silica exposure

  Safe

  At Risk

  N/A

• Q.2. Dust masks / respirators being worn where dust is created

  Safe

  At Risk

  N/A

• Q.3. All non-required personnel clear of silica dust area

  Safe

  At Risk

  N/A

• Q.4. Eating, drinking, and smoking performed outside of silica dust area

  Safe

  At Risk

  N/A

• Q.5. Wash station on site and available in immediate work area

  Safe

  At Risk

  N/A

• Q.6. Skin protected while working with wet concrete or dust

  Safe

  At Risk

  N/A

R. Confined Space Work

• R.1. Training performed in accordance with OSHA Standards

  Safe

  At Risk

  N/A

• R.2. Monitoring being performed for atmospheric hazards

  Safe

  At Risk

  N/A

• R.3. Entry permit completed and authorized prior to entry

  Safe

  At Risk

  N/A

• R.4. Attendant positioned at entry portal and is portal protected

  Safe

  At Risk

  N/A

• R.5. Rescue equipment on site and procedures established, local rescue team notified

  Safe

  At Risk

  N/A

• R.6. Ventilation being provided, as needed

  Safe

  At Risk

  N/A

• R.7. Communication established between entrants and attendant

  Safe

  At Risk

  N/A

• R.8. Accurate count / log maintained of personnel within space

  Safe

  At Risk

  N/A

• R.9. Combustion engines and flammable materials stored away from space

  Safe

  At Risk

  N/A

S. Lead Work

• S.1. Lead paint chip analyzed before beginning work

  Safe

  At Risk

  N/A

• S.2. Lead trailer or wash station on site and available in immediate working area. Is the lead trailer adequately stocked with rags, water, soap, duct tape, clean lead suits, etc.

  Safe

  At Risk

  N/A

• S.3. All lead burners medical surveillance and training up to date

  Safe

  At Risk

  N/A

• S.4. Curtains or doors installed between lead trailer rooms

  Safe

  At Risk

  N/A

• S.5. Container provided for dirty lead suits, lid closed at all times

  Safe

  At Risk

  N/A

• S.6. "Lead Contaminated Clothing" sign posted

  Safe

  At Risk

  N/A

• S.7. Lead exposure monitoring conducted for each task

  Safe

  At Risk

  N/A

• S.8. "Lead Work Area" sign(s) posted prior to burning

  Safe

  At Risk

  N/A

• S.9. Lead suits and respirators worn properly

  Safe

  At Risk

  N/A

• S.10. Engineering controls being used to minimize exposure

  Safe

  At Risk

  N/A

• S.11. All non-required personnel clear of lead fume area

  Safe

  At Risk

  N/A

• S.12. Eating, drinking and smoking performed outside of lead work area and only performed after appropriate cleaning

  Safe

  At Risk

  N/A

T. Subcontractors

• T.1. Site specific safety document reviewed and signed by each subcontractor employee

  Safe

  At Risk

  N/A

• T.2. Fay policies are being followed

  Safe

  At Risk

  N/A

• T.3. Weekly safety meetings being held and collected by Fay superintendent

  Safe

  At Risk

  N/A

JB Fay Summary Sheet

• Tools/Equipment Removed From Service

• Items Issued by Safety Personnel

• Remaining Safety Issues

• All Remaining Safety Issues Corrected

  Yes

  No

• Date All Remaining Safety Issues Corrected

  Date

Signatures

• Safety Personnel

  Sign

• Superintendent/Foreman

  Sign