Jobsite Safety Inspection Report

• Site conducted

• Conducted on

  Date

• Prepared by

• Superintendent in Charge

• Weather Conditions & Temperature (AM & PM)

• DOL/OSHA Required Poster Posted

  Yes

  No

  N/A

• Emergency Action Plan Posted

  Yes

  No

  N/A

• Safety Department & Project Management Phone Numbers Posted

  Yes

  No

  N/A

• Employee CPR/FA trained on site

  Yes

  No

  N/A

• Fully stocked First Aid Kit Available

  Yes

  No

  N/A

• First Aid Kit in date

  Yes

  No

  N/A

• PPE for rendering First Aid available? Exam gloves, face shield, cpr mask

  Yes

  No

  N/A

• Eye wash stations available within 10 seconds walk of employees performing work that produces flying debris (pouring concrete, cutting wood/rebar)

  Yes

  No

  N/A

• Emergency Eye Wash station inspected?

  Yes

  No

  N/A

• Eye wash station fluid in date?

  Yes

  No

  N/A

• Fluid Changed? replaced with potable water and eye wash solution concentrate

  Yes

  No

  N/A

• Access to drinking water (cold water in hot weather)

  Yes

  No

  N/A

• Restrooms available and clean

  Yes

  No

  N/A

• PTP filled out correctly and being used

  Good

  Fair

  Poor

  N/A

• CAZ properly barricaded and signage on all sides (signs should include: name of responsible party, phone number and company name, hazard inside of CAZ)

  Yes

  No

  N/A

• Required permits filled out and available (Excavation, hot work, confined space, ladder, concrete pump)

  Yes

  No

  N/A

• Competent person on site and inspecting frequently

  Yes

  No

  N/A

• Superintendent notified? Who

• Are there enough personnel to complete the tasks safely for the day?

  Yes

  No

  N/A

HOUSEKEEPING

• Is there General neatness of the work area?

  Good

  Fair

  Poor

  N/A

• Are projecting nails removed?

  Yes

  No

  N/A

• Are waste containers provided and used?

  Yes

  No

  N/A

• Are passageways and walkways clear

  Good

  Fair

  Poor

  N/A

• Is lighting adequate?

  Yes

  No

  N/A

• Is the lay down yard near and organized? (Rebar caps on verticals)

  Yes

  No

  N/A

FIRE PREVENTION

• Are there adequate fire extinguishers that are accessible and inspected (monthly/annually)

  Yes

  No

  N/A

• Are flammable liquids stored properly

  Yes

  No

  N/A

• Flammable Cabinet clear of items stored on top?

  Yes

  No

  N/A

• Bulk flammable storage and/or bulk fueling tank area have at least a 20lb ABC extinguisher no closer than 25ft and not farther than 75ft of the storage area?

  Yes

  No

  N/A

• Are no smoking signs posted and enforced.

  Yes

  No

  N/A

• Combustibles stored away from flammables?

  Yes

  No

  N/A

• Are funnels being used when refilling equipment

  Yes

  No

  N/A

• Is equipment shut down while fueling?

  Yes

  No

  N/A

• Is propane stored at least 25’ from occupied structures?

  Yes

  No

  N/A

ELECTRICAL

• All power cords inspected for frays, bare wires, missing ground pins or other damage?

  Yes

  No

  N/A

• Any cords taken out of service?

  Yes

  No

  N/A

• Are GFCI being used?

  Yes

  No

  N/A

• Are terminal boxes equipped with required covers?

  Yes

  No

  N/A

• Are flexible cords protected from damage (not being run over by equipment, shut in doors etc)

  Yes

  No

  N/A

• Are cords suspended above wet areas or areas with standing water?

  Yes

  No

  N/A

• Are generators inspected and grounded

  Yes

  No

  N/A

• Are multiple cords connected together (Daisey Chained)?

  Yes

  No

  N/A

• cords removed from service?

  Yes

  No

  N/A

• Are multi outlet splitters/Power strips in use?

  Yes

  No

  N/A

• Removed From Service?

  Yes

  No

  N/A

HAND TOOLS / POWER TOOLS

• Are hand tools inspected frequently?

  Yes

  No

  N/A

• Are broken handles, mushroom heads present?

  Yes

  No

  N/A

• Are protective guards in place on tools

  Yes

  No

  N/A

• Is the right tool being used for the job

  Yes

  No

  N/A

• Powder actuated tools in use? If so, are operators licensed?

  Yes

  No

  N/A

• Operator Licensed? (Include CERT)

  Yes

  No

  N/A

• Are operators using proper PPE

  Yes

  No

  N/A

• Are tools neatly stored and carried properly?

  Yes

  No

  N/A

FALL PROTECTION

• Are employees working more than 6’ above a lower level protected by guardrails, safety nets, PFAS

  Yes

  No

  N/A

• Are guardrails/safety nets secured properly and located at correct heights?

  Yes

  No

  N/A

• Are employees exposed to fall hazards using PFAS and properly tied off? (5k anchor point, correct lanyard)

  Yes

  No

  N/A

• Are employees using turbos along with rebar chains when positioning?

  Yes

  No

  N/A

• Handrails at inclines (such as excavations)

  Yes

  No

  N/A

• Steps of not more than 9.5”

  Yes

  No

  N/A

• Steps have a proper landing?

  Yes

  No

  N/A

• Steps have a hand rail?

  Yes

  No

  N/A

• Tools/hard hats equipped with lanyard?

  Yes

  No

  N/A

• Barricade around excavation?

  Yes

  No

  N/A

LADDERS

• Ladder permit in use?

  Yes

  No

  N/A

• Job Built ladders meet OSHA spec?

  Yes

  No

  N/A

• Are ladders at least 3’ above landing

  Yes

  No

  N/A

• Are ladders secured at top and bottom?

  Yes

  No

  N/A

• Corral and offset in place to prevent falls?

  Yes

  No

  N/A

• Damaged ladder taken out of service?

  Yes

  No

  N/A

• Why was the ladder taken out of service. (include Photos)

  Yes

  No

  N/A

• All ladders equipped with all decals?

  Yes

  No

  N/A

• Step ladders used in the fully open and locked position

  Yes

  No

  N/A

SCAFFOLDING

• Has scaffolding been inspected by a competent person?

  Yes

  No

  N/A

• Is there a green tag present and signed on correct date?

  Yes

  No

  N/A

• Is scaffolding erected on sound level footing?

  Yes

  No

  N/A

• Plumb, square with cross bracing?

  Yes

  No

  N/A

• Are guardrails, midrails, toeboards or screens in place?

  Yes

  No

  N/A

• Is planking full, sound and sturdy?

  Yes

  No

  N/A

• Overlap of at least 12” at corners, intersections and edges of planking?

  Yes

  No

  N/A

• Working areas free of dirt, snow, ice and grease?

  Yes

  No

  N/A

• Are employees below protected from falling objects?

  Yes

  No

  N/A

• Is fall protection available and in use?

  Yes

  No

  N/A

FLOOR AND WALL OPENINGS

• Are all floor or deck openings planked over or barricaded?

  Yes

  No

  N/A

• Is perimeter protection in place?

  Yes

  No

  N/A

• Are deck planks secured?

  Yes

  No

  N/A

• Are materials stored away from the edge?

  Yes

  No

  N/A

• Is corral in place with offset entrance and toe boards to prevent falls to lower level?

  Yes

  No

  N/A

• Do all corrals, covers and barricades include signage?

  Yes

  No

  N/A

TRENCHES, EXCAVATIONS & SHORING

• Competent person present and inspecting?

  Yes

  No

  N/A

• Are excavations 4’ or greater sloped or benched?

  Yes

  No

  N/A

• Are materials and spoil pile at least 2ft from edge of excavation?

  Yes

  No

  N/A

• Is equipment at least 2ft away from edge of excavation?

  Yes

  No

  N/A

• Are ladders provided every 25’ and secured top and bottom?

  Yes

  No

  N/A

• Have underground utilities been located?

  Yes

  No

  N/A

• Excavation permit completed?

  Yes

  No

  N/A

• Does mobile equipment have spotters?

  Yes

  No

  N/A

• Are swing radius markers in place on equipment?

  Yes

  No

  N/A

• Are Flagger wearing class 3 vests and have traffic wands?

  Yes

  No

  N/A

• What is the soil class? Pentrometer used? What is the pentrometer reading?

• Excavation sloped properly for class of soil?

  Yes

  No

  N/A

• Are handrails used to enter/exit excavations?

  Yes

  No

  N/A

MATERIAL HANDLING

• Are materials properly stored or stacked

  Good

  Fair

  Poor

  N/A

• Dunnage being used?

  Yes

  No

  N/A

• Tag lines used to guide loads?

  Yes

  No

  N/A

• Are there adequate employees for the operation?

  Yes

  No

  N/A

• Rebar 90D bars covered while in staging area?

  Yes

  No

  N/A

• Material free rigged from from forklift mast?

  Yes

  No

  N/A

• Material secured to forks/mast with strap?

  Yes

  No

  N/A

• Materials properly rigged to forklift?

  Yes

  No

  N/A

WELDING & CUTTING

• Are compressed gas cylinders stored upright and secured?

  Yes

  No

  N/A

• Is there 20ft min separation between fuels and oxygen?

  Yes

  No

  N/A

• Fire extinguishers within 25ft?

  Yes

  No

  N/A

• Hoses and regulators in good condition?

  Yes

  No

  N/A

CRANES

• Crane operator certified for type of crane being used?

  Yes

  No

  N/A

• Daily crane inspection completed?

  Yes

  No

  N/A

• Lift chart present in crane?

  Yes

  No

  N/A

• Chains, rigging hardware and slings inspected and tagged as required?

  Yes

  No

  N/A

• Hand signal charts located in crane?

  Yes

  No

  N/A

• Crane Operator DOT physical in date?

  Yes

  No

  N/A

• Warning whistles being used?

  Yes

  No

  N/A

• Clear communication between signalman and crane operator?

  Yes

  No

  N/A

CONCRETE CONSTRUCTION / SILICA

• Proper PPE being worn (faceshield,apron,chem gloves for pouring concrete) N95/Respirator for cutting/drilling ops

  Yes

  No

  N/A

• Are employees protected from cement dust?

  Yes

  No

  N/A

• Is exposed skin covered?

  Yes

  No

  N/A

• Are walls over 8’ supported properly?

  Yes

  No

  N/A

• Rebar covered by caps?

  Yes

  No

  N/A

• Concrete pump permit complete?

  Yes

  No

  N/A

• Saw cut operations producing acceptable amount of dust?

  Yes

  No

  N/A

• Cutting operations using water/vacuum as deigned?

  Yes

  No

  N/A

• Concrete bucket in good condition?

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Hard hats, Safety glasses, vests and gloves being worn properly?

  Yes

  No

  N/A

• Faceshields being worn when needed? (Any operation producing flying debris)

  Yes

  No

  N/A

• Are respirators being used when required/needed?

  Yes

  No

  N/A

• Hearing protection being worn in environments greater than 90db?

  Yes

  No

  N/A

MOBILE EQUIPMENT

• Mobile Equipment equipped with back-up alarm?

  Yes

  No

  N/A

• Maintenance Department Notified?

  Yes

  No

  N/A

• Inspection report complete? (include 1 per week at random)

  Yes

  No

  N/A

• Operators certified for equipment?

  Yes

  No

  N/A

• Seat belts being used

  Yes

  No

  N/A

• Fire extinguisher on machine and inspected?

  Yes

  No

  N/A

• All machines have a century label on them?

  Yes

  No

  N/A

• Mobile Equipment not used within 2 feet of excavation?

  Yes

  No

  N/A

STAIRS

• Stairs with more than 4 risers equipped with handrail?

  Yes

  No

  N/A

• Metal pan stairs filled with wood until filled with concrete?

  Yes

  No

  N/A

• Proper landing at top of stairs?

  Yes

  No

  N/A

• Stair risers no more than 9.5”

  Yes

  No

  N/A

HAZARD COMMUNICATION

• Is there an SDS available to all employees?

  Yes

  No

  N/A

• SDS inventory on site and accurate?

  Yes

  No

  N/A

• Each original container labeled with product identifier, signal words, hazard statement, pictograms, precautionary statements, name, address, phone number of chemical manufacturer.

  Yes

  No

  N/A

• Is each secondary container (example spray cans) labeled with original labeling or product ID and words, pictures, and/or symbols which provide general information regarding the chemical contained inside.

  Yes

  No

  N/A

• Are materials properly stored?

  Yes

  No

  N/A

• Are employees trained in HAZCOM?

  Yes

  No

  N/A

• Please list all unsafe actions observed and the abatement for each

• Summary of todays activities and conversations had.

• Conference with GC

  Yes

  No

  N/A

• Name & Title of GC Representative

NEAR MISSES

• Near Miss today

  Yes

  No

  N/A

• Describe near miss

• What can we do to prevent the near Miss or incident in the future?

INCIDENTS TODAY?

• Any first aids today?

  Yes

  No

  N/A

• Short Description of First Aid

• Root Cause

• Employee Name / Job Title

• Name of Superintendent notified

• Any incidents / Injuries Today?

  Yes

  No

  N/A

• Incident Report Complete?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Injury Report Complete

  Yes

  No

  N/A

• Employee Name / job title

• Name of superintendent notified of incident/injury

• Name of GC rep notified

• Injury type

• Incident type

• Employee taken for offsite treatment?

  Yes

  No

  N/A

UPCOMING HIGH RISK ACTIVITES

• Are there any high risk activities coming up in the next 4-6 weeks?

  Yes

  No

  N/A

• List high risk activities

• Special PPE needed? (PFAS, SRL, MEWP)

  Yes

  No

  N/A

TRAINING / TOOL BOX TALK

• Topic of training

• Copy of roster sent to GC?

  Yes

  No

  N/A

SAFETY PRO COMPLETING REPORT

• Add signature

  Sign