JOBSITE SAFETY INSPECTION REPORT

• Audit Title

• PROJECT NUMBER

• GENERAL CONTRACTOR

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

JOB INFORMATION

• OSHA 300 forms complete and posted from February 1 - April 30?<br>

  Yes

  No

  N/A

• OSHA and DOL posters posted?

  Yes

  No

  N/A

• Emergency phone numbers posted?

  Yes

  No

  N/A

• Tool box safety talks log up to date?

  Yes

  No

  N/A

• Weekly required jobsite safety inspections conducted?

  Yes

  No

  N/A

• MSDS filed?

  Yes

  No

  N/A

HOUSEKEEPING

• Work areas neat?

  Yes

  No

  N/A

• Projecting nails or screws bent over or removed?

  Yes

  No

  N/A

• Waste containers provided and used?

  Yes

  No

  N/A

• Passageways and walkways clear?

  Yes

  No

  N/A

• Cords and leads off the floor?

  Yes

  No

  N/A

FLOOR & WALL OPENINGS

• All floor openings planked over or barricaded?

  Yes

  No

  N/A

• Perimeter protection in place?

  Yes

  No

  N/A

• Deck planks secure?

  Yes

  No

  N/A

• Materials stored away from edge?

  Yes

  No

  N/A

FIRE PREVENTION

• Adequate fire extinguishers provided?

  Yes

  No

  N/A

• Fire Extinguishers accessible?

  Yes

  No

  N/A

• Fire Extinguishers inspected?

  Yes

  No

  N/A

• Phone no. of Fire Department posted?

  Yes

  No

  N/A

• "No Smoking" posted and enforced near flammables?

  Yes

  No

  N/A

ELECTRICAL

• Ground fault interrupters being used?

  Yes

  No

  N/A

• Panels clearly identified and secured?

  Yes

  No

  N/A

• Panel Schedules updated?

  Yes

  No

  N/A

• Only qualified electricians allowed access?

  Yes

  No

  N/A

• Terminal boxes equipped with required covers?

  Yes

  No

  N/A

• Temporary cords with bare wires or missing ground prongs taken out of service?

  Yes

  No

  N/A

LIGHTING

• Illumination sufficient for work being performed?

  Yes

  No

  N/A

• All temporary lighting originated from a separate branch circuit?

  Yes

  No

  N/A

• Temporary lighting fixture cages closed?

  Yes

  No

  N/A

• All temporary lighting supported by non conductive material?

  Yes

  No

  N/A

• Temporary Lighting supported every 10 feet?

  Yes

  No

  N/A

• Temporary Lighting installed at appropriate height?

  Yes

  No

  N/A

LOCK-OUT TAG-OUT SYSTEMS

• Locks with individual keys given to each electrician?

  Yes

  No

  N/A

• Personalized danger tags provided to each person?

  Yes

  No

  N/A

• Lock out system being utilized will reduce power to a zero-energy state?

  Yes

  No

  N/A

• All personnel test to verify and confirm zero energy?

  Yes

  No

  N/A

HAND, POWER & POWDER ACTUATED TOOLS

• Hand tools inspected regularly?

  Yes

  No

  N/A

• Electrically grounded?

  Yes

  No

  N/A

• Guards in place on machines?

  Yes

  No

  N/A

• Correct tool being used for job at hand?

  Yes

  No

  N/A

• Personnel adequately trained in the use of their tools?

  Yes

  No

  N/A

• Power cords in good condition?

  Yes

  No

  N/A

• Operators of powder actuated tools licensed?

  Yes

  No

  N/A

FALL PROTECTION

• Safety rails and cables secured properly?

  Yes

  No

  N/A

• Safety harnesses worn properly?

  Yes

  No

  N/A

• Anchor points capable of supporting 5000 lbs.?

  Yes

  No

  N/A

• Adequate anchor points available?

  Yes

  No

  N/A

• Employees exposed to fall hazards tied off?

  Yes

  No

  N/A

• 100 % use while in aerial lifts and bucket trucks?

  Yes

  No

  N/A

• Employees below protected from falling objects?

  Yes

  No

  N/A

LADDERS

• Serviceable?

  Yes

  No

  N/A

• Proper Use?

  Yes

  No

  N/A

• Not standing on two top steps

  Yes

  No

  N/A

• Proper height for the task

  Yes

  No

  N/A

• Stepladders in fully opened and locked position

  Yes

  No

  N/A

• Straight ladders used for access extend three feet above landing

  Yes

  No

  N/A

• Proper Ratio (4:1)

  Yes

  No

  N/A

• Three points of contact when ascending / descending

  Yes

  No

  N/A

• Ladders are secured to prevent slipping, sliding or falling?

  Yes

  No

  N/A

• Ladders with split or missing rungs taken out of service?

  Yes

  No

  N/A

SCAFFOLDING

• All scaffolding inspected daily?

  Yes

  No

  N/A

• Erected on sound rigid footing?

  Yes

  No

  N/A

• Tied to structure as required?

  Yes

  No

  N/A

• Guardrails, intermediate rails, toe boards and screens in place?

  Yes

  No

  N/A

• Planking is sound and sturdy?

  Yes

  No

  N/A

• Proper access provided?

  Yes

  No

  N/A

• Employees below protected from falling objects?

  Yes

  No

  N/A

STAIRS

• Uniform height and tread depth?

  Yes

  No

  N/A

• Grating type tread on exterior stairs?

  Yes

  No

  N/A

• Sturdy railings on all open sides?

  Yes

  No

  N/A

• Stairs free of stored materials and clutter?

  Yes

  No

  N/A

• Stairways equipped with adequate lighting?

  Yes

  No

  N/A

TRENCHES, EXCAVATION & SHORING

• All trenches and excavations have been inspected?

  Yes

  No

  N/A

• Competent person identified and present?

  Yes

  No

  N/A

• Excavations are treated as type "C" and sloped at 1 1/2 : 1?

  Yes

  No

  N/A

• Materials and spoil are stored at least 2' away from trench?

  Yes

  No

  N/A

• Shielding / Shoring in place (if over 5')?

  Yes

  No

  N/A

• Designed by engineer (if over 20')?

  Yes

  No

  N/A

• Ladders provided every 25' in trench?

  Yes

  No

  N/A

• Equipment is at a safe distance from edge of trench or excavation?

  Yes

  No

  N/A

MATERIAL HANDLING

• Materials properly stored or stacked?

  Yes

  No

  N/A

• Employees using proper lifting techniques?

  Yes

  No

  N/A

• Tag lines used to guide loads?

  Yes

  No

  N/A

• Proper number of workers for each operation?

  Yes

  No

  N/A

WELDING AND BURNING

• Gas cylinders stored upright?

  Yes

  No

  N/A

• Proper separating distances between fuels & oxygen?

  Yes

  No

  N/A

• Goggles or shields used?

  Yes

  No

  N/A

• Fire extinguishers readily available?

  Yes

  No

  N/A

• Hoses in good condition?

  Yes

  No

  N/A

CRANES

• Outriggers extended and swing radius barricade in place?

  Yes

  No

  N/A

• Operator is familiar with load charts?

  Yes

  No

  N/A

• Hand signal charts on crane?

  Yes

  No

  N/A

• Crane operator logs up to date?

  Yes

  No

  N/A

• Employees kept from under suspended loads?

  Yes

  No

  N/A

• Chains and slings inspected and tagged as required?

  Yes

  No

  N/A

CONCRETE CONSTRUCTION

• Employees are protected from cement dust?

  Yes

  No

  N/A

• Exposed skin covered?

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Hard hats being worn?

  Yes

  No

  N/A

• Safety glasses being worn?

  Yes

  No

  N/A

• Gloves properly chosen for work performed?

  Yes

  No

  N/A

• Respirators used when required? Proper respirator documentation available?

  Yes

  No

  N/A

• Hearing protection being worn when required?

  Yes

  No

  N/A

• Traffic vests or high visibility clothing material being worn?

  Yes

  No

  N/A

RECOMMENDATIONS

• List any additional recommendations or corrections

SIGNATURES

• MILLER ELECTRIC REPRESENTATIVE

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• SAFETY REPRESENTATIVE

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