Jobsite Safety Inspection - Revised

• Site

• General Contractor

• Conducted on

  Date

• Prepared by: Hermanson Company LLP 1221 2nd Ave North Kent, Wa 98032 www.hermanson.com

1.0 Safety Plans

• 1.1 Site Specific Safety Plan on site?

  Yes

  No

  N/A

• 1.11 Are employees oriented and signed off?

  Yes

  No

  N/A

• 1.2 Site Specific Safety Plan for Subcontractors?

  Yes

  No

  N/A

• 1.05 Other?

  Safe

  At Risk

  N/A

2.0 JHA/JSA/PTP/Work Permits

• 2.1 Job description adequate?

  Safe

  At Risk

  N/A

• 2.2 PTP completely understood by all?

  Safe

  At Risk

  N/A

• 2.3 PTP hazards and precautions match?

  Safe

  At Risk

  N/A

• 2.4 Quality of PTP steps and hazards?

  Safe

  At Risk

  N/A

• 2.05 Other?

  Safe

  At Risk

  N/A

3.0 Personal Protection

• 3.1 Hard hats, glasses, goggles, hearing protection?

  Safe

  At Risk

  N/A

• 3.2 Barricades up where applicable?

  Safe

  At Risk

  N/A

• 3.3 Proper gloves in use?

  Safe

  At Risk

  N/A

• 3.4 Job-specific PPE as required?

  Safe

  At Risk

  N/A

• 3.5 High visibility vests?

  Safe

  At Risk

  N/A

• 3.05 Other?

  Safe

  At Risk

  N/A

4.0 Safety Equipment

• 4.1 Fire extinguisher(s) in place?

  Safe

  At Risk

  N/A

• 4.2 Fire extinguisher(s) inspections complete (both annual and monthly)?

  Safe

  At Risk

  N/A

• 4.3 Eyewash available? Not expired?

  Safe

  At Risk

  N/A

• 4.4 First aid kit available?

  Safe

  At Risk

  N/A

• 4.5 First aid kit stocked properly?

  Safe

  At Risk

  N/A

• 4.05 Other?

  Safe

  At Risk

  N/A

5.0 General

• 5.1 Lighting?

  Safe

  At Risk

  N/A

• 5.2 Ventilation?

  Safe

  At Risk

  N/A

• 5.05 Other?

  Safe

  At Risk

  N/A

6.0 Tools and Equipment

• 6.1 Proper tools in use/used properly?

  Safe

  At Risk

  N/A

• 6.2 Guards/handles/safety devices in place?

  Safe

  At Risk

  N/A

• 6.3 Tools in good condition?

  Safe

  At Risk

  N/A

• 6.3.1 Cords are in good condition? No cuts/nicks/tear. No electrical tape covering cut/nick/tear.

  Yes

  No

  N/A

• 6.05 Other?

  Safe

  At Risk

  N/A

7.0 Body Positioning/Movement

• 7.1 Line of fire risk?

  Safe

  At Risk

  N/A

• 7.2 Attention to task?

  Safe

  At Risk

  N/A

• 7.3 Pinch points?

  Safe

  At Risk

  N/A

• 7.4 Proper lifting?

  Safe

  At Risk

  N/A

• 7.5 Avoid/protected from sharp edges?

  Safe

  At Risk

  N/A

• 7.05 Other?

  Safe

  At Risk

  N/A

8.0 Housekeeping

• 8.1 Work areas clean and neat?

  Safe

  At Risk

  N/A

• 8.1.1 Lunch area clean?

  Yes

  No

  N/A

• 8.2 Barricades maintained?

  Safe

  At Risk

  N/A

• 8.3 Cords rolled and stowed?

  Safe

  At Risk

  N/A

• 8.4 Materials properly staged/stored?

  Safe

  At Risk

  N/A

• 8.5 Floors swept and free of debris?

  Yes

  No

  N/A

• 8.05 Other?

  Safe

  At Risk

  N/A

9.0 Fall Protection/Working at Heights

• 9.1 Guardrails in place?

  Safe

  At Risk

  N/A

• 9.2 Warning lines used?

  Safe

  At Risk

  N/A

• 9.3 Guardrails/warning lines installed correctly?

  Safe

  At Risk

  N/A

• 9.4 100% fall protection over 4' achieved?

  Safe

  At Risk

  N/A

• 9.5 Proper fall protection equipment?

  Safe

  At Risk

  N/A

• 9.6 Fall Protection Work Plan for work over 10'?

  Safe

  At Risk

  N/A

• 9.7 Decking complete w/o holes?

  Safe

  At Risk

  N/A

• 9.8 Harness/Lanyard/Yo-Yo inspected and used properly?

  Yes

  No

  N/A

• 9.05 Other?

  Safe

  At Risk

  N/A

10.0 Ladders

• 10.1 Extension Ladder inspected and in good condition?

  Yes

  No

  N/A

• 10.1.1 Is ladder tied off top and bottom?

  Yes

  No

  N/A

• 10.1.2 Ladder extends 3' above landing?

  Safe

  At Risk

  N/A

• 10.1.3 Base angle 1/4 the working length of the ladder from top support?

  Yes

  No

  N/A

• 10.1.4 Ladder is not pulled apart and only the top half is used?

  Yes

  No

  N/A

• 10.2 A-Frame ladder inspected and in good condition

  Yes

  No

  N/A

• 10.2.1 Used properly and not leaned up against a surface?

  Yes

  No

  N/A

• 10.3 Cage on vertical ladder over 24'? Rest platform(s)?

  Safe

  At Risk

  N/A

• 10.4 Ladder placed on level stable surface?

  Yes

  No

  N/A

• 10.5 No material or debris is gathered at the base of the ladder?

  Yes

  No

  N/A

• 10.05 Other?

  Safe

  At Risk

  N/A

11.0 Scaffolds

• 11.1 Scaffold tag in place/current?

  Safe

  At Risk

  N/A

• 11.2 Top rail, mid rail and toe boards are in place?

  Yes

  No

  N/A

• 11.3 Guys, ties or braces required at the 4:1 height ratio?

  Yes

  No

  N/A

• 11.05 Other?

  Yes

  No

  N/A

12.0 Walking Working Surfaces

• 12.1 Aisles/stairs/floors clear/clean?

  Safe

  At Risk

  N/A

• 12.2 Designated walking area?

  Safe

  At Risk

  N/A

• 12.3 Holes 1" and larger covered?

  Safe

  At Risk

  N/A

• 11.05 Other?

  Safe

  At Risk

  N/A

13.0 Mobile Equipment/ Lifts

• 13.1 Forklift Pre-use inspection complete?

  Safe

  At Risk

  N/A

• 13.1.1 Fire extinguisher installed and inspected?

  Yes

  No

  N/A

• 13.2 Aerial/Scissor Lift Pre-use inspection complete?

  Yes

  No

  N/A

• 13.2.1 Proper fall protection worn?

  Yes

  No

  N/A

• 13.2.2 Netting around basket installed? If required.

  Yes

  No

  N/A

• 13.2.3 Fire extinguisher in basket if preforming hot work?

  Yes

  No

  N/A

• 13.3 Proper training?

  Safe

  At Risk

  N/A

• 13.4 Spotter used when appropriate?

  Safe

  At Risk

  N/A

• 13.05 Other?

  Safe

  At Risk

  N/A

14.0 Electrical

• 14.1 Assured Grounding complete? Correct color (Q1-white, Q2-green, Q3-red, Q4-orange) if required?

  Safe

  At Risk

  N/A

• 14.2 GFCI use on all power cords/tools?

  Safe

  At Risk

  N/A

• 14.3 Extension cords in good shape?

  Safe

  At Risk

  N/A

• 14.05 Other?

  Safe

  At Risk

  N/A

15.0 Welding/Grinding/Temporary Power

• 15.1 Hoses, leads, cords hung properly?

  Safe

  At Risk

  N/A

• 15.2 Sparks controlled?

  Safe

  At Risk

  N/A

• 15.3 Fire watch present?

  Safe

  At Risk

  N/A

• 15.4 Fire extinguisher near by?

  Yes

  No

  N/A

• 15.05 Other?

  Safe

  At Risk

  N/A

16.0 Cylinders/Hazardous Materials/Flammables/Combustibles

• 16.1 Flammable/O2 bottles stored properly?

  Safe

  At Risk

  N/A

• 16.2 Proper storage containers for flammables/combustibles?

  Safe

  At Risk

  N/A

• 16.3 Flammable cabinets free of cardboard, paper, plastic, etc.?

  Yes

  No

  N/A

• 16.3 Secondary labeling for chemicals?

  Safe

  At Risk

  N/A

• 16.05 Other?

  Safe

  At Risk

  N/A