Jobsite Safety Observation

• Project / Job Name

• Foreman

• Department

• Branch Office

• Conducted on

  Date

• Auditor

General Jobsite Safety

• Health and Safety Manual

• Claims Packets

• First Aid Kit

• Expiration Date of Kit

  Date

• Weekly Toolbox Talk reviewed

• Reviewed onsite

• This weeks TBT Topic:

• Fire Extinguishers available if needed

• Medcor Programmed into Company Phones

• If no company phones; stickers and/or poster visible

• Lean Trucks - Would the foreman feel comfortable giving the area manager / operations manager a ride in his truck?

  Yes

  No

  N/A

Specific Jobsite Safety

• Daily Huddle completed

• Daily Huddle Documented

• Stretching Routine completed

• PPE - Hardhats, Safety Glasses, Work Boots worn by all employees?

  Yes

  No

  N/A

• Additional PPE required or worn by employees:

• Electrical - cords in good condition?

  Yes

  No

  N/A

• GFCI in use

• Cords taped for appropriate quarter

• Fall Protection - in place?

  Yes

  No

  N/A

• Holes covered

• Guardrails in good condition

• Harnesses / tie-off points provided and in good condition

• Ladders - work completed from ladders performed safely?

  Yes

  No

  N/A

• Inspected before use

• Stickers in good condition?

• Lifts - work completed using aerial lifts performed safely

  Yes

  No

  N/A

• Pre-use lift inspection performed and documented?

• Hand Tools - in good condition

  Yes

  No

  N/A

• No Cheaters

• No Cracked Handles

• Material Handling - carts in use to transport materials

  Yes

  No

  N/A

• Rigging / slings in good condition

• Material Storage - Neat and in order? Good Housekeeping?

  Yes

  No

  N/A

Loss Prevention / Risk Management

General

• Discussed "Never work on Live Systems" and "Trust but verify" with field

• Sure-off Tester is available

Work Start

• Signed Agreement in place (contract, work order, signed PO with terms, etc.)

  Yes

  No

  N/A

• Control Valve is shut

  Yes

  No

  N/A

• Main Drain is open

  Yes

  No

  N/A

• Trapped water drained

  Yes

  No

  N/A

• Owner/Occupant property covered or removed from work area

  Yes

  No

  N/A

Review w/ crew for work end

• Clean up work area

• Test with air before water

• Turn on water in small increments / check work area for leaks

• Service Work Ticket?

  Yes

  No

  N/A

• Obtain 2nd Signature

• Circle "in-service" or "out of service"

• If system will be left out of service get owner/occupant to sign Deactivation Authorization Notice

  Yes

  No

  N/A