Information
-
General Contractor Name
- Big-D
- Doran Construction
- Doran Building
- DJ Kranz
- Erdman
- Frana
- KA
- Ironmark
- Rise
- Stevens
- North Shores
- Bruce Bourbon.
- Appro
- CBS
- Klamm Mech
- Cemstone
- Greystone
- Fairborn
-
Date & Time
-
Foreman
- Jake Hoeschen
- Ross Karpen
- Jeff Johnson
- Ross Brostrom
- Ty Torgerson
- Joel Fairbanks
- Joe Fenske
- Kevin Karpen
- Phil Hockensmith
- John Kozisek
- Chris Cullen
- Chris Lydon
-
Location
-
Kelleher Personnel onsite today
-
Any safety items that you may need coming up?
-
What is it that you need
-
Any Safety Concerns
-
What is the Concern
Details
Job Details Work to be performed, Hazards & Hazard Eliminations
-
Construction Activity Today
- Form walls
- Pour walls
- Strip wall forms
- Set Columns
- Pour Columns
- Strip columns
- Drill & Epoxy Rebar
- Set up Footings
- Pour footings
- Strip footings
- Pour Pan Steps
- PT Prep
- Pour deck
- Pour SOG
- Topping slab
- Pour Bollards
- Demo sidewalk
- Set up stoops
- Pour Stoops
- Set up sidewalk
- Pour sidewalk
- Grinding
- Patching
- Slab on grade set up
- Embeds plates
- Concrete Saw Cutting
- Clean up
- Load Truck
- Lay Out
- Other
- Concrete blankets (Remove or Cover)
-
Identify Potential Hazards
- Trips/Slips/Falls
- Soft Tissue Injuries
- Particles In Eyes
- Falls Over 6'
- Overhead Work
- Sprains/Strains
- Abrasions/Cuts
- Cave-In
- Loud Noises
- Heat/Cold Exposure
- Electric Shock
- Pinch Points
- Moving Machinery
- Working with Chemicals
- Spills
- Tools/ Materials
- Chemical Burn
- Elevated Loads
- Silica exposure
- Confined Space
- Carbon Monoxide ( Indoors)
-
Hazard Elimination
- Keep Area Picked Up
- Stretch and Bend
- Face Shield
- Fall Protection
- Toeboards/ Netting
- Lift / carry properly
- Wear proper clothing
- Proper Sloping/Shoring
- Hearing Protection
- Cords/Tools inspected
- Be in Proper Position
- Make Eye Contact
- Review the MSDS
- Tools/Materials (Tethers)
- Protective Clothing (Gloves)
- Proper Rigging/Taglines
- Hepa Vac
- Respiratory Protection (N95)
- Ventilation. / Fans /CO Monitors
- 4 Gas Monitor
- Integrated water.
- Retrieval System ( Tripod)
-
Does every crew member know how to use assigned tools and equipment
-
Attachments ,Guards are on all tools?
-
Is Excavation in good condition and have good access
-
Does your crew know where the first aid station is located?
-
Did you talk to your crew about the Hazards today if any?
-
Good Ventilation if inside work is being done with gas powered engines?
-
Is there proper lighting to complete your task if working inside
PPE
-
Proper PPE will be in place at all times (Class II vest, Glasses & Hardhat )
Crane Use
-
Tag lines will be on all loads when in the air
-
All rigging has been inspected prior to lifting the load.
Formwork
-
All wall Formwork scaffold will have 3 plank wide otherwise tie off will be in place
-
Handrail will be in place on both sides of formwork at 42 + or - 3 inches if formwork is over 6'
-
Good ladder access to the scaffold Tied off at the top and secured at the bottom also top of ladder is extended 3 feet above deck
-
Rebar will be protected to prevent Impalement hazard
Safety Equipment
-
Fall protection will be needed today
-
Will C/O Monitors be needed
Other
-
Did you see a near miss or did anyone report one today
-
undefined
-
Was anyone injured in the course of working today if so explain below.
-
undefined
Stretching
-
Stretch and bend will be done before shift and after lunch<br>
Signatures
-
On site foreman's signature
-
Crew Sign in log ( Has All The names in the drop down)
- Adair Jim (LF)
- Anderson Mike (LF)
- Aseson Jarrod (F)
- Auren Codie (L)
- Belsheim Isaiah (C)
- Blood Wheeler (C)
- Brostrom Ross (CF)
- Charpentier Matt (L)
- Cross Zian (LF)
- Cullen Chris (FF)
- Ellis Kevin (F)
- Fairbanks Joe (CF)
- Fenske Joe (CF)
- Foss Justin (LF)
- Greenwood Josh (F)
- Helmbbrecht Zach (C)
- Hockensmith Phil (FF)
- Hoeschen Jake (CF)
- Horejsi Tim (LF)
- Jacobs Tyler (L)
- Johnson Brett (L)
- Johnson Jeff (CF)
- Karpen Kevin (FF)
- Karpen Ross (CF)
- Kozisek John (FF)
- Larson Roy (L)
- Lett Fred (F)
- Liebelt Nate (L)
- Lydon Chris (FF)
- Miller AL (L)
- Pankiewicz Eric (L)
- Parker Chris (F)
- Robertson Kevin (LF)
- Salcido Jose (C)
- Schumm Grant (L)
- Schell Troy (LF)
- Shaw Mark (LF)
- Simila Drew (LF)
- Slate Dan (L)
- Stepanek Joe (F)
- Torgerson Tanner (C)
- Torgerson TY (CF)
- Valencia Greg (F)
- Volk Chase (LF)
- Walford Jemahl (F)
- Widholm Roger (L)
