Keystone Concrete

• Client / Site

• Project Superintendent

Job information

• Is the superintendent on site?

  Yes

  No

  N/A

• Who is the competent person on site?

• Number of workers on site (excluding superintendent)

• Tool box safety talks up to date?

  Yes

  No

  N/A

• MSDS & Safety Manual filed properly?

  Yes

  No

  N/A

• Work area properly signed and barricaded?

  Yes

  No

  N/A

• Work observed during visit

• Add media

  Media

Electrical Safety

• Is electric being used?

  Yes

  No

  N/A

• Cords grounded correctly? (Third prong, GFCI, correctly grounded electrical supply)

  Yes

  No

  N/A

• Cords free from visible damage?

  Yes

  No

  N/A

Fire Prevention

• Adequate fire extinguishers, checked and accessible?

  Yes

  No

  N/A

Housekeeping

• Work area clean and neat?

  Yes

  No

  N/A

• Protruding nails properly bent over or removed?

  Yes

  No

  N/A

• Waste container provided and used?

  Yes

  No

  N/A

Hand and Power tools

• Are hand tools being used on job at this time?

  Yes

  No

  N/A

• Hand tools inspected regularly as required/necessary?

  Yes

  No

  N/A

• Guards in place on tools?

  Yes

  No

  N/A

• Correct tool being used for job at hand?

  Yes

  No

  N/A

• Saw horses used while cutting?

  Yes

  No

  N/A

Fall Protection

• Is fall protection needed for task(s) being performed?

  Yes

  No

  N/A

• Safety cables and rails secured properly?

  Yes

  No

  N/A

• Safety harnesses worn properly?

  Yes

  No

  N/A

• Employees exposed to falls hazards 6' or greater are 100% tied off?

  Yes

  No

  N/A

• Employees below protected from falling objects?

  Yes

  No

  N/A

Ladders

• Are ladders being used on project?

  Yes

  No

  N/A

• Ladders are secure to prevent slipping, sliding or falling (tied off)?

  Yes

  No

  N/A

• Ladders extended at least 36" above landing?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Stepladders used in fully open position?

  Yes

  No

  N/A

• No step at top two rungs of ladder?

  Yes

  No

  N/A

• Rope/pulley provided to hoist tools and/or equipment?

  Yes

  No

  N/A

Shoring

• Is shoring being used on project?

  Yes

  No

  N/A

• All shoring inspected daily and green tagged (if required)?

  Yes

  No

  N/A

Trenching and Excavations

• Are there any trenching or excavation activities being performed on project?

  Yes

  No

  N/A

• Competent person identified and present?

  Yes

  No

  N/A

• Excavations are benched or sloped as required?

  Yes

  No

  N/A

• Materials stored at least 2' away from trench?

  Yes

  No

  N/A

• Ladders provided as required?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

Material Handling

• Material properly stored or stacked?

  Yes

  No

  N/A

• Employees using proper lifting techniques?

  Yes

  No

  N/A

Cranes

• Is there a Keystone controlled crane on site?

  Yes

  No

  N/A

• Crane operator logs up to date?

  Yes

  No

  N/A

• Hand signal charts on crane?

  Yes

  No

  N/A

• Outriggers extended and swing radius barricade in place?

  Yes

  No

  N/A

• Employees kept from under suspended loads?

  Yes

  No

  N/A

• Flaggers/riggers certifications current and documented?

  Yes

  No

  N/A

• Chains and slings inspected and tagged as required?

  Yes

  No

  N/A

• Tag lines used to guide loads?

  Yes

  No

  N/A

Concrete Construction

• Employees are protected from cement dust?

  Yes

  No

  N/A

• Exposed skin covered?

  Yes

  No

  N/A

• Exposed rebar ends are protected?

  Yes

  No

  N/A

Personal Protective Equipment

• Hard hats being worn?

  Yes

  No

  N/A

• Safety glasses being worn?

  Yes

  No

  N/A

• Respirators used as required?<br>

  Yes

  No

  N/A

• Hearing protection being worn when required?

  Yes

  No

  N/A

• Protective high visibility clothing being worn?

  Yes

  No

  N/A

• Are gloves being worn as required?

  Yes

  No

  N/A

Mobile Equipment

• Are keystone employees using any type of mobile equipment?

  Yes

  No

  N/A

• Do all operators of powered lifts, forklifts and/or heavy equipment have appropriate and current licensing to operate that equipment?

  Yes

  No

  N/A

• Daily equipment inspections completed?

  Yes

  No

  N/A

• Are seatbelts being worn as required?

  Yes

  No

  N/A

• Are fire extinguishers in equipment as required?

  Yes

  No

  N/A

• Is all equipment free of trash and debris?

  Yes

  No

  N/A

• Does equipment have backup alarms as required?

  Yes

  No

  N/A

• Are load charts in equipment as required?

  Yes

  No

  N/A

• Are harnesses being used as required while operating equipment?

  Yes

  No

  N/A

• Are all feet planted on the platforms of the lifts (I.e. not on railings)?

  Yes

  No

  N/A

General Safety Observations

• Is the work area sufficiently lighted as required?

  Yes

  No

  N/A

• Is Conex or storage rooms clean and in good condition?

  Yes

  No

  N/A

• First aid kit available and sufficient?

  Yes

  No

  N/A

• Are amenities sufficient? (toilets, wash area, lunch room, etc.)

  Yes

  No

  N/A

Audit deficiencies

• Have all deficiencies found on previous audits been corrected? If not, when will all items be corrected?

  Yes

  No

  N/A

• Have all deficiencies found on this audit been corrected? If not, when will all items be corrected?

  Yes

  No

  N/A

Signatures

• Superintendent name

  Sign

• Auditors name

  Sign