LSU Safety Survey

• Job Number

• Conducted on

  Date

• Prepared by

TRAINING & PLANNING

• JSA's completed and adequate for tasks being performed?

  Yes

  No

  N/A

• Training documentation on file?

  Yes

  No

  N/A

HAZARD COMMUNICATION/MSDS

• MSDS current for all contractors on site

  Yes

  No

  N/A

• Labels on containers

  Yes

  No

  N/A

STRUCTURE ENTRANCE

• Overhead protection at entrances where overhead work on-going?

  Yes

  No

  N/A

PUBLIC PROTECTION

• Public protection adequate including warning signs?

  Yes

  No

  N/A

HOUSEKEEPING & SANITATION

• Housekeeping: aisles clean, scrap removed, no protruding nails.

  Yes

  No

  N/A

• Adequate supply of water or water jugs, cups and trash containers?

  Yes

  No

  N/A

• Adequate toilet facilities and clean?

  Yes

  No

  N/A

PERSONAL PROTECTIVE & LIFE SAVING EQUIPMENT

• Respiratory protection worn when needed/required?

  Yes

  No

  N/A

• Head,eye,hearing,face,and hand protection worn?

  Yes

  No

  N/A

• Written program:<br>medical evaluations completed?<br>Documentation of fit test and training for respirators?

  Yes

  No

  N/A

• Safety harnesses, lifelines and lanyard worn when needed/required?

  Yes

  No

  N/A

FIRE PROTECTION & PREVENTION

• Fire extinguishers/ clear access? Fire extinguishers inspected monthly?

  Yes

  No

  N/A

• Flammable & combustible liquids in approved containers only?

  Yes

  No

  N/A

• "No smoking" posted and enforced where needed?

  Yes

  No

  N/A

• Fuel tanks protected and min 20 ft from bldgs w/ 20B fire exiting w/in 50 ft?

  Yes

  No

  N/A

ELECTRICAL

• Guarding of live parts by cabinets or other enclosures?

  Yes

  No

  N/A

• Warning signs posted (Danger high voltage)?

  Yes

  No

  N/A

• GFCI Protection?

  Yes

  No

  N/A

• GFCI's tested w/ test documented?

  Yes

  No

  N/A

• Temporary lighting adequate and bulbs protected?

  Yes

  No

  N/A

• Breaker boxes and switches properly labeled?

  Yes

  No

  N/A

• Lockout/Tagout being used?

  Yes

  No

  N/A

• Extension cords?

  Yes

  No

  N/A

TOOLS

• Proper tool being used for job?

  Yes

  No

  N/A

• All tools inspected at least daily?

  Yes

  No

  N/A

• Damaged tools repaired or replaced promptly?

  Yes

  No

  N/A

• Are tools being used properly?

  Yes

  No

  N/A

• Guards in place?

  Yes

  No

  N/A

• Pneumatic tools/air hoses have proper safeguards, secured connections?<br>

  Yes

  No

  N/A

• Powder Actuated Tools:<br>Operators trained/spot check cards?<br>Tools and charges protected from unauthorized use?

  Yes

  No

  N/A

STAIRWAYS AND LADDERS

• Stairway/ladder/ramp used where 19 inch break in elev.

  Yes

  No

  N/A

• Stairways clean and free of trip hazards w/ adequate lighting?

  Yes

  No

  N/A

• Handrails in stairways and guardrails at landing?

  Yes

  No

  N/A

• Metal pan stairs poured, filled or barricaded from use?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Do straight ladders extend 36" above top of landing?

  Yes

  No

  N/A

• Stepladders fully open when in use; no standing on top two steps?

  Yes

  No

  N/A

• Proper maintenance and storage of ladders?

  Yes

  No

  N/A

SCAFFOLDING

• Is scaffold equipment in good working order?

  Yes

  No

  N/A

• Inspected by competent person daily before use?

  Yes

  No

  N/A

• Erected on solid, level footing?

  Yes

  No

  N/A

• Guardrails on open sided and end more than 6 ft above the ground?

  Yes

  No

  N/A

• Tightly planked platform for full width and secured in place?

  Yes

  No

  N/A

• Access ladder provided?

  Yes

  No

  N/A

• Maximum height = four (4) times minimum base diminsion?

  Yes

  No

  N/A

FALL PROTECTION

• Floor opening covered/guardrails in place?

  Yes

  No

  N/A

• Open-sided floors/wall opening have guardrails & toe boards?

  Yes

  No

  N/A

• Roof edge adequately guarded?

  Yes

  No

  N/A

• Leading edge protection & signage utilized where required?

  Yes

  No

  N/A

• 100% fall tie off for all heights above 6 ft with proper anchor points?

  Yes

  No

  N/A

AERIAL MANLIFTS/SCISSORS LIFTS

• All personnel tied off?

  Yes

  No

  N/A

• Safety chains in place on scissors lifts?

  Yes

  No

  N/A

• Employee training verified?

  Yes

  No

  N/A

HOISTS AND CRANES

• Slings and chains , hooks and eyes in good condition and tagged/marked?

  Yes

  No

  N/A

• Equipment firmly supported?

  Yes

  No

  N/A

• Outriggers used if needed and proper cribbing in place?

  Yes

  No

  N/A

• Power lines inactive, removed or at a safe distance?

  Yes

  No

  N/A

• Hoist operator trained? Check for card?

  Yes

  No

  N/A

• Fire extinguisher installed (cranes and hoists)?

  Yes

  No

  N/A

HEAVY EQUIPMENT

• Regular inspection and maintenance logs complete?

  Yes

  No

  N/A

• Is the operator licensed/trained to operate equipment?

  Yes

  No

  N/A

• Lights, brakes, horn, back up alarm operative?

  Yes

  No

  N/A

• Seat belts being used?

  Yes

  No

  N/A

• Fire extinguisher installed?

  Yes

  No

  N/A

HANDLING & STORAGE OF MATERIALS

• Materials properly stored or stacked?

  Yes

  No

  N/A

• Stacks on firm footings not too high?

  Yes

  No

  N/A

• Are loads lifted correctly? Proper number of men or equipment used?

  Yes

  No

  N/A

EXCAVATION AND SHORING

• Comp. person(s) designated?

  Yes

  No

  N/A

• Are adjacent structures including roads/sidewalks properly shored/supported?

  Yes

  No

  N/A

• Is excavation properly sloped, shored or trench box used?

  Yes

  No

  N/A

• Tabulated data for trench box on site?

  Yes

  No

  N/A

• Means if egress within 25 feet?

  Yes

  No

  N/A

• Spoils and material back min. of 2 feet?

  Yes

  No

  N/A

• Is equipment a safe distance from edge of excavation?

  Yes

  No

  N/A

• Fall protection/barricading adequate?

  Yes

  No

  N/A

WELDING AND CUTTING/OTHER HOT WORK

• Screens and shields used where necessary?

  Yes

  No

  N/A

• Goggles, gloves, proper clothing worn?

  Yes

  No

  N/A

• Electrical equipment grounded?

  Yes

  No

  N/A

• Welding leads and gases hoses protected and in good condition?

  Yes

  No

  N/A

• Inspection of fire hazards?

  Yes

  No

  N/A

• Fire extinguishers nearby?

  Yes

  No

  N/A

• Gas cylinders secured and upright. Fuel cylinders at least 20 ft from oxygen?

  Yes

  No

  N/A

• Are cylinder caps in use?

  Yes

  No

  N/A

• Fire watch used where needed/required?

  Yes

  No

  N/A

STEEL ERECTION

• Erection floor solidly planked or decked or safety net within 25 feet?

  Yes

  No

  N/A

• Safety railing (1/2 wire rope) at perimeter?

  Yes

  No

  N/A

• Cable guardrails has no more than 3inches deflection and flagged every 6ft.

  Yes

  No

  N/A

• Floor and other opening covered and barricaded?

  Yes

  No

  N/A

• Ladders, stairs, or other access provided?

  Yes

  No

  N/A

• Other trades protected from overhead hazards or schedule arrangements made?

  Yes

  No

  N/A

• Tag lines used?

  Yes

  No

  N/A

CONCRETE AND MASONRY CONSTRUCTION

• Vertically protruding rebar capped?

  Yes

  No

  N/A

• Controls in place to limit silica exposure - water, vacuum tools, etc...

  Yes

  No

  N/A

• Limited access zone around masonry walls?

  Yes

  No

  N/A

• No dry cutting of black/concrete w/o adequate eng controls?

  Yes

  No

  N/A

• Safety hoisting equipment/material?

  Yes

  No

  N/A

• PROJECT MANAGER

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• SUPERINTENDENT

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