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MBJ3 Safety Manager Weekly/Daily Observations-Edited 06-06-2016
MBJ3 Safety Manager Weekly/Daily Observations-Edited 06-06-2016
John Cornelius

MBJ3 Safety Manager Weekly/Daily Observations-Edited 06-06-2016

This is MBJ3 Safety departments way of documenting all daily safety concerns seen by the MBJ3 safety professional throughout his or her day.

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Free MBJ3 Safety Manager Weekly/Daily Observations-Edited 06-06-2016 Checklist

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Information

  • Client / Site

  • Document No.

  • Audit Title (Ex. Cleve's Terminal E Audit observations, Juan's Terminal B Audit, etc.)

  • Week of: (Ex. Monday's date through Friday's date, 031416-031816, 03/14/2016-03/18/2016, etc.)

  • Audit Conducted By:

    • John Cornelius
    • Robert Arredondo
    • Cleve Magers
    • Juan Lopez
    • Bryce Powers

Safety Observations

    Safety Observation

  • Contractor

    • AMX
    • Andreola Terrazzo & Restoration
    • Carrco Painting & Contracting
    • DMCA Inc.
    • DSI
    • DSI/Air Balancing
    • DSI/Alpha Insulation
    • DSI/DENALI
    • DSI/PCI
    • DSI/Phillips May Corp
    • DSI/Ruiz Boyter
    • DSI/Schneider Electric
    • DSI/JaCom
    • DSI/Thermo Tech
    • E-Logic
    • Fish Construction
    • HP Environmental
    • KPost
    • Lantek Communications
    • MCDean
    • MCDean/Able Communications
    • MCDean/Burleson
    • MCDean/Ford Audio Video
    • MCDean/Gentzler
    • MCDean/Real Networks
    • MCDean/Vanguard
    • MCDean/Vanguard/Hicks Lightning
    • Marek
    • Marek/Alpha Insulation
    • Marek/Baker Triangle
    • Marek/Overhead Door
    • KMP
    • Kone
    • MBJ3(General Requirement)
    • MBJ3(Laborers/composite crew)
    • MBJ3/Alpha Insulation
    • MBJ3/KPost
    • MBJ3/ThyssenKrupe Elevator
    • MBJ3/Trinity Transcon/DMCA
    • MBJ3/Trinity Transcon/MGL Spec.
    • Northstar Fire Protection
    • National Fire Protection
    • Phillips May Corp(PMC)
    • PMC/AllTex Coring
    • PMC/American Terrazo
    • PMC/Armetco
    • PMC/Auger Drilling
    • PMC/Butler & Butler
    • PMC/GST
    • PMC/PDV Assoc.
    • PMC/PCI
    • PMC/Precision Demo
    • PMC/Shahan & Sons
    • PMC/Southwest Construction Services
    • PMC/Synergy Signs
    • PMC/T&R Excavation
    • PMC/Tioga
    • PMC/Trinity Transcon/DMCA
    • PMC/Trinity Transcon/MGL/Lasco Acoustics
    • PMC/Universal Fence
    • PMC/Universal Fence
    • Precision Demo
    • RNDI
    • Siemens
    • Siemens/M C Dean
    • Southwest Demoliton Services (SDS)
    • SDS/Southwest Sealers
    • SKYE
    • Walker Engineering (WE)
    • Walker Eng./GNS Electric
    • Waste Management
    • Other

  • Name of Other Contractor

  • Select the Safety Item(s) Observed

    • Concessions
    • Electrical
    • Excavations
    • Fall Protection
    • Fire Protection & Prevention
    • Forms and Documentation
    • General Requirements
    • Material Handling and Storage
    • Heavy Equipment Operations
    • Hoist, Cranes & Derricks
    • Housekeeping
    • Ladder Safety
    • Other
    • Personal Protective Equipment (PPE)
    • Scaffolding
    • Security
    • Tools: Hand & Power
    • Welding and Cutting
    • Work Area/Environment

  • Is a well stocked first aid cabinet on site for MBJ3 staff?

  • Is a first aid log posted on the cabinet?

  • Are emergency numbers posted?

  • Is the MBJ3 Emergency Action Plan and OSHA mandated posters posted?

  • Is the required PPE items for the tasks being worn?

  • Are ladders and scaffolding inspected and being used correctly?

  • Describe your ladder or scaffolding concerns.

  • Do you have a picture of the ladder or scaffolding concerns?

  • Take or insert picture here.

  • Are fall protection rules being used where there is a potential to fall 6' or more?

  • Describe your fall protection concerns.

  • Do you have a picture of the fall protection concerns?

  • Take or insert picture here.

  • Was housekeeping reviewed?

  • Is the jobsite initial appearance clean?

  • Are First Aid Kits readily available for all subs?

  • Are fire extinguishers inspected and readily available?

  • Are all passageways clear?

  • Are all sanitary facilities adequate and clean?

  • Are nails, boards, debris removed and/or stored appropriately?

  • Are adequate drinking water, cups and a trash containers available?

  • Is the extension cord(s) unprotected?

  • Take a picture of the unprotected cord

  • Is the extension cord(s) the correct AWG (12/3AWG or bigger required)?

  • Was the extension cord(s) inspected before use?

  • Is a GFCI being used properly?

  • Was LOTO required?

  • Is the extension cord(s) damaged in any way?

  • Take a picture of the damaged item.

  • Was LOTO done?

  • ALL WORK SHOULD STOP AND CITATIONS SHOULD BE GIVEN AND AN INCIDENT/INVESTIGATION SCHEDULED WITH ALL INVOLVED!!!

  • Other Concern(s)

  • Explain Other Concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

  • Has an excavation plan been submitted?

  • ALL WORK MUST STOP UNTIL PLAN HAS BEEN SUBMITTED TO AND APPROVED BY MBJ3 SAFETY!

  • Is the cave in protection done properly?

  • Explain Cave In protection concerns

  • Do you need to take a photo? If yes, slide the switch to the right.

  • Photo(s) of cave in protection concerns.

  • Is a ladder present for exiting the excavation? Ladder must be present once the excavation becomes 4' or deeper.

  • Is the ladder within 25' of each worker? A worker must be able to access the ladder before traveling more than 25'.

  • Are all spoil piles and equipment 4' back from the edge?

  • Other concerns?

  • Explain other concerns:

  • Do you need to take or add a photo? If yes, slide switch to the right.

  • Photo(s) of "Other" concerns

  • Has a lifting plan been submitted?

  • ALL WORK MUST STOP UNTIL PLAN HAS BEEN SUBMITTED TO AND APPROVED BY MBJ3 SAFETY!

  • Are all required inspections and documentation completed and onsite? A daily and annual inspection must be on site.

  • ALL WORK MUST STOP UNTIL DOCUMENTS ARE COMPLETED!

  • Explain missing or deficient documentation.

  • Is all cribbing under all outriggers?

  • Is the anti-two block installed and operating correctly?

  • Is the operator, rigger and signalman all qualified?

  • Take a photo(s) of all qualifications.

  • ALL WORK MUST STOP UNTIL DOCUMENTED PROOF IS PROVIDED!!!

  • Is the swing radius barricaded and only those required for the task within it?

  • Are taglines being used?

  • Other Concerns

  • Explain other concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

  • Is the operator authorized and or certified to operate the equipment?

  • Take a photo(s) of certifications.

  • Has a daily inspection been done and done correctly?

  • Take a photo of the inspection as it was done.

  • Are all safety devices functioning correctly? A back up alarm is working and seat belts are used.

  • Explain devices that are not functioning correctly.

  • Other Concerns

  • Explain other concerns

  • Do you need to take or add a photo? If yes, slide switch to the right.

  • Photo(s) of "Other" concerns

  • Is a fire extinguisher within 100' of workers?

  • Is a hot work permit and hot work checklist present and up to date?

  • Explain concerns with hot work permit or checklist.

  • Is the fire watch performing according to requirements?

  • Explain where the fire watch has fallen short.

  • Is a fire extinguisher located near outside storage tanks and/or flammable liquid storage areas?

  • Are no smoking signs posted in flammable storage areas?

  • Other Concerns

  • Explain other concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

  • Was a JHA done correctly?

  • Explain your concerns with the JHA.

  • Take a picture of the JHA.

  • Was a Tool List done correctly?

  • Describe your concerns with the Tool List

  • Take a picture of the Tool List

  • Was a Hot Work Permit and/or Hot Work Checklist done correctly?

  • Describe your concerns with the Hot Work Permit and/or Checklist.

  • Take a picture of the Permit or Checklist

  • Other Concerns

  • Explain other concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

  • Is housekeeping done well according to OSHA standards for egress and housekeeping?

  • Take a picture of the housekeeping concern

  • Explain your concerns with housekeeping.

  • Was the ladder inspected?

  • Take a picture of how you know the ladder was not inspected.

  • Was the extension ladder extended 3' above the landing area?

  • Was a 3' clearance provided around the base of the ladder?

  • Was the worker using the ladder correctly?

  • Explain your concern with using the ladder correctly.

  • Other Concerns

  • Explain other concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

  • Were gloves being used while handling material?

  • Is all material being stored on dunnage?

  • Is material out of exit paths and not causing any unnecessary congestion?

  • Other Concerns

  • Explain other concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

  • Were additional PPE items being worn for a specific task?

  • What additional items were being used?

    • Hearing Protection
    • Respiratory Protection
    • Face Protection
    • Foot Protection
    • Hand Protection (gloves)
    • Protective Clothing
    • PFAS

  • Are all required PPE items for the task being worn?

  • Explain what PPE item(s) were not being worn.

  • Other Concerns

  • Explain other concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

  • Was 100% fall protection used where the worker was exposed to a fall greater than 6'?

  • Take a photo of the incident

  • REMOVE THE WORKER(S) FROM THE JOBSITE UNTIL INCIDENT REVIEW WITH MBJ3 SAFETY TEAM AND CONTRACTOR SUPERVISION!!!

  • Was an inspection done prior to using the scaffold?

  • Is the scaffold incomplete or improperly built?

  • Provide picture of incomplete or improperly built scaffolding.

  • Other Concerns

  • Explain other concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

  • Was tool inspected prior to use?

  • Is the tool being used the correct tool for the job?

  • Is the tool being used according to the manufacturer recommendations?

  • Is all powder actuated tools being used by licensed operator?

  • Take photo of license.

  • Operator must stop using the tool and the foreman must be cited or disciplined.

  • Other Concerns

  • Explain other concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

  • Is a fire watch and fire extinguisher, "10lb ABC" present?

  • Explain your concerns with the fire watch or extinguisher.

  • Has the workers accounted for the monitoring the CO levels?

  • ALL WORK MUST STOP UNTIL MONITORING IS BEING DONE OR UNITS ARE MOVED TO A SAFE LOCATION!!!!!

  • What was the corrective measures to account for the CO levels?

  • Is all equipment in good repair, including no damage on the lead within 10' of the stinger and anti-flashback devices are on the fuel side of each line?

  • Take a photo(s) of all concerns.

  • Are all CG's contained and stored properly?

  • Take a picture of the incorrect storage of the CG containers.

  • Are all combustible items 20' from stored CG's?

  • Take a picture of combustible items near CG containers.

  • Other Concerns

  • Explain other concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

  • Is lighting adequate for the task?

  • Are all trades communicating with one another?

  • What is your concern about the trades communicating with one another?

  • Other Concerns

  • Explain other concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

  • Was Fall Protection in place where a fall of greater than 6' to a lower level was present?

  • Take a photo of the incident

  • REMOVE THE WORKER(S) FROM THE JOBSITE UNTIL INCIDENT REVIEW WITH MBJ3 SAFETY TEAM AND CONTRACTOR SUPERVISION!!!

  • Was the worker wearing the Personal Fall Arrest System(PFAS) correctly?

  • Other Concerns

  • Explain other concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

  • Describe your "Other" concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

  • Was a Tool List present?

  • Were all tools and equipment under the control of the worker?

  • Was the 5 to 1 escorting policy done correctly?

  • Do you have any other Security concerns?

  • Describe your security concerns:

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of security concerns

  • Describe your Concessions concerns:

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of security concerns

  • Other Concerns

  • Explain other concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

  • Other Concerns

  • Explain other concerns

  • Do you need to take or add a photo? If yes, slide the switch to the right.

  • Photo(s) of "Other" concerns

MBJ3 Safety Manager Weekly/Daily Observations-Edited 06-06-2016
John Cornelius

MBJ3 Safety Manager Weekly/Daily Observations-Edited 06-06-2016

This is MBJ3 Safety departments way of documenting all daily safety concerns seen by the MBJ3 safety professional throughout his or her day.

Use this Template
The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.

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