Information

  • Contractor Company:

  • Client:

  • Job Name / Number:

  • Task Observed:

  • Location:
  • Conducted on:

  • Jobsite Supervisor:

  • Prepared by:

  • Personnel Onsite: (Head Count)

  • General (Click this tab for all Jobs)

  • Task Hazard Analysis

Task Hazard Analysis

  • Was a THA completed for all tasks being performed?

  • Does the contractor review the THA with all visitors to jobsite?

  • Are all hazards addressed on the THA?<br>

  • Are appropriate control measures in place for the hazards?

  • Have all employees signed the THA?

  • Are all tasks properly and identified on the THA?

  • Are all obstructions such as, overhead lines, or items unique to the jobsite identified on the THA?

  • Other.

  • Add Section Notes and Observations.

  • Mechanical Equipment

Mechanical Equipment (including, foreman/lineman trucks, bucket trucks, digger derrick, etc.)

  • Are safety belts worn while operating?

  • Is the equipment being used as intended?

  • Have pre-use inspections been completed on all equipment?

  • Are there any defects noted on the equipment inspection?

  • Is there an operators manual onboard?

  • Is the housekeeping inside of the equipment satisfactory?

  • Is all equipment in satisfactory condition?

  • Is there a fire extinguisher on equipment or available onsite? And properly tagged and in date?

  • Have all operators been trained in the operation of their equipment?

  • What is the condition of the tires? Do the tires meet DOT requirements? (Add a photo if condition is not satisfactory)

  • Has equipment been grounded where needed?

  • Is there a backup alarm on all equipment or is the contractor using a spotter?

  • Is the Die electric inspection current? (on equipment booms)

  • Is the DOT tag current?

  • Do the employees driving the equipment that requires a CDL; are their CDL valid? (Are the CDL and Medical on the person?)

  • Other

  • Add Section Notes and Observations.

  • Housekeeping

Housekeeping

  • Has the contractor addressed all housekeeping issues on jobsite?

  • Are flammable liquids properly stored?

  • Are flammable liquids properly labeled?

  • Are there any chemical spills?

  • Is the spill a hazardous chemical?

  • Other

  • Add Section Notes and Observations.

  • Personal Protective Equipment

Personal Protective Equipment

  • Are all employees wearing at a minimum a hardhat, safety glasses w/side shields, proper footwear, and proper safety vest?

  • Are all employees wearing work gloves appropriate for the hazard?

  • Are all employees wearing appropriate fall protection when required? Note: 100% fall protection is required while working at elevated heights.

  • Are all employees working on or near energized equipment outfitted and wearing FR clothing properly. ***IF NOT STOP WORK IMMEDIATELY***

  • Is PPE in good condition?

  • Are employees staying out of pinch / crush points (or the bite)?

  • Other

  • Add Section Notes and Observations.

  • Personal Protective Equipment

Weather Conditions:

  • Are mitigation measures for Heat Stress in place addressed and reviewed?

  • Is storm or severe weather preparedness and evacuations addressed during the THA meeting and noted?

  • Is their lightning near by? What is the distance?

  • Other

  • Add Section Notes and Observations.

  • Communications

Communications

  • Is a complete emergency plan documented and on site? Note: Plan shall include emergency contacts, map to local hospital and procedures to follow in the event of an emergency.

  • Has the plan been reviewed with all employees?

  • Is a copy of the safety manual on site?

  • Are SDS available to on site personnel?

  • Is an AED available? (Note the date of the last inspection)

  • Are adequate first aid supplies available on site?

  • Is there a Blood Borne Pathogen kit onsite?

  • Is a radio in use when flagging, pulling wire, etc. (or hand signals)

  • Has job site supervision completed OSHA 30hour training, including subcontractor employees?

  • Have all employees completed OSHA 10 hour training, including subcontractor employees?

  • Other

  • Add Section Notes and Observations.

  • Fall Protection

Fall Protection

  • Is 100% Fall Protection being observed while working at elevated heights? ****STOP ALL WORK IMMEDIATELY IF NOT****

  • Does each person working at elevated heights have the appropriated PFAS? ****STOP ALL WORK IF NOT****

  • Is the appropriate Anchorage point in use? (5000 lb requirement).

  • Is there a fall rescue/retrieval or means of fall rescue available kit onsite?

  • Is the fall protection in use in good condition?

  • Is the manual retrieval device available for excavation work? (Note the condition of the device)

  • Other

  • Add Section Notes and Observations.

  • Traffic Control

Traffic Control

  • Was traffic control in place prior to the crew beginning the work task?

  • If there is a road closure, is the proper closure, signage, detours, and sidewalks closed?

  • Are the workers properly protected from vehicle traffic?

  • Are all persons in the work zone wearing high visibility clothing?

  • Have all required permits been obtained for any public road crossings?

  • Have all road crossings been properly guarded?

  • Are all staying out of the work zone when not involved in the task?

  • Are spotters / flaggers being used at all times?

  • Are flaggers properly trained?

  • Are proper communication methods in use? (What form)?

  • Other

  • Add Section Notes and Observations.

  • Hand Tools

Hand Tools

  • Are hand tools in good working conditions (i.e. broken handles, etc.)?

  • Are ladders in good working condition?

  • Are GFCIs used on all electrical equipment? Are all power cords in good condition

  • Are all power hand tools in good working condition with appropriate guards?

  • Is the proper tool in use for the task?

  • Other

  • Add Section Notes and Observations.

  • Overhead Work

  • De-energized work (check box if this applies to the current job)

De-energized work

  • Is there a clearance on the line?

  • Does the Foreman know who holds the clearance, non-reclose order or hold order for the facilities being worked?

  • Has the transmission dispatch representative been contacted?

  • Has the line been tested and grounded?

  • Was there a flag installed on the grounds?

  • Has the crew elected to work as hot but de-energized?

  • IS the crew wearing rubber gloves and sleeves?

  • Do the Foreman and crew know and understand the clearance points?

  • NRO Number? (Where is this documented onsite?)

  • Other

  • Add Section Notes and Observations.

  • Working on or Near Energized Equipment (check box if this applies to the current job)

Working on or Near Energized Equipment

  • Is there a rescue kit on site or a hand line on the pole?

  • Are all employees maintaining minimum approach distances (MAD)?

  • Are all energized facilities covered or guarded to prevent contact? Including the line.

  • Has contractor been advised of equipment under an NRO order and have they logged in with Dispatch?

  • Are all employees working on or near energized equipment outfitted and wearing FR clothing properly. ***IF NOT STOP WORK IMMEDIATELY***

  • Other

  • Add Section Notes and Observations.

  • Are the employees working with transformers or regulators? (check box if this applies to the current job)

Transformers or regulators

  • Has the transformer been verified as PCB or non PCB?

  • Are the employees disposing of the transformers properly?

  • Grounding (check box if this applies to the current job)

Grounding

  • Have all lines and equipment been de- energized, tested, and grounded when required?

  • Have all sources of energy been considered including induced voltage?

  • Are powerline grounds being installed and removed properly (chain or parallel)?

  • Is equipotential grounding used?

  • Has the equipotential zone been barricaded, is the barricaded and maintained?

  • Are crews grounding the equipment?

  • Other

  • Add Section Notes and Observations.

  • Underground Work

Underground Work

  • Excavation (check box if this applies to the current job)

Excavation

  • Have locates been called, located, marked, and cleared?

  • Are the locates current?

  • Has an excavation competent person inspected the job site prior to entry each shift and when conditions change?

  • Document the soil type.

  • Are the spoils 2ft back from the trench or excavation's edge?

  • Are opened excavations & opened trench ways barricaded, or properly protected?

  • Is a ramp or ladder available when the trench is greater than 4ft in depth?

  • Is the ladder no more than 25ft from the work?

  • Is fall protection in place for excavations or pier holes (PFAS, with proper anchor point, guardrails or hole covers)?

  • Are excavations or trench’s made safe when unattended (is public protected from fall or cave in exposures)?

  • Other

  • Add Section Notes and Observations.

  • Hydro vac operations (check box if none apply to current job)

Hydro vac operations

  • Are the employees wearing rain or water protective suits?

  • Are the employees wearing face shields?

  • Are the employees wearing hearing protection?

  • Are dig permits up to date?

  • Are the employees using fall protection after 6ft depth is reached?

  • Are proper anchorage points in use (what form anchor point)?

  • Are hydro vac exactions barricaded / or protected to prevent employee or public access or falls.

  • Foundations

Foundations

  • Right-of-Way

  • Right of Way or Substation (check box if this applies to the current job)

Right of Way or Substation

  • Has the transmission dispatch or client representative been contacted prior to entering the substation?

  • Does the crew understand the easement delineation of the ROW?

  • Is the crew/crews staying on R.O.W.?

  • Does the crew understand the proper clearances from power lines?

  • Does contractor keep gates closed and locked?

  • Other

  • Add Section Notes and Observations.

  • Shop and Yard

Shop and Yard

  • Cranes (check box if this applies to the current job)

Cranes

  • Are safety belts worn while operating?

  • Is the crew involved in a critical lift?

  • Has a critical lift plan been competed prior to the lift?

  • Have pre-use inspections been completed on all equipment?

  • Is all equipment in satisfactory condition?

  • Is the housekeeping inside of the equipment satisfactory?

  • Is there a fire extinguisher on equipment or available onsite? And properly tagged and in date?

  • Is a signalman identified on the THA?

  • Have all operators and signalmen completed the required training for job position?

  • Has equipment been grounded where needed?

  • Are the outriggers fully extended, with proper outrigger pads and solid ground or surface?

  • Are employees staying out of the drop zone / line of fire (also known as the bite)?

  • Is there a backup alarm on all equipment or is the contractor using a spotter?

  • Is the crane and or swing radius barricaded properly?

  • Is the proper rigging in use?

  • Has the rigging been inspected with capacity tags intact / in place?

  • Other

  • Add Section Notes and Observations.

Notes of Obersavation: Please provide comments below:

  • Add site descriptive media to detail your site audit.

  • Add Section Notes and Observations.

Sign Off

  • Supervisor/s

  • Date:

  • Auditor/s

  • Date:

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