Midwest ESSV

• Document No.

• Midwest ESSV

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Project Activities

• General Comments

Environmental Aspects

• Have the potential environmental impacts on the project been identified?

  Yes

  No

  N/A

• Are all soil and erosion control operational controls currently in place and maintained?

  Yes

  No

  N/A

• Do you know the procedures in the event of an environmental release?

  Yes

  No

  N/A

• Are there energy or water conservation measures in place on the project?

  Yes

  No

  N/A

• Are the waster diversion goals being met on the project?

  Yes

  No

  N/A

• Are pieces of machinery and equipment inspected and in good working order?

  Yes

  No

  N/A

Safety Aspects

• Did you attend the PLST or review previous meeting minutes?

  Yes

  No

  N/A

• Did you walk the project with the superintendent or other staff member?

  Yes

  No

  N/A

• Did you have a discussion with any craft workers about IFE

  Yes

  No

  N/A

• Did you lead or participate in stretch and flex?

  Yes

  No

  N/A

• Did you participate in pre-task planning?

  Yes

  No

  N/A

• Are OHSAS 18001 operational controls monitored/discussed?

  Yes

  No

  N/A

• Fall Protection Observations:

• PPE Observations:

• Housekeeping Observations:

• Innovative Ideas:

Jobsite Housekeeping

• Site Fencing Screening should be tight to fence, neat, orderly, and fully intact without damage. The perimeter of the site should be clean and trash and materials should not be stored against the fence.

  Select Outstanding 21-18 points Acceptable 17-14 points Unacceptable 13-7 points

  • Outstanding 21-18 points
  • Acceptable 17-14 points
  • Unacceptable 13-7 points

• Dumpster Location Area should be kept free of debris on the ground at all times. A clear path of travel to dumpster should be maintained, including truck access for haul off.

  Select Outstanding 21-18 points Acceptable 17-14 points Unacceptable 13-7 points

  • Outstanding 21-18 points
  • Acceptable 17-14 points
  • Unacceptable 13-7 points

• Stair/Corridor Cleanliness All stairs and corridors must be clean and provide a clear and appropriate egress route at all times. There shall be no storage of materials, equipment, or debris in corridors or stairs.

  Select Outstanding 21-18 points Acceptable 17-14 points Unacceptable 13-7 points

  • Outstanding 21-18 points
  • Acceptable 17-14 points
  • Unacceptable 13-7 points

• Path of Travel-Exterior Clear paths of travel around and into structures, including break/lunch areas, shall be maintained clear of debris and uneven surfaces. Concrete/stone walks shall be provided, where required, to keep employees from walking thru mud and water.

  Select Outstanding 21-18 points Acceptable 17-14 points Unacceptable 13-7 points

  • Outstanding 21-18 points
  • Acceptable 17-14 points
  • Unacceptable 13-7 points

• Interior Storage of Materials All material shall be stored on cribbing or pallets so they may be easily and promptly moved with a pallet jack, or stored on carts with wheels. All materials shall be stored in a manner to allow for proper housekeeping throughout the building. At no time shall flammable materials be stored inside the building.

  Select Outstanding 21-18 points Acceptable 17-14 points Unacceptable 13-7 points

  • Outstanding 21-18 points
  • Acceptable 17-14 points
  • Unacceptable 13-7 points

• Waste/Debris Management Trash Barrels with lids shall be located and regularly maintained at all break/lunch areas. Each trade shall maintain respective work areas throughout each shift so that debris does not prohibit other work form proceeding. All debris shall be removed on a continual basis by each trade.

  Select Outstanding 21-18 points Acceptable 17-14 points Unacceptable 13-7 points

  • Outstanding 21-18 points
  • Acceptable 17-14 points
  • Unacceptable 13-7 points

• Cord/Hose Management Cords, hose, welding leads, eat. Shall run in a manner that will not create a tripping or entanglement hazard. If run overhead, all cords/hoses must maintain a minimum 7 feet off the floor utilizing acceptable hanging methods.

  Select Outstanding 21-18 points Acceptable 17-14 points Unacceptable 13-7 points

  • Outstanding 21-18 points
  • Acceptable 17-14 points
  • Unacceptable 13-7 points