Montana Contractor's Compensation Fund Crusher Safety Audit

• Conducted on

  Date

• Pit Audited

• Location
  Address

• Project Name

• Type of location

  Job Site

  Office/Shop

  Other

• Location type

• Reason for Audit

  Random

  Requested

  Follow-up

  Other

• Point(s) of Contact/Title

• Auditor

• Type of work being performed

Administration

• First Aid Supplies immediately available/ adequately stocked

  Safe

  At Risk

  N/A

• Jobsite warning signs posted as necessary (Confined Space, Flammable, High Voltage)

  Safe

  At Risk

  N/A

Weather

• Weather Conditions

  Select Clear Partly Cloudy Overcast Windy Raining Thunderstorm Snowing Breezy

  • Clear
  • Partly Cloudy
  • Overcast
  • Windy
  • Raining
  • Thunderstorm
  • Snowing
  • Breezy

• Ground Conditions

  Dry

  Wet

  Saturated

  Frozen

  Snow cover

• Temperature Expected for the day

• If temperatures are below 50 degrees or above 80, there is a chance for weather-related issues. Please refer to the graphics below to determine if weather might be a safety issue.

• Heat Index

  

• Wind Chill Index

  

• Temperature Index Cautions

  Select Heat - Caution Heat - Extreme Caution Heat - Danger Heat - Extreme Danger Wind Chill - Caution Wind Chill - Danger Wind Chill - Great Danger N/A

  • Heat - Caution
  • Heat - Extreme Caution
  • Heat - Danger
  • Heat - Extreme Danger
  • Wind Chill - Caution
  • Wind Chill - Danger
  • Wind Chill - Great Danger
  • N/A

Utility Notification

• Ground disturbance occurring

• Has Utility Locate been notified

  Yes

  No

  N/A

• Working near overhead utility lines

• Precautions in place to prevent contact

  Safe

  At Risk

  N/A

Required Permits

• Hot Work

• Permit completed/on-site

  Safe

  At Risk

  N/A

• Fire watch identified/present

  Safe

  At Risk

  N/A

• Fire extinguisher present

  Safe

  At Risk

  N/A

• Confined Space

• Permit completed/on-site

  Safe

  At Risk

  N/A

• Competent person identified/present

  Safe

  At Risk

  N/A

• Other permits required
Required Permit

• Permit completed

  Safe

  At Risk

  N/A

• Permit completed/on-site

  Safe

  At Risk

  N/A

• Required Permit

Staging Area

• General neatness of working areas & walkways

  Safe

  At Risk

  N/A

• Eye flushing facilities available

  Safe

  At Risk

  N/A

• Slip/Trip/Fall hazards eliminated in staging area

  Safe

  At Risk

  N/A

• Are materials, scraps, or debris, piled and stored as to not create a hazard?

  Safe

  At Risk

  N/A

• Sanitary, adequate bathroom facilities

  Safe

  At Risk

  N/A

• Adequate supply of drinking water

  Safe

  At Risk

  N/A

• Waste/garbage containers available

  Safe

  At Risk

  N/A

• Containers labeled

  Safe

  At Risk

  N/A

• Job trailer landing areas clear

  Safe

  At Risk

  N/A

• If railings required, installed

  Safe

  At Risk

  N/A

• Wheels chocked/blocked against movement

  Safe

  At Risk

  N/A

Personal Protective Equipment

• No respirators worn by untrained employees, voluntary use of dust masks

  Safe

  At Risk

  N/A

• PPE maintained properly

  Safe

  At Risk

  N/A

• Proper PPE selected

  Safe

  At Risk

  N/A

• Have all controls been implemented to minimize PPE requirements

  Safe

  At Risk

  N/A

• Safety Glasses

  Safe

  At Risk

  N/A

• Goggles

  Safe

  At Risk

  N/A

• Face Shields

  Safe

  At Risk

  N/A

• Hearing protection

  Safe

  At Risk

  N/A

• Class II High-Visibility clothing

  Safe

  At Risk

  N/A

Fire Prevention

• Adequate number & type of fire extinguisher(s) available

  Safe

  At Risk

  N/A

• Fire extinguisher inspections accomplished (monthly/periodically/)

  Safe

  At Risk

  N/A

• Gas Cylinders stored correctly

  Safe

  At Risk

  N/A

• Gas Cylinders in use secured in upright position

  Safe

  At Risk

  N/A

• Combustible scrap, debris, and waste materials stored in covered metal receptacles, and removed from the work site promptly

  Safe

  At Risk

  N/A

• Proper storage methods used to minimize the risk of fire and spontaneous combustion

  Safe

  At Risk

  N/A

• Flammable liquids kept in closed containers when not in use

  Safe

  At Risk

  N/A

• Empty containers removed

  Safe

  At Risk

  N/A

• Containers stored in approved and appropriate area(s)

  Safe

  At Risk

  N/A

• Propane cylinders stored/secured in upright position

  Safe

  At Risk

  N/A

Motor Vehicles

• Seat belt use

  Safe

  At Risk

  N/A

• Operated properly?

  Safe

  At Risk

  N/A

• Fire extinguishers serviced/inspected

  Safe

  At Risk

  N/A

• Drivers compartment clear

  Safe

  At Risk

  N/A

• Windshield free of obstructive cracks

  Safe

  At Risk

  N/A

• Loose materials/trash secured/removed

  Safe

  At Risk

  N/A

• Tools/Equipment secure

  Safe

  At Risk

  N/A

• Beacons

  Safe

  At Risk

  N/A

• Back-up alarms (1 ton and above)

  Safe

  At Risk

  N/A

Commercial Motor Vehicles

• CMV's in use

• Seat belt use

  Safe

  At Risk

  N/A

• Operated properly?

  Safe

  At Risk

  N/A

• Fire extinguishers serviced/inspected

  Safe

  At Risk

  N/A

• Drivers compartment clear

  Safe

  At Risk

  N/A

• Windshield/side windows free cracks/chips

  Safe

  At Risk

  N/A

• Loose materials/trash secured/removed

  Safe

  At Risk

  N/A

• Beacons

  Safe

  At Risk

  N/A

• Back-up alarms

  Safe

  At Risk

  N/A

• Paperwork complete: CMV Inspections/Logs

  Safe

  At Risk

  N/A

• Defects corrected quickly

  Safe

  At Risk

  N/A

Heavy Equipment

• Heavy Equipment in use

• Seat belt use

  Safe

  At Risk

  N/A

• Operated properly?

  Safe

  At Risk

  N/A

• Fire extinguishers serviced/inspected

  Safe

  At Risk

  N/A

• Drivers compartment clear

  Safe

  At Risk

  N/A

• Windshield/side windows free cracks/chips

  Safe

  At Risk

  N/A

• Loose materials/trash secured/removed

  Safe

  At Risk

  N/A

• Beacons

  Safe

  At Risk

  N/A

• Back-up alarms

  Safe

  At Risk

  N/A

• Defects corrected quickly

  Safe

  At Risk

  N/A

Trailers

• Trailers in use

• Properly sized for load

  Safe

  At Risk

  N/A

• Properly attached to tow unit

  Safe

  At Risk

  N/A

• All tail/marker lights operatable

  Safe

  At Risk

  N/A

• Decking secure/stable

  Safe

  At Risk

  N/A

• Deck clear of debris

  Safe

  At Risk

  N/A

• Wheels chocked/blocked from movement if parked

  Safe

  At Risk

  N/A

• Load secured properly

  Safe

  At Risk

  N/A

• Proper signs/placards

  Safe

  At Risk

  N/A

Powered Industrial Trucks (Forklifts/Telehandlers)

• PITs in use

• Properly sized for load

  Safe

  At Risk

  N/A

• Properly attached to tow unit

  Safe

  At Risk

  N/A

• All tail/marker lights operatable

  Safe

  At Risk

  N/A

• Decking secure/stable

  Safe

  At Risk

  N/A

• Deck clear of debris

  Safe

  At Risk

  N/A

• Wheels chocked/blocked from movement if parked

  Safe

  At Risk

  N/A

• Load secured properly

  Safe

  At Risk

  N/A

• Proper signs/placards

  Safe

  At Risk

  N/A

• Trailers in use

• Properly sized for load

  Safe

  At Risk

  N/A

• Properly attached to tow unit

  Safe

  At Risk

  N/A

• All tail/marker lights operatable

  Safe

  At Risk

  N/A

• Decking secure/stable

  Safe

  At Risk

  N/A

• Deck clear of debris

  Safe

  At Risk

  N/A

• Wheels chocked/blocked from movement if parked

  Safe

  At Risk

  N/A

• Load secured properly

  Safe

  At Risk

  N/A

• Proper signs/placards

  Safe

  At Risk

  N/A

Additional Rolling Stock Hazards Identified

• Additional Rolling Stock Hazards Identified
Additional Rolling Stock Hazards Identified

• Additional Rolling Stock Hazards Identified

• Provisions in place

  Safe

  At Risk

  N/A

Hand Tools

• Proper tools and operator for the job task

  Safe

  At Risk

  N/A

• Hand tools free from damage (shaft, head,<br>splinters, etc.)

  Safe

  At Risk

  N/A

• Tools used properly

  Safe

  At Risk

  N/A

• Pneumatic Tools - proper hoses and connections

  Safe

  At Risk

  N/A

• Damaged tools repaired or replaced

  Safe

  At Risk

  N/A

• Tools equipped with required guards

  Safe

  At Risk

  N/A

• Tools stored properly when not in use

  Safe

  At Risk

  N/A

• Cuttoffs/Kill Switches /Anti-restart functioning

  Safe

  At Risk

  N/A

Material Handling

• Using mechanical lifting when possible

  Safe

  At Risk

  N/A

• Materials secured/balanced

  Safe

  At Risk

  N/A

• Materials moved as low as possible

  Safe

  At Risk

  N/A

• Correct body positioning

  Safe

  At Risk

  N/A

• Lifting with other employees

  Safe

  At Risk

  N/A

• Other Hazards/Provisions
Other hazards identified/precautions

• Other hazards

• Provisions in place

  Safe

  At Risk

  N/A

Hot Work

• Hot Work being performed

• Gas cylinders properly stored, in or out of service

  Safe

  At Risk

  N/A

• Welding cables: Leads, connectors & cable condition

  Safe

  At Risk

  N/A

• Power cables protected & in good repair

  Safe

  At Risk

  N/A

• Oxy/Acetylene torch sets, regulators, hoses and attachments in good repair

  Safe

  At Risk

  N/A

• Proper PPE being utilized

  Safe

  At Risk

  N/A

• Proper ventilation/filtering present

  Safe

  At Risk

  N/A

• Fire Extinguisher within 25 feet

  Safe

  At Risk

  N/A

• Flammable material protected or removed

  Safe

  At Risk

  N/A

• Fire watch being utilized when required

  Safe

  At Risk

  N/A

Crusher

• Crusher on site

• Bin ramps bermed properly

  Safe

  At Risk

  N/A

• Emergency Provider Checklist completed, displayed

  Safe

  At Risk

  N/A

• Containment berms

  Safe

  At Risk

  N/A

• Hot oil PPE present/maintained

  Safe

  At Risk

  N/A

• Hard Hats, Safety Toed Boots, Eye and Hearing Protection utilized

  Safe

  At Risk

  N/A

• Other Hazards/Provisions
Other hazards identified/precautions

• Other hazards

• Provisions in place

  Safe

  At Risk

  N/A

Closing

• Findings/Comments

• Findings/Comments

Signatures

• On-Site Representative:

  Sign
Auditor

• Auditor:

  Sign