Title Page

  • Conducted on

  • Prepared by

  • Location

Part 1: Prescriptive

  • Conduct a monthly report and forward a copy to the Health and Safety Department.

Fire / Gas Detection and Early Warning Systems

  • Fire Extinguishers - Every extinguisher should be shook to ensure the powder remains loose inside.

  • Fire Extinguishers - Extinguishers must be mounted to the walls to NFPA standards (No less than 4" off the ground and no more than 5' up the wall measured to the top of the unit), decals at eye level and free of obstructions.

  • Fire Extinguishers - Check pressure is adequate, inspect for excess rust and ensure the pin is in place.

  • Fire Extinguishers - Check that fire extinguishers have had their annual inspection (within one month of expiry organize an inspection).

  • Smoke Detectors - All detectors must have working batteries.

  • Gas Detectors - Multi Gas and CO detectors near appliances and 4 to 5 feet off the floor.

  • Early Warning Detectors (Smoke / Gas) - Test detectors as per manufactures instructions (push button on the front and wait 1-2 sec. for alarm to activate).

Ladders and High Point Access

  • Ladder and Ladder Safety - Ensure all ladders on site have been inspected and in good operating conditions. (Rungs, foot pads, fly sections, components such as roof hooks and lock dogs must be diligently inspected and in good operation).

  • Ladder and Ladder Safety - Pre-use inspection tags available and being used appropriately.

  • Fall Protection - Lanyards and harnesses must be in good operational condition and stored appropriately.

  • Ladders and High Point Access - Pre-use inspection tags available for ladders, man baskets and harnesses must be used and filled in appropriately.

First Aid Station / Emergency Kits

  • First Aid Kits - Ensure First Aid kits are complete and ready for service.

  • First Aid Kits - Ensure the site has a collar set / universal collar in good condition, free of dirt and ready for service.

  • Survival Kits - Ensure all emergency survival kits are full with no expired or damaged equipment within. Survival kits should be stored in an area where they can be quickly accessible and ready for service.

  • First Aid / Emergency Kits - Check first aid and emergency supplies for items that are reaching the expiry and replace them before expiration date(s) arrive.

  • Eyewash Stations - Ensure eyewash stations are filled and they have not reached expiry dates.

  • Eyewash Stations - Eyewash stations are located in areas of risk and readily available. Stations must be easily identified by decals and kept free and clear of obstructions.

Medical Emergency Response

  • Rapid Medical Transport - Spine boards / Scoop Stretcher, blankets, spider straps and other related safety equipment is readily accessible and ready for service.

  • AED (Automated External Defibrillator) - AED is ready, light is flashing, unit is correctly stored in case with appropriate signage and resuscitation kit present.

  • Medical Oxygen (O2) Bottles - Medical oxygen tanks are secured, hydrostatically tested within 5 years and components are in good order.

  • Medical Oxygen (O2) Bottles - Site has enough medical oxygen to accommodate a transported worker for the estimated time of transport (1 tank lasts an average of 10 min.)

  • Medical Oxygen (O2) Bottles - Medical oxygen tanks which are stored in carry bags / boxes must have regulator, wrench and O2 masks (1 mask min and a BCVM per kit) included for quick access.

  • Reference Material - Emergency procedure(s) posted at communication area(s).

  • Reference Material - Evacuation procedure(s) are posted in communication area(s).

  • Reference Material - Earthquake / Tsunami procedure(s) are posted in communication area(s).

Hazmat Emergency Control

  • Hazmat Containment - Secondary containment with 110% capacity available, tidy and not at overcapacity.

  • Hazmat Containment - Hazardous materials stored appropriately in a manner that keeps them free of collision, tipping or spilling and within the containment unit(s).

  • Hazmat Emergency Response - Spill kit fully stocked as indicated on spill kit check sheet (stored on or in the kit).

  • Hazmat Emergency Response - Extra 100 Ft. boom (Saltwater sites).

  • Hazmat Emergency Response - Mask and filters are in safe condition to use (no mold, grime or expired components).

Escape Response

  • Escape Response - Minimum requirements met, readily available and in a central location. (Saltwater sites: X2 Escape Panels With lead line or Cannonballs, Knife, Loaded Net Needles, Zap Straps and 4 X 50’ Rope. Freshwater sites: Seine Net, Garbage Bags, 20 X 20 Tarp, Net Bag, Silt Fencing).

Housekeeping Standards

  • Housekeeping - Materials and equipment properly stored.

  • Housekeeping - No materials stored in front of electrical panels.

  • Housekeeping - No materials stored by heat sources.

  • Emergency Evacuation - Aisles and emergency exits are clear, free of obstructions and ready for service.

  • Emergency Evacuation - Emergency exits must have signage, preferably glow in the dark or light up signs. Exits (not closets or access hatches) that have no means of safe escape must be marked "Not an exit."

Confined Space Equipment

  • Confined Space Equipment - Confined space fan and attachments in good order.

  • Confined Space Equipment - 4Gas monitor available and calibrated.

  • Confined Space Equipment - Rescue system in good condition. This includes Davit Posts, rescue winch, tripods, fall arrest system and harnesses.

WHMIS System

  • MSDS / SDS - Safety Data Sheets are up to date and readily available to employees when needed.

  • Workplace Labels - Workplace labels or supplier labels on all controlled product containers or conditions have been met to identify product to legislative standards required.

  • Warnings and Signage - Warning labels such as No Smoking, hazardous containment or storage, flammable, and other site appropriate WHIMIS labels must be posted and legible.

Part 2: Variable

  • Additional equipment and facility safety observations that are not covered on Page 1 should be included and addressed in the monthly safety meeting.

    Record observations below (Type / name of machine or equipment with brief description of problem), Record corrective actions (What plans are in place or actions required to fix the problem), Assign and record a rating; low, moderate or high (While corrective actions are being addressed the hazard must be communicated to all site workers and temporary procedures implemented)

    High: Could result in a serious injury (life or limb) - Must be addressed immediately
    Medium: May result in an injury that will require medical treatment and / or recovery time - Must be addressed within 30 days
    Low: May result in a minor injury - Must be addressed within 90 days

    Information (Text / Picture) options will appear upon assigning a rating.

Part 3: Regulatory / Endorsements

Regulatory Information

  • WorkSafeBC OHS Regulation Part 3 Rights and Responsibilities Workplace Inspections (3.5 General requirement) - Every employer must ensure that regular inspections are made of all workplaces, including buildings, structures, grounds, excavations, tools, equipment, machinery and work methods and practices, at intervals that will prevent the development of unsafe working conditions.

Inspector and management Endorsements

  • Inspector / Technician

  • Manager / Supervisor

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