MoPac Improvement Project - Daily Safety Walk

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Personnel

General

• Is the general impression of the work area safe

  Yes

  No

  N/A

• Was a JHA completed for the work

  Yes

  No

  N/A

• Barriers/Fencing Maintained

  Yes

  No

  N/A

• Construction debris in work area cleaned up

  Yes

  No

  N/A

• Are trash cans available for crews

  Yes

  No

  N/A

• Is access/egress to the work area clearly defined

  Yes

  No

  N/A

• Does the access/egress have tracking pads installed

  Yes

  No

  N/A

• Is there a clear line of site to the access/egress point

  Yes

  No

  N/A

• Misc items: (Describe)

  Yes

  No

  N/A

Safety Documentation

• Daily pre task plan conducted (STAC, Morning Huddle, SPTP, etc)

  Yes

  No

  N/A

• Equipment inspections completed

  Yes

  No

  N/A

• Critical pick plan completed

  Yes

  No

  N/A

• Excavation entry permit compelted

  Yes

  No

  N/A

• Confined space entry permit or certificate completed and posted at entry

  Yes

  No

  N/A

• Hot work permit completed

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• Proper PPE selected for task at hand

  Yes

  No

  N/A

• Hardhats

  Yes

  No

  N/A

• Eye Protection

  Yes

  No

  N/A

• Ear Protection

  Yes

  No

  N/A

• Respiratory Protective Equipment

  Yes

  No

  N/A

• Hi-Viz Vests/Shirts

  Yes

  No

  N/A

• Proper Footwear

  Yes

  No

  N/A

• Proper Hand Protection

  Yes

  No

  N/A

• Face Protection (Face Shield)

  Yes

  No

  N/A

• Misc items: (Describe)

  Yes

  No

  N/A

Cranes and Rigging

• Swing radius adequately barricaded

  Yes

  No

  N/A

• Tag lines used to control load

  Yes

  No

  N/A

• Rigging in good condition

  Yes

  No

  N/A

• Crane operator signaling that load is coming (horns)

  Yes

  No

  N/A

• Rigger using proper hand signals

  Yes

  No

  N/A

• Are the outriggers fully extended

  Yes

  No

  N/A

• Is the crane set up on firm level ground

  Yes

  No

  N/A

• Are there adequate crane pads installed under outriggers

  Yes

  No

  N/A

• Is the crane free from drips or leaks

  Yes

  No

  N/A

• Is the operator required to conduct any blind lifts

  Yes

  No

  N/A

• Rigger is qualified

  Yes

  No

  N/A

• Loads being hoisted at safe speeds

  Yes

  No

  N/A

• Crane shutdown during high wind

  Yes

  No

  N/A

• Proper rigging techniques used

  Yes

  No

  N/A

• Misc items: (Describe)

  Yes

  No

  N/A

Confined Space Entry

• Completed permit or certificate posted at space entrance with JHA

  Yes

  No

  N/A

• Entrants/Attendants verify that all requirements of the permit or certificate have been satisfied.

  Yes

  No

  N/A

• Entry supervisor and Attendant assigned

  Yes

  No

  N/A

• Monitoring results documented on permit or certificate

  Yes

  No

  N/A

• Confined Space properly barricaded

  Yes

  No

  N/A

• Misc items: (Describe)

  Yes

  No

  N/A

Concrete

• Adequate Impalement Protection

  Yes

  No

  N/A

• Nails removed immediately from formwork when removing forms

  Yes

  No

  N/A

• Wet cutting to control dust

  Yes

  No

  N/A

• Concrete trucks equipped with audiable backup alarms

  Yes

  No

  N/A

• Concrete pumping operation safe

  Yes

  No

  N/A

• Misc items: (Describe)

  Yes

  No

  N/A

Electrical

• GFCI (ground fault circuit interrupter) working

  Yes

  No

  N/A

• Extension Cords in good Condition

  Yes

  No

  N/A

• Heavy Duty Extension Cords used

  Yes

  No

  N/A

• Portable lighting adequate

  Yes

  No

  N/A

• Light plants properly staged

  Yes

  No

  N/A

• Employees working a safe distance from above ground energized electrical

  Yes

  No

  N/A

• Employees are not exposed to underground energized electrical

  Yes

  No

  N/A

• Misc items: (Describe)

  Yes

  No

  N/A

Excavations

• Excavation Entry Permit completed & updated

  Yes

  No

  N/A

• Excavation Entry Permit Followed

  Yes

  No

  N/A

• Safe means of egress/access provided

  Yes

  No

  N/A

• Material and spoils at least 2' from excavation edge

  Yes

  No

  N/A

• Cave in protection system in place

  Yes

  No

  N/A

• Underground utility lines located

  Yes

  No

  N/A

• Underground utility lines supported

  Yes

  No

  N/A

• Barricades and adequate fall protection systems in place for excavations

  Yes

  No

  N/A

• Misc items: (Describe)

  Yes

  No

  N/A

Fall Protection

• Top-Rail is 39"-45" above working surface

  Yes

  No

  N/A

• Mid-Rail installed and splitting the difference from Top-Rail to working surface

  Yes

  No

  N/A

• Toe-boards installed

  Yes

  No

  N/A

• Fall Protection equipment in safe and serviceable condition

  Yes

  No

  N/A

• Personnel using 100% tie off with double lanyards

  Yes

  No

  N/A

• Personnel using fall protection correctly

  Yes

  No

  N/A

• Personnel not using material hoists as fall protection

  Yes

  No

  N/A

• Personnel calculating fall distance

  Yes

  No

  N/A

• Entry location properly maintained

  Yes

  No

  N/A

• Guardrails in good condition

  Yes

  No

  N/A

• Overhead work is properly barricaded to protect workers/public below

  Yes

  No

  N/A

• Misc items: (Describe)

  Yes

  No

  N/A

Fire Prevention

• Fire Extinguishers provided with 100' from ANY work area

  Yes

  No

  N/A

• Fire Extinguisher provided within 50' of any fuel source

  Yes

  No

  N/A

• Fire Extinguisher provided in immediate hot work area

  Yes

  No

  N/A

• Flammable/Combustible liquids stored properly

  Yes

  No

  N/A

• Containers are properly labeled

  Yes

  No

  N/A

• Hot work areas kept clear from anything flammable

  Yes

  No

  N/A

• Area in front and around Fire Extinguishers kept clear

  Yes

  No

  N/A

• Misc items: (Describe)

  Yes

  No

  N/A

Heavy Equipment

• Operating at safe speeds

  Yes

  No

  N/A

• Loads not hoisted overhead

  Yes

  No

  N/A

• Blade/Bucket/Fork/Boom landed and equipment shutdown when operator is out of equipment

  Yes

  No

  N/A

• Operator making eye contact with employees on ground

  Yes

  No

  N/A

• Operator using seatbelt

  Yes

  No

  N/A

• No visible leaks on equipment

  Yes

  No

  N/A

• Are the floor boards kept clear of all trash and other debris

  Yes

  No

  N/A

• Is a spotter in use when required

  Yes

  No

  N/A

• Personnel maintaining safe distance from equipment

  Yes

  No

  N/A

• Back up alarms functioning & audible

  Yes

  No

  N/A

• All operators following distracted driving policy

  Yes

  No

  N/A

• Operators are conducting daily equipment checklists

  Yes

  No

  N/A

• Misc items: (Describe)

  Yes

  No

  N/A

Scaffolds

• Daily inspection conducted by Competent Person

  Yes

  No

  N/A

• All Scaffold access has tag (Green, Yellow, Red) and is signed off daily

  Yes

  No

  N/A

• Safe means of egress provided

  Yes

  No

  N/A

• Work platform fully planked

  Yes

  No

  N/A

• Scaffold planks in good condition

  Yes

  No

  N/A

• Toe boards with no visible gaps below

  Yes

  No

  N/A

• Misc items: (Describe)

  Yes

  No

  N/A

Stairways and Ladders

• Any break in elevation 19" or greater has a step or ladder

  Yes

  No

  N/A

• Extension ladders at 4:1 ratio

  Yes

  No

  N/A

• Extension ladders extend 3' above landing surface

  Yes

  No

  N/A

• Extension ladders secured at the top, bottom and middle

  Yes

  No

  N/A

• User not straddling step ladder

  Yes

  No

  N/A

• Step ladders used properly

  Yes

  No

  N/A

• User is facing ladder at all times

  Yes

  No

  N/A

• Three points of contact continuously made while climbing

  Yes

  No

  N/A

• Belt buckle kept between side rails of ladder

  Yes

  No

  N/A

• Ladders are in good condition

  Yes

  No

  N/A

• Defective ladders tagged and removed from service

  Yes

  No

  N/A

• Area below and above ladder kept clear of debris

  Yes

  No

  N/A

• Misc items: (Describe)

  Yes

  No

  N/A

Welding and Cutting

• Hot work permit completed and posted near hot work area

  Yes

  No

  N/A

• Suitable fire extinguisher available in hot work area

  Yes

  No

  N/A

• Oxygen and fuel gas cylinders stored properly

  Yes

  No

  N/A

• Welding shields used when necessary

  Yes

  No

  N/A

• Proper PPE worn

  Yes

  No

  N/A

• Misc items: (Describe)

  Yes

  No

  N/A

• Signature

  Sign