MPW General Job Site Field Audit

• Project/Job #

• Project/Job

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

BEHAVIOR

• A. Are JSA (Job Safety Analysis) reviewed and signed?

  Yes

  No

  N/A

• B. Are WTSR (Work Task Safety Requirements) for each job?

  Yes

  No

  N/A

• C. Is the Water Blast Checklist being completed and followed?

  Yes

  No

  N/A

• D. Is the Wet/Dry Vacuuming Checklist being completed and followed?

  Yes

  No

  N/A

• E. Is the EH&S checklist being completed and followed?

  Yes

  No

  N/A

• F. Are crew leaders / supervisors identified with White Hard Hats?

  Yes

  No

  N/A

• G. Are any incidents being discussed?

  Yes

  No

  N/A

• H. Are meaningful observations being completed?

  Yes

  No

  N/A

• I. Other

  Yes

  No

  N/A

WORK AREAS

• A. General Housekeeping

  Safe

  At Risk

  N/A

• B. Walking - Working Surfaces

  Safe

  At Risk

  N/A

• C. Unprotected Sides or Holes

  Safe

  At Risk

  N/A

• D. Restrooms identified and available? Trash cans present?

  Safe

  At Risk

  N/A

• E. Material Storage/Lay Down

  Safe

  At Risk

  N/A

JOB SITE POSTERS

• A. OSHA Posters<br> 300A during Feb 1st thru April 30th

  Safe

  At Risk

  N/A

• B. Emergency Evacuations Plans / Maps / Muster points posted

  Safe

  At Risk

  N/A

• C. Emergency Contacts List

  Safe

  At Risk

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• A. Hard Hats

  Safe

  At Risk

  N/A

• B. Safety Glasses with Side Shields

  Safe

  At Risk

  N/A

• C. Face Shield / Goggles (If Required)

  Safe

  At Risk

  N/A

• D. Respiratory Protection (If Required)

  Safe

  At Risk

  N/A

• E. Hearing Protection (If required)

  Safe

  At Risk

  N/A

• F. Clothing (FRC etc. if required)

  Safe

  At Risk

  N/A

• G. Gloves

  Safe

  At Risk

  N/A

• H. Foot Protection

  Safe

  At Risk

  N/A

FALL PROTECTION

• A. Trained Personnel (Competent Person)

  Safe

  At Risk

  N/A

• B. Worn Properly

  Safe

  At Risk

  N/A

• C. Suitable Anchorage Points

  Safe

  At Risk

  N/A

• D. Inspected/Color Coded

  Safe

  At Risk

  N/A

• E. Stored Properly

  Safe

  At Risk

  N/A

• F. Emergency High Angle Rescue Plan

  Safe

  At Risk

  N/A

LADDERS

• A. Base/Footing/Set Up

  Safe

  At Risk

  N/A

• B. Inspections/Color Coded

  Safe

  At Risk

  N/A

• C. Proper Type for Task

  Safe

  At Risk

  N/A

TOOLS AND EQUIPMENT

• A. In Good Condition

  Safe

  At Risk

  N/A

• B. Inspected/Color Coded

  Yes

  No

  N/A

• C. Whip-Checks

  Yes

  No

  N/A

• D. Water Blast Guns with shrouds?

  Yes

  No

  N/A

• E. Are Foot Pedals with Carbon Steel fittings?

  Yes

  No

  N/A

CONFINED SPACE

• A. Trained Personnel (Competent Person)

  Safe

  At Risk

  N/A

• B. Attendant Trained

  Yes

  No

  N/A

• C. Entrants Trained

  Yes

  No

  N/A

• D. Attendant has means to summon rescue

  Yes

  No

  N/A

• E. Attendant completing the Sign In/Out Sheet

  Yes

  No

  N/A

• F. Permit Required

  Safe

  At Risk

  N/A

• G. Permit Followed

  Safe

  At Risk

  N/A

• H. Air Monitoring

  Safe

  At Risk

  N/A

• I. Emergency Rescue Plan

  Safe

  At Risk

  N/A

ELECTRICAL

• A. G.F.C.I.'s

  Safe

  At Risk

  N/A

• B. Extension Cords

  Safe

  At Risk

  N/A

• C. Power Tools

  Safe

  At Risk

  N/A

• D. Lock Out/Tag Out

  Safe

  At Risk

  N/A

RIGGING AND HOISTING

• A. Capacity Tags

  Safe

  At Risk

  N/A

• B. Hooks and Latches

  Safe

  At Risk

  N/A

• C. Chain falls/Come-a-longs

  Safe

  At Risk

  N/A

• D. Tag Lines

  Safe

  At Risk

  N/A

• E. Inspected/Color Coded

  Safe

  At Risk

  N/A

SCAFFOLD

• A. Trained Personnel (Competent Person)

  Safe

  At Risk

  N/A

• B. Hand and Mid-rails, Toeboards

  Safe

  At Risk

  N/A

• C. Platform Decked/Secured

  Safe

  At Risk

  N/A

• D. Level Footing/Set up

  Safe

  At Risk

  N/A

• E. Access/Egress

  Safe

  At Risk

  N/A

• F. Away from Powerlines

  Safe

  At Risk

  N/A

• G. Barricades

  Safe

  At Risk

  N/A

• H. Inspection/Tagged Correctly

  Safe

  At Risk

  N/A

EQUIPMENT

• A. Equipment Inspections

  Safe

  At Risk

  N/A

• B. Operator Qualified and Certified

  Safe

  At Risk

  N/A

• C. Operator Manual

  Safe

  At Risk

  N/A

• D. Flagman with Vest

  Safe

  At Risk

  N/A

• E. Proper setup and use

  Safe

  At Risk

  N/A

HAZCOM

• A. MSDS on Site

  Yes

  No

  N/A

• B. MSDS for all Chemicals on Site

  Yes

  No

  N/A

• C. Proper Storage of Chemicals

  Safe

  At Risk

  N/A

• D. Proper PPE for Handling Chemicals

  Yes

  No

  N/A

OTHER

• A.

  Safe

  At Risk

  N/A

• B.

  Safe

  At Risk

  N/A

• C.

  Safe

  At Risk

  N/A

• D.

  Safe

  At Risk

  N/A

Comments/Recommendations

• Suggested corrective actions

Sign Off

• Health and Safety Representative

  Sign

• Account Manager

  Sign

• Field Supervision / Supervisor

  Sign