Information
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Site conducted
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Client Name
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Location
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Job site photo
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Conducted on
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Conducted by
Site Inspection/Site Visit
Client Contact
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Client Contact Name
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Title
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Contact #
1. General Safety and Health Provisions
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1.1 Safety and Training Education: <br>Is each employee instructed in the recognition and avoidance of unsafe conditions and the regulations applicable to their work environment to control or eliminate any hazards or other exposure to illness or injury? 1926.21(b)(2) CAL OSHA 3203
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1.2 Harmful Substances: <br>Are employees who are required to handle or use poisons, caustics, and other harmful substances instructed in their safe handling and use, and made aware of the potential hazards, personal hygiene, and personal protective measures? 1926.21(b)(3) CAL OSHA 5192(p)(7)
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1.3 Confined Space/Enclosed Space: <br>Are employees who are required to enter confined or enclosed spaces instructed as to the nature of the hazards involved, the necessary precautions to be taken, and in the use of protective and emergency equipment? 1926.21(b)(6)(i) CAL OSHA 1956(a)
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1.4 Housekeeping: <br>Is form and scrap lumber with protruding nails and all other debris kept cleared from work areas, passageways, and stairs? 1926.25(a) CAL OSHA 1513(a)
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1.5 Is all regulated waste, as defined in the OSHA Bloodborne Pathogens standard (29 CFR 1910.1030), discarded according to Federal, state and local regulations? CAL OSHA 5193(d)(E)
2. Personal Protective and Life Saving Equipment
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2.1 Head Protection: <br>Are protective helmets (hard hats) worn at all times where there is a possible danger of head injury from impact, falling or flying objects, or electrical shock and burns? 1926.100 CAL OSHA 3381(a)
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2.2 Hearing Protection:<br> Are ear protection devices provided and used wherever it is not feasible to reduce noise levels or where a deviation to exposures levels specified in Table D-2, Permissible noise exposure in 1926.52 exist? 1926.101 Cal OSHA 5097(a) 5098(a)(1)(2)
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2.3 Eye and Face Protection: <br>Are employees provided with and use eye and face protection when machines or operations present potential eye or face injury from physical, chemical, or radiation agents? 1926.102 CAL OSHA 3382(a)
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2.4 Is foot protection needed? 1926.96 CAL OSHA 3408(b)<br>
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2.5 Selection, Issuance, Use and Care of Respirators: <br>Are employers provided with and use appropriate respiratory protective devices in emergencies or when controls required by Subpart D of this part either fail or are inadequate to prevent harmful exposure? 1926.103(a)(1) CAL OSHA 5144(a)(1)(2)
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2.6 Working Over or Near Water: <br>Are employees working over or near water provided with and use U.S. Coast Guard-approved life jacket or buoyant work vests and are ring buoys with at least 90 feet of line and at least one lifesaving skiff provided? 1926.103 CAL OSHA 1602(a)(1)
3.Walk Ways
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3.1 Are aisles and passageways kept clear and marked as appropriate? CAL OSHA 8391(a)
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3.2 Are holes in the floor, sidewalk, or other walking surface repaired properly, covered, or otherwise made safe? CAL OSHA 1735
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3.3 Are materials or equipment stored in such a way that sharp projections will not interfere with the walkway?
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3.4 Are changes of direction or elevations readily identifiable? CAL OSHA 7046 and 3273(c)
4. First aid and medical Services
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4.1 Is there a hospital, clinic, or infirmary for medical care near your workplace or is at least one employee on each shift currently qualified to render first aid? CAL OSHA 3400(b)
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4.2 Have all employees who are expected to respond to medical emergencies as part of their job responsibilities received first aid training; had hepatitis B vaccination made available to them; had appropriate training on procedures to protect them from bloodborne pathogens, including universal precautions; and have available and understand how to use appropriate PPE to protect against exposure to bloodborne diseases? CAL OSHA 3400(b)
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4.3 If employees have had an exposure incident involving bloodborne pathogens, was an immediate post-exposure medical evaluation and follow-up provided? CAL OSHA 5193
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4.4 Are emergency phone numbers posted. CAL OSHA 3400(f)(1)<br>
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4.5 Are fully supplied first aid kits easily accessible to each work area, periodically inspected and replenished as needed? CAL OSHA 3400(c)<br>
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4.6 Is there an eye-wash station or sink available for quick drenching or flushing of the eyes and body in areas where corrosive liquids or materials are handled? CAL OSHA 3400(d)
5. Fire Protection
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5.1 Is firefighting equipment conspicuously located? 1926.150(a)(3) CAL OSHA 1920(c)<br>
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5.2 Is firefighting equipment periodically inspected and maintained in operating condition? 1926.150(a)(4) CAL OSHA 1922(a)(4) and 1920(d) and 6773(b)<br>
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5.3 Is firefighting equipment selected and provided according to the listed requirements? 1926.150(c) CAL OSHA 1920(a)<br>
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5.4 Has an educational program to familiarize employers with the general principles of fire extinguishers use and the hazards involved been provided? 1910.150(c)(xi) CAL OSHA 1920(a)<br>
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5.5 Flammable and Combustible Liquids: Are all flammable and combustible liquids stored and handled in approved containers and portable tanks? 1926.152(a)(1) CAL OSHA 1930(a)<br>
6. Tools, Hand and Power
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6.1 General Requirements: Are hand and power tools furnished by employer or employee maintained in a safe condition? 1926.300(a) Cal OSHA 2395.45, 2395.51 and 2395.59<br>
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6.2 Are power tools, belts, gears, shafts, pulleys, sprockets, spindles, drums, fly wheels, and chains properly guarded? 1926.300 (b)(1) & (2) CAL OSHA 2340.17(a) <br>
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6.3 Power-Operated hand tools: Are electric power operated tools equipped with proper ground or are they double insulated? 1926.302(a) CAL OSHA 1707<br>
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6.4 Have all employees who operate power actuated tools been trained in the use of the particular tool they use? 1926.302(e)(1) CAL OSHA 1510<br>
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6.5 Woodworking tools: Do all portable circular saws have a guard above the base plate and a guard below the base plate that will automatically and instantly return to the covering position when the saw is withdrawn from the work? 1926.304(d) CAL OSHA 4307(a)<br>
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6.6 Do all circular saws have an exhaust hood or a guard to prevent accidental contact with the saw blade if there is a possibility of contact either beneath or behind the table? 1926.304(f) ANSI 01.0-1926 Section 4.1.1 CAL OSHA 4307(b)(1)<br>
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6.7 Do hand-fed circular rip saws have an upper blade guard? 1926.304(f) ANSI 01.0-1926 Section 4.1.2(a) CAL OSHA 4307 (a)<br>
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6.8 Do hand-fed circular rip saws have a spreader? 1926.304(f) ANSI 01-1-1926 Section 4.1.2(b) CAL OSHA 4300.1(b)<br>
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6.9 Do hand-fed circular rip saws have non-kickback fingers or dogs? 1926.304(f) ANSI 01-1-1926 Section 4.1.2 CAL OSHA 4300.1(c)(1)<br>
7. Electrical
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7.1 General Requirements: Does the employer examine all electrical equipment to ensure that recognized electrical hazards (i.e. exposed live parts, splices in cords, missing ground pins, reverse polarity, etc.) are identified? 1926.403(b)(1)CAL OSHA 2940(b)(1)(2)(3)<br>
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7.2 Are disconnecting means legibly marked to indicate purpose unless located so that purpose is evident? 1926.403(h) CAL OSHA 2718(a)<br>
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7.3 Are live electrical parts guarded against accidental contact? 1926.403(i)(2) CAL OSHA 2340.17(a)<br>
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7.4 Are ground fault circuit interrupters used to protect employees? 1926.404(b)(1)(i) CAL OSHA 2405.4 and 2360.3<br>
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7.5 If not is an assured equipment grounding program in place? 1926.404(b)(1)(iii) CAL OSHA 2360.3(b)(3)<br>
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7.6 Are all 120-volt, single phase, 15-and 20-ampere receptacle outlets on construction sites, which are not a part of the permanent wiring of the building or structure and which are in use by employees, protected by a ground-fault circuit interrupter(s) GFCI? 1926.404(b)(1)(ii) Cal OSHA 2360.3(a)&(b)(1)<br>
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7.7 Are outlet devices correctly matched with load being served? 1926.404(b)(2) CAL OSHA 2360.4<br>
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7.8 Are all electrical circuits and equipment grounded? Is path to ground from circuits, equipment and enclosures permanent and continuous? 1926.404(f)(6) CAL OSHA 2743<br>
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7.9 Are exposed noncurrent carrying metal parts of cord and plug-connected equipment grounded? 1926.404(f)(7)(iv) Are electrical extension cords of the three wire type? 1926.405(a)(2)(ii)(J) CAL OSHA 2743(a)(2) & (b)<br>
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7.10 Are lamps for general illumination protected against breakage? 1926.405(a)(2)(ii)(E) CAL OSHA 2405.2(f)<br>
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7.11 Are flexible cords and cables protected from damage? 1926.405(a)(2)(ii)(l) CAL OSHA 2405.2(g)&(I)<br>
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7.12 Are conductors entering boxes, cabinets, or fittings protected from abrasion and do unused openings in cabinets, boxes and fittings have covers? 1926.405(b)(1) CAL OSHA 2754.1(a)
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7.13 Are all cabinets, cut out boxes, fittings, boxes, panel board enclosures, switches, circuit breakers, and switchboards located in wet or damp locations enclosed in weather proof enclosures? 1926.405(e)(1) and (2)CAL OSHA 2712(c)
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7.14 Are fixtures and receptacles in wet or damp locations identified for that purpose and installed so that water cannot enter? 1926.405(j)(1)(v) and (j)(2)(ii) CAL OSHA 2712(b)
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7.15 Safety related work practices: Are electrical cords or cables taken out of service when worn or frayed? 1926.416(e)(1) CAL OSHA 1518<br>
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7.16 Are contractors/subcontractors (painters) using aluminum extension handles (or ladders) around electrical power lines? CAL OSHA 3276(18)<br>
8. Fall Protection >6 Feet
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8.1 When excavations, wells, shafts, pits, are not readily seen (shrubs, plants, etc.) are employees protected by guardrails, fences or barricades? 1926.501(b)(7)(i) and (iii) CAL OSHA 1541(L)(2)
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8.2 General Requirements: Is walking/working surface strong enough to support employees and the work to be done? 1926.501(a)(2) CAL OSHA 3212(b)<br>
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8.3 Are employees on walking/working surfaces with unprotected sides and edges protected by guardrails, safety nets, or personal fall arrest systems? 1926.501(b)(1) CAL OSHA 3210(a)<br>
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8.4 Are employees who are constructing leading edges protected by guardrails, safety nets or personal fall arrest systems if feasible? (If not feasible, requirements of paragraph (k) of 1926.502 must be met) 1926.501(b)(2)(i) CAL OSHA 1670<br>
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8.5 Is each employee in a hoist area protected by either guardrails or personal fall arrest system? 1926.501(b)(3) CAL OSHA 1670<br>
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8.6 In hoisting areas where guardrails are used and guardrails are removed to facilitate landing of material and the employee must lean out over the edge or through the access opening, is that employee protected by a fall arrest system? 1926.501(b)(3) CAL OSHA 1670(a)<br>
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8.7 Are employees exposed to falling through holes (including skylights) protected by fall arrest systems, guardrails or covers? 1926.501(b)(4)(i) CAL OSHA 1670(a)<br>
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8.8 Are employees on walking/working surfaces protected from tripping or stepping into holes by covers? 1926.501(b)(4)(iii) CAL OSHA 1735<br>
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8.9 Are employees on walking/working surfaces protected from objects falling through holes by covers? 1926.(b)(4)(iii)<br>
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8.10 Are exposed employees working on the face of form work or reinforcing steel protected by fall arrest systems, safety nets, or positioning device systems? 1926.501(b)(5)<br>
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8.12 Are employees working on ramps, runways or other walkways protected by guardrail systems? 1926.501(b)(6)<br>
9. Stairways and Ladders
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9.1 General requirements: Is a ladder or stairway provided at all personnel points of access where there is a break in elevation of 19 inches or more? 1926.1051(a) CAL OSHA 1541(c)<br>
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9.2 Is there always at least one clear point of access between levels of a building or structure? 1926.1051(a)(3) & (4) CAL OSHA 1621(a)<br>
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9.3 Stairways: Is each stairway having four or more risers or rising mroe than 30 inches equipped with :(a): at least one handrail:(b):at least one stairrail system along each unprotected side or edge? 1926.1052(c)(1) CAL OSHA 1629 (a)<br>
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9.4 Are there unprotected sides and edges of stairway landings provided with a guardrail system? 1926.1052(c)(12) CAL OSHA 3214(a)<br>
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9.5 Ladders: Are ladder rungs, cleats, and steps parallel, level and evenly spaced when the ladder is positioned for use? 1926.1053(a)(2) CAL OSHA 3276(c)(5)<br>
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9.6 Does each stepladder have a metal spreader or locking device? 1926.1053(a)(8) CAL OSHA 3276<br>
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9.7 Do portable ladders used for access to an upper landing surface have side rails that extend at least 3 feet above the landing? 1926.1053(b)(1) CAL OSHA 3276(e)(11)<br>
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9.8 Do ladders that are used where the employee or the ladder could contact exposed energized parts have nonconductive side rails? 1926.1053(b)(12) (see 1926.951(c)(1) for exception)<br>
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9.9 Are ladders periodically inspected by a competent person? 1926.1053(b)(15) CAL OSHA 3276(e)(2)<br>
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9.10 Are portable ladders with structural defects marked as defective and withdrawn from service? 1926.1053(b)(16) CAL OSHA 3276(e)(3)<br>
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9.11 Training Requirements: Have all employees been trained to recognize hazards related to ladders and stairways? 1926.1060(a) CAL OSHA 3276(f)<br>
10. Occupational Health and Environmental Controls
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10.1 Sanitation: Are potable (drinking) water and adequate toilet facilities available at the site? 1926.51 CAL OSHA 1524(a) and 8433<br>
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10.2 Illumination: Are employees provided with adequate lighting? CAL OSHA 1523<br>
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10.3 Hazard Communication: Does the employer have any hazardous materials on site? If so, does the employer have a written HazCom program? 1926.59(e)(1) CAL OSHA 5194(e)<br>
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10.4 Does employer have a complete list of hazardous chemicals used on site at the worksite? 1926.59(e)(1)(i) CAL OSHA 5189.1<br>
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10.5 Are containers of hazardous chemicals, labeled, tagged or marked? 1926.59(f)(1) CAL OSHA 5194(I)(2)<br>
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10.6 Does the employer have an SDS for each hazardous chemical on site? 1926.59(g)(1) CAL OSHA 5194(I)(1)(2)(3)<br>
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10.7 Are SDS available to employees in their work area? 1926.59(g)(8) CAL OSHA 5194(I)(2)<br>
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10.8 Are employees trained in the hazards of chemicals in their work area? 1926.59(h) CAL OSHA 5194(I)(3)<br>
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10.9 Are hazardous substances, blood and other potentially infectious materials, which may cause harm by inhalation, ingestion, or skin absorption or contact, identified? CAL OSHA 5194
11. Excavations
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11.1 General Requirements: Are all surface encumbrances that may create a hazard removed or supported as necessary to safeguard employees? 1926.651(a) CAL OSHA 1541(a)<br>
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11.2 Have all underground utility installations been located? 1926.651(b)(1), (2) and (3) CAL OSHA 1541(b)<br>
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11.3 In trenches more than 4 feet deep, are stairways, ladders or ramps located so that travel to them is no more than 25 feet? 1926.651(c)(2) CAL OSHA1541(c)<br>
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11.4 Are employees exposed to vehicular traffic wearing warning vests made of reflectorized or high visibility material? 1926.651(d) CAL OSHA 1598(a)<br>
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11.5 Is a warning system such as barricades, hand or mechanical signals or stop logs used when mobile equipment approaches the edge of the excavation? 1926.651(f) CAL OSHA 1541(f)<br>
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11.6 Are testing and controls used to prevent exposure to hazardous atmospheres? 1926.651(g) CAL OSHA 5158(d)(3)<br>
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11.7 Are excavation or other materials kept at least 2 feet from the edge of excavations? 1926.651 (j)(2) CAL OSHA 1541(j)(2)<br>
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11.8 Is the excavation inspected daily and after any hazard increasing occurrence by a competent person? 1926.651 (k)(1) CAL OSHA 1541(k)(1)<br>
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11.9 Requirements for protective systems: Are employees in an excavation 5 feet deep or more, or with the potential for cave in, protected by an adequate protective system? 1926.652 (a)(1) Note: See appendices A, B, C, D, E, and F to this standard CAL OSHA 1541(j)<br>
12. Industrial Trucks CAL OSHA 3650
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12.1 Are employees properly trained in the use of the type of industrial truck they operate. CAL OSHA 3668(a)
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12.2 Is substantial overhead protective equipment provided on high lift rider equipment?
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12.3 Does each industrial truck have a warning horn, whistle, gong, or other device that can be clearly heard above normal noise in the areas where it is operated?<br>
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12.4 Does the parking brake of the industrial truck prevent the vehicle from moving when unattended?<br>
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12.5 Are employees prohibited from standing or passing under elevated portions of trucks, whether loaded or empty?<br>
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12.6 Are unauthorized employees prohibited from riding on trucks?
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12.7 Are loads handled only within the rated capacity of the truck?
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12.8 Are trucks in need of repair removed from service immediately?
13. Flammable and Combustible Materials
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13.1 Is proper storage practiced to minimize the risk of fire, including spontaneous combustion? CAL OSHA 3221(c) & 1936
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13.2 Are approved containers and tanks used to store and handle flammable and combustible liquids? CAL OSHA 1930(a)
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13.3 Are all connections on drums and combustible liquid piping, vapor and liquid tight? CAL OSHA 1930(a)(3)
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13.4 Are bulk drums of flammable liquids grounded and bonded to containers during dispensing? CAL OSHA 5451(p)
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13.5 Are appropriate fire extinguishers mounted within 75 feet (22.86 meters) of outside areas containing flammable liquids and within 10 feet (3.048 meters) of any inside storage area for such materials?<br>
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13.6 Are all extinguishers serviced, maintained and tagged at intervals not to exceed one year? CAL OSHA 6151(a)
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13.7 Are all extinguishers fully charged and in their designated places CAL OSHA 6151(a)
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13.8 Are safety cans used for dispensing flammable or combustible liquids at the point of use? CAL OSHA 5451(d)
Corrective Action
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Time for corrective actions to be completed (Client Determination)
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Who is responsible for Corrective Action? Name and Title (Client Determination)
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Does auditor have safety training recommendations for the client?<br>
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If so, what?
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Additional Comments:
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Client Contact Signature
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Auditor Signature