OVERAA SAFETY AUDIT TEMPLATE

• Overaa Construction/ Job Site Name

  Select
• Job Site Location
  Address
• Add location
  Address

• Job Number

• Conducted on

  Date

• Superintendent /Foreman:

• Number of Overaa Employees

• Number of Subcontractors / Total Employees

• Short Serviced Employee

• Site Personnel Walking Project With

POSTING, SIGNAGE, BINDER AND DOCUMENTATION

• PPE signs / Stretch & Flex banner / Excavation / Silica / Prop. 65 signage posted on-site / Overaa banner posted on-site?

  Yes

  No

  N/A

• Safe-Site Check-In QR code posted on the access & egress areas?

  Yes

  No

  N/A

• New Incident Procedure Posted (Picture Required)?

  Yes

  No

  N/A

• OSHA 300A Log posted (Feb. to Apr.) each year on-site? / Min. wage, Heat Illness, Employee Rights, Labor Law postings posted on-site/in trailer?

  Yes

  No

  N/A

• Safety Manual / AnchoRock QR Code available?

  Yes

  No

  N/A

• Annual Excavation Permit, Project Permit (If required), Steel Erection Permit (If required) posted on-site?

  Yes

  No

  N/A

OVERAA'S BEST SAFETY PRACTICES

• Any recommendation for the Safety Champion? Provide the name of the employee(s) that has demonstrated above and beyond safety behavior.

• Any Safety Alert generated this week? (Please upload the picture)

  Overaa

  Sub-contractor

  Both

  N/A

• Please select the company name from the drop-down.

  Select

• Have the JHAs been conducted for all the tasks?

  Yes

  No

  N/A

• Is the JHA available in the task area?

  Yes

  No

  N/A

• Has the JHA been filled out effectively? (All steps, hazards and preventive included)?

  Yes

  No

  N/A

• Have the subs conducted the JHAs?

  Yes

  No

  N/A

• Does the Jobsite conduct stretch & flex every morning and discuss potential hazards/ Safety Flash with the crew and/or subs?

  Yes

  No

  N/A

• Did the operation team at the job site conduct weekly CJSR for the week? Verify in AnchoRock.

  Yes

  No

  N/A

• Are portable eyewash stations / first aid kits readily accessible and available on-site?

  Yes

  No

  N/A

• Do the employees onsite have training related to the activities being performed? (Confined Space, Excavation, Silica, Scaffold, etc.?)

  YES

  NO

• Do the employees need any training on-site?

  YES

  NO

• Do we have at least two people with a CPR/First certification on-site?

  Yes

  No

  N/A

• Do Overaa employees have their AnchoRock ID card?

  YES

  NO

• Has the last safety inspection of this job site been reviewed and all previous recommendations completed?

  Yes

  No

  N/A

• Are safety tailgate meetings completed at least once a week?

  Yes

  No

  N/A

• What was the tailgate topic for the week?

• Any good catch, near miss, or incident occurred/reported this week?

  YES

  NO

ACCESS / STAIRWAYS / RAMPS

• Does the building with two or more stories (24' or more in height) have at least one stairway OR buildings with more than three stories have two or more stairways?

  Yes

  No

  N/A

• Stairways, ramps, or ladders provided at all points where a break in elevation of 18 inches or more in frequently traveled passageway, entry or exit?

  Yes

  No

  N/A

• Are stairways rising more than 30" or have four or more risers equipped with at least one handrail and a stair rail?

  Yes

  No

  N/A

• Is the foot ramp at least 20" wide and secured & supported to avoid deflection or springing action?

  Yes

  No

  N/A

• Are open sides of the ramp (6' or more above ground) have standard guardrails?

  Yes

  No

  N/A

INSPECTIONS

• Has the job site inspected fire extinguishers monthly?

  Yes

  No

  N/A

• Has the job site inspected eye-wash stations monthly?

  Yes

  No

  N/A

• Has heavy equipment on-site been inspected on a daily basis? [Heavy Equipment: Backhoe, Skip Loader, Excavator, Compactor, Dozer, Loader, Heavy Crane, Boom-Truck Crane, Forklift, Bobcat, Mini-ex, MEWP]

  Yes

  No

  N/A

• Has the job site conducted quarterly color code inspections on electrical cords/rigging accessories/equipment?

  Yes

  No

  N/A

• Are harnesses, lanyards, yo-yos, and lifelines inspected before use, quarterly, or stored in the connex while not in use?

  Yes

  No

  N/A

ELECTRICAL & LIGHTING

• Is there LOTO required on-site?

  YES

  NO

• LOTO documentation / Procedure reviewed / Affected employees notified / Employees trained?

  Yes

  No

  N/A

• Zero energy verified / Energy isolated / Locks & Tags placed with contact info. & instructions / stored energy released?

  Yes

  No

  N/A

• Is the lighting (Flashlights) sufficient for required illumination?

  Yes

  No

  N/A

• Are electrical cords, TEMP BOXES/ GFCI maintained & placed securely?

  Yes

  No

  N/A

• Are electrical cords located away from high traffic areas or where they could be damaged from contact with moving machinery?

  Yes

  No

  N/A

• Lighting/String Lights/Cages/Securing?

  Yes

  No

  N/A

• Are all types of equipment min. 10' away from the overhead powerlines?

  Yes

  No

  N/A

• Are all electrical panels or equipment have a 36" clearance extending from the floor to the height of the equipment?

  Yes

  No

  N/A

FIRE PROTECTION

• Do we have any hot work (Grinding, torching, metal cutting, welding, etc.) on-site?

  YES

  NO

• Is Overaa's hot work permit filled out?

  Yes

  No

  N/A

• Do we have a fire extinguisher available within 10'?

  Yes

  No

  N/A

• Has the job site used any signages or postings to indicate a hot work area?

  Yes

  No

  N/A

• Is the employee performing hot work wearing required PPEs (Faceshield / Gloves / Welding hood / Safety glasses / Flame resistant cloth)?

  Yes

  No

  N/A

• Are portable fire extinguishers available within 75'? (50' for Class B fire)

  Yes

  No

  N/A

• Are all flammables stored inside yellow flammable cabinets?

  Yes

  No

  N/A

• Are all oxygen cylinders stored separately from fuel gas cylinders? (Separation distance. of 20' or by a non-combustible barrier of at least 5' with a fire-resistance rating of the one-half hour?

  Yes

  No

  N/A

• Are all cylinders capped and stored securely while not in use?

  Yes

  No

  N/A

• Who was the contributing factor to the violation(s) in this section?

  Overaa

  Sub-contractor

  Both

  N/A

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

FALL PROTECTION

• Is there a fall protection competent person on-site?

  Yes

  No

  N/A

• Who is the competent person on-site?

• Are all employees on-site trained on the Fall Protection System and the use of the fall protection equipments?

  Yes

  No

  N/A

• Are employees working at a height of 6' or more tied off including Scissor lift & JLG (Exception of specific trades like steel beam connectors=30',roofers=20', metal decking workers=15')?

  Yes

  No

  N/A

• Does the guardrail properly set (Top to mid-rail: 42" -+3/Toeboard:3 1/2"/ Top-rail & Mid-rail: Withheld 200lbs & 150lbs)?

  Yes

  No

  N/A

• Are floor holes/openings with potential falls covered by objects twice the intended load and marked with the word OPENING - DO NOT REMOVE?

  Yes

  No

  N/A

• Has the system been rigged to prevent contact with the ground or a lower level<br>after a fall / Fall clearance? (Lanyard=18.5')?

  Yes

  No

  N/A

• Do lifelines, lanyards, snap hooks, and D-rings have a minimum strength of<br>5,000 pounds? / Are all anchorages capable of supporting a 5,000-pound load per worker<br>attached?

  Yes

  No

  N/A

• Are all roofers in the area between the warning line and the roof edge protected by a guardrail system, safety monitor, or personal fall arrest (PFA) system?

  Yes

  No

  N/A

• Who was the contributing factor to the violation(s) in this section?

  Overaa

  Sub-contractor

  Both

  N/A

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

LADDER

• Are all step ladders and extension ladders on the job site being used properly?

  Yes

  No

  N/A

• Are all ladders properly secured, labeled and in good structural condition?

  Yes

  No

  N/A

• Ladders utilizing 4 to 1 ratio / Extended 3' of the landing area / 3 points of contact during access & egress?

  Yes

  No

  N/A

• Right ladder for the job / Ladder stored properly while not in use?

  Yes

  No

  N/A

• Who was the contributing factor to the violation(s) in this section?

  Overaa

  Sub-contractor

  Both

  N/A

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

Personal Protective Equipment (PPE)

• Eye Protection/Side Shields/Face Shield/Goggles?

  All Wearing

  One employee w/o

  Three employee w/o

  Five employee w/o

• Hands/Gloves/Leather/Nitrile?

  Yes

  No

  N/A

• Head Protection/Overhead Cover?

  All Wearing

  One employee w/o

  Three employee w/o

  Five employee w/o

• Hearing Protection/Plugs/Muffs?

  Yes

  No

  N/A

• High Visibility Vest/Clothing/Flashlight?

  All Wearing

  One employee w/o

  Three employee w/o

  Five employee w/o

• Foot Protection/Rubber Boots/Toe Caps?

  Yes

  No

  N/A

• Who was the contributing factor to the violation(s) in this section?

  Overaa

  Sub-contractor

  Both

  N/A

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

HEAT ILLNESS PREVENTION

• Current temperature at the jobsite?

  <80F

  >80 F & <95F

  >95F & <105F

  >105F & <110F

• Water supply / Shade & Break Areas available on-site?

  Yes

  No

  N/A

• Water supply / Shade areas available on-site?

  Yes

  No

  N/A

• Do we have an observation or communication method set up in case of a high heat emergency?

  Yes

  No

  N/A

• Did the Jobsite discuss symptoms of heat illness during pre-shift?

  Yes

  No

  N/A

• Water supply / Shade areas available on-site?

  Yes

  No

  N/A

• Do we have an observation or communication method set up in case of a high heat emergency?

  Yes

  No

  N/A

• Did the Jobsite discuss symptoms of heat illness during pre-shift?

  Yes

  No

  N/A

• Is the job site providing a 10-minute break every two hours or breaks upon employee requests?

  Yes

  No

  N/A

• Is water & Shade available?

  Yes

  No

  N/A

• New employee observed for 14 days for acclimatization / Buddy system?

  Yes

  No

  N/A

RESPIRABLE SILICA

• Do we have respirable silica exposure on-site?

  YES

  NO

• Who is the competent person on-site?

• Are dust control methods being used? (HEPA Vac / Water Spray)

  Yes

  No

  N/A

• Have other employees been prevented from exposure by barricading the task area?

  Yes

  No

  N/A

• Are employees required to wear a respirator?

  Yes

  No

  N/A

• Is the employee wearing respirator fit-tested annually & medically evaluated?

  Yes

  No

  N/A

• Are respirators stored properly while not in use?

  Yes

  No

  N/A

• Who was the contributing factor to the violation(s) in this section?

  Overaa

  Sub-contractor

  Both

  N/A

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

TRENCH/EXCAVATION

• Does the job site have trench/excavation on-site?

  YES

  NO

• Who is the excavation/trench competent person on site?

• Has the competent person filled out the daily trench/excavation checklist?

  Yes

  No

  N/A

• Does the job site have a USA ticket? (Ask subs their ticket if subs are responsible)

  Yes

  No

  N/A

• Spoils, materials, and equipment set back at least two feet from the edge of the excavation?

  Yes

  No

  N/A

• Are all excavation barricaded / warning line systems in use when heavy equipment is in use?

  Yes

  No

  N/A

• Lateral travel to means of egress no greater than 25' in excavations four feet or more in-depth and extended 3'?

  Yes

  No

  N/A

• Surface water or runoff diverted or controlled to prevent accumulation in<br>the excavation?

  Yes

  No

  N/A

• Where a hazardous atmosphere could reasonably exist, the atmosphere is being tested for low or high oxygen, hazardous vapors, and toxic gasses before employees enter the excavation?

  Yes

  No

  N/A

• Have underground utilities been marked / 811 called?

  Yes

  No

  N/A

• Soil classified using 1 visual and 1 manual method, or default Type C?

  Type A

  Type B

  Type C

• Protective systems in place / Barricaded?

  Yes

  No

  N/A

• The protective system used to prevent cave-in?

  Sloping

  Benching

  Shielding

  Shoring

• Is the excavation sloped at 45 degrees?

  Yes

  No

  N/A

• Is the excavation benched per standard?

  Yes

  No

  N/A

• Sheild 18" extended to prevent employees inside?

  Yes

  No

  N/A

• Tabulated data available on-site?

  Yes

  No

  N/A

• Shroing performed as per tabulated data?

  Yes

  No

  N/A

• The protective system used to prevent cave-in?

  Sloping

  Benching

  Shielding

  Shoring

• Is the excavation sloped at 34 degrees?

  Yes

  No

  N/A

• Sheild 18" extended to prevent employees inside?

  Yes

  No

  N/A

• Tabulated data available on-site?

  Yes

  No

  N/A

• Did shoring perform as per tabulated data?

  Yes

  No

  N/A

• Who was the contributing factor to the violation(s) in this section?

  Overaa

  Sub-contractor

  Both

  N/A

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

CONFINED SPACE

• Does the job site have confined space on site?

  YES

  NO

• Type of Confined Space

  Permit Required

  Alternative Entry

  Non-permit Required

• Have the employees tested the air for hazardous atmosphere prior to entry?

  Yes

  No

  N/A

• Have the employees eliminated or isolated physical hazards?

  Yes

  No

  N/A

• Confined space does not contain or have the potential to contain a hazardous atmosphere?

  Yes

  No

  N/A

• Has the permit entry been completed and communicated prior to entry? (Location of space/Purpose/Date/Duration/Entrant Names)

  Yes

  No

  N/A

• Does the space have an entry supervisor, authorized entrant, and attendant? (Entry sup. can act as AE or Attendant )

  Yes

  No

  N/A

• Does the space have a rescue plan, a stand-by rescue team, PPEs, and rescue equipment available in case of emergency?

  Yes

  No

  N/A

• Are the employees frequently testing the atmosphere?

  Yes

  No

  N/A

• Have the employees set up the equipment that is acceptable prior to entry?

  Yes

  No

  N/A

• Have the employees eliminated or isolated or controlled physical hazards? (Prevention from entrapment & engulfment)

  Yes

  No

  N/A

• Have the employees eliminated all the physical hazards?

  Yes

  No

  N/A

• Have the employees provided continuous forced air ventilation to keep the hazardous atmosphere under control?

  Yes

  No

  N/A

• Are the employees frequently testing the atmosphere?

  Yes

  No

  N/A

• Who was the contributing factor to the violation(s) in this section?

  Overaa

  Sub-contractor

  Both

  N/A

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

SCAFFOLD

• Does the job site have a scaffold on-site?

  YES

  NO

• Who is our Scaffold Competent Person on-site?

• Has the scaffold been inspected by a Competent Person on a daily basis?

  Yes

  No

  N/A

• Planks: Fully planked / Stamped / No more than 1" gap / Overlap 12" max. and extend 6" min. / platforms at least 18" wide?

  Yes

  No

  N/A

• Are legs, posts, frames, and uprights on base plates attached to mudsills (if on dirt) / 2 nails nailed diagonally / max. 12" extension?

  Yes

  No

  N/A

• Is scaffold max. 14" away from the face of the building (18" for masonry)?

  Yes

  No

  N/A

• Are scaffold erectors or dismantlers tied off at 10' height or more?

  Yes

  No

  N/A

• Toeboard / Working Load / Access & Egress / 10' from powerlines / Guy wires

  Yes

  No

  N/A

• Are all mobile scaffolds (bakers scaffolding) wheels locked when in use and guarded properly?

  Yes

  No

  N/A

• Who was the contributing factor to the violation(s) in this section?

  Overaa

  Sub-contractor

  Both

  N/A

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

HAND AND POWER TOOLS

• PPEs available / Laser Signs / Properly stored while not in use / Cords inspected and equipment maintained?

  Yes

  No

  N/A

• Did the employee using the grinder review Overaa's grinder policy and complete the quiz?

  Yes

  No

  N/A

• Grinder: Stored in the trailer / Has handle / No dead man switch / safe guards?

  Yes

  No

  N/A

• Skilsaw: Saw horses being utilized / Safeguards in place / Body positioning?

  Yes

  No

  N/A

• Chainsaw: Saw chap being used / Barricaded / Object stability / PPE?

  Yes

  No

  N/A

• Other handheld power/pneumatic/mechanical tools/ PPEs/ Condition & Storage?

  Yes

  No

  N/A

• Does the Jobsite have Powder Actuated Tools?

  YES

  NO

• Are employees operating PAT trained in their use and have operators' cards?

  Yes

  No

  N/A

• Is each PAT stored in its own locked container when not being used?

  Yes

  No

  N/A

• PPEs available / Unloaded while not in use / 7" x 10" sign posted to warn others / inspected prior to use?

  Yes

  No

  N/A

SWPPP

• Housekeeping/Waste handling/Cans & dumpsters covered?

  Yes

  No

  N/A

• Portable toilets/Secondary containment/Secured?

  Yes

  No

  N/A

• Wall Map/ Gate Sign?

  Yes

  No

  N/A

• Site entrance maintained/Street Sweeping?

  Yes

  No

  N/A

• BMP's Maintained/Inspections?

  Yes

  No

  N/A

• Equipment fueling/Containment/Spill kit?

  Yes

  No

  N/A

• Concrete washout maintained?

  Yes

  No

  N/A

• Stockpile protection (Cover if inactive more than 14 days)

  Yes

  No

  N/A

• Smoking Areas? Disposal / Clean/Orderly?

  Yes

  No

  N/A

• Weather reports/REAPs/Rain gauge readings

  Yes

  No

  N/A

EQUIPMENT

• Crane: Swing radius barricaded / Horn / Spotter / Certified?

  Yes

  No

  N/A

• Lifting: Lifting plan reviewed / Taglines being used / qualified riggers?

  Yes

  No

  N/A

• Employees are not underneath the load?

  Yes

  No

  N/A

• Are spotters being used while load lifting, load transferring, and reversing equipment/machinery?

  Yes

  No

  N/A

• Is running equipment with an operator? (25' for Forklift)

  Yes

  No

  N/A

• Lifting equipment / Slings / Chains in proper condition?

  Yes

  No

  N/A

• Who was the contributing factor to the violation(s) in this section?

  Overaa

  Sub-contractor

  Both

  N/A

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

• Select the company name from the drop-down.

  Select

• Select the other company name from the drop-down, if applicable.

  Select

Overaa Covid-19 (Take Pictures)

• Safe Site Check In QR Code posted at the entrance or near Stretch & Flex/Break Area

  Yes

  No

  N/A

JOBSITE HAZARDS

• Overall housekeeping/slip & trip hazards/ water bottles?

  Yes

  No

  N/A

• Are safety data sheets (SDS) accessible for all chemicals found on-site?

  Yes

  No

  N/A

• Has the Jobsite communicated about the new chemicals on-site to the employees [Hazcomm]?

  Yes

  No

  N/A

• Asbestos abatement followed / PPEs / Barricaded?

  Yes

  No

  N/A

• Are all hazardous materials being properly stored and disposed of?

  Yes

  No

  N/A

• Forms/Falsework/Rebar/ Bracing/Cap?

  One missing

  Three missing

  Five+ missing

  All caps on

  N/A

• Are “Red Danger and Yellow Caution” Tape being used correctly throughout the job site? (Red tape means Red tape means….”Do not enter unless the entrant contacts the supervisor of the area and Yellow tape means, Enter, but proceed with caution.”)

  Yes

  No

  N/A

Other (***Any safety practices or observations not listed in the audit can be mentioned here.)

• Observation 1: (See Note & Media)

  Yes

  No

  N/A

• Observation 2: (See Note & Media)

  Yes

  No

  N/A

Sign Off

• OnSite Supervisor

  Sign

• Auditor's signature

  Sign