Information

  • Location
  • Conducted on

  • Document No.

  • Project Information

  • Contractors working on site:

  • Auditor?

Job Safety Analysis (JSA)

  • :Picture of JSA

  • Conttractor(s)

JSA AUDIT

  • JSA available and posted at the site location? In plain view or easy to locate?

  • Responsible Contractor

  • Has the Specific Job Location / Job Description been completed and accurate?

  • Responsible Contractor?

  • Does the JSA identify the specific equipment to be worked on ?

  • Responsible Contractor

  • Contract Company name and Supervisor filled out and is accurate?

  • Responsible Contractor?

  • PFI Production Manager and PFI Project Manger filled out and accurate?

  • Responsible Contractor

  • Has the "Filled Out By" and "Today's Date" filled out and accurate?

  • Responsible Contractor

  • Has the "Project End Date" and "Form Expiration Date" filled out, accurate and is within the 30 day allotment period?

  • Responsible Contractor

  • Notes:

LOCATION OF:

  • Does the JSA identify a Medical Treatment Facility?

  • Responsible Contractor

  • Does the JSA list directions to the Medical Treatment Facility?

  • What evacuation location is listed on the JSA?

  • Does the JSA identify an Evacuation Route and Location?

  • What location is listed and is the location appropriate to the location of the construction activities

  • Responsible Contractor

  • Does the JSA list the location of the SDS (MSDS)?

  • Responsible Contractor

  • Does the JSA identify an Eye Wash Station and is the location accurate?

  • Responsible Contractor

  • Does the JSA list the locations and type of fire extinguishers?

  • Responsible Contractor?

  • Does the JSA list the location of the contractors First Aid kit?

  • Responsible Contractor?

  • Notes:

Personal Protective Equipment

  • Does the JSA identify proper PPE requirements for the task being performed? (Hardhat, Safety Glasses, Gloves, Foot Protection, Face Shield, Hearing Protection, etc)<br>

  • Responsible Contractor

  • Notes:

JSA ASSESSMENT

  • Is the work being performed in a Production Area?

  • Is the work being performed in close proximity to the production?

  • Does the JSA outline the precautions being taken to assure no product contamination?

  • Responsible Contractor

  • Project Manager Notified?

  • Corrective Action Issued?

  • Will any used equipment be introduced into the Production Area?

  • Does the JSA explain how the equipment is prepared not to cross contaminate?

  • Responsible Contractor

  • Project Manager notified?

  • Correction Action issued?

  • Will the contractor be introducing any chemicals and / or paint into the production area?

  • List chemical(s), listed on the JSA

  • Has the SDS (MSDS) been submitted tot he project manager?

  • Responsible Contractor

  • Project Manager aware?

  • Notes

PERMITS

  • Is there any location the contractor will be performing work that is classified as a confined space?

  • Has the location been air sampled to verify that it is not Permit Required Confined Space?

  • What is the last air sample reading?

  • Responsible Contractor

  • Project Manager notified

  • Corrective Action issued?

  • Is the contractor conducting hot work? (Producing any sparks or flames)

  • Does the JSA identify a hot work permit?

  • Responsible Contractor?

  • Does the JSA address fire suppression methods?

  • Responsible Contractor

  • Does the JSA cover all points of Permits?

  • Responsible Contractor

  • Notes:

JOB STEPS

  • Does the JSA outline Preparation Sequence Steps? Is the Steps accurate?

  • Responsible Contractor?

  • Does the JSA properly identify Preparation Food and Human Safety Hazards?

  • Responsible Contractor?

  • Does the JSA list the Steps to Preparation - Eliminate and / or Reduce Food and Human Safety Hazards?

  • Responsible Contractor?

  • Does the JSA identify Traffic Flow Sequence Steps?

  • Responsible Contractor

  • Does the JSA identify Traffic Flow Food and Human Safety Hazards?

  • Responsible Contractor

  • Does the JSA identify Steps to Traffic Flow Eliminate / Reduce Food and Human Safety Hazards?

  • Responsibile Contractor?

  • Does the JSA properly identify the Job Steps - Sequence of Steps?

  • Responsible Contractor

  • Does the JSA properly identify Job Steps - Food and Human Safety Hazards?

  • Responsible Contractor

  • Does the JSA properly identify Job Steps - Steps to Eliminate or Reduce Food and Human Safety Hazards?

  • Responsible Contractor?

  • Does the JSA cover all points of the Job Steps?

  • Responsible Contractor

  • Notes:

COMPLETION (CLEAN UP, REMOVAL of TRASH, CURTAIN REMOVAL and PROJECT RELEASE)

  • Has the JSA, Completion - Sequence of Steps been properly filled out and is complete?

  • Responsible Contractor

  • Has the JSA, Completion - Food and Human Safety Hazards been properly filled out and complete? Is the information accurate?

  • Responsible Contractor

  • Has the JSA, Completion - Steps to Eliminate or Reduce Food and Human Safety Hazards been filled out and complete? Is the information accurate?

  • Responsible Contractor

  • Does the JSA cover all points of Completion?

  • Responsible Contractor

  • Notes:

OTHER

  • Does the JSA identify break location(s)

  • Responsible Contractor

  • Has the JSA been signed by all workers working at the location?

  • Responsible Contractor

  • Does the JSA identify Heat Illness and Injury Prevention methods / distribution of water?

  • Responsible Contractor

  • Does the JSA identify Smoking locations?

  • Responsible Contractor

CORRECTIVE ACTIONS

  • Is the JSA accurate? No corrective actions required?

  • List the corrective actions needed.

  • Project Manager has been notified of the corrective actions needed?

  • Is the contractor(s) aware of any corrective actions that need to be completed?

  • What companies were notified of JSA deficiencies

  • How was the contractor(s) notified?

  • Date and time the contractor was informed of the corrective action

Site Audit

AERIAL and SCISSOR LIFTS

  • Workers have been trained in the use of equipment?

  • Exposing Contractor

  • Lift occupants wearing harness correctly? Employees been trained in fall protection?

  • Exposing Contractor

  • Workers tied off to boom or basket? (Not required in scissor lifts unless the lift moves when lift is up)

  • Exposing Contractor

  • Lift controls clearly marked and readable?

  • Exposing Contractor

  • Workers not tied off to adjacent structures?

  • Exposing Contractor

  • Both feet remain on the floor of the basket?

  • Exposing Contractor

  • Operators not exceeding the load limits of the basket / lift?

  • Exposing Contractor

  • Lift is stationary when boom is elevated?

  • Exposing Contractor

  • Employees are not transferring at height while in a scissor lift?

  • Exposing Contractor

  • Mid-rail chain / gate used when in operation?

  • Exposing Contractor

  • Operators maintaining safety compliance while operating lift?

  • Exposing Contractor

  • Notes:

CONCRETE / MASONRY

  • Rebar / flat stakes guarded (covered) to eliminate impalement hazard?

  • Exposing Contractor

  • Employees working in concrete wearing proper hand and foot protection?

  • Exposing Contractor

  • Connectors, ties or whips used to secure pressurized air hoses?

  • Exposing Contractor

  • Guard down on pump (on pump truck)?

  • Exposing Contractor

  • Masonry saw blades guarded?

  • Exposing Contractor

  • Fugitive dust controlled while cutting block or conducting finish work?

  • Exposing Contractor

  • Masons wearing face shields AND safety glasses while cutting block?

  • Exposing Contractor

  • Formwork capable of supporting vertical / lateral loads?

  • Exposing Contractor

  • Shoring equipment inspected?

  • Exposing Contractor

  • Base plates secured to foundation / mud sill / formwork?

  • Exposing Contractor

  • Jacks / supports do not exceed the rated capacity?

  • Exposing Contractor

  • Limited access zone equal to the wall height plus 4 feet?

  • Exposing Contractor

  • Limited access zone strictly enforced?

  • Exposing Contractor

  • Walls over 8 feet braced to prevent collapse?

  • Exposing Contractor

  • Masons maintaining safety compliance?

  • Exposing Contractor

  • Notes:

CONFINED SPACE

  • JSA and rescue plan on-site and available? Employees been trained on the plan?

  • Exposing Contractor

  • Entry permit completed and signed?

  • Exposing Contractor

  • Air sampling completed and documented prior to entry?

  • Exposing Contractor

  • Proper warning signage posted at entry to the permit space?

  • Exposing Contractor

  • Forced air ventilation used for the duration of entry?

  • Exposing Contractor

  • Proper lighting provided?

  • Exposing Contractor

  • Rescue team trained and readily available?

  • Exposing Contractor

  • Retrieval system (Tripod) available and utilized?

  • Exposing Contractor

  • Entrants attached to the retrieval line?

  • Exposing Contractor

  • Attendant on duty outside the permit space?

  • Exposing Contractor

  • Attendant only performs monitoring duties?

  • Exposing Contractor

  • Confined space team is maintaining safety compliance?

  • Exposing Contractor

  • Notes:

CRANES / RIGGING

  • Crane(s) inspected and properly maintained?

  • Exposing Contractor

  • Crane operator, rigger and signal person certified?

  • Exposing Contractor

  • Crane load charts visible to the operator?

  • Exposing Contractor

  • Hand signal charts posted or available?

  • Exposing Contractor

  • Fire extinguisher located within the cab?

  • Exposing Contractor

  • Pick (Lift) plan on-site, reviewed and the load is within load capacity?

  • Exposing Contractor

  • Crane outriggers fully extended and on cribbing properly?

  • Exposing Contractor

  • Swing radius identified and barricaded?

  • Exposing Contractor

  • Workers remained clear of the in the swing radius and under suspended loads?

  • Exposing Contractor

  • All power lines are a minimum 15 feet away from all lifting and boom swing radius?

  • Exposing Contractor

  • Rigging equipment inspected and in good condition?

  • Exposing Contractor

  • Rigging equipment maintain lift capacity markings?

  • Exposing Contractor

  • Crane operations maintaining safety compliance?

  • Exposing Contractor

  • Notes:

ELECTRICAL

  • Electrical cords maintain ground posts?

  • Exposing Contractor

  • Electrical cords are free from damage / repair / alterations?

  • Exposing Contractor

  • Electrical cords protected from damage and roll over?

  • Exposing Contractor

  • Electrical cords are not ran through door ways or windows?

  • Exposing Contractor

  • Electrical cords kept clear of work areas and walk ways?

  • Exposing Contractor

  • Electrical cords are rated for construction? Flat cords removed from site?

  • Exposing Contractor

  • Spider box being inspected quarterly?

  • Exposing Contractor

  • Power strips and 3 way splitters construction rated?

  • Exposing Contractor

  • Electrical equipment being used per the manufacturers specifications?

  • Exposing Contractor

  • GFCI being used on 120V single-phase, 15/20 amp outlets?

  • Exposing Contractor

  • All outlets have cover plates when outlets are energized?

  • Exposing Contractor

  • Temp light cords are hung with non-metallic fastener, off the ground and does not cause a hazard?

  • Exposing Contractor

  • Temp light bulbs maintain cages and all bulbs?

  • Exposing Contractor

  • Electrical rooms maintain proper warnings and labels per NFPA 70e?

  • Exposing Contractor

  • Access to electrical room(s) restricted per NFPA 70e?

  • Exposing Contractor

  • Electrical panels are covered, labeled and all breaker slots are covered?

  • Exposing Contractor

  • 3 foot clearance around all electrical panels being maintained?

  • Exposing Contractor

  • Employees are not allowed to work near unprotected circuits / panels?

  • Exposing Contractor

  • Employees are locking and tagging out equipment and panels and NOT working on hot equipment?

  • Exposing Contractor

  • Employees working with energy maintaining safety compliance?

  • Exposing Contractor

  • Notes:

FALL PROTECTION

  • JSA and fall protection rescue plan has been established and all effected employees have been trained?

  • Exposing Contractor

  • All employees have been trained in fall protection?

  • Exposing Contractor

  • A fall protection system is provided for all employees working above 7 1/2 feet? (6 feet for rod busters)

  • Exposing Contractor

  • PFA rigged to prevent contact with any surface? (Max fall distance allowed is 6 feet)

  • Exposing Contractor

  • Harnesses have been inspected prior to use?

  • Exposing Contractor

  • Employee wearing harness correctly, wearing the appropriate lifeline (lanyard) and attached to an anchor?

  • Exposing Contractor

  • Fall protection anchors are set up per specifications and all elements are rated to 5000 lbs?

  • Exposing Contractor

  • Guardrails are able to with stand 200 lbs outward and down force?

  • Exposing Contractor

  • Guardrails do not exceed 2 inch deflection in any direction?

  • Exposing Contractor

  • Guardrails and mid-rails are at the proper height?

  • Exposing Contractor

  • Guardrail posts are not more than 8 foot OC?

  • Exposing Contractor

  • Guardrails / mid-rails are constructed to be on the inside on the guardrail posts?

  • Exposing Contractor

  • Guardrails and mid-rails have been placed around floor / roof openings?

  • Exposing Contractor

  • Floor holes greater than 2 inches have been covered, properly labeled and secured from movement?

  • Exposing Contractor

  • The fall protection selected is appropriate for the fall exposure?

  • Exposing Contractor

  • Floor hole covers are capable of handling 2 times the intended load?

  • Exposing Contractor

  • Safety monitor performs only monitoring duties?

  • Exposing Contractor

  • Safety monitor is at the same surface as the work with visual and verbal contact?

  • Exposing Contractor

  • Warning line 6 feet back for roofing activities?

  • Exposing Contractor

  • Warning line 15 feet for non-roofing activities?

  • Exposing Contractor

  • Warning line erected on all open sides?

  • Exposing Contractor

  • Warning line flagged and suspended at proper height?

  • Exposing Contractor

  • Access and hoisting areas guarded?

  • Exposing Contractor

  • All materials stored more than 6 feet back from roof or deck edge?

  • Exposing Contractor

  • Safety compliance being maintained?

  • Exposing Contractor

  • Notes:

FIRE SAFETY

  • Employees trained in the use of fire extinguishers?

  • Exposing Contractor

  • Fire extinguishers in good condition, fully charged and recently inspected?

  • Exposing Contractor

  • Fire extinguishers replaced annually?

  • Exposing Contractor

  • Fire extinguishers are within 75 feet of workers?

  • Exposing Contractor

  • Fire extinguishers within 15 feet of hot work?

  • Exposing Contractor

  • Minimum of 1 fire extinguisher per floor / level?

  • Exposing Contractor

  • Fire extinguishers within 50 feet of flammable materials?

  • Exposing Contractor

  • Flammables stored in an approved and closed containers?

  • Exposing Contractor

  • No smoking signs posted near flammables?

  • Exposing Contractor

  • Flammable liquids protected from ignition sources?

  • Exposing Contractor

  • Flammables not stored near access and egress locations?

  • Exposing Contractor

  • Scrap piles, debris and trash stored more than 10 feet from building or structure?

  • Exposing Contractor

  • Maintaining fire safety compliance?

  • Exposing Contractor

  • Notes:

FORKLIFTS

  • Forklift operators been trained for the specific forklift they are operating?

  • Exposing Contractor

  • Forklift inspected prior to use?

  • Exposing Contractor

  • Forklifts have not been modified or altered?

  • Exposing Contractor

  • Outriggers being used on extended reach fork lift?

  • Exposing Contractor

  • Forklift is operating within lift capacities?

  • Exposing Contractor

  • Forklift slings have been inspected and maintain lift capacity tags?

  • Exposing Contractor

  • Forklifts have lift, load and angle charts?

  • Exposing Contractor

  • Forklift has fire extinguisher in the cab?

  • Exposing Contractor

  • Forklift forks are down when not in operation?

  • Exposing Contractor

  • Forklift operator wearing seat belt when in operation?

  • Exposing Contractor

  • Forklift has an audible back up alarm that can be heard up to 200 feet away?

  • Exposing Contractor

  • Spotters are used when forklift has to travel through barrier curtains or blind accesses?

  • Exposing Contractor

  • Operator is traveling less than 10 MPH, stopping at all intersections and stop signs?

  • Exposing Contractor

  • Workers under lifted / suspended loads?

  • Exposing Contractor

  • Lift basket secured to forklift?

  • Exposing Contractor

  • Forklift maintains an operator when the lift basket has employees in it?

  • Exposing Contractor

  • Forklift operators maintaining safety compliance?

  • Exposing Contractor

  • Notes:

HOUSEKEEPING

  • Work site / location reasonably organized - Good housekeeping?

  • Exposing Contractor

  • Lunch trash picked up and removed from site?

  • Exposing Contractor

  • Trash removed at regular intervals?

  • Exposing Contractor

  • Scrap, pipe cut offs, pipe and other slip / trip hazards removed?

  • Exposing Contractor

  • Staging / lay down area in good condition / good housekeeping?

  • Exposing Contractor

  • Gang boxes free from combustible / flammable materials?

  • Exposing Contractor

  • All scrap lumbar / planks has nails removed or bent over?

  • Exposing Contractor

  • Housekeeping is being maintained?

  • Exposing Contractor

  • Notes:

LADDERS and STAIRS

  • Ladders inspected / no visible defects?

  • Exposing Contractor

  • Ladders rated for construction (1 AA ladder) ?

  • Exposing Contractor

  • Spreaders fully extended and locked into position on A frame ladders?

  • Exposing Contractor

  • Top two steps of a step ladder not being used?

  • Exposing Contractor

  • Ladders set up on firm stable base?

  • Exposing Contractor

  • Ladders being used for the intended purpose?

  • Exposing Contractor

  • Proper ladder selected for task?

  • Exposing Contractor

  • Extension ladder extends 3 feet above landing surface?

  • Exposing Contractor

  • Extension ladder set up at 4:1 angle?

  • Exposing Contractor

  • Extension ladders tied off at the top and secured at the bottom to prevent slip?

  • Exposing Contractor

  • Stair/ladder/ramp used at elevation break of 18 inches or more?

  • Exposing Contractor

  • Handrails on stairs with 4 or more risers?

  • Exposing Contractor

  • 3 feet around the ladder at the top and bottom remain clear of all materials and debris?

  • Exposing Contractor

  • Employee is maintaining 3 points of contact while climbing ladders?

  • Exposing Contractor

  • Treads / landings on pan stairways filled?

  • Exposing Contractor

  • Ladder / steps used when access a flat bed trailer?

  • Exposing Contractor

  • Ladder users maintaining safety compliance?

  • Exposing Contractor

  • Notes:

MEDICAL / FIRST AID

  • Emergency numbers posted on site, visible to all employees?

  • Exposing Contractor

  • Location of nearest medical facilities posted, visible to all employees?

  • Exposing Contractor

  • Eye wash / body wash stations set up when required?

  • Exposing Contractor

  • A minimum of 1 CPR / FA / AED certified employee per crew?

  • Exposing Contractor

  • Every trade maintains their own first aid kit / supplies? First aid kit fully stocked?

  • Exposing Contractor

  • Maintaining safety compliance with medical / first aid?

  • Notes:

PERSONAL PROTECTIVE EQUIPMENT

  • Maintaining safety compliance with personal protection equipment ?

  • Exposing Contractor

  • PPE provided to the employee / available as required?

  • Exposing Contractor

  • PPE being maintained in good condition?

  • Exposing Contractor

  • Replacement PPE readily available?

  • Exposing Contractor

  • Hard hats being worn, properly and without alterations?

  • Exposing Contractor

  • Eye protection used as required? Glasses rated as eye protection?

  • Exposing Contractor

  • Hand protection used when required? (Digging, handling tag lines etc)

  • Exposing Contractor

  • Safety boots (Steal toe) footwear worn when required (Compacting soil, jack hammering etc)?

  • Exposing Contractor

  • Respirators provided / used as required?

  • Has the employee been trained in respiratory protection?

  • Does employer maintain a current written respirator program?

  • Has the employee been seen by a physician and been fit tested?

  • Employee using the proper filter for respirator?

  • Respirator being stored correctly?

  • Exposing Contractor

  • Hearing protection used as required?

  • Exposing Contractor

  • High visibility clothing worn as required?

  • Exposing Contractor

  • Face protection used as required?

  • Exposing Contractor

  • Notes:

POSTINGS / SAFETY SIGNS

  • OSHA Workplace Poster displayed at all locations?

  • Exposing Contractor

  • Emergency numbers / contacts posted?

  • Exposing Contractor

  • OSHA 300 log posted Feb. 1st through April 30th?

  • Exposing Contractor

  • Danger / warning signs posted? Each site maintains proper signage?

  • Exposing Contractor

  • Danger - Keep out signs posted on security fencing?

  • Exposing Contractor

  • All posting meet safety compliance?

  • Notes:

SAFETY TRAINING

  • Toolbox / tailgate meetings completed daily? Documented?

  • Exposing Contractor

  • Toolbox / tailgate meetings completed weekly? Documented?

  • Exposing Contractor

  • Equipment (Machine) operator training conducted and documented?

  • Exposing Contractor

  • Job-specific safety training provided / documented?

  • Exposing Contractor

  • Safety orientation training provided and verified?

  • Exposing Contractor

  • All employees have been trained in Heat Illness and Injury Prevention? (8CCR3395)

  • Exposing Contractor

  • Employer is maintaining good safety training and maintaining compliance?

  • Notes:

SANITATION

  • Adequate supply of potable water provided at no cost to the employee ( Minimum of 1 quart of water per hour per employee)?

  • Exposing Contractor

  • Single use, disposable drinking cups provided? (Common cup and drinking directly from the container is prohibited)

  • Exposing Contractor

  • Trash cans provided at all drinking locations?

  • Exposing Contractor

  • NON-POTABLE water is clearly marked and identified?

  • Exposing Contractor

  • 1 toilet per 20 workers at the job site? Females have a separate facilities?

  • Exposing Contractor

  • Hand washing stations provided? 1 hand washing outlet per 20 workers?

  • Exposing Contractor

  • Facilities (toilets and hand washing facilities) are being maintained in sanitary conditions?

  • Exposing Contractor

  • Sanitation locations are being maintained in good conditions and maintaining safety compliance?

  • Notes:

SCAFFOLDS

  • Guard rails are installed between 42 - 48 inches off of platform?

  • Exposing Contractor

  • Mid-rails are installed between 21 - 24 inches off of platform?

  • Exposing Contractor

  • Perry Scaffolds has guard rails and mid rails when platform is at 7 1/2 feet?

  • Exposing Contractor

  • Perry Scaffolds have outriggers when scaffold is 3 times the base?

  • Exposing Contractor

  • Perry Scaffold is built per manufacturers specifications?

  • Exposing Contractor

  • Employees are not "surfing" or scooting on Perry Scaffolds?

  • Exposing Contractor

  • Employees have both feet on the platform at all times?

  • Exposing Contractor

  • Trades maintaining good compliance with Scaffolds?

  • Exposing Contractor

  • Scaffold(s) are free of materials for the employees to gain additional height?

  • Exposing Contractor

  • All employees have been trained in Scaffold Awareness to work off of scaffolds?

  • Exposing Contractor

  • Competent person inspecting scaffold before daily occupancy? From all trades working off of scaffolds?

  • Exposing Contractor

  • Scaffold was erected under the supervision of a Competent Person?

  • Exposing Contractor

  • Scaffold inspection tags are located at each scaffold ladder? Inspection tags filled out and maintains current inspections?

  • Exposing Contractor

  • Working platforms fully planked?

  • Exposing Contractor

  • Fall protection provided at 7 1/2 feet and above?

  • Exposing Contractor

  • Legs / frames bear on base plates / mud sills?

  • Exposing Contractor

  • Base plates / mud sills clear from dirt, debris and obstructions? Able to inspect? Base plate secured to mud sill?

  • Exposing Contractor

  • Mud sills free from undermining?

  • Exposing Contractor

  • Planks in good condition? Scaffold grade planks? Free from splits, cuts and damage?

  • Exposing Contractor

  • Planks / Working platform clean, free from excessive debris, trash and materials?

  • Exposing Contractor

  • Ladder provided and used to access all scaffold platforms?

  • Exposing Contractor

  • Scaffold plank overlap a minimum of 6 inches max. 18 inches, and overlap is over a frame?

  • Exposing Contractor

  • Scaffold is tied into structure at 12, 26 and 30 feet (or top of structure)?

  • Exposing Contractor

  • Toe-boards provided above all access / egress points and anywhere employees are working below?

  • All types of scaffold(s) maintaining safety compliance?

  • Notes:

STEEL ERECTION

  • Site erection plan available for review?

  • Exposing Contractor

  • Lay down area graded, drained and adequate?

  • Exposing Contractor

  • Decking secured upon placement?

  • Exposing Contractor

  • Guardrails around stair / elevator / perimeters openings?

  • Exposing Contractor

  • Floor opening covers properly marked and secured?

  • Exposing Contractor

  • Structure members secured with two bolts per connection?

  • Exposing Contractor

  • Diagonal bracing secured with one bolt per connection?

  • Exposing Contractor

  • Tools secured against accidental displacement?

  • Exposing Contractor

  • Perimeter cables installed when decking is completed?

  • Exposing Contractor

  • Perimeter cables flagged at 6 foot intervals?

  • Exposing Contractor

  • Perimeter cables maintain less than 2 inch deflection?

  • Exposing Contractor

  • Ramps and runways properly guarded?

  • Exposing Contractor

  • Iron workers / steel erection maintaining safety compliance?

  • Notes:

TOOLS (HAND and POWER)

  • Hand and power tools in safe operating condition?

  • Exposing Contractor

  • Tool guards in place and functional on all power tools?

  • Exposing Contractor

  • All tools stopped and turned off during refueling and maintenance?

  • Exposing Contractor

  • Power tools maintain a ground post or be double or triple insulated?

  • Exposing Contractor

  • Tools are in like new condition with no alterations, repairs or damage?

  • Exposing Contractor

  • Handles on tools free from splinters and cracks?

  • Exposing Contractor

  • Safety spring(s) being maintained in all nail guns?

  • Exposing Contractor

  • Grinders and cutting wheels maintain fully functioning guards?

  • Exposing Contractor

  • All air delivery equipment maintain air pressure gauges and hose connection safety's (ties/whips/connection pins)?

  • Exposing Contractor

  • Tools are properly hoisted / lowered?

  • Exposing Contractor

  • All tools being maintained within safety compliance?

  • Notes:

TRAFFIC CONTROL

  • Personal trained in work zones traffic safety techniques?

  • Exposing Contractor

  • Manual on Uniform Traffic Control Devices available?

  • Exposing Contractor

  • Traffic Control Plan available and updated?

  • Exposing Contractor

  • Work zone inspected? Documented?

  • Exposing Contractor

  • Warning signs alert drivers to upcoming road work?

  • Exposing Contractor

  • Warning signs visible and spaced properly?

  • Exposing Contractor

  • Warning signs in good condition, legible, clean and working?

  • Exposing Contractor

  • Delineation devices (cones, barrels, panels) positioned properly?

  • Exposing Contractor

  • Delineation devices (cones, barrels, panels) in good condition?

  • Exposing Contractor

  • Barricades provided / placed where required?

  • Exposing Contractor

  • Barricades erected with correct directional stripes?

  • Exposing Contractor

  • High visibility clothing is worn within the work zone? Proper rating (class 2 or class 3)?

  • Exposing Contractor

  • Beacon lights activated on vehicles near active traffic lanes?

  • Exposing Contractor

  • Contractors maintaining traffic control safety?

  • Exposing Contractor

  • Notes:

TRENCHING / EXCAVATION

  • Excavations not more than 2 feet below protective systems?

  • Exposing Contractor

  • Pavements / structures not undermined unless supported?

  • Exposing Contractor

  • Excavation contractor maintaining safety compliance?

  • Exposing Contractor

  • Utilities located / identified prior to start of excavation? PM or Dig Alert contacted?

  • Exposing Contractor

  • Competent person identified on the JSA and has completed daily inspections?

  • Exposing Contractor

  • Competent person on-site and at location when trench is occupied?

  • Exposing Contractor

  • Soil has been properly classified by manual tests and properly documented?

  • Exposing Contractor

  • Atmospheric conditions tested prior to entry (where required) ?

  • Exposing Contractor

  • Signs / barricades provided on all open trenches? Barricades a minimum of 6 feet away from the trench?

  • Exposing Contractor

  • Employees are protected from cave-in by protective systems?

  • Exposing Contractor

  • Sloping / benching adequate for soil type?

  • Exposing Contractor

  • Spoils / materials / equipment set back 2 feet from edge? No material / equipment on the benches?

  • Exposing Contractor

  • Travel distance to egress is no more than 25 feet?

  • Exposing Contractor

  • Surface encumbrances removed or supported?

  • Exposing Contractor

  • Stability of adjacent structures ensured?

  • Exposing Contractor

  • Water runoff controlled to prevent accumulation?

  • Exposing Contractor

  • Access prohibited when water accumulation is uncontrolled?

  • Exposing Contractor

  • Back filling occurs following removal of support system?

  • Exposing Contractor

  • Trenches and excavations are within good safety compliance?

  • Notes:

WELDING / CUTTING / HOT WORK

  • Welding screens provided and used when required?

  • Exposing Contractor

  • JSA and Hot work permit filled out completely and is accurate?

  • Exposing Contractor

  • Welders are operating safely and maintaining safety compliance?

  • Exposing Contractor

  • Regulators / gauges / valves in proper working order?

  • Exposing Contractor

  • Cylinders maintained in good condition?

  • Exposing Contractor

  • Welding hoses in good condition?

  • Exposing Contractor

  • Fire extinguisher within 20 feet of hot work?

  • Exposing Contractor

  • Valve caps in place when stored / transported?

  • Exposing Contractor

  • Combustibles removed / protected from heat / spark / slag?

  • Exposing Contractor

  • Cylinders secured in upright position?

  • Exposing Contractor

  • Fuel gas cylinders separated from oxygen cylinders (by 20 feet) when not in use, or has a firewall between tanks?

  • Exposing Contractor

  • Fuel gas has a flash arrestor in-line or at the handle?

  • Exposing Contractor

  • Cylinders in transportation are secured in a vertical position?

  • Exposing Contractor

  • Fire watch is in place when required?

  • Exposing Contractor

  • Notes:

OTHER

  • Construction areas properly illuminated?

  • Exposing Contractor

  • Security fencing installed, maintained in good condition and is closed when site is not occupied?

  • Exposing Contractor

  • Frequent / regular inspections by the contractor of the job site completed?

  • Exposing Contractor

  • Defective equipment tagged or removed from job site?

  • Exposing Contractor

  • Any unsafe acts observed?

  • Exposing Contractor

  • Notes:

MISC. INFORMATION

  • Notes:

  • This space is available for draw out.

  • This report was emailed to the Project Manager / GM

  • Date and time when the report was submitted?

  • This report emailed to the Exposing Contractor(s)?

  • Date and time when the report was sent to Exposing Contractor(s)

  • Auditor Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.