PM Safety inspection

• Project Manager Safety Inspection

• Job Name and Number

• Conducted on

  Date

• Prepared By:

  Select Pat Olson Danny Grimes Josh Snowden James Stevens Bill Smiley Matt Tolbert Greg Gilreath Rusty Carver Brian Springer Brad Hawkins

  • Pat Olson
  • Danny Grimes
  • Josh Snowden
  • James Stevens
  • Bill Smiley
  • Matt Tolbert
  • Greg Gilreath
  • Rusty Carver
  • Brian Springer
  • Brad Hawkins
• Location
  Address

• Superintendent

Soft Tissue Injury Mitigation Program

• Material Handling Plan in Place no Lifting over 55 Lbs

  Safe

  At Risk

  N/A

• Material Moving Equipment on site and in use (i.e. carts, dolleys, hoists, fork lifts, etc.)

  Safe

  At Risk

  N/A

• Proper Lifting procedures, addressed on site specific plan and enacted on the field?

  Safe

  At Risk

  N/A

• Repetitive motion injuries addressed and plan in place to mitigate them?

  Safe

  At Risk

  N/A

• Team members trained on STOMP procedures.

  Safe

  At Risk

  N/A

• Comments

Fall Protection and Ladders

• Fall protection in use, in good condition, inspected, and within expiration date

  Safe

  At Risk

  N/A

• Ropes and rope grabs inspected and anchored correctly

  Safe

  At Risk

  N/A

• Anchors are in sound condition and secured to a proper point. Capable of supporting at least 5000 pounds per worker

  Yes

  No

  N/A

• Retractable lanyards are used in boom lifts/scissor lifts

  Yes

  No

  N/A

• Floor holes (over 2 inches) and wall openings properly protected, securely covered and marked

  Yes

  No

  N/A

• Ladders in good condition; tied back; extended 3ft. beyond the landing point. Ladder angle at 4:1 ratio

  Safe

  At Risk

  N/A

• Step ladders inspected and spreader bars extended and locked in place while in use

  Yes

  No

  N/A

• Extension ladders should be used only for access no work performed from ladders ?

  Safe

  At Risk

  N/A

Electrical Safety Procedures

• Is Energized work being performed?

  Yes

  No

  N/A

• Is the qualified person trained in hot work procedures

  Yes

  No

  N/A

• Is the proper PPE available and inspected

  Yes

  No

  N/A

• is there a back up person trained in the procedures available

  Yes

  No

  N/A

• LOTO Procedures in place?

  Yes

  No

  N/A

• Affected team members trained?

  Yes

  No

  N/A

• LOTO equipment on site and being used?

  Yes

  No

  N/A

• Electrical equipment connected properly, grounded and in good condition. GFCI in good condition.

  Yes

  No

  N/A

• Comments

Tools and Equipment

• Tools and equipment in good condition and properly guarded

  Yes

  No

  N/A

• All mobile equipment inspected and documented daily by competent person and operator has been trained in operation.

  Safe

  At Risk

  N/A

• Seatbelts in use by all operators and passengers

  Yes

  No

  N/A

• Back-up alarms are functional

  Yes

  No

  N/A

General

• Safe access to work area and good housekeeping

  Yes

  No

  N/A

• Barricades/warning signs in place

  Yes

  No

  N/A

• Fire extinguisher: good condition, current inspection<br>tag, 50 ft. rule

  Yes

  No

  N/A

• First aid; kit and certified employees onsite. Eye<br>wash available

  Yes

  No

  N/A

• Yes

  No

  N/A

Paperwork and other Postings

• Employees have received Safety Orientation and are familiar with JBI Safety Procedures

  Yes

  No

  N/A

• Yes

  No

  N/A

• OSHA posters and emergency phone numbers posted

  Yes

  No

  N/A

• Job logs, Job Safety Check Sheets being performed and JHA completed

  Yes

  No

  N/A

• Daily Huddle conducted at the beginning of each shift and documented

  Yes

  No

  N/A

• Site specific safety plan being used and updated as job progresses.

  Yes

  No

  N/A

• Employees have received a site specific safety orientation and signed the site specific safety plan.

  Yes

  No

  N/A

• Task training performed and employee suitability<br>verified prior to task assignment

  Yes

  No

  N/A

• Address behavioral issues positive and negative – Other general comments – PPE worn – Supervisor set proper example – accidents / near misses reported

• Project Manager Signature

  Sign