PRSI Job Site Safety-Milling

• Conducted on

  Date

• Prepared by

• Customer-Operator(s) and Equipment on site.

• Client / job #

• Location
  Address

Identify & Verbalize Known Risks for Today

• Underground Utilities located and marked?

  Yes

  No

  N/A

• Overhead Power lines?

  Safe

  At Risk

  N/A

• Weather

  Safe

  At Risk

  N/A

• Dusty Conditions

  Safe

  At Risk

  N/A

• Heat Illness Risk

  Yes

  No

  N/A

• Night Work-Low Light Conditions

  Safe

  At Risk

  N/A

• Pedestrian Hazards-Bike Lane, School Zone

  Safe

  At Risk

  N/A

• Are we protecting Gutters and Utilities

  Yes

  No

  N/A

• Is there other equipment working onsite?

  Yes

  No

  N/A

Traffic Control

• Proper Pre-warning signs?

  Safe

  At Risk

  N/A

• Do we have proper Flaggers onsite?

  Safe

  At Risk

  N/A

• Is traffic Control protecting the public?

  Yes

  No

  N/A

• Is Traffic Control Protecting Our Operation?

  Yes

  No

  N/A

• Cones/Delineators in good condition?<br>

  Safe

  At Risk

  N/A

Equipment Operation

• 4 Factors- Rushing, Distraction, Complacency, Frustration

  Safe

  At Risk

  N/A

• Any Equipment Issues-Clean and free of any oil leaks?

  Yes

  No

  N/A

• Is backup alarms working and loud on all equipment?

  Yes

  No

  N/A

• Is grade below mill stable?

  Safe

  At Risk

  N/A

• Cell phone policy being followed?

  Yes

  No

  N/A

• Machine leaving clean cuts, matching properly and loading clean?

  Yes

  No

  N/A

• Is the operator well experienced on this mill?

  Yes

  No

  N/A

• Is the operator in control of his jobsite?

  Yes

  No

  N/A

• Is Traffic flowing smoothly and aware of lane closures

  Safe

  At Risk

  N/A

Trucking On-Site

• Seat belts being used?

  Safe

  At Risk

  N/A

• Wearing proper PPE when out of their trucks?

  Yes

  No

  N/A

• Back Up Alarms loud and working?

  Safe

  At Risk

  N/A

• Warning Lights and Beacons used?

  Safe

  At Risk

  N/A

• Use Of Cell Phones

  Safe

  At Risk

  N/A

PPE

• Hard Hats, Safety Glasses, Vests all being worn?

  Yes

  No

  N/A

• Gloves worn when needed?

  Safe

  At Risk

  N/A

• Visitors and Vendors wearing proper PPE?

  Yes

  No

  N/A

PRSI Vehicles

• Cameras Installed and working, Green Light on?

  Yes

  No

  N/A

• All Tags and Stickers in place and current?

  Yes

  No

  N/A

• Company Stickers

  Safe

  At Risk

  N/A

• Parked in secure location and Coned off?

  Safe

  At Risk

  N/A

• Tires/ Wheels in good shape?

  Yes

  No

  N/A

• Oil Containers Labeled?

  Safe

  At Risk

  N/A

• IIPP, First aid kits, spill kits readily available?

  Yes

  No

  N/A

• Outside and Inside clean and free of trash?

  Yes

  No

  N/A

• Fire Extinguishers mounted, current tag and checked monthly?

  Safe

  At Risk

  N/A

PRSI Trailers

• Tires/Wheels in good shape?

  Yes

  No

  N/A

• Decking secured, wood? clean and in good shape

  Safe

  At Risk

  N/A

• Are all teeth containers secured in the deck?

  Safe

  At Risk

  N/A

• Cones placed around trailer/Clean?

  Safe

  At Risk

  N/A

• Chains and Binders in good shape?

  Yes

  No

  N/A

Heat Illness

• Clean water available?

  Yes

  No

  N/A

• Is operator aware of shade Location?

  Yes

  No

  N/A

• High heat hazard? Temperature over 95?

  Safe

  At Risk

  N/A

Discuss at least one Important Safety Message

• Did our crew attend a Safety Meeting this morning?

  Yes

  No

  N/A

• Any Near Misses discussed or observed today?

  Yes

  No

  N/A

• Yes

  No

  N/A