Information
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Location
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Conducted on
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Personnel
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Prepared by
1. Site Safety Basics
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1.1 Member of management on site
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1.2 Are entrances/exits clear of debris and obstructions
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1.3 Are all employees fit for duty
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1.4 Emergency Action Plan is posted
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1.5 First-aid kit is readily available and properly supplied
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1.6 Fire extinguisher is readily accessible and in operating condition
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1.7 MSDS (SDS) available on site for chemicals in use
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1.8 Hazardous Storage and Disposal
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1.9 Utilities Marked/Identified
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1.10 Poster (OSHA, Federal, NY State Law, etc.)
2. Facility Security and Public Safety
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2.1 Site Perimeter Fence
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2.2 Warning Signs (PPE, Traffic Control, etc.)
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2.3 Travel/Access Ways (Unobstructed and Maintained)
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2.4 Adequate Lighting for Site and Public
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2.5 Traffic Control Plan / Necessary Traffic Details / Detours
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2.6 Visitor Controls (Signs, Visitor PPE, etc.)
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2.7 Discussed Site Safety and Emergency Action Plan with visitors
3. Personal Protective Equipment
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3.1 Are employees wearing/donned their proper PPE for task?
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3.2 Hard Hats are Being Worn
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3.3 High Visibility Vests are in Use & Clean
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3.4 Safety Glasses are in Use
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3.5 Gloves are used for Required Tasks
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3.6 Proper Footwear is Being Worn
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3.7 Face Shields are used while Grinding, Brushing, Chipping, etc.
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3.8 Filtering Facepieces are used during Dusty/Silica Operations (Saw-cutting or Routing)
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3.9 Hearing Protection is in use during High Noise Operations
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3.10 Has all PPE been Inspected per-Manufacture and is being used properly
- Yes
- No
- N/A
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3.11 Safety Shower / Eyewash Stations in needed areas
4. Housekeeping
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4.1 Exit / Access Ways maintained and unobstructed
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4.2 Stairs and Landings are maintained and clear of debris / obstruction
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4.3 Trash Receptacles: Adequate Number and Maintained
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4.4 Trash Piles
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4.5 Materials Stored Properly
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4.6 Material stored laying down on dunnage (no leaning material)
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4.7 Projecting Nails / Splinters
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4.8 Toilet Facilities clean and in good service
5. Contractor (Subs) Provisions
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5.1 Ensure all contractors have Site Specific Safety Plan and that they understand our expectations
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5.2 Ensure all contractors have submitted HazComm Program and SDS
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5.3 All contractors are conducting themselves accordingly
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5.4 All contractors are familiar with Emergency Action Plan
6. Fire Protection / Prevention
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6.1 Fire Prevention Plan / Evacuation Plan Communicated to all
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6.2 Fire Extinguishers Inspected and Maintained
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6.3 Gas Cylinders stored and segregated properly
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6.4 Hot Work Fire Extinguisher within 25ft
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6.5 Hot Work no combustible material within 5ft or use fire blankets
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6.6 Fire Hydrants / Standpipes accessible to Fire Department
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6.7 Site Smoking Policy
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6.8 Fire Department Permits obtained and on site
7. Fall Protection
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7.1 Inspect Guardrails (top rail 38-42" mid rail 19-21" and toe board 3")
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7.2 Holes, Openings, Gaps or Voids 2" in any direction must be covered 2x intended load, secured and marked hole/cover or barricaded
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7.3 Personal Fall Protection Inspected before use
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7.4 100% Tie-off when working 6' and above
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7.5 Personal Fall Arrest System includes Full Body Harness, Static Lanyard/SRL with Double Locking Snap Hooks and 5000lb load capacity Anchor Point
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7.6 Dropped Object Prevention (tool lanyards, tool bag, netting, etc.)
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7.7 Ladders inspected before use
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7.8 Ladders set at 4:1 pitch
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7.9 Ladders extend 3' above landing, tied off and one person on a ladder at a time
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7.10 Damaged ladders are removed from service
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7.11 Stairs inspected before use
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7.12 Hand Rails for four or more risers (top rail withstand 200lbs in any direction, mid rail withstand 150lbs in any direction, toe board withstand 50lbs in any direction)
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7.13 Risers - uniform height and width
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7.14 Treads - uniform height and width
8. Electrical
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8.1 Power Tools inspected and removed from service if defective
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8.2 All cords/plugs are 3 prong and heavy duty
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8.3 GFCI's are used and placed at the source
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8.4 Unplug, Lockout/Tagout any equipment/machinery before servicing
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8.5 Lockout/Tagout Program in Place
9. Hand & Power Tools
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9.1 Tools Inspected before use
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9.2 Tools effectively grounded or double insulated
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9.3 Tools used properly
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9.4 Damaged tools removed from service (cut cord and trash)
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9.5 Pneumatic hoses/air lines inspected for deterioration, damage, make sure they have whip checks and safety pins in place
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9.6 Proper PPE worn
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9.7 Tools Equipped with required guards and handles
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9.8 Tools properly stored
10. Welding & Cutting
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10.1 Performed my Qualified Individuals
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10.2 All combustibles removed
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10.3 Fire Watch posted
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10.4 Proper PPE used
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10.5 Equipment Inspected before use
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10.6 Hoses & Welding Leads in good condition
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10.7 Torch Regulators & Gauges in good condition
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10.8 Torches with Flash Arrestors or Check Valves
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10.9 Fuel Gas Shut Off Key/Wrench available
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10.10 Gas Cylinders Upright and Secured
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10.11 Separation of stored Oxygen & Fuel, gases, oils etc. by 20' or .5hr fire rated wall
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10.12 Fully charged Fire Extinguisher within 25' of Hot Work
11. Traffic Control (lifts and trenches)
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11.1 Traffic Control Plan in place
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11.2 Flaggers in place
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11.3 Barricades, Delineators, Signage, etc.
12. Heavy Equipment
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12.1 Licensed/Qualified Operator (on file at site)
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12.2 Inspections, Service Records, Operators Manual (on file at site)
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12.3 Seat Belts function properly, being worn
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12.4 Defective Equipment removed from service until repaired /corrected
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12.5 Horn, Back Up Alarms working properly
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12.6 Roll Over Protective Structures installed & secured (ROPS)
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12.7 Falling Object Protective Structures (FOPS)
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12.8 Unauthorized Riders on equipment
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12.9 Fly Wheel, Belts, Gears, Rollers and other pinch points guarded
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12.10 Swing Radius Protection
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12.11 Proper clearance from edges of drop-offs and unstable surfaces
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12.12 Proper clearance from Utility Lines minimum >10'
13. Cranes & Rigging
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13.1 Licensed / Qualified Operator
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13.2 Annual Inspection
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13.3 Daily Inspections (report on file and up to date)
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13.4 Load Charts available on crane
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13.5 Outriggers fully deployed and balanced
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13.6 Floats /Tracks on mats or pads
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13.7 Swing Radius Protection
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13.8 Proper clearance from Utility Lines minimum >10'
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13.9 Hoist Certified and inspected
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13.10 Hoist Capacity clearly posted
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13.11 Hooks/Rigging inspected
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13.12 Pick Plan discussed reviewed by everyone
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13.13 Competent Rigger and Communication / Signals established
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13. 14 Employees are kept clear of suspended loads
14. Conveyors
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14.1 Guards Installed before Startup
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14.2 Emergency Stops / Pull Stops
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14.3 Manage In/End-Running Nips / Pinch Points
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14.4 Overhead Protection - Access under conveyors, decks etc.
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14.5 Conveyors Inspected and pulleys greased
15. Trenches
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15.1 Utilities Located and Marked
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15.2 Competent Person on site
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15.3 Sloping/Benching (per-OSHA Standards)
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15.4 Trench Shield in place
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15.5 Trench Box in place
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15.6 Spoils/Materials stored at least 2' from trench edges
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15.7 Proper Access/Egress (ladders) 4' deep or more set at every 25' of travel
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15.8 Protection from Vehicular Traffic
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15.9 Protection from Pedestrians (barricades, travel signs, warning signs, etc.
16. Weather Conditions
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16.1 Is there enough water on site
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16.2 If freezing (32°f) are the walkways salted down to prevent falls
Summary
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Rate Overall Job Site (5 being best)
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Rate Your Performance During Inspection (5 being best)
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How many employees did you correct
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How many employees did you compliment
Sign Off
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On site representative
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Auditor's signature