RBC Safety Inspection

• Safety Inspection

• Area inspected

• Location
  Address

• Conducted on

  Date

• Coordinator:

  Sign

• Assisted by:

  Sign

1. Volunteer Habits and Actions

• Applicable for this project

  Off

  On

• 1.1. Have volunteers been given adequate training for the job?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 1.2. Are unsafe actions of any kind visible?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 1.3. Is anyone cleaning near moving machinery?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 1.4. Are proper material-handling methods and lifting techniques being used?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 1.5. Has any risk-taking or horseplay been noted, or is it known of?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 1.6. Is proper respect shown for others, for equipment, and for machinery?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 1.7. Do entrants and attendants have a written permit for confined space work?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

2. Lockout / Tagout

• Applicable for this project

  Off

  On

• 2.1. Are personal lockout devices being used?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 2.2. Are write-ups posted or readily available?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 2.3. Are lockout or tagout steps followed properly?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 2.4. Have pressure lines been bled down?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 2.5. Are valve blocks in place?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 2.6. Are blocks for gravity restraint in place?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 2.7. Are circuit breaker lockout devices in use?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 2.8. Have valve handles been removed or chained in the "off" position?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 2.9. Are cords and plugs under worker control?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

3. Personal Protective Equipment

• Applicable for this project

  Off

  On

• 3.1. Are respirators provided and used?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 3.2. Are gloves, safety shoes, and hard hats in use?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 3.3. Is protective clothing available?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 3.4. Is eye protection used?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 3.5. Is hearing protection worn as needed?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 3.6. Are welding helmets and aprons in use as needed?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

4. Equipment Safeguard

• Applicable for this project

  Off

  On

• 4.1. Are all guards in place?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 4.2. Are necessary guards provided, and are pinch points protected?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 4.3. Are compressors and other fixed-place machinery securely anchored?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 4.4. Are breakdowns promptly reported?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 4.5. Is machinery safety-checked before being put into use?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 4.6. Is machinery designed for its present use?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 4.7. Is machinery well maintained?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 4.8. Are guards durable and strong?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 4.9. Are all shafts, chains, and belts guarded?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

5. Hand and Power Tool

• Applicable for this project

  Off

  On

• 5.1. Are tools in good condition?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 5.2. Are cords and extension cords in good shape with no damage to insulation or plug?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 5.3. Do chisels have mushroomed heads?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 5.4. Have tools been safety-checked before using?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 5.5. Are the proper tools provided?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 5.6. Are they stored properly?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 5.7. Are tools being used for the intended purpose?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 5.8. Is the policy for repair/replacement of damaged tools known to all?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

6. Heavy Equipment/Materials Handling

• Applicable for this project

  Off

  On

• 6.1. Are operators maintaining adequate distance from other workers?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 6.2. Is the equipment in good repair?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 6.3. What about footholds, handholds, windshields, seats, tires, hydraulic equipment, backup alarms, rollover protection, lights?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 6.4. Are trenches properly sloped, shielded, and barricaded?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 6.5. Are materials properly tied down during transport?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

7. Ergonomics Note: "Ergonomics" refers to the scientific discipline concerned with understanding the interactions among humans and other elements in the environment around them with the goal of creating a healthy work environment compatible with the needs, abilities, and limitations of people.

• Applicable for this project

  Off

  On

• 7.1. Does the nature of the work require highly repetitive movements?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 7.2. Are workers required to use excessive force or to place themselves in awkward positions or postures?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 7.3. Are workplaces and job layouts designed to prevent undue stress on wrists, knees, and shoulders?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 7.4. Are workers on highly routine jobs rotated periodically to maintain alertness?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 7.5. Do workers obtain sufficient rest, or are they overly fatigued?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

8. Personal Safety/Passersby Hazards

• Applicable for this project

  Off

  On

• 8.1. Do trip hazards or dangers from sharp objects exist?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 8.2. Is there sufficient overhead clearance?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 8.3. Are railings, "Warning" signs, or "Danger" signs needed?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 8.4. Are flagmen needed?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 8.5. Are dangerous areas barricaded or roped off?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 8.6. Is anything loose on parapets or ledges?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 8.7. Are restraining devices needed?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 8.8. Are tiebacks in place?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 8.9. Are sidewalks and private roadways in good repair?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 8.10. Are pedestrians alert to moving vehicles?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

9. Hazards (chemical, electrical, environmental, fire, etc.)

• Applicable for this project

  Off

  On

• 9.1. Is there excessive dust, noise, fumes, heat, or vibration?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.2. Is there adequate ventilation and illumination?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.3. Is the physical environment in the work area acceptable?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.4. Are respiratory protection write-ups posted or readily available?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.5. Are fire extinguishers charged and in good condition?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.6. Are they serviced in accord with local fire codes and tagged with proof of service?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.7. Are rags and other combustibles stored properly?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.8. Is there a danger of spontaneous combustion?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.9. Are flammable or explosive materials used?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.10. Is their use controlled?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.11. Are personnel trained to handle special hazard exposures?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.12. Are emergency procedures understood?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.13. Is eyewash station nearby?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.14. Are MSDS sheets accessible?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.15. Is all electrical equipment properly grounded?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.16. Are all panels readily accessible and identified?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 9.17. Is the wiring in good condition?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

10. Emergency Response

• Applicable for this project

  Off

  On

• 10.1. Are emergency phone numbers posted (on a wall or other known location) for first aid, fire, chemical, and electrical emergencies?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 10.2. Do workers know whom to call?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 10.3. Are any needed supplies on hand?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

11. Fall Prevention

• Applicable for this project

  Off

  On

• 11.1. Is scaffolding level?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.2. Are all legs bearing a load, with none floating?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.3. Are levelling jacks being used?<br>(No unsecured wood, concrete blocks, or other debris are permitted as substitutes.)

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.4. Do dangers exist for persons below?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.5. Is safety netting needed?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.6. Are toeboards needed?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.7. Are baseplates or casters used?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.8. Are casters locked?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.9. Are safety pins installed?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.10. Are outriggers needed?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.11. Should staging be tied into the building?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.12. Are decks/planks tied down?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.13. Are there any gaps in the working platform?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.14. Is the platform free of trip hazards?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.15. Are safety rails attached?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.16. Are safety gates being used?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.17. Are floor openings covered?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.18. Are catwalks and elevated walkways in good condition?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.19. Are handrails sturdy?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.20. Is everything secured from wind?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.21. Is there sufficient lighting?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 11.22. Are safety lines and harnesses needed?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

12. Ladders

• Applicable for this project

  Off

  On

• 12.1. Are they in good condition?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 12.2. Is the top being used for standing or for holding materials?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 12.3. Is anyone overreaching or carrying materials that should be hoisted?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 12.4. Are stepladders of adequate height?<br>(Extension ladders must lean with the extension side out. No metal ladders can be used for electrical work. Stationary ladders must extend 900 mm above the roof.)

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 12.5. Are safety belts needed if both hands need to be free?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

13. Housekeeping/Storage Methods

• Applicable for this project

  Off

  On

• 13.1. Are areas free of clutter, dirt, and spills?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 13.2. Do they reflect orderliness, with a place for everything and everything in its place?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 13.3. Are materials stacked and stored properly?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 13.4. Are heavy objects on lower shelves?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 13.5. Are aisles, catwalks, and walkways well defined and in obstructed?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 13.6. Are storage piles stable?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 13.7. Are they too high?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 13.8. Is there any unusual congestion?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 13.9. Is the pallet storage acceptable?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 13.10. Are items exposed to weather?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

14. Building Integrity

• Applicable for this project

  Off

  On

• 14.1. Is the building in good condition?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 14.2. Is the use of the building consistent with its design?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 14.3. Is there any unusual erosion or corrosion?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 14.4. Is there unusual buildup of dust/debris?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 14.5. Are any collapse hazards evident?

  Safe

  At Risk

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 14.6. Are coping and facades in good condition?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 14.7. Are all exits locked?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 14.8. If work is being performed, is the door under surveillance?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 14.9. Are designated brothers contacted if needed?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

• 14.10. Is there an arrangement in place to keep the building secure?

  Yes

  No

  N/A

• Specific Location

• Describe Unsafe Condition and Recommended Solution

• Date Corrected

  Date

Sign Off

• Coordinator

  Sign

• Assisted by

  Sign