R.C. Mathews Contractor Jobsite Safety Inspection

• Conducted on

  Date

• Prepared by

R.C. Mathews Contractor, LLC

• Jobsite / Project #:
  Address

• Inspection Date:

  Date

• Superintendent(s):

• Safety Manager:

Project Inspection Overview

General:

• OSHA 300 Forms / Labor Department Posters Posted:

  Yes

  No

  N/A

• OSHA Poster Location(s):

• Medical Clinic / Emergency Numbers Posted:

  Yes

  No

  N/A

• New Hire Orientation:

• Safety Meetings (Tool Box Talks / Stand Downs):

• Project Specific Safety Meetings:

• Near Misses / Incidents:

• Daily Reports / Job Safety Analysis Completed:

  Yes

  No

  N/A

• Emergency Action Plan in Place:

  Yes

  No

  N/A

• First Aid Kits / Trained RCMC Employees:

  Yes

  No

  N/A

• Location of First Aid Kit(s):

• Sanitation / Hand Washing / Toilets:

• SWPPP:

• Perimeter Fencing & RCMC Signage in Place:

  Yes

  No

  N/A

Structure Entrance:

• Overhead Protection in Place at Entrances:

  Yes

  No

  N/A

• Drop-zone Area Established (overhead work):

  Yes

  No

  N/A

Personal Protective Equipment (PPE):

• Hard Hats:

  Safe

  At Risk

  N/A

• Eye / Face Protection:

  Safe

  At Risk

  N/A

• Hearing Protection:

  Safe

  At Risk

  N/A

• Respiratory Protection:

  Safe

  At Risk

  N/A

• Foot Protection / Footwear:

  Safe

  At Risk

  N/A

• Proper Work Clothing:

  Safe

  At Risk

  N/A

• Hand Protection:

  Safe

  At Risk

  N/A

• Personal Fall Arrest Systems:

  Safe

  At Risk

  N/A

• PPE Overview:

Housekeeping:

• Walkways / Stairs / Access & Egress:

  Safe

  At Risk

  N/A

• Staging / Storage Areas:

  Safe

  At Risk

  N/A

• Materials / Trash Removal:

  Safe

  At Risk

  N/A

• Nails Bent or Removed:

  Safe

  At Risk

  N/A

• Housekeeping Overview:

Fire Protection / Prevention:

• Fire Extinguishers:

  Safe

  At Risk

  N/A

• Flammable Materials Storage:

  Safe

  At Risk

  N/A

• Flammable Liquids Stored in Approved Containers:

  Safe

  At Risk

  N/A

• Fuel Tanks Stored at a Minimum of 20' from Structures with Fire Extinguishers in place within 50':

  Safe

  At Risk

  N/A

• Welding / Cutting Operations:

  Safe

  At Risk

  N/A

• Fire Watch:

  Safe

  At Risk

  N/A

• Fire Protection / Prevention Overview:

Hand & Power Tools:

• Tool Condition:

  Safe

  At Risk

  N/A

• Guarded / Power Cords:

  Safe

  At Risk

  N/A

• Proper Usage:

  Safe

  At Risk

  N/A

• Pneumatic Tools Inspected and Connections Secured:

  Safe

  At Risk

  N/A

• Air Hoses & Whip Checks:

  Safe

  At Risk

  N/A

• Power Actuated Tools Inspected and Operators Trained:

  Safe

  At Risk

  N/A

• Hand & Power Tools Overview:

Stairways / Ladders:

• Ladder Condition / Use:

  Safe

  At Risk

  N/A

• Stairway / Ladder / Ramp used where 19" Break in Elevation Exists:

  Yes

  No

  N/A

• Ladders Secured (Top & Bottom):

  Safe

  At Risk

  N/A

• Ladders Extended 3' above landing:

  Safe

  At Risk

  N/A

• 36" clearance of Materials around base of Ladder

  Safe

  At Risk

  N/A

• Proper Working Angle (4:1):

  Safe

  At Risk

  N/A

• Cleats / Base Pad in Safe Working Condition:

  Safe

  At Risk

  N/A

• Rungs & Rails in Safe Working Condition:

  Safe

  At Risk

  N/A

• Labels Visible & Legible:

  Yes

  No

  N/A

• Ladder Overview:

Fall Protection:

• Fall Arrest Systems Inspected Daily & Before Use:

  Safe

  At Risk

  N/A

• Fall Protection Utilized when Exposed to Lower Level Falls (Greater than 6'):

  Safe

  At Risk

  N/A

• Guardrails (Wood / Cable):

  Safe

  At Risk

  N/A

• Warning Line Systems:

  Safe

  At Risk

  N/A

• Safety Nets:

  Safe

  At Risk

  N/A

• Horizontal Lifeline:

  Safe

  At Risk

  N/A

• Holes (Greater than 2") / Wall Openings Covered and Identified:

  Safe

  At Risk

  N/A

• Fall Protection Overview:

Scaffolding:

• Daily & Monthly Inspections Completed:

  Safe

  At Risk

  N/A

• Scaffolding Erected on Solid, Level Footing:

  Safe

  At Risk

  N/A

• Braced / Secured to Structure:

  Safe

  At Risk

  N/A

• Planks & Platforms:

  Safe

  At Risk

  N/A

• Access & Egress in Place:

  Safe

  At Risk

  N/A

• Top / Mid / Toe-board in Place and Secured:

  Safe

  At Risk

  N/A

• Scaffolding Overview:

Aerial / Boom Lifts:

• Scissor Lifts Inspected Before Use:

  Safe

  At Risk

  N/A

• Chain / Access Secured while Operating Scissor Lift:

  Safe

  At Risk

  N/A

• Aerial / Boom Lifts Inspected Before Use:

  Safe

  At Risk

  N/A

• Fall Protection Utilized while Operating Aerial / Boom Lifts:

  Safe

  At Risk

  N/A

• Proper Usage:

  Safe

  At Risk

  N/A

• Proper Anchorage Points Used:

  Safe

  At Risk

  N/A

• Personnel Trained for Lift Operations:

  Safe

  At Risk

  N/A

• Aerial / Boom Lift Overview:

Electrical:

• Lighting / Covers:

  Safe

  At Risk

  N/A

• Grounding:

  Safe

  At Risk

  N/A

• Extension Cords, Plugs, Receptacles:

  Safe

  At Risk

  N/A

• Temporary Power / Lighting / Portable Boxes:

  Safe

  At Risk

  N/A

• GFCI's in Place:

  Safe

  At Risk

  N/A

• Wires Marked & Identified:

  Safe

  At Risk

  N/A

• Warning & Danger Signs in Place:

  Safe

  At Risk

  N/A

• Electrical Overview:

Trenching & Excavation:

• Competent Person(s) Identified:

  Yes

  No

  N/A

• Daily Inspections Completed / if Conditions Change:

  Yes

  No

  N/A

• Underground Utilities Marked and Identified:

  Safe

  At Risk

  N/A

• Soil Classification Identified (Type A, B or C):

  Yes

  No

  N/A

• Spoils Placed 2' back or more:

  Safe

  At Risk

  N/A

• Means of Access / Egress within 25':

  Safe

  At Risk

  N/A

• Benching - Type B (1:1) / Sloping - Type C (1.5:1):

  Safe

  At Risk

  N/A

• Trench Box / Shielding Used (Greater than 5'):

  Safe

  At Risk

  N/A

• Tabulated Data Onsite and Documented with Trench Box:

  Safe

  At Risk

  N/A

• Fall Protection / Barricades in place and Adequate:

  Safe

  At Risk

  N/A

• Equipment Positioned / Moved away from Trench or Excavation Edge:

  Yes

  No

  N/A

• Trenching & Excavation Overview:

Cranes:

• Rigging (slings, chains, hooks and shackles) Inspected and in Good Working Condition:

  Safe

  At Risk

  N/A

• Crane Positioned on Firm / Level Surface:

  Safe

  At Risk

  N/A

• Outriggers / Proper Cribbing used Properly:

  Safe

  At Risk

  N/A

• Swing Radius Marked and Identified:

  Safe

  At Risk

  N/A

• Load Chart Posted in Cab:

  Safe

  At Risk

  N/A

• 10' of Power-line Clearance up to (50kv) / 20' of Power-line Clearance if Voltage is Unknown:

  Safe

  At Risk

  N/A

• Crane Operators Trained / Certification Cards up-to-date:

  Yes

  No

  N/A

Miscellaneous:

Comments:

Observations:

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