RGW Construction Underground Activities

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1. Housekeeping/Material Storage/Chemical Storage/Sanitation

• 1.1. Chemical/Fuel Storage (Gasoline, Diesel, Combustibles stored in metal safety cans or other authorized storage). Oxygen/Acetylene Properly Stored (Upright and Secured, 20 Feet Apart or Non-Combustible 30 Minute Fire Barrier)

  Yes

  No

  N/A

• 1.2 Access Passageways/Ladder Landings Clear of Debris, Walkways/Work Areas Clear of Debris

  Yes

  No

  N/A

• 1.3 Scrap Materials Free of Nails/Hazardous Protrusions or Properly Stockpiled/Barricaded/Caution Taped, Loose/Light Material Secured Against Displacement/Overhead Locations

  Yes

  No

  N/A

• 1.4 Lumber/Pipe/Materials Properly Stored/Secured Against Displacement

  Yes

  No

  N/A

• 1.5 Appropriate Number of Toilets For Number of Employees (1 per 20 Employees or Fraction Thereof of Each Sex)

  Yes

  No

  N/A

• 1.6 Wash Station Available for Each Toilet Facility (Wash Station Located Outside or Separate From Toilet Facility)

  Yes

  No

  N/A

2. Personal Protective Equipment

• 2.1. All Employees Wearing Proper Protective Eye Wear For Task Performed (Safety Eye Wear Required)

  Yes

  No

  N/A

• 2.2. All Employees Wearing Approved Head Protection

  Yes

  No

  N/A

• 2.3. All Employees Wearing Minimum Class II High Visibility Clothing (Or Site Specific High Visibility Clothing)

  Yes

  No

  N/A

• 2.4. All Employees Wearing Hearing Protection (as Required)

  Yes

  No

  N/A

• 2.5. All Employees Wearing Appropriate Foot Wear (Steel Toe/Metatarsal Guard For Impact/Compaction Equipment)

  Yes

  No

  N/A

• 2.6. All Employees Wearing Appropriate Hand Protection For Assigned Task

  Yes

  No

  N/A

• 2.7. Employees Wearing Appropriate Respiratory Protection (If Required)

  Yes

  No

  N/A

• 2.8. First Aid Kit Stocked and Available

  Yes

  No

  N/A

• 2.9. Water, Shade Available As Required (1Quart Per Person Per Hour, Shade to Accommodate 1/4 Of Crew At Any Time)

  Yes

  No

  N/A

3. Excavations

• 3.1. RGW Pothole Protocol Utilized Prior To Opening New Excavation

  Yes

  No

  N/A

• 3.2. Excavations/Trenches Properly Sloped/Benched/Shored, Trenches/Excavations/Boxes/Shores Inspected By Competent Person Prior To Entry By Personnel

  Yes

  No

  N/A

• 3.3 Excavations Over 20' Designed and Stamped by Registered Engineer

  Yes

  No

  N/A

• 3.4 Ladder Access Within 25' of Employees in Trenches/Excavations Over 4' Deep

  Yes

  No

  N/A

• 3.5 Trenches/Excavations Properly Barricaded (As Needed/Required), All Pits/Shafts/Manholes etc. Properly Covered As Needed/Required

  Yes

  No

  N/A

• 3.6 Spoils/Tools/Equipment Properly Placed, Not Less Than 2' From Top Edge of Excavation

  Yes

  No

  N/A

• 3.7 Air Sampling Performed In All Trenches Greater Than 4' Deep, Where Hazardous Atmospheres May Exist (Landfills, Waste Treatment, etc.)

  Yes

  No

  N/A

• 3.8 Above Ground/Sub-Surface Installations Protected, Supported or Removed

  Yes

  No

  N/A

4. Fall Protection/Retrieval Systems/Standard Guardrails

• 4.1. Full Body Harnesses/Lanyards/Devices In Serviceable Condition

  Yes

  No

  N/A

• 4.2. Proper Anchor Points Provided/In Use (Support 5000 lbs. per person attached w/lanyard, Support 3000 lbs. per person attached with retractable lifeline)

  Yes

  No

  N/A

• 4.3. Retrieval Systems in Serviceable Condition (Tripod, Winches, Retractables, Related Hardware)

  Yes

  No

  N/A

• 4.4. Standard Guardrails Installed At All Walking/Working Locations Over 6' High (Or Protected By Appropriate Fall Protection Devices)

  Yes

  No

  N/A

• 4.5. Upright Post, Top and Mid Rails Properly Installed (Upright Spaced Not More Than 8' Apart, Top Rail Between 42"-45" from Floor, Mid Rail Half Way In Between)

  Yes

  No

  N/A

• 4.6. Toe Boards Properly Installed Over Walking/Working Areas Below Elevated Locations

  Yes

  No

  N/A

5. Hoisting And Lifting Equipment

• 5.1. Cranes/Boom Trucks, Documented Daily Inspection Complete Prior To Hoisting Operations

  Yes

  No

  N/A

• 5.2. Cranes/Boom Trucks Properly Set Up ( Outriggers/Mats/Swing Radius

  Yes

  No

  N/A

• 5.3. Rigging/Hardware In Serviceable Condition, Inspected By Competent Person

  Yes

  No

  N/A

• 5.4. All Rigging/Signaling Performed By Competent Person

  Yes

  No

  N/A

• 5.5. Power Lines Identified/Marked

  Yes

  No

  N/A

• 5.6. Tag Lines In Use Where Required

  Yes

  No

  N/A

6. Material Handling Equipment/Powered Industrial Trucks

• 6.1 Back Up Alarms Operational

  Yes

  No

  N/A

• 6.2 Seat Belts In Serviceable Condition

  Yes

  No

  N/A

• 6.3 Seat Belts In Use

  Yes

  No

  N/A

• 6.4 Buckets/Forks/Attachments/Connectors In Serviceable Condition (Attachment Pins, etc.)

  Yes

  No

  N/A

• 6.5 Equipment Operators Qualified/Certified

  Yes

  No

  N/A

7. Tools and Equipment

• 7.1. Hand Tools Maintained in Safe Condition (striking surfaces, handles, etc.)

  Yes

  No

  N/A

• 7.2. Power Tools Maintained In Safe Condition (Electrical Cords, Safety Guards, Handles, etc.)

  Yes

  No

  N/A

• 7.3. Pneumatic Tools Maintained In Safe Condition (Air Hose Connections, Safety Devices, etc.)

  Yes

  No

  N/A

• 7.4. Gas Powered Tools Maintained In Safe Condition (Guards, Handles, etc.)

  Yes

  No

  N/A

• 7.5. Powder Actuated Tools Maintained In Safe Condition (Guards, Handles, Loads Properly Stored)

  Yes

  No

  N/A

• 7.6. Specialty Tools Maintained In Safe Condition (Gas Operated Tools, Jacks, etc.

  Yes

  No

  N/A

• 7.7. Extension Cords Maintained In Safe Condition (Grounding Pins, Insulation, Protected Against Vehicular Traffic, etc.)

  Yes

  No

  N/A

• 7.8. Ground Fault Circuit Interruptors (GFCI) Operational

  Yes

  No

  N/A

8. Welding/Cutting/Fire Protection

• 8.1. Welding Leads, Torch Hoses Maintained In Safe Condition (Back Flow Preventers Installed On Torches)

  Yes

  No

  N/A

• 8.2. Combustibles/Flammables Stored Away From Hot Work

  Yes

  No

  N/A

• 8.3. Regulators, Gauges Properly Installed/Maintained

  Yes

  No

  N/A

• 8.4. Fire Extinguishers/Water Cans Located Near Hot Work

  Yes

  No

  N/A

• 8.5. Fire Extinguishers Have Current Inspection Tags (Must Have Up To Date Annual Inspection Sticker)

  Yes

  No

  N/A

9. Confined Spaces

• 9.1 Confined Spaces Identified/Marked

  Yes

  No

  N/A

• 9.2. Personnel Training Complete

  Yes

  No

  N/A

• 9.3. Air Sampling Complete, Engulfment Hazards Blocked Out

  Yes

  No

  N/A

• 9.4. Air Blowers Installed As Needed

  Yes

  No

  N/A

• 9.5. Entry Documentation Complete

  Yes

  No

  N/A