River Spirit Casino Phase II Safety Review

• Document Title

• Conducted on

  Date

• Headcount

1. General Safety and Health

• 1.1 PTSP documented and signed?

  Safe

  At Risk

  N/A

• 1.1.1 Reviewed every morning?

  Safe

  At Risk

  N/A

• 1.1.2 Adequate literature for task, hazards, action plan?

  Yes

  No

  N/A

• 1.2 Daily stretch and flex?

  Safe

  At Risk

  N/A

• 1.3 Plan for emergency evacuation?

  Safe

  At Risk

  N/A

• 1.4 Knowledge of how to get first aid, emergency equipment, etc.?

  Safe

  At Risk

  N/A

• 1.5 Potable water provided?

  Safe

  At Risk

  N/A

• 1.6 Adequate number of trash containers?

  Safe

  At Risk

  N/A

• 1.7 Housekeeping/Slip, Trip, or Fall Hazards?

  Safe

  At Risk

  N/A

• 1.8 Material stored properly?

  Safe

  At Risk

  N/A

2. Personal Protective Equipment

• 2.1 Hard Hat

  Safe

  At Risk

  N/A

• 2.2 Eye/Face Protection

  Safe

  At Risk

  N/A

• 2.3 Hand Protection (Task Specific)<br>

  Safe

  At Risk

  N/A

• 2.4 Proper Footwear? (Steel toe boots, metatarsal guards, etc.)

  Safe

  At Risk

  N/A

• 2.5 Clothing?

  Safe

  At Risk

  N/A

3. Electrical Safety

• 3.1 GFCI in use?

  Safe

  At Risk

  N/A

• 3.2 Extension/Power cords in good condition with ground prong?

  Safe

  At Risk

  N/A

• 3.3 Work area lightning sufficient?

  Safe

  At Risk

  N/A

4. Fall Protection

• 4.1 Guardrails adequate?

  Safe

  At Risk

  N/A

• 4.2 Holes marked and covered?<br>

  Safe

  At Risk

  N/A

• 4.3 Anchor points approved?

  Safe

  At Risk

  N/A

• 4.4 PFAS used and in good condition?

  Safe

  At Risk

  N/A

• 4.5 PFAS inspected?

  Safe

  At Risk

  N/A

5. Heavy Equipment

• 5.1 User/Operator trained and certified (if applicable)?

  Safe

  At Risk

  N/A

• 5.2 Duct Jacks in good condition and inspected?

  Safe

  At Risk

  N/A

• 5.3 Roust-a-Bouts in good condition and inspected?

  Safe

  At Risk

  N/A

• 5.4 100% tied off in scissor lifts?

  Safe

  At Risk

  N/A

• 5.5 All heavy equipment in good condition and inspected? (Scissor lifts, forklifts, etc.)

  Safe

  At Risk

  N/A

6. Ladders

• 6.1 Ladder in good condition?

  Safe

  At Risk

  N/A

• 6.2 Is the ladder positioned correctly and secured?

  Safe

  At Risk

  N/A

• 6.3 Is the annual ladder inspection up to date?

  Safe

  At Risk

  N/A

• 6.4 Is the ladder suitable for the job? (e.g. metal ladder used for electrical work)

  Safe

  At Risk

  N/A

• 6.5 Using the ladder correctly? (3 point contact, facing ladder, below top 2 steps, etc.)

  Safe

  At Risk

  N/A

7. Hand and Power Tools

• 7.1 Guards in place?

  Safe

  At Risk

  N/A

• 7.2 In good condition?

  Safe

  At Risk

  N/A

• 7.3 Used for intended purpose?

  Yes

  No

  N/A

• 7.4 Adequate tools to perform work in area?

  Safe

  At Risk

  N/A

• 7.5 Inspected daily?

  Yes

  No

  N/A

8. Chemical Labeling and Storage

• 8.1 Unsafe storage location? (e.g. flammables near ignition sources)

  Safe

  At Risk

  N/A

• 8.2 Incompatible chemicals stored near each other?

  Safe

  At Risk

  N/A

• 8.3 Adequate spill containment equipment?

  Safe

  At Risk

  N/A

• 8.4 Safety Data Sheets accessible on site?

  Safe

  At Risk

  N/A

• 8.5 Familiarity with emergency procedure for chemicals used?

  Safe

  At Risk

  N/A

• 8.6 Excessive quantities stored on site or in vehicles?

  Safe

  At Risk

  N/A

• 8.7 Ventilation sufficient?

  Safe

  At Risk

  N/A

• 8.9 Chemicals stored in approved containers with legible label?

  Safe

  At Risk

  N/A

9. Hot Work

• 9.1 Fire Extinguisher near hot work? (inspected and up to date)

  Safe

  At Risk

  N/A

• 9.2 Compressed Gas Cylinders stored properly? (Valve cap, upright, secured, etc.)

  Safe

  At Risk

  N/A

• 9.3 Hot Work equipment (Cylinder, Gauges, Valves, Hoses, Etc.) in good condition?

  Safe

  At Risk

  N/A

10. Confined Space

• 10.1 Permit/Non-Permit Space?

  Safe

  At Risk

  N/A

• 10.2 Space Evaluated and Air Quality Tested?<br>

  Safe

  At Risk

  N/A

• 10.3 Rescue Equipment / Trained Personnel? (Non-Entry Rescue)

  Safe

  At Risk

  N/A

11. Excavation Safety

• 11.1 Soil Tested and Classified?

  Safe

  At Risk

  N/A

• 11.2 Ladders in place for Entry and Egress?

  Safe

  At Risk

  N/A

• 11.3 Benching/ Shoring in Place?

  Safe

  At Risk

  N/A

• 11.4 Competent Person on Site?

  Safe

  At Risk

  N/A

12. Crane Safety

• 12.1 Crane Paper Work in Place?

  Safe

  At Risk

  N/A

• 12.2 Competent Person on Site?

  Safe

  At Risk

  N/A

• 12.3 Rigger, Signaler, Operator are qualified/certified?

  Safe

  At Risk

  N/A

• 12.4 Rigging Equipment Inspected?

  Safe

  At Risk

  N/A

Sign Off

• Enter any corrective actions that will be undertaken

• Auditor's signature

  Sign

• On site representative

  Sign