SITE EVALUATION

AERIAL and SCISSOR LIFTS

Does the crew maintain a JSA, properly filled out and within 15 feet (4.5 meters) of work being performed?

Workers have been trained in the use of equipment?

Lift occupants wearing harness correctly? Employees been trained in fall protection?

Workers tied off to boom or basket using the manufacturers anchor points?

Lift controls clearly marked and readable?

Both feet remain on the floor of the basket?

Operators are staying within the load limits of the basket / lift?

Lift is stationary when boom is elevated?

Operators / employees are refraining from transferring at height while in a scissor lift?

Mid-rail chain / gate used when in operation?

Operators maintaining safety compliance while operating lift?

Notes:

CONCRETE / MASONRY

Does the crew maintain a JSA, properly filled out and within 15 feet (4.5 meters) of work being performed?

Rebar / flat stakes guarded (covered) to eliminate impalement hazard?

Employees working in concrete wearing proper hand and foot protection?

Connectors, ties or whips used to secure pressurized air hoses?

Guard down on pump (pump truck)?

Masonry saw blades guarded?

Fugitive dust controlled while cutting block or conducting finish work?

Masons wearing face shields AND safety glasses while cutting block?

Formwork capable of supporting vertical / lateral loads?

Shoring equipment inspected?

Base plates secured to foundation / mud sill / formwork?

Jacks / supports do not exceed the rated capacity?

Limited access zone equal to the wall height plus 4 feet (1.2 meters)?

Limited access zone strictly enforced?

Walls over 8 feet (2.5 meters) braced to prevent collapse?

Masons maintaining safety compliance?

Notes:

CONFINED SPACE

Does the crew maintain a JSA, properly filled out and within 15 feet (4.5 meters) of work being performed?

JSA and rescue plan on-site and available? Employees been trained on the plan?

Entry permit completed and signed?

Air sampling completed and documented prior to entry?

Proper warning signage posted at entry to the permit space?

Forced air ventilation used for the duration of entry?

Proper lighting provided?

Rescue team trained and readily available?

Retrieval system (Tripod) available and utilized?

Entrants attached to the retrieval line?

Attendant on duty outside the permit space?

Attendant only performs monitoring duties?

Confined space team is maintaining safety compliance?

Notes:

CRANES / RIGGING

Does the crew maintain a JSA, properly filled out and within 15 feet (4.5 meters) of work being performed?

Crane(s) inspected and properly maintained?

Crane operator, rigger and signal person certified?

Crane load charts visible to the operator?

Hand signal charts posted or available?

Fire extinguisher located within the cab?

Pick (Lift) plan on-site, reviewed and the load is within load capacity?

Crane outriggers fully extended and on cribbing properly?

Crane swing radius identified and barricaded?

Workers remained clear of the in the swing radius and under suspended loads?

All power lines are a minimum 15 feet (4.5 meters) away from all lifting and boom swing radius?

Rigging equipment inspected and in good condition?

Rigging equipment maintain lift capacity markings?

Crane operations maintaining safety compliance?

Notes:

ELECTRICAL

Does the crew maintain a JSA, properly filled out and within 15 feet (4.5 meters) of work being performed?

Electrical cords maintain ground posts?

Electrical cords are free from damage / repair / alterations?

Electrical cords protected from damage (roll over)?

Doorways and windows are free from electrical cords?

Electrical cords kept clear of work areas and walk ways?

Electrical cords are rated for construction? Flat cords removed from site?

Spider box being inspected quarterly? (Assured Grounding Program)

Power strips and 3 way splitters construction rated?

Electrical equipment being used per the manufacturers specifications?

Are GFCI's (ELCB) being used, if not on an AGP? Is the GFCI being used closest to the operator?

All outlets have cover plates when outlets are energized?

Temp light cords are hung with non-metallic fastener, off the ground and does not cause a hazard?

Temp light bulbs maintain cages and all bulbs?

Electrical rooms maintain proper warnings and labels per NFPA 70e or equivalent?

Access to electrical room(s) restricted per NFPA 70e or equivalent?

Electrical panels are covered, labeled and all breaker slots are covered?

3 foot clearance around all electrical panels being maintained?

Employees are clear of all unprotected circuits / panels?

Employees are locking and tagging out equipment and panels? (NOT working on hot equipment)

Employees working with energy maintaining safety compliance?

Notes:

FALL PROTECTION

Does the crew maintain a JSA, properly filled out and within 15 feet (4.5 meters) of work being performed?

JSA and fall protection rescue plan has been established and all effected employees have been trained?

All employees have been trained in fall protection?

A fall protection system is provided for all employees working above 6 feet (1.8 meters)

PFA rigged to prevent contact with any surface? (Max fall distance allowed is 6 feet (1.8 meters))

Harnesses have been inspected prior to use?

Employee wearing harness correctly, wearing the appropriate lifeline (lanyard) and attached to an anchor?

Fall protection anchors are set up per specifications and all elements are rated to 5000 lbs (2268 kg)?

Guardrails are able to with stand 200 lbs (91 kg) outward and down force?

Guardrails (cable rails) do not exceed 2 inch (50 mm) deflection in any direction?

Guardrails and mid-rails are at the proper height?

Guardrail posts are not more than 8 foot (2.4 meters) On center?

Guardrails / mid-rails are constructed to be on the inside on the guardrail posts?

Guardrails and mid-rails have been placed around floor / roof openings?

Floor holes greater than 2 inches (50 mm) have been covered, properly labeled and secured from movement?

The fall protection selected is appropriate for the fall exposure?

Floor hole covers are capable of handling 2 times the intended load?

Warning line 6 feet (1.8 meters) back for roofing activities?

Warning line 15 feet (4.5 meters) for non-roofing activities?

Safety monitor performs only monitoring duties?

Safety monitor is at the same surface as the work with visual and verbal contact?

Warning line erected on all open sides?

Warning line flagged and suspended at proper height?

Access and hoisting areas guarded?

All materials stored more than 6 feet back from roof or deck edge?

Safety compliance being maintained?

Notes:

FIRE SAFETY

Does the crew maintain a JSA, properly filled out and within 15 feet of work being performed?

Employees trained in the use of fire extinguishers?

Fire extinguishers in good condition, fully charged and recently inspected?

Fire extinguishers replaced annually?

Fire extinguishers are within 75 feet (22 meters) of workers?

Fire extinguishers within 15 feet (4.5 meters) of hot work?

Minimum of 1 fire extinguisher per floor / level?

Fire extinguishers within 50 feet (15 meters) of flammable materials?

Flammables stored in an approved and closed containers?

No smoking signs posted near flammables?

Flammable liquids protected from ignition sources?

Flammables are clear from access and egress locations?

Scrap piles, debris and trash stored more than 10 feet (3 meters) from building or structure?

Maintaining fire safety compliance?

Notes:

FORKLIFTS

Does the crew maintain a JSA, properly filled out and within 15 feet (4.5 meters) of work being performed?

Forklift operators been trained for the specific forklift they are operating?

Forklift inspected prior to use?

Forklifts are free from modifications or alterations?

Outriggers being used on extended reach fork lift?

Forklift is operating within lift capacities?

Forklift slings have been inspected and maintain lift capacity tags?

Forklifts have lift, load and angle charts?

Forklift has fire extinguisher in the cab?

Forklift forks are down when not in operation?

Forklift operator wearing seat belt when in operation?

Forklift has an audible back up alarm that can be heard up to 200 feet (60 meters) away?

Spotters are used when forklift has to travel through barrier curtains or blind accesses?

Operator is traveling less than 15 MPH (24 kilometers) stopping at all intersections and stop signs?

Workers are clear of all lifted / suspended loads?

Lift basket secured to forklift?

Forklift maintains an operator when the lift basket has employees in it?

Forklift operators maintaining safety compliance?

Notes:

HOUSEKEEPING

Does the crew maintain a JSA, properly filled out and within 15 feet (4.5 meters) of work being performed?

Impalement hazards (flat stakes, rebar or other like material) maintain impalement protection?

Work site / location reasonably organized - Good housekeeping?

Lunch trash picked up and removed from site?

Trash removed at regular intervals?

Scrap, pipe cut offs, pipe and other slip / trip hazards removed?

Staging / lay down area in good condition / good housekeeping?

Gang boxes free from combustible / flammable materials?

All scrap lumbar / planks has nails removed or bent over?

Housekeeping is being maintained?

Notes:

LADDERS and STAIRS

Does the crew maintain a JSA, properly filled out and within 15 feet (4.5 meters) of work being performed?

Ladders inspected / no visible defects?

Ladders rated for construction (1 AA ladder) ?

Spreaders fully extended and locked into position on A frame ladders?

Top two steps of a step ladder not being used?

Ladders set up on firm stable base?

Ladders being used for the intended purpose?

Proper ladder selected for task?

Extension ladder extends 3 feet (.91 meters) above landing surface?

Extension ladder set up at 4:1 angle?

Extension ladders tied off at the top and secured at the bottom to prevent slip?

Stair/ladder/ramp used at elevation break of 18 inches (457 millimeters) or more?

Handrails on stairs with 4 or more risers?

3 feet around the ladder at the top and bottom remain clear of all materials and debris?

Employee is maintaining 3 points of contact while climbing ladders?

Treads / landings on pan stairways filled?

Ladder / steps used when access a flat bed trailer?

Ladder users maintaining safety compliance?

Notes:

MEDICAL / FIRST AID

Emergency numbers posted on site, visible to all employees?

Location of nearest medical facilities posted, visible to all employees?

Eye wash / body wash stations set up when required?

Every trade maintains their own first aid kit / supplies? First aid kit fully stocked?

A minimum of 1 CPR / FA / AED certified employee per crew?

Maintaining safety compliance with medical / first aid?

Notes:

PERSONAL PROTECTIVE EQUIPMENT

PPE provided to the employee / available as required?

PPE being maintained in good condition?

Replacement PPE readily available?

Hard hats being worn, properly and without alterations?

Eye protection used as required? Glasses rated as eye protection?

Hand protection used when required? (Digging, handling tag lines etc)

Safety boots (Steal toe) footwear worn when required (Compacting soil, jack hammering etc)?

Respirators provided / used as required?

Has the employee been trained in respiratory protection?

Does employer maintain a current written respirator program?

Has the employee been seen by a physician and been fit tested?

Employee using the proper filter for respirator?

Respirator being stored correctly?

Hearing protection used as required?

Face protection used as required?

High visibility clothing worn as required?

Maintaining safety compliance with personal protection equipment ?

Notes:

POSTINGS / SAFETY SIGNS

OSHA Workplace Poster displayed at all locations?

Emergency numbers / contacts posted?

OSHA 300 log posted Feb. 1st through April 30th?

Danger / warning signs posted? Each site maintains proper signage?

Danger - Keep out / Construction signs posted on security fencing?

All posting meet safety compliance?

Notes:

SANITATION

Adequate supply of potable water provided at no cost to the employee ( Minimum of 1 quart of water per hour per employee)?

Single use, disposable drinking cups provided? (Common cup and drinking directly from the container is prohibited)

Trash cans provided at all drinking locations?

NON-POTABLE water is clearly marked and identified?

1 toilet per 20 workers at the job site? Females have a separate facilities?

Hand washing stations provided? 1 hand washing outlet per 20 workers?

Facilities (toilets and hand washing facilities) are being maintained in sanitary conditions?

Sanitation locations are being maintained in good conditions and maintaining safety compliance?

Notes:

SCAFFOLDS

Does the crew maintain a JSA, properly filled out and within 15 feet of work being performed?

Guard rails are installed and secured between 42 - 48 inches (1066 - 1219 millimeters) off of platform?

Mid-rails are installed and secured between 21 - 24 inches (533 - 609 millimeters) off of platform?

Perry Scaffolds has guard rails and mid rails when platform is at 6 feet (1.8 meters)?

Perry Scaffolds have outriggers when scaffold is 3 times the base?

Perry Scaffold is built per manufacturers specifications?

Employees are not "surfing" or scooting on Perry Scaffolds?

Employees have both feet on the platform at all times?

Trades maintaining good compliance with Scaffolds?

Scaffold(s) are free of materials for the employees to gain additional height?

All employees have been trained in Scaffold Awareness to work off of scaffolds?

Competent person inspecting scaffold before daily occupancy? From all trades working off of scaffolds?

Scaffold inspection tags are located at each scaffold ladder? Inspection tags filled out and maintains current inspections?

Scaffold was erected under the supervision of a Competent Person?

Working platforms fully planked?

Fall protection provided at 6feet (1.8 meters) and above?

Legs / frames bear on base plates / mud sills?

Mud sills free from undermining?

Base plates / mud sills clear from dirt, debris and obstructions? Able to inspect? Base plate secured to mud sill?

Planks in good condition? Scaffold grade planks? Free from splits, cuts and damage?

Planks / Working platform clean, free from excessive debris, trash and materials?

Ladder provided and used to access all scaffold platforms?

Scaffold plank overlap a minimum of 6 inches (152 millimeter) max. to 18 inches (457 millimeters) and overlap is over a frame?

Scaffold is tied into structure at 12 (3.6 meters) 26 (7.9 meters) and 30 feet 9.1 meters) (or top of structure)?

Toe-boards provided above all access / egress points and anywhere employees are working below?

All types of scaffold(s) maintaining safety compliance?

Notes:

STEEL ERECTION

Does the crew maintain a JSA, properly filled out and within 15 feet of work being performed?

Site erection plan available for review?

Lay down area graded, drained and adequate?

Decking secured upon placement?

Guardrails around stair / elevator / perimeters openings?

Floor opening covers properly marked and secured?

Tools secured against accidental displacement?

Perimeter cables installed when decking is completed?

Perimeter cables flagged at 6 foot (1.8 meters) intervals?

Perimeter cables maintain less than 2 inch (50 millimeter) deflection?

Iron workers / steel erection maintaining safety compliance?

Ramps and runways properly guarded?

Notes:

TOOLS (HAND and POWER)

Does the crew maintain a JSA, properly filled out and within 15 feet of work being performed?

Hand and power tools in safe operating condition?

Tool guards in place and functional on all power tools?

All tools stopped and turned off / unplugged during maintenance / refueling?

Power tools maintain a ground post or be double or triple insulated?

Tools are in like new condition with no alterations, repairs or damage?

Handles on tools free from splinters and cracks?

Safety spring(s) being maintained in all nail guns?

Grinders and cutting wheels maintain fully functioning guards?

All air delivery equipment maintain air pressure gauges and hose connection safety's (ties/whips/connection pins)?

Tools are properly hoisted / lowered?

All tools being maintained within safety compliance?

Notes:

TRAFFIC CONTROL

Does the crew maintain a JSA, properly filled out and within 15 feet (4.5 meters) of work being performed?

Personal trained in work zones traffic safety techniques?

Manual on Uniform Traffic Control Devices available?

Traffic Control Plan available and updated?

Work zone inspected? Documented?

Warning signs visible and spaced properly?

Warning signs alert drivers to upcoming road work?

Warning signs in good condition, legible, clean and working?

Delineation devices (cones, barrels, panels) positioned properly?

Delineation devices (cones, barrels, panels) in good condition?

Barricades provided / placed where required?

Barricades erected with correct directional stripes?

High visibility clothing is worn within the work zone? Proper rating (class 2 or class 3)?

Beacon lights activated on vehicles near active traffic lanes?

Contractors maintaining traffic control safety?

Notes:

TRENCHING / EXCAVATION

Does the crew maintain a JSA, properly filled out and within 15 feet (4.5 meters) of work being performed?

Competent person identified on the JSA and has completed daily inspections?

Competent person on-site and at location when trench is occupied?

Soil has been properly classified by manual tests and properly documented?

Competent person identified on the JSA and has completed daily inspections?

Atmospheric conditions tested prior to entry (where required) ?

Employees are protected from cave-in by protective systems?

Sloping / benching adequate for soil type?

Spoils / materials / equipment set back 2 feet (.6 meters) from edge? No material / equipment on the benches?

Travel distance to egress is no more than 25 feet (7.62 meters)?

Stability of adjacent structures ensured?

Pavements / structures not undermined unless supported?

Utilities located / identified prior to start of excavation? PM or Dig Alert contacted?

Signs / barricades provided on all open trenches? Barricades a minimum of 6 feet (1.8 meters) away from the trench?

Surface encumbrances removed or supported?

Water runoff controlled to prevent accumulation?

Access prohibited when water accumulation is uncontrolled?

Back filling occurs following removal of support system?

Trenches and excavations are within good safety compliance?

Excavation shield / trench box extend at least 18 inches (457 mm) above shelf or vertical slide?

Excavation contractor maintaining safety compliance?

Notes:

WELDING / CUTTING / HOT WORK

JSA and Hot work permit filled out completely and is accurate?

Welding screens provided and used when required?

Regulators / gauges / valves in proper working order?

Cylinders maintained in good condition?

Welding hoses in good condition?

Fire extinguisher within 20 feet (6.1 meters) of hot work?

Valve caps in place when stored / transported?

Area identified and employees protected from falling slag?

Combustibles removed / protected from heat / spark / slag?

Cylinders secured in upright position?

Fuel gas cylinders separated from oxygen cylinders (by 20 feet / 6.1 meters) when not in use, or has a firewall between tanks?

Fuel gas has a flash arrestor in-line or at the handle?

Cylinders in transportation are secured in a vertical position?

Fire watch is in place when required?

Welders are operating safely and maintaining safety compliance?

Notes:

OTHER

Construction areas properly illuminated?

Security fencing installed, maintained in good condition and is closed when site is not occupied?

Frequent / regular inspections by the contractor of the job site completed? Documented?

Defective equipment tagged or removed from job site?

Was the site free from any Immanent Danger to Life or Health (IDLH) exposures?

Notes:

MISC. INFORMATION

Notes:

This space is available for draw out.
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.