Safety Evaluation 2017

• Document No.

• Audit Title/Date

• Project Name

• Job Number

• Conducted on

  Date

• Prepared by

• Location
  Address

• Project Team

Mission Task Analysis

• MTA completed for activities being performed

  Yes

  No

  N/A

• MTA signed by coworkers

  Yes

  No

  N/A

Fall Protection

• Guard/ Safety rails on place

  Yes

  No

  N/A

• Rails installed in good condition

  Yes

  No

  N/A

• Guard/safety rails are at correct height (top rail 42+/-, mid rail 21+/-)

  Yes

  No

  N/A

• Toe boards on place and secured

  Yes

  No

  N/A

• Floor/ground openings covered or barricaded

  Yes

  No

  N/A

• Hole covers secured and marked "HOLE"

  Yes

  No

  N/A

• Personal fall arrest system in use

  Yes

  No

  N/A

• Fall protection equipment installed and used properly

  Yes

  No

  N/A

• proper tie-off points being used.

  Yes

  No

  N/A

• Debris netting installed (if required)

  Yes

  No

  N/A

• Is netting in good condition

  Yes

  No

  N/A

• Leading edge work barricaded or guard rails installed

  Yes

  No

  N/A

• Rebar impalement protection in place

  Yes

  No

  N/A

Hand and Power Tools

• Data plate on tools legible

  Yes

  No

  N/A

• Double insulated or grounded

  Yes

  No

  N/A

• Drill handles in place (if equipped)

  Yes

  No

  N/A

• All guards in place and properly working

  Yes

  No

  N/A

• Power cords in good condition

  Yes

  No

  N/A

• Wooden handles free of splinters/cracks

  Yes

  No

  N/A

• Impact tools free from mushroomed heads

  Yes

  No

  N/A

• Tools being inspected and used properly for the task

  Yes

  No

  N/A

• Safety whip cables in place on air compressors

  Yes

  No

  N/A

Personal Protective Equipment

• Hard Hats

  Yes

  No

  N/A

• Proper footwear

  Yes

  No

  N/A

• Tarsal guards being used (during required task)

  Yes

  No

  N/A

• Hearing protection

  Yes

  No

  N/A

• Eye protection

  Yes

  No

  N/A

• Face shields

  Yes

  No

  N/A

• Was PPE inspected.

  Yes

  No

  N/A

Chemical Safety HAZCOM/SDS

• Site specific SDS on file

  Yes

  No

  N/A

• All chemical containers labeled

  Yes

  No

  N/A

• chemicals storage in the designated area.

  Yes

  No

  N/A

Electrical

• Proper cords being used and in good shape

  Yes

  No

  N/A

• Extension cords being suspended correctly

  Yes

  No

  N/A

• Extension cords inspected daily.

  Yes

  No

  N/A

• Danger signs around high voltage areas

  Yes

  No

  N/A

• GFCI's used at the receptacle

  Yes

  No

  N/A

• Equipment at least 10 feet from power lines

  Yes

  No

  N/A

Housekeeping

• All work areas in orderly condition

  Yes

  No

  N/A

• Walking / working surface free from tripping hazards.

  Yes

  No

  N/A

• Aisle-ways and emergency routes clean of material and debris.

  Yes

  No

  N/A

• Material on upper floors secured to prevent displacement.

  Yes

  No

  N/A

• Regular site clean up and trash disposal

  Yes

  No

  N/A

• Protruding nails removed

  Yes

  No

  N/A

• Trash box used correctly (not overfilled)

  Yes

  No

  N/A

Cranes/Equipment

• Rigging equipment in proper condition

  Yes

  No

  N/A

• Is the Rigging appropriate for the lift.

  Yes

  No

  N/A

• Tag lines being used

  Yes

  No

  N/A

• Whistles being used

  Yes

  No

  N/A

• Crane yearly inspections current

  Yes

  No

  N/A

• Daily equipment inspections completed

  Yes

  No

  N/A

• Can crane operator see the signal person

  Yes

  No

  N/A

• Are the ANSI approve hand signals being used.

  Yes

  No

  N/A

• Are two way radios being used to communicate with the operator

  Yes

  No

  N/A

• crane located at a safe distance from power lines

  Yes

  No

  N/A

• Is weather conditions adequate for lifts.

  Yes

  No

  N/A

• Back up alarms properly working

  Yes

  No

  N/A

• Seat belts worn in equipment and vehicles

  Yes

  No

  N/A

• copy of the crane operator's qualification /certifications on file

  Yes

  No

  N/A

Excavcation

• Proper shoring, sloping, shielding for soil type and depth

  Yes

  No

  N/A

• Underground utilities located prior to digging

  Yes

  No

  N/A

• Proper access/egress to trench

  Yes

  No

  N/A

• Spoil piles properly located

  Yes

  No

  N/A

First Aid and Health

• Drinking water readily available

  Yes

  No

  N/A

• First Aid kits stocked and available

  Yes

  No

  N/A

• Eye wash stations available

  Yes

  No

  N/A

• Toilets available and clean

  Yes

  No

  N/A

Work Zone

• Traffic control correctly laid out per plan

  Yes

  No

  N/A

• Flaggers performing duties adequately

  Yes

  No

  N/A

• Adequate lighting for night work

  Yes

  No

  N/A

Scaffolds

• Properly erected-(fully planked, footings secured, cross-bracing, tied to structure, etc.)

  Yes

  No

  N/A

• Ladder access provided

  Yes

  No

  N/A

• Fall protection in place (guardrails or tied off)

  Yes

  No

  N/A

• Inspection completed by competent person

  Yes

  No

  N/A

• Rolling scaffolds moved correctly (not being surfed from platform)

  Yes

  No

  N/A

Stairways

• Handrails/Stair rails in place

  Yes

  No

  N/A

• Sides and edges of stairway landings protected by guardrail systems

  Yes

  No

  N/A

• stacked materials kept at a safe distance from the toe boards

  Yes

  No

  N/A

Fire Safety

• Fire extinguisher readily available and in proper order

  Yes

  No

  N/A

• No smoking signs posted where needed

  Yes

  No

  N/A

• Flammables/combustibles properly stored

  Yes

  No

  N/A

• Containers clearly identified/labeled

  Yes

  No

  N/A

• SDS available

  Yes

  No

  N/A

Ladders

• Ladders in good condition

  Yes

  No

  N/A

• Spreaders on the step ladder locked

  Yes

  No

  N/A

• Are ladders being used properly

  Yes

  No

  N/A

• job made ladder built properly (no double head nails)

  Yes

  No

  N/A

• Are ladders being used at the proper angle (1-4)

  Yes

  No

  N/A

• Manufacturer's label affixed and legible

  Yes

  No

  N/A

• Ladders extend 3' above surface

  Yes

  No

  N/A

• Ladders tied off

  Yes

  No

  N/A

• Proper access/egress on elevated decks

  Yes

  No

  N/A

• Access provided at 19"

  Yes

  No

  N/A

Oxy-Acetylene Torch

• Cylinders properly stored

  Yes

  No

  N/A

• Proper PPE worn

  Yes

  No

  N/A

• Cables, hoses, regulator, torches in good condition

  Yes

  No

  N/A

• Hot work permit completed

  Yes

  No

  N/A

• is there at least one 10 lb extinguisher withing 50 feet of oxygen and acetylene storage areas.

  Yes

  No

  N/A

• Fire watch in place for cutting

  Yes

  No

  N/A

• Is cutting torch in good working condition.

  Yes

  No

  N/A

Aerial Lifts

• Are coworkers using proper fall protection

  Yes

  No

  N/A

• coworkers remaining on the platform at all times

  Yes

  No

  N/A

• the gate or chain closed when occupied

  Yes

  No

  N/A

• Lift st on level ground, per manufacturer's recommendations

  Yes

  No

  N/A

• Operator has been trained

  Yes

  No

  N/A

• Tools and materials secured from displacement

  Yes

  No

  N/A

• Has the equipment been inspected prior to use.

  Yes

  No

  N/A

• Are lanyards/retractable attached to proper anchorage points.

  Yes

  No

  N/A

• is the lift capacity visible and appropriate for the task

  Yes

  No

  N/A

Documentation

• Weekly tool box safety talk completed

  Yes

  No

  N/A

• BCC required safety postings in place

  Yes

  No

  N/A

• OSHA 5-in-1 poster in place

  Yes

  No

  N/A

• Emergency numbers posted

  Yes

  No

  N/A

• Overall Comments

• Add signature

  Sign

• Select date

  Date