Safety Inspection

• Document No.

• Names of Foreman - Safety Manager Visit

• Conducted on

  Date

• Prepared by:

  Christopher Cole
• Location (Drop pin for GPS and street address):
  Address

General Safety

• All required Posters, Paperwork, posted in a visible location, and up to date?

  Yes

  No

  N/A

• Has the previous Inspection Report been distributed through Share Point?

  Yes

  No

  N/A

• Are there any outstanding issues which have not been addressed?

  Yes

  No

• Has the (JHA) Job Hazard Analysis been updated for today?

  Yes

  No

  N/A

• Last JHA update posted:

  Date

• Are Toolbox Talks being performed through the UIG safe work application?

  Yes

  No

  N/A

• Topic covered today?

• Employees wearing all required PPE (gloves, hi-viz, glasses, hardhats, etc)?

  Yes

  No

  N/A

• Signage & Barricades in place where required?

  Yes

  No

  N/A

• All employees wearing appropriate rated footwear for tasks today?

  Yes

  No

  N/A

• Are employees wearing hearing protection when noise levels are in excess of 85 dBa?

  Yes

  No

  N/A

• dBa Measurement during Visit:

• Is the Uni-pack spill kit available and fully stocked?

  Yes

  No

  N/A

• Are there portable restrooms for the site? Are there at least (1) portable restroom for every (10) workers?

  Yes

  No

  N/A

• Condition of restroom

  Media

• Is there a designated smoking area?

  Yes

  No

  N/A

• Is smoking debris properly disposed of?

  Yes

  No

  N/A

Chemical Safety

• Have all materials/chemicals been labeled using the NFPA labels)?

  Yes

  No

  N/A

• Have safety data sheets been updated for new products in inventory? Spot check (3):

  Yes

  No

  N/A

• Is PPE being used as required (respirators, masks, etc)?

  Yes

  No

  N/A

Safety Center

• Picture of Safety Center

  Media

• Add drawing

  Drawing

• Is the eyewash station on the safety board, and within the manufacturers expiration date?

  Yes

  No

  N/A

• Is the safety center board in place, painted and within (75) ft of work force?

  Yes

  No

  N/A

• Is SDS information on the safety board and current?

  Yes

  No

  N/A

• Is the first aid kit available and stocked?

  Yes

  No

  N/A

• Is the blood borne pathogen kit available and stocked?

  Yes

  No

  N/A

• Is all spare PPE available and fully stocked?

  Yes

  No

  N/A

Clean-up & Housekeeping

• Are entries walkways and drive lanes kept clear?

  Yes

  No

  N/A

• Stairs kept clear and free of debris?

  Yes

  No

  N/A

• Bins emptied regularly?

  Yes

  No

  N/A

• Oily rags and combustible refuse stored in covered metal containers?

  Yes

  No

  N/A

• Bins or Dumpsters located at suitable points around Jobsite?

  Yes

  No

  N/A

Trenches, Excavations & Openings

• Trenches & Excavations are barricades as required? (Barricade 6ft from any open excavation) Controlled Access Zone when required?

  Yes

  No

  N/A

• Protective systems in place as required (trench boxes, etc)

  Yes

  No

  N/A

• Air monitoring for all areas of work which are considered confined spaces, or areas containing airborne contaminants?

  Yes

  No

  N/A

• Excavations adequately benched, with spoils away from sides?

  Yes

  No

  N/A

• Adequate access/egress provided? (Within 75ft)

  Yes

  No

  N/A

• Have all openings, holes, etc been covered & marked as necessary?

  Yes

  No

  N/A

• Re-Bar Caps in use where necessary?

  Yes

  No

  N/A

Fall Protection

• Is perimeter protection in place where necessary?

  Yes

  No

  N/A

• Personal Fall Arrest systems in use where required (all work over 6ft)?

  Yes

  No

  N/A

• Are Harnesses in good condition, and recently inspected?

  Yes

  No

  N/A

• Are all Lanyards, Retractables, etc clearly marked with weight limits and other required info?

  Yes

  No

  N/A

• Are PFAs being correctly fitted, attached, and used?

  Yes

  No

  N/A

• Personal Fall Arrest anchor points adequate?

  Yes

  No

  N/A

Equipment & Machinery

• Are trucks and equipment smoke and ash free?

  Yes

  No

  N/A

• Wheels on Foreman's truck chocked?

  Yes

  No

  N/A

• Back-up Alarms working correctly?

  Yes

  No

  N/A

• Adequate roll-over protection provided?

  Yes

  No

  N/A

• Seatbelts installed and functional on all Equipment?

  Yes

  No

  N/A

• All Equipment inspections completed & filed?

  Yes

  No

  N/A

• Rigging & Equipment inspections complete prior to any lifts?

  Yes

  No

  N/A

• Load calculations clearly posted in each piece of equipment?

  Yes

  No

  N/A

• Fuel stored in proper containers?

  Yes

  No

  N/A

• Air scrubbers or other equipment in use where required?

  Yes

  No

  N/A

Fire Prevention & Protection

• Hot Work Permits received and posted for all work requiring them?

  Yes

  No

  N/A

• Evacuation Plans displayed & visible?

  Yes

  No

  N/A

• Emergency contact form complete and posted?

  Yes

  No

  N/A

• Photo of form

  Media

• Fire Extinguishers located throughout areas of work, and freely accessible?

  Yes

  No

  N/A

• Fire Extinguishers fully charged, and recently certified?

  Yes

  No

  N/A

• Fire Extinguishers located within reach where any hot-work is being performed?<br>

  Yes

  No

  N/A

• Bottles/Cylinders properly stored?

  Yes

  No

  N/A

• Area around Temp Heaters or similar equipment clear?

  Yes

  No

  N/A

Electrical

• Temp or Permanent Lighting adequate (meets OSHA standards, at a minimum)?

  Yes

  No

  N/A

• Temp Lighting connections secure, and covered?

  Yes

  No

  N/A

• Electrical Cords in good condition?

  Yes

  No

  N/A

• All tools & equipment powered via GFCI Protected circuits?

  Yes

  No

  N/A

• All Panels, Boxes, etc secured and covered?

  Yes

  No

  N/A

Power Tools

• Power Tools?

  Off

  On

• Power Tools in good working order?

  Yes

  No

  N/A

• Guards/Shields functional?

  Yes

  No

  N/A

• Powder Actuated Tools in good condition, with appropriate signage in place?

  Yes

  No

  N/A

• Required training for all Personnel using Powder Actuated Tools?

  Yes

  No

  N/A

Welding & Cutting?

• Welding & Cutting?

  Off

  On

• Cylinders stored properly?

  Yes

  No

  N/A

• Hoses in good condition?

  Yes

  No

  N/A

• Adequate shielding provided?

  Yes

  No

  N/A

• Fire Blankets used where necessary?

  Yes

  No

  N/A

Ladders & Scaffold

• Ladders & Scaffold?

  Off

  On

• Ladders tied-off?

  Yes

  No

  N/A

• Ladders extended 3ft above all landings?

  Yes

  No

  N/A

• All Ladders adequately rated for use?

  Yes

  No

  N/A

• Ladders used correctly (not standing on top rung, leaning against walls, etc)?

  Yes

  No

  N/A

• Non-conductive Ladders used for Electrical Work?

  Yes

  No

  N/A

• Extension Ladders - All ropes, pulley, etc in good condition?

  Yes

  No

  N/A

• Scaffold installed on solid, level ground?

  Yes

  No

  N/A

• Bracing adequate?

  Yes

  No

  N/A

• Planking adequate, with proper material used?

  Yes

  No

  N/A

• Guardrails in place, and at proper elevation?

  Yes

  No

  N/A

• Adequate access/egress provided?

  Yes

  No

  N/A

• Fall Protection in use for all Aerial Lifts?

  Yes

  No

  N/A

Stairways (Permanent or Temporary)

• Stairways (Permanent or Temporary)?

  Off

  On

• Pans filled?

  Yes

  No

  N/A

• Stairs free and clear of debris?

  Yes

  No

  N/A

• Handrail/Guardrail in place?

  Yes

  No

  N/A

Steel Erection

• Steel Erection?

  Off

  On

• Floor Decked as required?

  Yes

  No

  N/A

• Perimeter protection in place?

  Yes

  No

  N/A

• Fall Protection in use where required?

  Yes

  No

  N/A

Roof Operations

• Roof Operations?

  Off

  On

• Perimeter Protection in place?

  Yes

  No

  N/A

• Rooftop Operation Plans developed, posted, and accessible for all personnel working on the Roof?

  Yes

  No

  N/A

• Adequate anchor points provided?

  Yes

  No

  N/A

Observations and notes:

GoCodes Inventory

• Does the site crew have any asset purchases since the last visit?

  Yes

  No

• What was purchased and tagged into the asset inventory today?

• Foreman's approval of accuracy:

  Sign

Signature:

• Completed by the Safety Manager:

  Sign