Safety Matters Hazard Recognition Program

• Weekly Safety Inspection

• Conducted on

  Date

• Diamond Structures Inc

• Site

• Prepared By

• Location
  Address

• Personnel Present During Inspection

1) Personal Protective Equipment

• Hard Hat and Safety Glasses worn at all times?

  Safe

  At Risk

  N/A

• Face shield used while chipping and grinding?

  Safe

  At Risk

  N/A

• Hearing Protection used?

  Safe

  At Risk

  N/A

• Respirator used properly? Correct cartridges used for task?

  Safe

  At Risk

  N/A

• Hi Visibility clothing used if required?

  Safe

  At Risk

  N/A

• Other PPE - Proper foots are, knee pads, welding screen in place, etc?

  Safe

  At Risk

  N/A

2) Work Area General Conditions

• Is access/egress clear of debris and marked? Hallways and building entry clear?

  Safe

  At Risk

  N/A

• Is garbage maintained and disposed of properly? Enough containers provided for disposal?

  Safe

  At Risk

  N/A

• Adequate lighting in stairwells, hallways and public walkways?

  Safe

  At Risk

  N/A

• Adequate number of bathroom and a hand washing station?

  Safe

  At Risk

  N/A

3) Safety Administration and Documentation

• Weekly Safety meeting conducted?

  Safe

  At Risk

  N/A

• SDS available for hazardous materials?

  Safe

  At Risk

  N/A

• Site-specific Orientations completed?

  Safe

  At Risk

  N/A

• Required Posters are posted on Safety Board?

  Safe

  At Risk

  N/A

• Employees training current and training documented?

  Safe

  At Risk

  N/A

• Pre-task planners filled out and reviewed daily?

  Safe

  At Risk

  N/A

• Equipment inspections conducted and on file?

  Safe

  At Risk

  N/A

4) Electrical

• TPU's and Energized Panels covered and 3' clearance maintained?

  Safe

  At Risk

  N/A

• GFCI's used?

  Safe

  At Risk

  N/A

• LOTO procedures in place? Is a written procedure plan on site and available?

  Safe

  At Risk

  N/A

• Cords suspended or protected from damage?

  Safe

  At Risk

  N/A

• Are all electrical cord plugs factory installed?

  Safe

  At Risk

  N/A

5) Fire Protection/Hot Work

• Fuel used in approved containers and stored in a FLAM locker?

  Safe

  At Risk

  N/A

• Burn permits completed and placed in hot work area?

  Safe

  At Risk

  N/A

• Fire extinguishers within 25' of hot work and adequate number on site?

  Safe

  At Risk

  N/A

• Fire extinguishers have full charge and inspected monthly?

  Safe

  At Risk

  N/A

• Is hot work area free of combustible material? Removed from the building daily?

  Safe

  At Risk

  N/A

• If combustible material can be removed is fire watch assigned?

  Safe

  At Risk

  N/A

6) Fall Protection

• Fall protection plans completed and signed by employees on falls > 10'?

  Safe

  At Risk

  N/A

• Fall Protection gear inspected daily and stored properly?

  Safe

  At Risk

  N/A

• Wall openings and floors holes are guarded or covered?

  Safe

  At Risk

  N/A

• Guard Rails (rails at 42' and 22" +/-) and toe boards in place? Cable rails less than 3" of deflection?

  Safe

  At Risk

  N/A

• Rebar protection in place when exposed fall is present?

  Safe

  At Risk

  N/A

• Fall protection used 4' on working/walking surfaces and 6' on everything else?

  Safe

  At Risk

  N/A

• Proper anchor point used and can hold 3,000 Lbs while using fall arrest equipment?

  Safe

  At Risk

  N/A

7) Aerial Lifts and Scaffolding

• Scaffold have green tag and inspected daily?

  Safe

  At Risk

  N/A

• Is falling object protection in place? Toe boards, Netting, Etc

  Safe

  At Risk

  N/A

• Guardrails set at +/- 42" and 22" and installed on all open sides?

  Safe

  At Risk

  N/A

• Base set up correctly with base plates/screw jacks and adequate cross bracing?

  Safe

  At Risk

  N/A

• Scaffold fully planked with min. 12" overlap?

  Safe

  At Risk

  N/A

• Wheels locked on rolling scaffolds?

  Safe

  At Risk

  N/A

8) Cranes and Rigging

• Rigging inspected and free of damage? Stored properly?

  Safe

  At Risk

  N/A

• Cranes inspected daily? Daily log available from operator?

  Safe

  At Risk

  N/A

• Overhead hazards/power lines identified and marked?

  Safe

  At Risk

  N/A

• Loads properly secured and tag lines used?

  Safe

  At Risk

  N/A

• Are operator, signal person, and rigger properly trained and certifications updated?

  Safe

  At Risk

  N/A

• Rigger performing loading activities have proper fall arrest if applicable?

  Safe

  At Risk

  N/A

• Critical lift plan filled out if load is > 75% of cranes maximum load capacity?

  Safe

  At Risk

  N/A

9) Ladders, Stairs and Ramps

• No one standing above the top 2 rungs?

  Safe

  At Risk

  N/A

• Step ladders used properly? Spreader bars open and locked?

  Safe

  At Risk

  N/A

• Extension ladders used for access secured top and bottom? Extended 3' above platform?

  Safe

  At Risk

  N/A

• 3 point contact used while climbing any ladder? Haul ropes provided for materials and tools?

  Safe

  At Risk

  N/A

• 4'-1' rule maintained on extent ion ladders?

  Safe

  At Risk

  N/A

• Stairwells have handrails and have no missing treads?

  Safe

  At Risk

  N/A

• Job-made ladders to built to specifications?

  Safe

  At Risk

  N/A

10) Environmental

• Chemicals in clearly marked containers? SDS available?

  Safe

  At Risk

  N/A

• Adequate number of spill kits available?

  Safe

  At Risk

  N/A

• Dust and noise controls used according to safety plan?

  Safe

  At Risk

  N/A

• Temporary soil erosion control plan in place if needed? (Fences, catch basins, waddles, etc)

  Safe

  At Risk

  N/A

• Is a visible sheen across site present indicating spilled contaminates?

  Safe

  At Risk

  N/A

• Are control zones present and being used according to environmental plan?

  Safe

  At Risk

  N/A

11) Traffic Control and Public Awareness

• Is Traffic Control plan in place and effective?

  Safe

  At Risk

  N/A

• Are all materials keep inside site and pedestrian walkways clear of debris?

  Safe

  At Risk

  N/A

12) Controlled Zones

• Overhead hazards delineated with Danger/Caution Tape?

  Safe

  At Risk

  N/A

• Danger Tape properly tagged and identified with the hazards beyond?

  Safe

  At Risk

  N/A

13) Forklifts and Heavy Equipment

• Forklifts inspected daily and documentation present?

  Safe

  At Risk

  N/A

• Seatbelt being used during operation of heavy equipment.

  Safe

  At Risk

  N/A

• Fire extinguisher available and inspected regularly?

  Safe

  At Risk

  N/A

• Operator certified?

  Safe

  At Risk

  N/A

• Truck drivers have full PPE on when leaving vehicle?

  Safe

  At Risk

  N/A

14) Confined Spaces

• Permit filled out and posted at entry?

  Safe

  At Risk

  N/A

• Has space been tested with 4 gas meter and proper PPE being used according to permit?

  Safe

  At Risk

  N/A

• Adequate ventilation for confined space used?

  Safe

  At Risk

  N/A

• Does permit required confined space have an attendant at entry trained in rescue? Tripod available?

  Safe

  At Risk

  N/A

• Do entrants have confined space training?

  Safe

  At Risk

  N/A

Excavations

• Excavations >4' sloped, benched or shored?

  Safe

  At Risk

  N/A

• Approved means of access/egress supplied in excavations >4' minimum 25'?

  Safe

  At Risk

  N/A

• Spoils set back from excavation minimum 4'?

  Yes

  No

  N/A

• Have underground utilities been clearly marked?

  Safe

  At Risk

  N/A

• Corrective Actions/Who assigned to/Date of Pending Correction

• Corrective Actions from Previous Audit still Pending

• General Notes and Observations

• Superintendent

  Sign

• Safety Representative

  Sign