Safety Program Evaluation

• GRANITE CONSTRUCTION CO. - SAFETY PROGRAM EVALUATION
  
  This evaluation worksheet is intended to be completed by manager/professional as part of their regualr work area safety inspection process. This evaluation is not inteded to be an indepth Audit of the work area, but rather a high level evaluation that will allow the professional to provide immediate feedback to the project team of items that can be improved. Once completed the form will provide a score for each area evaluated. Please remember that if you find an area where an immediate danger to personnel, the genreral public or the environment exists you must STOP the work and correct the defficiency immediately.

• Document No.

• Project Name

• Conducted on

  Date

• Prepared by

• INSPECTION DATE

  Date

• PROJECT NAME

• Add location
  Address

• PROJECT MANAGER

• FRONTLINE SUPERVISOR

• SAFETY MANAGER

SUPPLEMENTAL WORK EXPOSURES

• Select the SUPPLEMENTAL WORK EXPOSURES covered under this evaluation

  Select Respiratory Protection Confined Space Hazardous Substances Training / Retraining of Miners Job Hazard Analysis Lock-Out Procedures Excavation/ Trenching Blood Borne Pathogens Fall Protection Heat Illness Prevention Hearing Conservation Arc Flash Prevention Other

  • Respiratory Protection
  • Confined Space
  • Hazardous Substances
  • Training / Retraining of Miners
  • Job Hazard Analysis
  • Lock-Out Procedures
  • Excavation/ Trenching
  • Blood Borne Pathogens
  • Fall Protection
  • Heat Illness Prevention
  • Hearing Conservation
  • Arc Flash Prevention
  • Other

• If 'OTHER' was selected please list the exposure here:

PROJECT MANAGEMENT EXPOSURES

• Are MONTHLY WORK AREA INSPECTIONS being documented?

  Yes

  No

  N/A

• Work Area Inspections are being documented by?

• Region/Area Managers (Responsibilities 2.4)?

• Project/Plant Managers (Responsibilities 3.5)?

• Equipment Managers (Responsibilities 3.5)?

• Superintendents (Responsibilities 4.6)?

• Are DAILY work area inspections documented by Frontline Supervisors/Foreman (Responsibilities 7.6)?

  Yes

  No

  N/A

• Are new employees wearing a RED HARD HAT or equivalent (Procedures 4.2.2)?

  Yes

  No

  N/A

• TOTAL number of Red Hard Hats (New Employees) on-site?

  0-5

  6-10

  11-15

  16-20

  20+

• Is the project/site documenting:

• Job Hazard Analysis (Procedures 4.1.3)?

• Site-specific training of employees (Procedures 4.2.2)?

• Training of employees when NEW hazards are introduced (Procedures 4.2.4)?

• Does the project/site have random drug & alcohol testing for all employees (Program Supplement 11: 5.1)?

  Yes

  No

  N/A

EMERGENCY RESPONSE PREPAREDNESS

• Are FIRST AID materials readily available on the site?

  Yes

  No

  N/A

• TOTAL number of first-aid kits available?

• Are emergency response contacts (doctors, hospitals, fire department and ambulance services) POSTED?

  Yes

  No

  N/A

• Are the telephone numbers of local Fire Fighting Agencies posted at each work location?

  Yes

  No

  N/A

• Are Fire Extinguishers inspected MONTHLY (Procedures 4.23.9)?

  Yes

  No

  N/A

• Has the Project/Area Manager been trained in Crisis Communication?

  Yes

  No

  N/A

EMPLOYEE EXPOSURES

• Is DRINKING WATER provided for all personnel (Procedures 4.4.1 & Program Supplement 12)?

  Yes

  No

  N/A

• Select the available type(s) of drinking water provided?

  Select Bottled Water Water Cooler Disposable Cups Personal Water Bottle

  • Bottled Water
  • Water Cooler
  • Disposable Cups
  • Personal Water Bottle

• Are adequate TOILET FACILITIES provided (or transportation readily available) for personnel (Procedures 4.4.4)?

  Yes

  No

  N/A

• Are HAND WASHING facilities (with soap and water) availble for personnel (Procedures 4.4.6 & 4.4.7)?

  Yes

  No

  N/A

• Are the following PERSONAL PROTECTIVE EQUIPMENT requirements followed:

• HEAD protection worn by all personnel at all jobsites and outdoor workplaces (Procedures 4.7.4)?

  Yes

  No

  N/A

• HEARING protection worn when noise levels exceed 85 decibles (Procedures 4.7.12 & Program Supplement 13)?

  Yes

  No

  N/A

• EYE protection worn by personnel exposed to dust, flying particles, splashes, chemical and/or radiation agents (Procedures 4.7.5)?

  Yes

  No

  N/A

• HAND protection worn when handling hazardous materials, hot objects, tools/equipment that cause hand injuries (Procedures 4.7.9)?

  Yes

  No

  N/A

• HIGH VISIBILITY shirts or vests worn by personnel exposed to mobile equipment or motor vehicle traffic (Procedures 4.7.7)?

  Yes

  No

  N/A

• FOOT protection worn by personnel exposed to impact or crushing foot injuries (Procedures 4.7.8)?

  Yes

  No

  N/A

• LEG protection worn by personnel operating chainsaws and cutoff saws (Procedures 4.8.15)?

  Yes

  No

  N/A

• RESPIRATORY protection worn for exposure to respiratory hazards, such as dusts, fumes, mists, vapors or gases (Procedures 4.7.10 & Program Supplement 1)?

  Yes

  No

  N/A

• Are logs for ENCLOSED/CONFINED SPACE entries completed daily showing that space was tested prior to personnel entering (Procedures 4.29 & Program Supplement 2)?

  Yes

  No

  N/A

• Are the locations of each "PERMIT Required Confined Space" clearly posted (Program Supplement 2, section 3)

  Yes

  No

  N/A

• TOTAL number of 'Permit Required Confined Space(s)'

POWER & HAND TOOLS

• Are all POWER TOOLS, including cords, inspected before use with guards & safety devices in place and functioning (Procedures 4.8.2 & 4.8.3)?

  Yes

  No

  N/A

• Is a DUST reduction system in place on tools used to cut, grind, drill or core (Procedures 4.8.17)?

  Yes

  No

  N/A

• Are gasoline and other Flammable Liquids stored in APPROVED portable tanks or safety cans (Procedures 4.23.13)?

  Yes

  No

  N/A

• Are TEMPORARY POWER SOURCES protected by either a GFCI or an assured equipment grounding program (Procedures 4.8.6)?

  Yes

  No

  N/A

• Are the CONNECTIONS of compressed air hoses (1/2" diameter or greater) provided with clips or chains to prevent whipping (Procedures 4.8.13 &4.8.14)?

  Yes

  No

  N/A

EXCAVATION & TRENCHING

• Is there a current OSHA Excavation & Trenching Permit (if required, see Program Supplement 8)?

  Yes

  No

  N/A

• Who is the individual designated as the COMPETENT PERSON (Procedures 4.16.3)?

• Are Soil Evaluations documented prior to beginning work by the competent person (Procedures 4.16.1)?

  Yes

  No

  N/A

• Are Excavations 4' or more in depth provided with a safe means of ingress and egress (Procedures 4.16.8 & 4.16.9)?

  Yes

  No

  N/A

• Are Excavations 5' or more in depth provided with shoring, sloping or benching as a means of protecting workers (Procedures 4.16.5)?

  Yes

  No

  N/A

• Do Excavations 20' or more in depth have a detailed plan prepared by a Professional Engineer (Procedures 4.16.7)?

  Yes

  No

  N/A

• Is there a system in place that allows employees to Cross Excavations (Procedures 4.16.10)?

  Yes

  No

  N/A

• Are employees only lifting from Manufacture Approved Pick Points on backhoes/excavators (Procedures 4.16.12 & 4.14.5)?

  Yes

  No

  N/A

WORK AREAS & STORAGE

• Are LADDERS inspected priot to their use (Procedures 4.20.4)?

  Yes

  No

  N/A

• Are all damaged ladders removed from service immediately (Procedures 4.20.5)?

  Yes

  No

  N/A

• Are the PORTABLE ladders in use:

• Extending at least 36 inches above the top landing (Procedures 4.20.7)?

  Yes

  No

  N/A

• Placed on a substantial footing and securely fastened (Procedures 4.20.6)?

  Yes

  No

  N/A

• Are all FIXED Ladders extending at least 42 inches above the top landing (Procedures 4.20.10)?

  Yes

  No

  N/A

• Are REBAR covers, rebar troughs or fall protection system used:

• To protect personnel working at grade or at the same surface from exposed projections (Procedures 4.21.1.1)?

  Yes

  No

  N/A

• To protect personnel working above grade and exposed to vertically protruding projections (Procedures 4.21.1.2)?

  Yes

  No

  N/A

• Are REBAR CAPS being used as vertical impalement protection (Procedures 4.21.1.3.1)?

  Yes

  No

  N/A

• Are TRAFFIC CONTROL devices compliant with the Manual on Uniform Traffic Control Devices (Procedures 4.24.8.1)?

  Yes

  No

  N/A

• Are work & storage areas maintained in a clean and orderly condition (Procedures 4.27.1, 4.27.4)?

  Yes

  No

  N/A

• Select the appropriate level of effort observed:

  No effort to comply

  Effort made, but much more is needed

  Effort was made, but not quite achieved

  Site needs some minimal attention

  Site is clean & orderly

HEAVY EQUIPMENT & HIGHWAY VEHICLES

• Are BACK-UP ALARMS functional on all equipment with restricted view to the rear (Procedures 4.11.12)?

  Yes

  No

  N/A

• Are Equipment Operators performing and documenting their PRE-SHIFT Inspection, before they place equipment into service (Procedures 4.11.6)?

  Yes

  No

  N/A

• Are conditions that effect the SAFE OPERATION of the equipment corrected before placing equipment into service (Procedures 4.11.7)?

  Yes

  No

  N/A

• Are personnel wearing SEAT BELTS, when provided and when the equipment has ROPS (Procedures 4.11.14)?

  Yes

  No

  N/A

• Are FORKLIFTS only operated by authorized, trained and properly certified personnel (Procedures 4.12.1)?

  Yes

  No

  N/A

• Are the wheels/tracks of all mobile equipment parked on a grade, properly CHOCKED or turned into a bank (Procedures 4.11.15 & 4.11.16)?

  Yes

  No

  N/A

• Are AERIAL LIFT personnel wearing a body harness and lanyard attached as indicated by equipment manufacturer (Procedures 4.19.7)?

  Yes

  No

  N/A

• Are aerial lift personnel standing on the floor of the basket without sitting or climbing on the edge (Procedures 4.19.8)?

  Yes

  No

  N/A

PUBLIC PROTECTION

• Are there sufficient number of WARNING SIGN & DEVICES to provide adequate warning to the general public (Procedures 4.25.1)?

  Yes

  No

  N/A

• Is the SPILLAGE of earth, rock, asphalt, mud or other materials removed and kept clear throughout the day (Procedures 4.25.9)?

  Yes

  No

  N/A

EVALUATION COMPLETION

• COMMENTS:

• EVALUATION COMPLETED BY:

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