SCI SAFETY INSPECTION REPORT

• Document No.

• Job Site Name

• Job Site Number

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Site Superintendent

CONCRETE

• Proper PPE in Use (Boots, Gloves, Glasses, Respirators, Etc.)

  Yes

  No

  N/A

• Dust Control when Cutting Concrete

  Yes

  No

  N/A

• Rebar Capped Properly

  Yes

  No

  N/A

• Concrete Pre-Pour Checklist Filled Out & on File

  Yes

  No

  N/A

• Forms Properly Installed & Braced

  Yes

  No

  N/A

• Traffic Control (Spotters) in Place

  Yes

  No

  N/A

• Adjacent Finishes Protected

  Yes

  No

  N/A

• Adequate Water & Cleaning Supplies Provided

  Yes

  No

  N/A

• Tools & Hoppers Cleaned After Use

  Yes

  No

  N/A

• Forms Clean & Oiled

  Yes

  No

  N/A

CONFINED SPACE

• Confined Space Entry Permit is on site and completed by a competent person

  Yes

  No

  N/A

• Proper signage and barricading is in place

  Yes

  No

  N/A

CRANES & RIGGING

• Pre-shift crane inspection completed by a competent person

  Yes

  No

  N/A

• Monthly crane inspection conducted, documented and on file

  Yes

  No

  N/A

• Annual crane inspection conducted, documented and on file

  Yes

  No

  N/A

• Swing radius of counter weight barricaded off to avoid striking workers/equipment

  Yes

  No

  N/A

• Outrigger pads are solid, sturdy and appear at least three times the area of the outrigger plates

  Yes

  No

  N/A

• Outriggers are fully extended

  Yes

  No

  N/A

• Employees kept from under suspended loads

  Yes

  No

  N/A

• Chains and slings inspected/tagged

  Yes

  No

  N/A

• Fire extinguisher located in the cab

  Yes

  No

  N/A

ELECTRICAL

• Cords in Good Condition and Protected in Traffic Areas

  Yes

  No

  N/A

• GFCI Protection Used

  Yes

  No

  N/A

• Lockout/Tag-Out Equipment Available

  Yes

  No

  N/A

• Lockout/Tag-Out Required & in Use

  Yes

  No

  N/A

• Proper Covers on Wiring Boxes and Panels

  Yes

  No

  N/A

• Temporary Lights used Correctly and with Proper Guards

  Yes

  No

  N/A

• Adequate Lighting Provided and In Use

  Yes

  No

  N/A

EXCAVATION

• Excavations protected by guardrails, fences, or barricades if not readily seen due to plant growth or other visual barriers

  Yes

  No

  N/A

• Competent person with knowledge of excavation hazards, pertinent OSHA regulations, and soil analysis on hand

  Yes

  No

  N/A

• Excavation inspected daily by a competent person before workers enter

  Yes

  No

  N/A

• Materials and spoil piles are stored at least two feet from trench or excavation

  Yes

  No

  N/A

• Equipment is a safe distance from edge of trench/excavation

  Yes

  No

  N/A

• Ladders provided every 25 feet in trench

  Yes

  No

  N/A

• Proper access/egress is available for trenches greater than four feet deep

  Yes

  No

  N/A

• Excavations are shored or sloped back for excavations greater than five feet deep

  Yes

  No

  N/A

• Underground Utilities Located

  Yes

  No

  N/A

FALL PROTECTION

• Safety rails/cables are secured properly

  Yes

  No

  N/A

• Employees exposed to fall hazards are properly protected

  Yes

  No

  N/A

• Fall protection equipment is appropriate for working height

  Yes

  No

  N/A

• Employees below protected from falling objects

  Yes

  No

  N/A

• Harness & Lanyard Inspected & in Good Condition

  Yes

  No

  N/A

• Fall protection plan completed and signed by all team members

  Yes

  No

  N/A

• Proper tie-off points used

  Yes

  No

  N/A

FIRE PROTECTION

• Adequate number of fire extinguishers on site

  Yes

  No

  N/A

• Travel distance between extinguishers does not exceed 100 feet

  Yes

  No

  N/A

• Extinguishers Available and Inspected

  Yes

  No

  N/A

• No Smoking Areas Properly Marked

  Yes

  No

  N/A

• LP tanks properly secured

  Yes

  No

  N/A

• Flammable/combustible liquids stored in approved containers and labeled

  Yes

  No

  N/A

• Unobstructed access to fire hydrants/extinguishers

  Yes

  No

  N/A

FLOOR & WALL OPENINGS

• All floor/deck openings are planked over/barricaded

  Yes

  No

  N/A

• Perimeter protection is in place

  Yes

  No

  N/A

• Deck planks are secured

  Yes

  No

  N/A

• Materials stored away from edge

  Yes

  No

  N/A

• Floor openings properly marked

  Yes

  No

  N/A

HAND, POWER & POWDER-ACTUATED TOOLS

• Guards in place on machines/equipment

  Yes

  No

  N/A

• When powder-actuated tools are used is proper PPE being worn (eyes, face, ears and hands)

  Yes

  No

  N/A

• Hand tools in good condition

  Yes

  No

  N/A

• Guards on machines/equipment in good condition

  Yes

  No

  N/A

• Tool cords/plugs in good condition (strain relief)

  Yes

  No

  N/A

• Employees are using power tools properly

  Yes

  No

  N/A

• Right tool being used for job at hand

  Yes

  No

  N/A

HEAVY EQUIPMENT

• LIST TYPE OF EQUIPMENT

• Equipment Inspected

  Yes

  No

  N/A

• Workers in harness and tied off - As Applicable

  Yes

  No

  N/A

• Barricades in Place at Work Area

  Yes

  No

  N/A

• Authorized Equipment Operator

  Yes

  No

  N/A

• Spotter in Place – As Applicable

  Yes

  No

  N/A

• Load Handled Properly (Forklifts)

  Yes

  No

  N/A

• Load Capacity & Lifting Range Rules Followed

  Yes

  No

  N/A

• Work Area Kept Clean & Organized

  Yes

  No

  N/A

• Seat Belt in Use

  Yes

  No

  N/A

• Slings, Cables & Hooks in Good Condition and Propely Tagged

  Yes

  No

  N/A

• Fire Extinguisher on the Equipment & with Current Inspection

  Yes

  No

  N/A

HOUSEKEEPING/SECURITY

• Adequate Barricades in Place & in Good Condition (Plastic Fence Upright & Supported, Caution Tape in Place & in Good Condition, Warning Cones in Place, Etc.)

  Yes

  No

  N/A

• Work area neat, debris picked up and free of trip hazards

  Yes

  No

  N/A

• Floor holes guarded or provided with secure labeled covers

  Yes

  No

  N/A

• Waste containers provided/used

  Yes

  No

  N/A

• Recycling Containers Provided & in Use

  Yes

  No

  N/A

• Materials properly stored, clear of stairways and exit routes, stacked and protected

  Yes

  No

  N/A

• Potential impalement hazards from protruding rebar, form stakes, pipe stubs, and nails removed, capped or covered

  Yes

  No

  N/A

• Drinking Water & Cups Provided

  Yes

  No

  N/A

• Adequate Toilet Facilities Provided & Clean

  Yes

  No

  N/A

• Job Trailer Clean & Organized

  Yes

  No

  N/A

• Protruding Nails Removed

  Yes

  No

  N/A

• Hazardous Materials Labeled & Secondary Containers Labeled

  Yes

  No

  N/A

• Security Measures in Place (Door Locks, Security Fence, Trailers Secured, Storage Trailers w/ Locks, Outside Equipment Chained & Locked, Etc.)

  Yes

  No

  N/A

• Company Vehicles Clean & Organized

  Yes

  No

  N/A

JOB INFORMATION/ADMINISTRATIVE

• Job Hazard Analysis

  Yes

  No

  N/A

• OSHA 300A form posted between February 1 and April 30

  Yes

  No

  N/A

• OSHA & Workers' Compensation posters posted

  Yes

  No

  N/A

• Specific Emergency Action Plan available and reviewed by all Team Members

  Yes

  No

  N/A

• Red Tag Kit available

  Yes

  No

  N/A

• First aid kit available/stocked

  Yes

  No

  N/A

• MSDS Information Available and Accessible

  Yes

  No

  N/A

• Daily Safety Inspection Completed

  Yes

  No

  N/A

LADDERS & STAIRS

• Ladders are of appropriate duty rating for the task

  Yes

  No

  N/A

• Ladders are of proper type and size for the task

  Yes

  No

  N/A

• Ladders extend at least 36 inches above the landing (ladder access kept clear at all times)

  Yes

  No

  N/A

• Ladders are secured to prevent slipping, sliding or falling (ladders pitched at a 4:1 ratio, staked, tied, etc.)

  Yes

  No

  N/A

• Stepladders used in fully open position

  Yes

  No

  N/A

• Stairway or ladder provided at points of access where a break in elevation of 19 inches or more exists

  Yes

  No

  N/A

• Stairway rails or handrails installed when required

  Yes

  No

  N/A

• Crew not Working from Ladders Unless Using Fall Protection

  Yes

  No

  N/A

• Ladders affixed with proper tags

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT (PPE)

• Hard Hats in Use

  Yes

  No

  N/A

• Safety Glasses are being worn and meet ANSI Z87 requirements

  Yes

  No

  N/A

• Face Shields in Use

  Yes

  No

  N/A

• High-visibility vests/clothing are being worn where needed

  Yes

  No

  N/A

• Gloves in Good Condition and in Use

  Yes

  No

  N/A

• Proper Boots & Clothing are being worn and are in good condition

  Yes

  No

  N/A

• Hearing protection in use when required

  Yes

  No

  N/A

• Dust masks and/or respirators being used when needed/required

  Yes

  No

  N/A

SCAFFOLDING

• Proper baseplates and mudsills in place

  Yes

  No

  N/A

• Tied to structure as required

  Yes

  No

  N/A

• Scaffold is plumb, square, and level

  Yes

  No

  N/A

• Complete guardrail system around working platform (guardrail, intermediate rails, toe boards, screens in place)

  Yes

  No

  N/A

• All working-level platforms fully planked/decked

  Yes

  No

  N/A

• Proper access/egress provided and adequate

  Yes

  No

  N/A

• Proper pins used in all connections

  Yes

  No

  N/A

• Employees below protected from falling objects

  Yes

  No

  N/A

• Scaffold Erection Tag completed by a competent person and attached

  Yes

  No

  N/A

WELDING AND CUTTING

• Fire Extinguisher Available & Inspected

  Yes

  No

  N/A

• Gas Cylinders Upright, Secured & Properly Stored

  Yes

  No

  N/A

• Proper separation between fuels and oxygen (1/2 hr-rated fire wall or a minimum distance of 20 feet)

  Yes

  No

  N/A

• Hoses are in good condition

  Yes

  No

  N/A

• Burn Permit Issued

  Yes

  No

  N/A

• Screens in Place

  Yes

  No

  N/A

• Fire Watch in Place

  Yes

  No

  N/A

COMMENTS/UNSAFE ACTS OR PRACTICES OBSERVED

• PHOTOS OF INFRACTIONS

  Media

• SITE SUPERINTENDENT SIGNATURE

  Sign

• INSPECTOR SIGNATURE

  Sign