Silverline Safe - Site Safety Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Yes

  No

  N/A

Housekeeping/ Sanitation

• Project work areas are clean, orderly and free of excess trash & debris?<br>

  Score

• Trash Dumpster are being maintained/emptied properly?

  Score

• Material and equipment clean, properly stored and orderly?<br>

  Score

• Proper number of porta johns & hand wash facilities; no graffiti; maintained?<br>

  Score

• Scrap material free of protruding nails or other puncture hazards?<br>

  Score

Fall Protection and Impalement Hazards

• Fall prevention/protections method reviewed prior to start work (PSM)?<br>

  Score

• Is fall protection being stored properly?<br>

  Score

• Personal fall arrest systems are working satisfactory?<br>

  Score

• Have Impalement hazards have been secured?<br>

  Score

• Fall arrest systems installed and inspected properly by a competent person<br>

  Yes

  No

  N/A

Ladders/Stairs in Place and Maintained

• Ladders properly used and maintained/inspected?<br>

  Score

• Ladders are properly constructed and used as per the mfg guidelines?<br>

  Score

• Ladders used for access to upper/lower levels are provided with 'walk thru' rails?<br>

  Score

• Proper access/egress are provided to upper/lower working levels?<br>

  Score

• All access and egress to ladders & stairs clear and free of debris?<br>

  Score

Scaffolds - Constructed Properly and Maintained

• Scaffold tags in place & inspected daily by a competent person (Red/Green Tag)?<br>

  Score

• Scaffolds erected properly and maintained/tied in correctly?<br>

  Score

• Proper access and egress provided?<br>

  Score

• Swing gates provided for vertical ladders?<br>

  Score

• Engineered/Stamped drawings reviewed for complex scaffold systems?<br>

  Score

Floor Openings/Penetrations

• Hole covers are inspected and maintained on a daily basis?<br>

  Score

• All holes greater than 2" in diameter covered, marked and secured?<br>

  Score

• All holes larger then 1' x 2 ' are provided with a secondary means of protection?

  Score

• Guardrails around holes provided with toeboards and maintained?<br>

  Score

• All covers support at least twice the maximum intended load?<br>

  Score

Excavations - Protected Properly/Egress Routes

• Crew has up to date dig permit and confined space documentation?<br>

  Score

• Ladders provided for access within 25 ft?<br>

  Score

• Proper sloping/benching/shoring/boxing for excavations greater than 4 ft deep?<br>

  Score

• Physical barricades provided at the top edge of excavations ?<br>

  Score

• Air monitoring being documented?<br>

  Score

Adequate Lighting Provided

• Temp light plants being used have outriggers extended properly?<br><br>

  Score

• Adequate task lighting is provided for each employee?<br><br>

  Score

• Temp lighting is inspected on a regular basis?<br><br>

  Score

• Temp lighting protected properly ( string Lights)?<br><br>

  Score

• Lights provided for access points around the perimeter of the project?<br>

  Score

Electrical Power (GFCI/Electrical Cords/Powerlines)

• All Electrical cords are 12ga ?<br>

  Score

• Breakers or circuits properly labeled and identified?<br>

  Score

• Flexible cords are in good working condition?<br>

  Score

• Space around Service panels are free from debris ( 3 feet)?<br>

  Score

• Overhead power lines have been identified with proper signage?<br>

  Score

Miscellaneous/Special Attention Comments

Hot work/Fire Protection

• Does the work area have the required amount of fire extinguishers?<br>

  Score

• Fire extinguishers inspected, tagged, logged monthly & serviced annually?<br>

  Score

• Emergency plan practiced, egress routes maintained?<br>

  Score

• Hot work permits are utilized for all hot work operations & Fire watch provided?<br>

  Score

• Evacuation routes posted & all employees are informed of gathering point?<br>

  Score

Cranes/Hoisting Apparatus/Rigging Condition and Inspection

• Cranes inspected on a daily basis & documentation is filed?<br>

  Score

• Rigging inspected before each use, properly labeled, and stored properly?<br>

  Score

• Crane set up per policy ( tires off the ground, outriggers fully extended)?<br>

  Score

• Lift Load calculations are being done?<br>

  Score

• Proper cribbing/dunnage and radius protection provided?<br>

  Score

Personal Protective Equipment Utilization

• Proper eye protection worn at all times & face protection when needed?<br>

  Score

• Hard hat worn at all times?<br>

  Score

• Type 3 Reflective vests/highly visible fluorescent shirts worn at all times?<br>

  Score

• Hearing protection used around high noise sources above 90 dBA?<br>

  Score

• Proper level one or greater gloves worn at all times per policy?<br>

  Score

Caught in between/ Struck by hazards

• Spotters are being used for operation?<br>

  Score

• Crews are aware of loads being carried over their head?<br>

  Score

• Machine Guards are attached to tools? <br>

  Yes

  No

  N/A

• Excavation is secured from possible collapse?<br>

  Yes

  No

  N/A

• Workers are protected from swing radius from moving equipment?<br>

  Score

Hand and Power Tools

• Hand and power tools inspected and maintained?<br>

  Score

• Proper guards in place and maintained?<br>

  Score

• Power tools are grounded (3-prong plug) or double insulated?<br>

  Score

• Tools are being used for their intended use?<br>

  Score

• Whip lines and/or pins are provided for at all air compressor connections?<br>

  Score

Flammable and Combustible Liquids

• Flammable/combustible liquids are stored and handled properly?<br>

  Score

• All containers are properly labeled/protected?<br>

  Score

• Fire extinguisher provided within 50 ft of storage area(s)?<br>

  Score

• No smoking/open flame signs secured near F/C storage area(s)?<br>

  Score

• F/C liquids are stored within 10 ft from stairwells, elevators & exits?

  Score

Signage

• FD and truck access signs are visible?<br>

  Score

• Green cones are being used?<br>

  Score

• Excavation signage being utilized?<br>

  Score

• TMA trucks/ arrow boards and VMA boards are properly set up?<br>

  Score

• MOT signs properly setup?<br>

  Score

Mobile Equipment

• Daily inspection conducted on all mobile equipment - documented?<br>

  Score

• Fire extinguishers on all mobile equipment?<br>

  Score

• Audible alarms working properly?<br>

  Score

• Seat belts functional and worn on mobile equipment (as required)?<br>

  Yes

  No

  N/A

• Proper attachments used on all mobile equipment ( Beacon Light etc.)?<br>

  Score

CONFINED SPACE(s)

• Has air been tested and or monitored with ranges between 19.5%- 23.5%?<br>

  Score

• Is Adequate ventilation being provided?<br>

  Score

• Are all required posting/documentation up to date?<br>

  Score

• Has the confined space been inspected by a competent person?<br>

  Score

• Has all hazards been secured and identified with crew?<br>

  Score

Evaluation Summary

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