Site Safety Audit Liberty

• Conducted on

  Date

• Weather Conditions

  Select

• Division

  LRP

  RPE Storm

• Show Up Location

  Chester Springs, PA

  Halethorpe, MD

  Trevose, PA

  Upper Marlboro, MD

  Agostino Yard

• Customer

  Select ACE BGE DELMARVA PECO PEPCO Crown Castle Blair Park Storm Restoration Service Work

  • ACE
  • BGE
  • DELMARVA
  • PECO
  • PEPCO
  • Crown Castle
  • Blair Park
  • Storm Restoration
  • Service Work

• Work Type

• Work Order Number

• Job Location
  Address

• Prepared by

• Preparer Employee Number

• Superintendent

  Select

• General Foreman

  Select Bob Krieger Al Agostino

  • Bob Krieger
  • Al Agostino

• Supervisor/Foreman

• Job Description

Job Briefing Form

• Job Briefing Form

  Compliant

  Non-Compliant

  N/A

• Are All Applicable Event Free Performance Tools Documented on the Job Briefing Form?

  Compliant

  Non-Compliant

  N/A

Rules & Procedures

• Are All Applicable Event Free Performance Tools Being Utilized by the Crew?

  Compliant

  Non-Compliant

  N/A

• Energy Source Hazards Identified with Energy Wheel.

  Compliant

  Non-Compliant

  N/A

• 360° Walkaround

  Compliant

  Non-Compliant

  N/A

• Wheel Chocks

  Compliant

  Non-Compliant

  N/A

• Outrigger Pads

  Compliant

  Non-Compliant

  N/A

• Situational Awareness / Eyes on Path

  Compliant

  Non-Compliant

  N/A

• Signaling & Spotter

  Compliant

  Non-Compliant

  N/A

• Hazard Communication

  Compliant

  Non-Compliant

  N/A

• Proper Hydration & Fatigue Management

  Compliant

  Non-Compliant

  N/A

Work Area Protection

• Green Cone

  Compliant

  Non-Compliant

  N/A

• Traffic Control

  Compliant

  Non-Compliant

  N/A

• Work Zone

  Compliant

  Non-Compliant

  N/A

• Line of Fire From Above Zone

  Compliant

  Non-Compliant

  N/A

PPE

• Head Protection

  Compliant

  Non-Compliant

  N/A

• Eye Protection

  Compliant

  Non-Compliant

  N/A

• Hand Protection

  Compliant

  Non-Compliant

  N/A

• Foot Protection

  Compliant

  Non-Compliant

  N/A

• Rubber Gloves & Sleeves

  Compliant

  Non-Compliant

  N/A

• Dielectric Footwear

  Compliant

  Non-Compliant

  N/A

• Fall Protection

  Compliant

  Non-Compliant

  N/A

• Hearing Protection

  Compliant

  Non-Compliant

  N/A

• Chainsaw Chaps

  Compliant

  Non-Compliant

  N/A

• Respiratory Protection

  Compliant

  Non-Compliant

  N/A

Rubber & Hard Cover

• Rubber Cover Inspected and in Good Condition?

  Compliant

  Non-Compliant

  N/A

• Hard Cover Inspected and in Good Condition?

  Compliant

  Non-Compliant

  N/A

• Proper Cover Installed?

  Compliant

  Non-Compliant

  N/A

Grounding & Bonding Systems

• Grounds Inspected and in Good Condition?

  Compliant

  Non-Compliant

  N/A

• Line / Equipment Tested Properly and Confirmed De-energized?

  Compliant

  Non-Compliant

  N/A

• Primary Grounds Installed as Required? (Specify EPZ, Running etc, LOF))

  Compliant

  Non-Compliant

  N/A

Tooling & Equipment

• Tool Condition

  Compliant

  Non-Compliant

  N/A

• Tool Use

  Compliant

  Non-Compliant

  N/A

• Equipment Condition

  Compliant

  Non-Compliant

  N/A

• Equipment Use

  Compliant

  Non-Compliant

  N/A

• Insulated Tools

  Compliant

  Non-Compliant

  N/A

• Voltage Testers

  Compliant

  Non-Compliant

  N/A

Ergonomics

• Three Points of Contact

  Compliant

  Non-Compliant

  N/A

• Lifting

  Compliant

  Non-Compliant

  N/A

• Work Positioning

  Compliant

  Non-Compliant

  N/A

Housekeeping

• Clutter

  Compliant

  Non-Compliant

  N/A

• Garbage

  Compliant

  Non-Compliant

  N/A

• Tripping Hazards

  Compliant

  Non-Compliant

  N/A

• Spills / Leaks

  Compliant

  Non-Compliant

  N/A

Emergency Response Material

• Fire Extinguishers

  Compliant

  Non-Compliant

  N/A

• First Aid Kits

  Compliant

  Non-Compliant

  N/A

• AED

  Compliant

  Non-Compliant

  N/A

• Burn Kit

  Compliant

  Non-Compliant

  N/A

• Eyewash Stations

  Compliant

  Non-Compliant

  N/A

Excavation Safety

• One Call / Dig Ticket

  Compliant

  Non-Compliant

  N/A

• Prudent Digging Methods

  Compliant

  Non-Compliant

  N/A

• Spoil Retention

  Compliant

  Non-Compliant

  N/A

• Excavation Securement

  Compliant

  Non-Compliant

  N/A

• Emergency Rescue

  Compliant

  Non-Compliant

  N/A

Other Hazards

• Other Hazards Identified and Mitigated?

  Compliant

  Non-Compliant

  N/A

Additional Comments

• Additional Comments

• Pictures

  Media

Audit Closeout

• Audit Closure

  Open

  Closed