Site Visit Report - AAC

• Job Number

  Select

• Work in progress

• Inspection Date

  Date

• Inspector Name

  Select Cole Hardenbrook Tim Laursen Lucas Boyle TJ Schenkel

  • Cole Hardenbrook
  • Tim Laursen
  • Lucas Boyle
  • TJ Schenkel
• Location
  Address

• PROJECT

• Project manager

• Foreman

• Subcontractor?

  Yes

  No

  N/A

• Subcontractor name

• Personnel on site

Personal Protective Equipment

• Head Protection — Hard Hats were worn by all personnel.

  Yes

  No

  N/A

• Eye and Face Protection — ANSI Approved Safety Glasses were being worn at all times.

  Yes

  No

  N/A

• Full Face Shield — Worn as required.

  Yes

  No

  N/A

• Hand Protection — Cut, tear-resistant gloves were worn by all personnel if required

  Yes

  No

  N/A

• Protective Clothing — Good Condition - full leg length work pants, — no shorts or sweat pants

  Yes

  No

  N/A

• Respiratory Protection - Appropriate for the hazard — dust. Must meet ANSI/OSHA specifications for type/fit/medical clearance/training. Filtering Face piece and tight-fitting respirators were worn with P100

  Yes

  No

  N/A

• Hearing Protection — Supplied by specific contractors for TWA of 85+ decibels

  Yes

  No

  N/A

• Foot Protection — Substantial work boots or ANSI Safety Boots.

  Yes

  No

  N/A

General Site Safety

• JHA

  Yes

  No

  N/A

• Site emergency action plan

  Yes

  No

  N/A

• Daily job safety meeting documented

  Yes

  No

  N/A

• Log books up to date

  Yes

  No

  N/A

• Air monitoriing current

  Yes

  No

  N/A

• Project survey/specs on site

  Yes

  No

  N/A

• Hazcomm/SDS on site

  Yes

  No

  N/A

• Training certificates current

  Yes

  No

  N/A

• Notification, waste manifest on site

  Yes

  No

  N/A

• Specialized equipment checklist

  Yes

  No

  N/A

• Forms book on site

  Yes

  No

  N/A

• Potable Water — Available at break area

  Yes

  No

  N/A

• Lavatories —1 Toilet for 20 or less employees & 1 Toilet & 1 Urinal 21-40 employees, I additional and separately marked toilet for female employees. Port-a-John on site

  Yes

  No

  N/A

• Washing Facilities — as required for painters, chemical handling, other workers

  Yes

  No

  N/A

• Safety Eyewashes and Showers — As required for chemical handling

  Yes

  No

  N/A

• State and Federal postings displayed

  Yes

  No

  N/A

• State license/permits on site

  Yes

  No

  N/A

• Signage — No Trespassing — Authorized Construction Personnel Only, Hard Hat and Safety Glasses Required, etc.

  Yes

  No

  N/A

• Security Lighting - Interior and Exterior - As required Existing in work area and stairwell.

  Yes

  No

  N/A

• Perimeter Security Fencing - As required. Exterior of work area on Broad Street is restricted with yellow barrier tape and cones. Work area is monitored by employees.

  Yes

  No

  N/A

• Other issues

  Yes

  No

  N/A

Housekeeping and Hazard Control

• Grounds Cleaned of excess trash and waste materials disposed of daily in trash bins. Shoot use to move debris down to dumpster. Water mist in use to minimize airborne dust levels.

  Yes

  No

  N/A

• Debris free of cut/puncture hazards

  Yes

  No

  N/A

• Walkways & Work Areas - clear of debris, tripping hazards & sharp objects. Clean up in progress during demolition.

  Yes

  No

  N/A

• Fire Control — No flammable materials were on site. Fire extinguishers were available on all occupied floors.

  Yes

  No

  N/A

• Fire extinguisher annual inspection current

  Yes

  No

  N/A

• Fire extinguisher monthly inspection current

  Yes

  No

  N/A

• First aid kit available

  Yes

  No

  N/A

• Construction Materials & Supplies — Properly staged or stored

  Yes

  No

  N/A

• Emergency Access Routes - Doorways, Aisles Fire Exits — 38" clear pathway of travel. EVAC plan gone over with crew by Supervisor in tool box talk.

  Yes

  No

  N/A

• Lighting—Area is properly illuminated.

  Yes

  No

  N/A

• Tools and Equipment — Properly staged and stored

  Yes

  No

  N/A

• Hazard Warning Signs Barricades - Minimum protection 38" from hazards

  Yes

  No

  N/A

• Waste Containers — located throughout the site & near dining facilities

  Yes

  No

  N/A

• Holes covered and marked

  Yes

  No

  N/A

• Cylinders properly stored

  Yes

  No

  N/A

• Approved fuel cans

  Yes

  No

  N/A

• Fuel containment in place

  Yes

  No

  N/A

• Other issues

  Yes

  No

  N/A

Material Handling

• Hand Carts - All tools, Carts, pallet jacks and hand operated transport materials in good condition

  Yes

  No

  N/A

• Powered material handling equipment — All Lull's, forklifts, and other powered industrial vehicles are in good operating condition and inspected

  Yes

  No

  N/A

• Personnel Training - All personnel are trained and qualified to operate the on-site powered equipment.

  Yes

  No

  N/A

• Seat Belts in use by all operators. No vehicles were in use at the time of inspection.

  Yes

  No

  N/A

• Roll over protection (ROPS) Supplied on all equipment.

  Yes

  No

  N/A

Asbestos Work

• NYS notification posted and amended

  Yes

  No

  N/A

• Asbestos assessment

  Yes

  No

  N/A

• EPA notification posted and amended

  Yes

  No

  N/A

• Applicable variances posted

  Yes

  No

  N/A

• Air samples taken as needed

  Yes

  No

  N/A

• Proper signage posted

  Yes

  No

  N/A

• Regulated area(s) established

  Yes

  No

  N/A

Stairways and Ladders

• Permanent & Temporary Stairways / Ladders - Railings, barricades or fall protection in place

  Yes

  No

  N/A

• Landings - Protected against falls by Top rail, Mid Rail, Toe-board. Opening to the 8th floor stairwell was protected during the time of the inspection. Supervisor corrected opening by having a worker create a railing to protect employees from falling.

  Yes

  No

  N/A

Ladders

• Ladders Inspected - No damaged ladders in use. Approved for work application. No job made ladders.

  Yes

  No

  N/A

• Secured Against Tipping. Tied off at top when used to access a landing. Ladder extends min 36 inches above landing.

  Yes

  No

  N/A

• Extension ladders placed at a 4:1 angle, stable footings, base and top clear of tripping hazards,.

  Yes

  No

  N/A

• Employees using 3 points of contact, fall protection over 20 feet of height or if a fall hazard exists over 6 feet in height.

  Yes

  No

  N/A

• Ladder Extends min 36" above landing.

  Yes

  No

  N/A

• Folding, "A" Frame Ladders - "NO STEP" zone on ladder enforced, fully open and not used as straight ladder.

  Yes

  No

  N/A

Scaffolding

• Scaffold tag in use

  Yes

  No

  N/A

• Access ladders provided

  Yes

  No

  N/A

• Scaffolds inspected daily

  Yes

  No

  N/A

• Guards/midrails installed

  Yes

  No

  N/A

• Planking overlaps support by 6 "

  Yes

  No

  N/A

• Scaffold on sound footing

  Yes

  No

  N/A

• Workers trained as erector or user

  Yes

  No

  N/A

• Scaffold inspection sheet completed

  Yes

  No

  N/A

Fall Protection

• Leading Edges — Fall hazards of 6 feet or more protected by:

  Yes

  No

  N/A

• Guardrails, with a Top rail 39"-43", Mid rail 19"-23" & a 3.5" Toe-board or rated for 200 LBS of force, Wire rope flagged

  Yes

  No

  N/A

• Class III Personal Fall Protection Systems. Restraint Systems, Controlled Access Zones, Warning line Systems

  Yes

  No

  N/A

• Approved Safety Nets

  Yes

  No

  N/A

• Controlled Access Zones, Warning line Systems - Flagged at 6' intervals as required

  Yes

  No

  N/A

• Holes - Holes 2" X 2" or greater in size, covered to bear 2 times the weight exerted on it and marked "HOLE" in bright color.

  Yes

  No

  N/A

• Wall Openings Windows - 2" x 2" or greater and less than 43" off floor - approved railing or barricade in place.

  Yes

  No

  N/A

• Protection required for Fall Hazards of 6' or greater

  Yes

  No

  N/A

Electrical Hazards

• Lockout/tagout being used properly

  Yes

  No

  N/A

• Ground Fault Circuit Interrupters in use on all wiring and tools or lighting - inspected and tested daily

  Yes

  No

  N/A

• Cords/Lights/Equipment - No damage to insulation. No electrical tape repairs. Cords were protected from damage from other equipment, doors, window sills, heat, etc.

  Yes

  No

  N/A

• Generators Grounded — External grounding per manufacturers specifications.

  Yes

  No

  N/A

• All multiple Power Outlets and Extensions Cords - UL approval, construction load rated. No job or home built cords with multiple outlets.

  Yes

  No

  N/A

• Power tools properly grounded

  Yes

  No

  N/A

• Lighting - meets UL and National Electric codes and is GFCI Protected.

  Yes

  No

  N/A

• Transmission Lines - grounded and shut down

  Yes

  No

  N/A

Tools & Equipment

• Inspected routinely - Guards In Place. Tools used according to manufacturer's recommendations. Tools are in good operating condition.

  Yes

  No

  N/A

• Powered Hand Tools - GFCI Protected, grounded, or double insulated

  Yes

  No

  N/A

• Personal Protective Equipment - in use on all power tools and appropriate for the job.

  Yes

  No

  N/A

• All blades sharp and in good repair.

  Yes

  No

  N/A

Equipment Operation

• Heavy equipment inspected

  Yes

  No

  N/A

• Equipment clear of overhead power lines

  Yes

  No

  N/A

• Caps guarded/protected

  Yes

  No

  N/A

• Backup alarms working

  Yes

  No

  N/A

• Safe use of equipment/vehicle

  Yes

  No

  N/A

• Spotter when moving equipment

  Yes

  No

  N/A

• Operator trained for equipment

  Yes

  No

  N/A

• Grounded/off while fueling

  Yes

  No

  N/A

Aerial Lifts

• Aerial lifts - Maintained and Inspected as Required. Although not in use at time of the inspection, the contractor had no inspection forms or means to show inspections were being conducted prior to use.

  Yes

  No

  N/A

• Positioned on flat, stable surface - Railings in use and doors secured, - area secured

  Yes

  No

  N/A

• Personal Fall Protection Employed (Class Ill harness and lanyard) on all aerial booms, lifts and buckets. Retractable lanyard for aerial Lifts.

  Yes

  No

  N/A

Demolition

• Written demolition plan on site

  Yes

  No

  N/A

• Demolition survey complete

  Yes

  No

  N/A

• Service lines located and identified

  Yes

  No

  N/A

• Live utilities tagged/protected

  Yes

  No

  N/A

• Wet method/no visible emissions

  Yes

  No

  N/A

• Adequate ventilation

  Yes

  No

  N/A

• Co monitoring

  Yes

  No

  N/A

• Excavation sloped/shored

  Yes

  No

  N/A

• Drop zone marked/protected

  Yes

  No

  N/A

• Silica assessment

  Yes

  No

  N/A

• Lead assessment

  Yes

  No

  N/A

Comments

• Overall impression of Site

  Outstanding

  Above Average

  Average

  Below Average

• State reason(s) Site Visit was Below Average

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• Yes

  No

  N/A

• Safety Champion awarded?

  Yes

  No

  N/A

• Names of individuals

  Yes

  No

  N/A

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• Report Written by (Name and Signature)

  Sign

• Reviewed by (Name and Signature)

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