Title Page

  • Job Number

  • Work in progress

  • Inspection Date

  • Inspector Name

  • Location
  • PROJECT

  • Project manager

  • Foreman

  • Subcontractor?

  • Subcontractor name

  • Personnel on site

Personal Protective Equipment

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

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

  • Full Face Shield — Worn as required.

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

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

  • 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

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

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

  • Other- Specialized PPE, or otherwise unique to the situation

  • What type of PPE is being used?

  • What condition is the PPE in?

General Site Safety

  • JHA

  • Are JHA's applicable to the work being completed?

  • Have all hazardous tasks been identified with a JHA?

  • What tasks, or hazards, are not addressed?

  • Site emergency action plan

  • Daily job safety meeting documented

  • Log books up to date

  • Air monitoriing current

  • Project survey/specs on site

  • Hazcomm/SDS on site

  • Training certificates current

  • Notification, waste manifest on site

  • Specialized equipment checklist

  • Forms book on site

  • Potable Water — Available at break area

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

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

  • Safety Eyewashes and Showers — As required for chemical handling

  • State and Federal postings displayed

  • State license/permits on site

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

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

  • Perimeter Security Fencing - As required

  • Other issues

  • Description:

Housekeeping and Hazard Control

  • Grounds cleaned of excess trash and waste materials disposed of daily in trash bins. A chute is used to move debris down to the dumpster as applicable. Water mist is used to minimize airborne dust levels as applicable.

  • Debris free of cut/puncture hazards

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

  • Fire Control — No fire hazards were present on site. Fire extinguishers were available on all occupied floors.

  • Fire extinguisher annual inspection current

  • Fire extinguisher monthly inspection current

  • First aid kit available and adequate.

  • Construction Materials & Supplies — Properly staged or stored

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

  • Lighting—Area is properly illuminated.

  • Tools and Equipment — Properly staged and stored

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

  • Waste Containers — located throughout the site & near break areas

  • Holes covered and marked

  • Cylinders properly stored

  • Approved fuel cans

  • Fuel containment in place

  • Ladders are properly stored and maintained

  • Other issues

Material Handling

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

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

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

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

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

Asbestos Work

  • Is this an asbestos abatement job?

  • NYS notification posted and amended

  • Asbestos assesment

  • EPA notification posted and amended

  • Applicable variances posted

  • Air samples taken as needed

  • Proper signage posted

  • Regulated area(s) established

  • Should this site be further evaluated for regulatory compliance?

Stairways and Ladders

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

  • Landings - Protected against falls by Top rail, Mid Rail, Toe-board

Ladders

  • Are ladders used on this project?

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

  • Secured Against Tipping. Tied off at top when used to access a landing.

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

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

  • Ladder Extends min 36" above landing.

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

  • No demolition work taking place from ladders

Scaffolding

  • Is scaffolding being used?

  • Scaffold inspection tag in use

  • Access ladders provided

  • Scaffolds inspected daily

  • Guards/midrails installed

  • Planking overlaps support by 6 "

  • Scaffold on sound footing

  • Workers trained as erector or user

  • Decking is complete with no more than a 1" gap between planks

  • Is there an obstruction preventing complete decking?

  • Are planks installed as close as possible? Less than 9" gap?

Fall Protection

  • Is fall protection needed on this project?

  • Guardrails: Top rail 39"-43", Mid rail 19"-23" & a 3.5" Toe-board. Rated for 200 LBS of force.

  • PFAS in use

  • Body harness being used, properly sized, inspected and in good condition

  • Anchor point rated for 5,000lbs per person

  • SRL, Lanyard, Vertical Lifeline, Horizontal Lifeline: Good condition, inspected and used appropriately

  • Rescue plan in place?

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

  • Safety Monitor assigned?

  • 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.

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

  • Protection required for Fall Hazards of 6' or greater

Electrical Hazards

  • Lockout/tagout being used properly

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

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

  • Generators Grounded — External grounding per manufacturers specifications.

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

  • Power tools properly grounded

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

Tools & Equipment

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

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

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

  • All blades sharp and in good repair.

Equipment Operation

  • Is heavy equipment used on this site?

  • Is this equipment inspected prior to use?

  • Is equipment clear of overhead power lines?

  • Are backup alarms working?

  • Is the equipment being operated safely?

  • Is a spotter used when backing up, or when the operator doesn't have a clear line of sight?

  • Is the operator trained for the equipment they are using?

  • Are safe fueling operations followed?

Aerial Lifts

  • Are aerial lifts being used at this time?

  • 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.

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

  • Personal Fall Protection deployed on all aerial boom lifts and buckets. Retractable lanyards are used on all aerial lifts

Demolition

  • Is this a demolition job?

  • Is the written demolition plan on site?

  • Is the demolition survey complete?

  • Have the service lines been located and identified?

  • Are live utilities protected and flagged?

  • Are wet methods with no visible emissions being used?

  • Is there adequate ventilation?

  • Is CO being monitored?

  • Are excavations sloped/shored or otherwise protected from collapse?

  • Is the drop zone marked/protected?

  • Has a silica assessment been completed?

  • Has a lead assessment been completed?

Comments

  • Overall impression of Site

  • State reason(s) Site Visit was Below Average

Review and Signatures

  • Report Written by (Name and Signature)

  • Reviewed by (Name and Signature)

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