S.M. Hentges Jobsite Inspection Checklist-2016

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Sewer/Water Trenching & Excavating

• Is a Competent Person inspecting the Trench Daily?

  Yes

  No

  N/A

• Is the Spoil Pile Kept Back at Least 2' from the Edge?

  Yes

  No

  N/A

• Has a safe means of Egress been provided if 4'or more in depth?

  Yes

  No

  N/A

• Is the means of egress within 25' of all workers?

  Yes

  No

  N/A

• Is the protective system in compliance with OSHA standards where greater than 5'?

  Yes

  No

  N/A

• Class A Soil - 53 - 3/4:1

• Class B Soil- 45 - 1:1

• Class C Soil - 34 - 1 1/2:1

Potential Hazards

• Locates Completed & Recorded/Documented?

  Yes

  No

  N/A

• Pot Holing Complete?

  Yes

  No

  N/A

• Underground Utilities Protected/Supported?

  Yes

  No

  N/A

• Water Accumulation Controlled?

  Yes

  No

  N/A

• Proper Clearance to OverHead Powerlines?

  Yes

  No

  N/A

Power Tools/Equipment

• Electrical Cords Free from Damage

  Yes

  No

  N/A

• Hand Tools in Good Repair?

  Yes

  No

  N/A

• Ladders in Good Repair?

  Yes

  No

  N/A

• Power Tools in Good Repair?

  Yes

  No

  N/A

• Quick Cut Saw Used with Water to Control Silica Exposure?

  Yes

  No

  N/A

First Aid/Fire Prevention

• Fire Extinguishers Readily Available?

  Yes

  No

  N/A

• Flammable Liquids in UL Listed Safety Cans?

  Yes

  No

  N/A

• Safety Data Sheets on Site?

  Yes

  No

  N/A

• First Aid Kit Stocked & On Site?

  Yes

  No

  N/A

Trucks / Mobile Equipment

• Backup Alarms Working?

  Yes

  No

  N/A

• Seatbelts in Use?

  Yes

  No

  N/A

• DOT Vehicle Inspections Currrent?

  Yes

  No

  N/A

Work Zone Safety / Traffic Control

• Advanced Warning Signs

  Yes

  No

  N/A

• MUTCD applied as required / practicle?

  Yes

  No

  N/A

• Flaggers trained, properly positioned, highly visible?

  Yes

  No

  N/A

• Public prohibited from entering work zone?

  Yes

  No

  N/A

Confined Space Entry

• Is This a Sewer System Entry?

  Yes

  No

  N/A

• Has a Permit Been Completed?

  Yes

  No

  N/A

• Is the 4-Gas Meter in Use on site?

  Yes

  No

  N/A

• Non-Entry Rescue Plans in Place?

  Yes

  No

  N/A

Communication

• Has the Weekly Tool Box Talk been completed?

  Yes

  No

  N/A

Personal Protective Equipment

• Hardhats in Use?

  Yes

  No

  N/A

• Safety Glasses in Use?

  Yes

  No

  N/A

• High Visibility Vests in Use?

  Yes

  No

  N/A

• Hearing Protection in Use?

  Yes

  No

  N/A

• Gloves in Use?

  Yes

  No

  N/A

• Dust Masks/Respirators in Use?

  Yes

  No

  N/A

• Cement Burn Protection (Dove Soap) Available?

  Yes

  No

  N/A

Other Safety Concerns

• Any Other Safety Concerns Noted?

  No

  Yes