SML Safety Questionnaire

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General Safety Conditions

• Are all materials stored neatly and secured?

  Yes

  No

  N/A

• Are adequate orange barrels and fencing provided around equipment/materials?

  Yes

  No

  N/A

• Are sidewalk closures set up per DOT guidelines?

  Yes

  No

  N/A

• Are access ramps provided as necessary?

  Yes

  No

  N/A

• Have required MPT signs been furnished and maintained?

  Yes

  No

  N/A

• Are reflectorized signs used?

  Yes

  No

  N/A

• Is there adequate access to fire hydrants and emergency vehicles?

  Yes

  No

  N/A

• Are pedestrian barrels/fences placed as specified?

  Yes

  No

  N/A

• Are sidewalks open and clear (min. 5' width)?

  Yes

  No

  N/A

• Have steel plates been pinned and ramped and made skid resistant?

  Yes

  No

  N/A

• Are roadway covers subject to loads from motor vehicles or other moving equipment of supporting twice the maximum load to which they may be subjected (tested & certified)?

  Yes

  No

  N/A

Protection of Public

• Are there materials stored on parapets, walls, scaffold ends, or in locations where a fall hazard is present?

  Yes

  No

  N/A

• Are warning signs posted near dangerous areas or where traffic hazards are present?

  Yes

  No

  N/A

• Are flaggers directing traffic or public when work interferes with open areas?

  Yes

  No

  N/A

• Are scaffolds, ramps, runways, or platforms protected?

  Yes

  No

  N/A

• Are temporary walkways or foot bridges at least 5' wide?

  Yes

  No

  N/A

• If required, does the site have a noise mitigation plan?

  Yes

  No

  N/A

Jobsite Safety

• Are weekly safety meetings conducted and documented?

  Yes

  No

  N/A

• Do all employees on site have 10 hour OSHA training cards and appropriate scaffold training card(s)?

  Yes

  No

  N/A

• Are the jobsite injury records maintained at the site (OSHA 300 Log, Accident Reports, & Investigations)?

  Yes

  No

  N/A

• Is a copy of the Site Safety Plan (Drawing and/or Site Specific) available?

  Yes

  No

  N/A

• Are Emergency Protocol and contact telephone numbers posted at the site?

  Yes

  No

  N/A

Site Housekeeping

• Are containers covered and secure when full?

  Yes

  No

  N/A

• Are projecting nail heads/points removed or bent over?

  Yes

  No

  N/A

• Are sanitary facilities (toilets, hand washing stations) available in sufficient numbers and clean?

  Yes

  No

  N/A

• Is an adequate supply of drinking water provided?

  Yes

  No

  N/A

• Are all aisles, passageways, and access roads/ramps clear, level, and free of trip hazards?

  Yes

  No

  N/A

• Are barricades provided for special work (sandblasting, hydro blasting, lead removal, contaminated hazardous soil)?

  Yes

  No

  N/A

• Are lighting levels adequate for construction activities?

  Yes

  No

  N/A

• Is sweeping and dust control adequate?

  Yes

  No

  N/A

• Are personnel following accepted lifting methods (i.e., no excessive bending, twisting, etc.)?

  Yes

  No

  N/A

• Are work areas and public areas maintained free of debris, ice, snow, etc.?

  Yes

  No

  N/A

• Are materials properly stored on firm footing and protected from weather conditions?

  Yes

  No

  N/A

• Are oil and grease removed or cleaned?

  Yes

  No

  N/A

Protective Equipment

• Is head protection provided and used?

  Yes

  No

  N/A

• Is hearing protection provided and used when needed?

  Yes

  No

  N/A

• Are eye and face protection provided and used when needed?

  Yes

  No

  N/A

• Are hand, wrist, and arm protection provided and used when required?

  Yes

  No

  N/A

• Is foot protection provided and used?

  Yes

  No

  N/A

• Is respiratory protection provided and used where necessary?

  Yes

  No

  N/A

• Is special protective equipment provided (welding helmets, disposable protective suits, chemical resistant gloves or boots)?

  Yes

  No

  N/A

• Are body harnesses provided and used when fall potential of 6 feet exists?

  Yes

  No

  N/A

Fire Prevention

• Are Hot Work Permits used?

  Yes

  No

  N/A

• Are combustible/flammable materials stored in appropriate containers or storage areas designed for these materials?

  Yes

  No

  N/A

• Are "No Smoking" signs posted?

  Yes

  No

  N/A

• Is a fire alarm system in place?

  Yes

  No

  N/A

• Are Fire Watchers and Fire Guards (with certificates) provided during Hot Work activities?

  Yes

  No

  N/A

• Are hydrants, standpipes, siamese connections, and fire extinguishers clear of obstructions and accessible and regularly inspected?

  Yes

  No

  N/A

• Does the contractor have a fire prevention/protection plan?

  Yes

  No

  N/A

• Are standpipe signs posted?

  Yes

  No

  N/A

• Are standpipes painted?

  Yes

  No

  N/A

• Is smoking occurring on site?

  Safe

  At Risk

  N/A

Flammable & Compressed Gas Storage

• Are walkways, aisles, emergency exits, fire extinguishers in storage areas kept clear of material storage at all times?

  Yes

  No

  N/A

• Are cylinder caps in place when stored (not in use) or when cylinders are moved?

  Yes

  No

  N/A

• Are fuel gas and O2 (oxidizers) kept a minimum of 20' apart when stored or separated by a 5' 1/2 hour fire retardant wall?

  Yes

  No

  N/A

• Are empty cylinders marked "empty" or "MT"?

  Yes

  No

  N/A

• Are chemically reactive gases stored at least 50' apart?

  Yes

  No

  N/A

• Are gas cylinders clearly marked with contents and protected from accidental rupture?

  Yes

  No

  N/A

• Are gas cylinders stored in a shaded, well ventilated area, and at least 50' from exposed electrical components or combustible materials?

  Yes

  No

  N/A

Electrical

• Is approved electrical equipment used?

  Yes

  No

  N/A

• Are live parts of electrical equipment/installations guarded against accidental contact?

  Yes

  No

  N/A

• Are electrical systems protected by fuses or circuit breakers?

  Yes

  No

  N/A

• Are GFCI's or an assured grounding program in place for electrical equipment?

  Yes

  No

  N/A

• Are electrical hazard warning signs posted?

  Yes

  No

  N/A

• Is a lock-out/tag-out procedure used for equipment under repair?

  Yes

  No

  N/A

• Are lighting, temporary light guards, and bulbs provided?

  Yes

  No

  N/A

• Are worn or frayed cords removed from service?

  Yes

  No

  N/A

• Are grounding pins in place in all cords?

  Yes

  No

  N/A

Tools

• Are power cords or tools in good condition?

  Yes

  No

  N/A

• Are power tools electrically grounded?

  Yes

  No

  N/A

• Are power tools equipped with guards, as required by design, when in use?

  Yes

  No

  N/A

• Are tools & equipment properly stored when not in use?

  Yes

  No

  N/A

• Are operators qualified and/or licensed to operate power tools?

  Yes

  No

  N/A

• Is safety instruction and supervision provided?

  Yes

  No

  N/A

• Are the selected tools appropriate for the job and free of defects or damage?

  Yes

  No

  N/A

• Are tools and cartridges protected from unauthorized use?

  Yes

  No

  N/A

Ladders

• Are ladders extended at least 36 inches above the level of the platform, roof, or other surface?

  Yes

  No

  N/A

• Are ladders secured to prevent slipping, sliding, or falling?

  Yes

  No

  N/A

• Is the material used in the construction of the ladders free from cracks, splits, or other deformities?

  Yes

  No

  N/A

• If climbing height requires a series of offset ladders and platforms, are the platforms at least 2 feet long and equipped with guardrails, intermediate rails, and tow boards?

  Yes

  No

  N/A

• Is each ladder set at the ideal angle of 75 degrees, or one horizontal foot from the structure for every four vertical feet?

  Yes

  No

  N/A

• Are all ladders in doorways or passageways protected by guards or barricades?

  Yes

  No

  N/A

• Are ladders free of any unsecured, hanging tools?

  Yes

  No

  N/A

• Do job-built ladders conform to OSHA requirements?

  Yes

  No

  N/A

• Are metal ladders used around electrical equipment?

  Yes

  No

  N/A

• Are ladders on solid/level surfaces, equipped with safety feet and properly secured?

  Yes

  No

  N/A

• Are workers following proper climbing practice (i.e., not carrying tools or heavy materials up or down)?

  Yes

  No

  N/A

• Are all ladders inspected by competent persons for defects (cracks, loose rungs, etc.) and documented?

  Yes

  No

  N/A

• Are ladders being used for their intended purpose?

  Yes

  No

  N/A

• Do all single rung job-built ladders have breaks in elevation at 30 feet?

  Yes

  No

  N/A

• Do all double rung job-built ladders have breaks in elevation at 24 feet?

  Yes

  No

  N/A

Scaffolds

• Are scaffold loads distributed evenly?

  Yes

  No

  N/A

• Are ropes supporting suspended scaffolds able to support 6 times the load (tested and certified)?

  Yes

  No

  N/A

• Are scaffold platforms and walkways at least 18" wide?

  Yes

  No

  N/A

• Are the ladder jack, top plate bracket, roof bracket, and pump jack scaffold platforms at least 12" wide?

  Yes

  No

  N/A

• Are the front edges of all platforms no more than 14" from the face of the work (3" from the face for outrigger scaffolds and 18" from the face for plastering and lathing operations)?

  Yes

  No

  N/A

• Do all platforms (planks) greater than 10' extend no more than 18" past end support?

  Yes

  No

  N/A

• Is a licensed rigger supervising the construction/erection of the scaffold?

  Yes

  No

  N/A

• Is fall protection provided for all scaffolds at 10 feet?

  Yes

  No

  N/A

• Is protection from falling objects provided (Hardhats, barricades to exclude working below, toe boards at edges of platforms, panels, screens, or canopies)?

  Yes

  No

  N/A

• Is the scaffold being inspected regularly by a competent person and documented?

  Yes

  No

  N/A

• Are the scaffolds being used of the correct type and capacity?

  Yes

  No

  N/A

• Are the platforms fully and properly planked or decked (no more than 1" gaps, ends overlapped at least 6")?

  Yes

  No

  N/A

• Are scaffolds anchored at least every 30 feet and are locking devices/tie-ins secure?

  Yes

  No

  N/A

• Is safe access to the scaffold provided; are ladder ways secured and protected?

  Yes

  No

  N/A

• Are scaffolds free of defects, leveled and properly aligned?

  Yes

  No

  N/A

• Are scaffolds clear of tripping hazards (ice/snow, debris, oil/grease, away from electrical wires, etc.)?

  Yes

  No

  N/A

• If necessary, do all scaffold users have a Local Law 52 4-hour training card?

  Yes

  No

  N/A

• If necessary, do all erecting/dismantling workers have a Local Law 52 32-hour training card?

  Yes

  No

  N/A

• Do all suspended scaffold workers have the required training card?

  Yes

  No

  N/A

Fall Protection

• Is each mid-rail installed at 21 inches above the working surface?

  Yes

  No

  N/A

• Do the wire mesh or screens being used meet the height and strength requirements?

  Yes

  No

  N/A

• Is plastic banding being used as a guardrail?

  Yes

  No

  N/A

• Are guardrails made of wire rope flagged over 6 feet?

  Yes

  No

  N/A

• Is a guardrail system in place that includes a top rail, mid-rail, and toe board?

  Yes

  No

  N/A

• Are horizontal lifelines installed, used under the supervision of a qualified person,tested and certified?

  Yes

  No

  N/A

• Do vertical lifelines or lanyards have a breaking strength of 5,000 pounds (tested & certified)?

  Yes

  No

  N/A

• Do the self-retracting lifelines limit free all to 2 feet and are they capable of sustaining a 3,000 pound load (tested & certified)?

  Yes

  No

  N/A

• Is each worker attached to a separate vertical lifeline?

  Yes

  No

  N/A

• Are chaff guards being used to prevent cutting or abrading?

  Yes

  No

  N/A

• Is the personal fall arrest system being inspected before each use and documented?

  Yes

  No

  N/A

• Are the anchorages assembled under the supervision of a qualified person and capable of supporting at least 5,000 pounds (tested/certified/documented)?

  Yes

  No

  N/A

• Is the height of each top rail 42 inches (+/- 3 inches) above the working surface?

  Yes

  No

  N/A

• Are chains, gates, or removable guardrails in place in hoist areas (when no hoisting is taking place)?

  Yes

  No

  N/A

Excavation

• Do excavating and trenching operations conform with established NYC codes?

  Yes

  No

  N/A

• Are underground utilities in the area identified, located, and supported?

  Yes

  No

  N/A

• Are trenches 5 feet or more (and all excavations where employees are exposed to danger from moving ground or cave-in) shored, supported, or sloped back to the angle of repose?

  Yes

  No

  N/A

• Are daily inspections of trenches and excavations being made (and monitored for stability and documented)?

  Yes

  No

  N/A

• Does any evidence of a cave-in or slide result in stop work order until all necessary precautions are taken?

  Yes

  No

  N/A

• Is all spoil and material placed at least 2 feet from the edge?

  Yes

  No

  N/A

• Are substantial barricades installed at the edge of excavations?

  Yes

  No

  N/A

• Are the materials used for sheeting, shoring, or bracing in good condition; are the timbers sound, free of large or loose knots, and of adequate dimensions?

  Yes

  No

  N/A

• Are walkways or bridges with standard guardrails provided where workers or equipment must crossover excavations or trenches?

  Yes

  No

  N/A

• For any excavation/trench at least 4 feet deep, are ladders provided, secured and placed no more than 25 feet apart, extended 3 feet above the upper level?

  Yes

  No

  N/A

• Are sides shored or braced to withstand forces exerted where vehicles or equipment operate near edges of excavations or trenches?

  Yes

  No

  N/A

• Is the atmosphere tested by a competent person prior to entry if oxygen deficiency, hazardous or explosive gases or dust are possible?

  Yes

  No

  N/A

• Are trenches or excavations covered, guarded, or back filled overnight or when unattended?

  Yes

  No

  N/A

Welding & Cutting

• Are hoses and cords in good condition, not in standing water, and out of the way?

  Yes

  No

  N/A

• Are welders using appropriate PPE (welding jacket, gloves, helmet, & goggles)?

  Yes

  No

  N/A

• Are fire extinguishers/fire watches/fire guards in place?

  Yes

  No

  N/A

• Do welders have appropriate licenses/certificates?

  Yes

  No

  N/A

• Is ventilation provided (as appropriate)?

  Yes

  No

  N/A

• Are cylinders stored properly, caps on, fuel and oxygen separated by 20' distance?

  Yes

  No

  N/A

• Are screens and shields in place?

  Yes

  No

  N/A

Confined Space

• Have all workers involved in confined space entry completed a training program?

  Yes

  No

  N/A

• Has any required air sampling been completed and documented?

  Yes

  No

  N/A

• Has the required ventilation been provided and made functional?

  Yes

  No

  N/A

• Is a stand-by person in place, and is emergency equipment available?

  Yes

  No

  N/A

• Has PPE been specified for the entrants?

  Yes

  No

  N/A

Environmental: Hazardous Materials or Waste

• Is dust protection used to prevent migration off-site?

  Yes

  No

  N/A

• Has there been posting, delineation, or enclosure of hazardous waste area?

  Yes

  No

  N/A

• Are hazardous waste storage areas covered, diked with overflow spill basin?

  Yes

  No

  N/A

• Are soils, ground water, and waterways protected from spills or run-off?

  Yes

  No

  N/A

• Is the shipper licensed & certified; is the ultimate disposal site EPA approved?

  Yes

  No

  N/A

• Has the personnel training (i.e., HAZWOPER) been completed and are the files maintained?

  Yes

  No

  N/A

• Are the hazardous waste management specifications, HASP, contingency plan, and communication emergency plan in place?

  Yes

  No

  N/A

• Is fire protection and personnel protection provided?

  Yes

  No

  N/A

• Do containers integrity, marking, labeling meet requirements?

  Yes

  No

  N/A

• Are inspections performed according to procedures and documented?

  Yes

  No

  N/A

• If this is an environmental site, is there a site program including medical clearance records?

  Yes

  No

  N/A

Health Hazard

• Are all postings per NYC, NYS, and USEPA rules (where applicable)?

  Yes

  No

  N/A

• Does all sampling include inside and outside containment as required in specifications and per regulations?

  Yes

  No

  N/A

• Are workers using required personal protection equipment?

  Yes

  No

  N/A

• Has post-abatement sampling been conducted, and were areas cleared before re-occupancy?

  Yes

  No

  N/A

• Has abatement work been separated, isolated from other construction, and set-up per specifications?

  Yes

  No

  N/A

Hazard Communication

• Does the contractor have a written program onsite?

  Yes

  No

  N/A

• Have the employees been trained in HazCom and is the training documented?

  Yes

  No

  N/A

Cranes

• Have cranes been inspected and have all deficiencies been corrected prior to start of work on project?

  Yes

  No

  N/A

• Do operators possess crane operator certifications?

  Yes

  No

  N/A

• Are all crane permits obtained and on-site?

  Yes

  No

  N/A

• Is a readable load chart in the crane cab?

  Yes

  No

  N/A

• Are nylon slings used in accordance with manufacturer's requirements?

  Yes

  No

  N/A

• Do all members of a crane jumping crew have appropriate training certifications?

  Yes

  No

  N/A

• Has a crane safety coordination meeting been conducted?

  Yes

  No

  N/A

• Has a pre-jump safety meeting been held?

  Yes

  No

  N/A

• Has a plan for raising or lowering a crane been submitted to the DOB?

  Yes

  No

  N/A

• Are tag lines in use for control lines?

  Yes

  No

  N/A

• Does rigging meet OSHA requirements and industry practice?

  Yes

  No

  N/A

• Is the hoist-hook block labeled with the maximum capacity?

  Yes

  No

  N/A

• Is the equipment firmly supported on solid mats or cribbing?

  Yes

  No

  N/A

• Are outriggers used and in fully extended position?

  Yes

  No

  N/A

• Are power lines de-energized, clearances maintained, lines insulated or removed to safe distance?

  Yes

  No

  N/A

• Is the crane grounded?

  Yes

  No

  N/A

• Are the standard signals understood, posted, and used by a designated signalman?

  Yes

  No

  N/A

• Are the swing radius barricades in place; is any material stored within the swing radius?

  Yes

  No

  N/A

• Does the high wind operating restriction level exceed 30 mph or the manufacturer's limits?

  Yes

  No

  N/A

• Are chokers, chains, wire ropes, slings hooks, and shackles inspected and maintained?

  Yes

  No

  N/A

• Has the crane been inspected and certified by the engineer of record?

  Yes

  No

  N/A

Heavy Equipment

• Are operators following manufacturer guidelines for safe operation of equipment?

  Yes

  No

  N/A

• Are operators licensed, qualified/tested for the equipment they are operating (i.e., forklifts, lulls, etc.)?

  Yes

  No

  N/A

• Are appropriate permits obtained pursuant to NYC DOB/DOT codes (where applicable)?

  Yes

  No

  N/A

• Is speed limit control enforced (no more than 10 mph on site)?

  Yes

  No

  N/A

• Are flagmen used for directing vehicles in traffic as needed and per code requirements?

  Yes

  No

  N/A

• Are fire extinguishers installed on equipment?

  Yes

  No

  N/A

• Are operators complying with rollover protection and seatbelt use requirements?

  Yes

  No

  N/A

• Are all local, state, and federal motor vehicle laws and regulations being observed?

  Yes

  No

  N/A

• Are back-up alarms installed on pick-ups and larger vehicles with obstructed rear views?

  Yes

  No

  N/A

• Are accident/incident report forms in glove compartment of all licensed vehicles?

  Yes

  No

  N/A

Pile Driving

• Are piles, casings, and equipment stored orderly and securely?

  Yes

  No

  N/A

• Is equipment inspected and maintained as required by manufacturer?

  Yes

  No

  N/A

• Are tag lines used to guide pile into lead (installation location)?

  Yes

  No

  N/A

• Is equipment rigged so loft worker can use safety harness; Is harness being used?

  Yes

  No

  N/A

• Is proper signaling being used by a single designated signal person?

  Yes

  No

  N/A

• Is an ear protection area posted and used?

  Yes

  No

  N/A

• Is the loft worker off the lead before pile driving begins?

  Yes

  No

  N/A

• If equipped with a loft platform, are standard guardrails used?

  Yes

  No

  N/A

Concrete Construction

• Are forms properly installed and braced?

  Yes

  No

  N/A

• Is the area restricted during form stripping?

  Yes

  No

  N/A

• Is all rebar capped or bent over to prevent impalement?

  Yes

  No

  N/A

• Is a concrete safety manager on site for 2,000 cubic yard pours?

  Yes

  No

  N/A

• Do workers climbing forms have fall protection at 6' and higher?

  Yes

  No

  N/A

Steel Erection

• Has controlling contractor provided erector with safe site layout, including pre-planning routes for hoisting loads?

  Yes

  No

  N/A

• Is there a site specific erection plan?

  Yes

  No

  N/A

• Is the contractor meeting the requirement of 4 anchor bolts per column?

  Yes

  No

  N/A

• Are dockers in a controlled decking zone and connectors protected at heights greater than 2 stories or 30 feet?

  Yes

  No

  N/A

• Are all connectors between 15 and 30 feet wearing fall arrest or restraint equipment; can they be tied off or be provided another means of fall protection?

  Yes

  No

  N/A

• Are the controlled decking zone provisions adequate and being followed?

  Yes

  No

  N/A

• Have all exposed workers been trained in fall protection?

  Yes

  No

  N/A

Demolition

• Has the operation been planned properly; Has the contractor obtained NYC permits prior to commencing (where applicable)?

  Yes

  No

  N/A

• If needed, has shoring of adjacent structures occurred?

  Yes

  No

  N/A

• Have trash chutes, hoppers, gondolas, and barrels been provided?

  Yes

  No

  N/A

• Has an operating space been cleared for trucks and other vehicles?

  Yes

  No

  N/A

• Are there dust suppression and falling debris controls in place?

  Yes

  No

  N/A

• Are fire protection systems maintained?

  Yes

  No

  N/A

• Does the contractor have on site Chapter 33 of the NYC DOB (where applicable)?; Is contractor in compliance with Chapter 33 (where applicable)?

  Yes

  No

  N/A

Interior, Vertical Openings and Covers

• Are covers subject to loads from workers, equipment, or material capable of supporting twice the maximum load to which they may be subjected?

  Yes

  No

  N/A

• Are vertical openings and holes properly covered and marked with the words "Hole/Cover"?

  Yes

  No

  N/A