Information
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Job Name/Number
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Job Address
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Geotag
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Job Superintendent/Foreman
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Solex Employees on site
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Conducted on
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Prepared by
Program Administration
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Is the Solex Safety Banner hung up at site entrance?
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Picture of banner
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Is the Solex 2016 I&IPP/Codes of Safe Practices book available for review?
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Is the Solex Job Site Safety Binder on-site?
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Has the Solex Daily Job Site Safety Analysis (JSA) been filled out?
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Has every employee on site reviewed and signed the JSA?
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Does the JSA cover all hazards in detail. (tools, lifts, falls, scaffolds, RF exposure, etc.)
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Is the Emergency Action Plan filled out?
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Is the Solex Emergency Calling Tree available?
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Has the Weekly Tailgate Meetings been completed with individual signatures of each person on site?
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Has all applicable inspection forms been completed? (equipment operator inspection, trench inspection, etc.)
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Is drinking water available on site?
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Deficiencies Found
Hazard Communications
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Are SDS forms for Solex purchased items available on site? (i.e. glues, paints, etc.)
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Do subcontractors have their SDS sheets on site? (i.e. paint, epoxy, etc.)
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Deficiencies Found
Medical
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Is an ANSI rated 1st Aid Kit available and properly stocked?
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Picture of first aid kit in accessible and visible location
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Is there at least two certified 1st Aid/CPR trained employees on site?
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Deficiencies Found
Fire prevention and protection
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Is there type ABC fire extinguisher(s) readily available for immediate use on site?
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Is there a fire extinguisher available for each separate work area? (i.e. rooftop and lower level equipment room)
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Picture of fire extinguisher(s) in accessible and visible location
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Are flammable liquids stored in metal safety cans and properly labeled?
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Picture of Flammable liquid storage
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Are all work areas clear of combustible scraps and debris?
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Are all emergency exit pathways kept clear?
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Are fire lanes kept clear so emergency vehicles can enter the site?
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"No smoking" signs posted and enforced? Note: part of Solex Safety Banner
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Deficiencies Found
Personal protective equipment
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Is proper personal protective equipment being used when required?
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Are Hard Hats being worn at all times?
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Picture of hardhats being worn
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Are all employees wearing Z-87 Safety Glasses on site?
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Are safety glasses appropriate for lighting conditions?
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Is face protection being used when needed? Face shields for grinders or chop saws.
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Is proper footwear being worn by all personnel?
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Is hearing protection being used when needed?
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Is respiratory protection being used when needed?
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Is fall protection being used when required? (exposure to falls of 6 feet or greater to a lower level)
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Are personnel using cut resistant gloves when handling sharp/rough material or tools?
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Are all employees wearing long pants and shirts with minimum 4 inch sleeves?
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Deficiencies Found
Ladders
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Are ladders on site?
Ladders
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Is the proper ladder for the job being used?
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Picture of ladders
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Are ladder inspections being performed?
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Are ladders in good condition (no missing or broken rungs)?
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Metal ladders are NOT being used?
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Multi purpose, adjustable ladders are NOT being used?
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Are defective ladders immediately withdrawn from service and marked "do not use" or destroyed?
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Is 100% fall protection being used for working on ladders greater than 6 feet in height?
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Deficiencies Found
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Are step ladders on site?
Ladders
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Are step ladders fully open when in use?
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Is employee not standing on top two rungs of step ladder?
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Are extension ladders on site?
Extension ladders
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Are extension ladders being set up at a 4 to 1 ratio?
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Are extension ladders tied off or secured at top?
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Do siderails extend 36 inches above the top of opening or has a handgrip been put in place 36 inches high?
Scaffolding
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Is scaffolding on site?
Scaffolding
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Has scaffolding been erected correctly?
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Picture of scaffolding
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Is scaffold erected on a firm and substantial surface?
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Are scaffolds fully planked?
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Are toeboards and guardrails in place on scaffolding?
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Is a green tag in place and signed by a certified competent erector on all scaffolds? (scaffold company erector green tag)
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Are workers tied off by an independent vertical life line while on yellow tagged scaffold?
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Is the Solex daily inspection tag in place and signed by the supervisor for everyday the scaffold is being used.
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Deficiencies Found
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Is there rolling scaffolding (baker type) on site?
Rolling scaffolding
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Do rolling scaffolds have locking wheels and are locked when used?
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Picture of rolling scaffold (baker type)
Tools
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Are the power tools with cords on site?
Power tools
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Are cords in good condition not frayed, damaged or missing ground pins?
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Picture of tools
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Are handles, shields, and guards on all tools in good condition and being used correctly?
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Are hoses on air or hydraulic tools in good condition and attached securely?
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Does air tools have automatic air shut off for accidental release or whip ties at connections joints to prevent whip action?
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Deficiencies Found
Electrical
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Is electrical lockout/tag out needed?
Lockout
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Are all switch panels and devices that are energized marked and guarded to prevent accidental contact?
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Are lockout devices used on all circuits that could become energized while work is being performed?
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Do all employees working on the circuit have control over the lockout device?
Is live electrical work being completed?
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Is live electrical work being completed by certified licensed electricians or Specific Equipment Qualified Persons (SEQP)?
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Are rated insulated tools being used?
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Is proper NFPA 70E category electrical PPE being worn?
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Are fish tapes non-metallic?
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Is there temporary electrical supply on site?
Temp Electrical
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Is temporary lighting per the electrical wiring standard? (proper flexible cords, junction boxes or receptacles, no exposed wire nuts, etc.)
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Are all temporary lights in work areas and supply trailers protected with guard? Are guards closed, bulbs in place, and not burned out?
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Picture of temp lighting
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Is temporary lighting hung by non-conductive material?
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Deficiencies Found
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Are temporary receptacles affixed to walls or stands? (wall mounted, spider box, etc.)
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Are there any visual signs of outlet overloading?
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Are temporary circuits properly guarded and grounded with GFCI protection?
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Is there any job made outlets with extension cords affixed? (these type are not allowed and must be removed, only UL Listed types rated for hard usage)
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Are extension cords on site?
Extension Cords
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Are OSHA approved type extension cords being used on job site? Only UL Listed, rated at a minimum, HARD USAGE, no general type allowed.
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Are extension cords being correctly used? They are not fastened with staples, hung from nails, or suspended by wire?
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Are extension cords not damaged, frayed, missing ground pins, and are of the three wire type?
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Do all cords have ground prongs and are not bent or broken?
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Are all extension cords protected by GFCI at source of power?
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Are extension cords protected from sharp edges and doorways? (i.e. protective sleeves at doorways or over metal stud track)
Trenching and excavation
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Is there currently trenching and excavation taking place on site?
Trenching and Excavation
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Do the subs have a competent person on site when deeper than 4 feet?
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Has the competent person form for trenches deeper than 4 feet been signed?
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Are all trenches and excavations properly barricaded? (i.e. danger/caution tape with delineators)
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Does trenches have floor coverings at access/egress walk paths supporting at minimum 400 lbs.?
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Picture of trenches
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Is all excavated material properly stored 2 feet or more from edge?
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In trenches more than 4 feet deep, are ladders within 25 feet travel distance?
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Is protective shoring or trench boxes in place for trenches deeper than 4 feet?
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If shoring or boxes are in place, is the tabulated data available on-site?
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Is proper sloping being used for trenches?
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Deficiencies Found
Welding
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Is Welding/soldering currently taking place?
Welding
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Has a hot work permit been obtained and on-site?
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Is a fire extinguisher within range of welding/soldering work?
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Are fire blankets being used where needed?
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Are all shields, helmets and goggles in place and in good condition?
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Picture of PPE for Welding
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Have all cylinders been chained upright with valve caps in place?
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Are hoses and gauges in good working order?
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Are inspections for fire hazards be done when welding is completed?
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Deficiencies Found
General
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Are competent person forms for each sub on site?
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Are proper housekeeping procedures being performed daily?
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Are all tools and materials properly stored and placed so as not to produce slip or trip hazards?
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Are all openings in floors and walls through which employees can fall protected?
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Are all holes covered, secured, and marked?
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Are rebar caps in place when needed?
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Picture of rebar caps
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Are sanitary systems and supplies available and adequate?
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Is adequate lighting provided in all work areas?
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At night is jobsite secure so that unauthorized persons are not at danger from tools, equipment and materials?
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Are subcontractors being notified in writing when violations are found?
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Deficiencies Found
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Are copies of notifications being kept in jobsite safety manual?
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Notes
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Subcontractors on site today
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Picture of violation
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Picture of violation