Information

  • Job Name/Number

  • Job Address

  • Geotag
  • Job Superintendent/Foreman

  • Solex Employees on site

  • Conducted on

  • Prepared by

Program Administration

  • Is the Solex Safety Banner hung up at site entrance?

  • Picture of banner

  • Is the Solex 2016 I&IPP/Codes of Safe Practices book available for review?

  • Is the Solex Job Site Safety Binder on-site?

  • Has the Solex Daily Job Site Safety Analysis (JSA) been filled out?

  • Has every employee on site reviewed and signed the JSA?

  • Does the JSA cover all hazards in detail. (tools, lifts, falls, scaffolds, RF exposure, etc.)

  • Is the Emergency Action Plan filled out?

  • Is the Solex Emergency Calling Tree available?

  • Has the Weekly Tailgate Meetings been completed with individual signatures of each person on site?

  • Has all applicable inspection forms been completed? (equipment operator inspection, trench inspection, etc.)

  • Is drinking water available on site?

  • Deficiencies Found

Hazard Communications

  • Are SDS forms for Solex purchased items available on site? (i.e. glues, paints, etc.)

  • Do subcontractors have their SDS sheets on site? (i.e. paint, epoxy, etc.)

  • Deficiencies Found

Medical

  • Is an ANSI rated 1st Aid Kit available and properly stocked?

  • Picture of first aid kit in accessible and visible location

  • Is there at least two certified 1st Aid/CPR trained employees on site?

  • Deficiencies Found

Fire prevention and protection

  • Is there type ABC fire extinguisher(s) readily available for immediate use on site?

  • Is there a fire extinguisher available for each separate work area? (i.e. rooftop and lower level equipment room)

  • Picture of fire extinguisher(s) in accessible and visible location

  • Are flammable liquids stored in metal safety cans and properly labeled?

  • Picture of Flammable liquid storage

  • Are all work areas clear of combustible scraps and debris?

  • Are all emergency exit pathways kept clear?

  • Are fire lanes kept clear so emergency vehicles can enter the site?

  • "No smoking" signs posted and enforced? Note: part of Solex Safety Banner

  • Deficiencies Found

Personal protective equipment

  • Is proper personal protective equipment being used when required?

  • Are Hard Hats being worn at all times?

  • Picture of hardhats being worn

  • Are all employees wearing Z-87 Safety Glasses on site?

  • Are safety glasses appropriate for lighting conditions?

  • Is face protection being used when needed? Face shields for grinders or chop saws.

  • Is proper footwear being worn by all personnel?

  • Is hearing protection being used when needed?

  • Is respiratory protection being used when needed?

  • Is fall protection being used when required? (exposure to falls of 6 feet or greater to a lower level)

  • Are personnel using cut resistant gloves when handling sharp/rough material or tools?

  • Are all employees wearing long pants and shirts with minimum 4 inch sleeves?

  • Deficiencies Found

Ladders

  • Are ladders on site?

  • Ladders
  • Is the proper ladder for the job being used?

  • Picture of ladders

  • Are ladder inspections being performed?

  • Are ladders in good condition (no missing or broken rungs)?

  • Metal ladders are NOT being used?

  • Multi purpose, adjustable ladders are NOT being used?

  • Are defective ladders immediately withdrawn from service and marked "do not use" or destroyed?

  • Is 100% fall protection being used for working on ladders greater than 6 feet in height?

  • Deficiencies Found

  • Are step ladders on site?

  • Ladders
  • Are step ladders fully open when in use?

  • Is employee not standing on top two rungs of step ladder?

  • Are extension ladders on site?

  • Extension ladders
  • Are extension ladders being set up at a 4 to 1 ratio?

  • Are extension ladders tied off or secured at top?

  • Do siderails extend 36 inches above the top of opening or has a handgrip been put in place 36 inches high?

Scaffolding

  • Is scaffolding on site?

  • Scaffolding
  • Has scaffolding been erected correctly?

  • Picture of scaffolding

  • Is scaffold erected on a firm and substantial surface?

  • Are scaffolds fully planked?

  • Are toeboards and guardrails in place on scaffolding?

  • Is a green tag in place and signed by a certified competent erector on all scaffolds? (scaffold company erector green tag)

  • Are workers tied off by an independent vertical life line while on yellow tagged scaffold?

  • Is the Solex daily inspection tag in place and signed by the supervisor for everyday the scaffold is being used.

  • Deficiencies Found

  • Is there rolling scaffolding (baker type) on site?

  • Rolling scaffolding
  • Do rolling scaffolds have locking wheels and are locked when used?

  • Picture of rolling scaffold (baker type)

Tools

  • Are the power tools with cords on site?

  • Power tools
  • Are cords in good condition not frayed, damaged or missing ground pins?

  • Picture of tools

  • Are handles, shields, and guards on all tools in good condition and being used correctly?

  • Are hoses on air or hydraulic tools in good condition and attached securely?

  • Does air tools have automatic air shut off for accidental release or whip ties at connections joints to prevent whip action?

  • Deficiencies Found

Electrical

  • Is electrical lockout/tag out needed?

  • Lockout
  • Are all switch panels and devices that are energized marked and guarded to prevent accidental contact?

  • Are lockout devices used on all circuits that could become energized while work is being performed?

  • Do all employees working on the circuit have control over the lockout device?

  • Is live electrical work being completed?
  • Is live electrical work being completed by certified licensed electricians or Specific Equipment Qualified Persons (SEQP)?

  • Are rated insulated tools being used?

  • Is proper NFPA 70E category electrical PPE being worn?

  • Are fish tapes non-metallic?

  • Is there temporary electrical supply on site?

  • Temp Electrical
  • Is temporary lighting per the electrical wiring standard? (proper flexible cords, junction boxes or receptacles, no exposed wire nuts, etc.)

  • Are all temporary lights in work areas and supply trailers protected with guard? Are guards closed, bulbs in place, and not burned out?

  • Picture of temp lighting

  • Is temporary lighting hung by non-conductive material?

  • Deficiencies Found

  • Are temporary receptacles affixed to walls or stands? (wall mounted, spider box, etc.)

  • Are there any visual signs of outlet overloading?

  • Are temporary circuits properly guarded and grounded with GFCI protection?

  • 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)

  • Are extension cords on site?

  • Extension Cords
  • Are OSHA approved type extension cords being used on job site? Only UL Listed, rated at a minimum, HARD USAGE, no general type allowed.

  • Are extension cords being correctly used? They are not fastened with staples, hung from nails, or suspended by wire?

  • Are extension cords not damaged, frayed, missing ground pins, and are of the three wire type?

  • Do all cords have ground prongs and are not bent or broken?

  • Are all extension cords protected by GFCI at source of power?

  • Are extension cords protected from sharp edges and doorways? (i.e. protective sleeves at doorways or over metal stud track)

Trenching and excavation

  • Is there currently trenching and excavation taking place on site?

  • Trenching and Excavation
  • Do the subs have a competent person on site when deeper than 4 feet?

  • Has the competent person form for trenches deeper than 4 feet been signed?

  • Are all trenches and excavations properly barricaded? (i.e. danger/caution tape with delineators)

  • Does trenches have floor coverings at access/egress walk paths supporting at minimum 400 lbs.?

  • Picture of trenches

  • Is all excavated material properly stored 2 feet or more from edge?

  • In trenches more than 4 feet deep, are ladders within 25 feet travel distance?

  • Is protective shoring or trench boxes in place for trenches deeper than 4 feet?

  • If shoring or boxes are in place, is the tabulated data available on-site?

  • Is proper sloping being used for trenches?

  • Deficiencies Found

Welding

  • Is Welding/soldering currently taking place?

  • Welding
  • Has a hot work permit been obtained and on-site?

  • Is a fire extinguisher within range of welding/soldering work?

  • Are fire blankets being used where needed?

  • Are all shields, helmets and goggles in place and in good condition?

  • Picture of PPE for Welding

  • Have all cylinders been chained upright with valve caps in place?

  • Are hoses and gauges in good working order?

  • Are inspections for fire hazards be done when welding is completed?

  • Deficiencies Found

General

  • Are competent person forms for each sub on site?

  • Are proper housekeeping procedures being performed daily?

  • Are all tools and materials properly stored and placed so as not to produce slip or trip hazards?

  • Are all openings in floors and walls through which employees can fall protected?

  • Are all holes covered, secured, and marked?

  • Are rebar caps in place when needed?

  • Picture of rebar caps

  • Are sanitary systems and supplies available and adequate?

  • Is adequate lighting provided in all work areas?

  • At night is jobsite secure so that unauthorized persons are not at danger from tools, equipment and materials?

  • Are subcontractors being notified in writing when violations are found?

  • Deficiencies Found

  • Are copies of notifications being kept in jobsite safety manual?

  • Notes

  • Subcontractors on site today

  • Picture of violation

  • Picture of violation

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