SPARTAN CONCRETE SAFETY WALK

• Project

  Select

• General Contractor

• Date + Time

  Date
• Location
  Address

• Conducted By

• Site Representative

• Phase

GENERAL

• SSSP Complete

  Yes

  No

  N/A

• Near Misses Reported

  Yes

  No

  N/A

• OSHA Required Posters

  Yes

  No

  N/A

• Evacuation Plan Posted

  Yes

  No

  N/A

• Emergency Contact List Posted

  Yes

  No

  N/A

• First Aid Kit Available

  Yes

  No

  N/A

• Eye Wash Station Available

  Yes

  No

  N/A

• MSDS on Site

  Yes

  No

  N/A

WORK SPACES

• Site Office + Connex Housekeeping

  Good

  Fair

  Poor

  N/A

• Project Housekeeping

  Good

  Fair

  Poor

  N/A

• Egress

  Good

  Fair

  Poor

  N/A

• Impalement Hazards

  Good

  Fair

  Poor

  N/A

• Sanitary Facilites

  Good

  Fair

  Poor

  N/A

• Material Storage/ Laydown

  Good

  Fair

  Poor

  N/A

PPE

• Hard Hats

  Compliant

  Non-Compliant

  N/A

• Safety Glasses

  Compliant

  Non-Compliant

  N/A

• Proper Footwear

  Compliant

  Non-Compliant

  N/A

• Face Shield (PRN)

  Compliant

  Non-Compliant

  N/A

• Respirator (PRN)

  Compliant

  Non-Compliant

  N/A

• Gloves (PRN)

  Compliant

  Non-Compliant

  N/A

FALL PROTECTION

• Temporary Guard Rails

  Good

  Fair

  Poor

  N/A

• In Good-Working Condtion

  Good

  Fair

  Poor

  N/A

• Certifications Up-to-Date

  Yes

  No

  N/A

• Properly Worn

  Yes

  No

  N/A

• Qualified Anchorage Points

  Yes

  No

  N/A

• JHA Complete

  Yes

  No

  N/A

RIGGING + HOISTING

• Hooks + Latches Intact

  Good

  Fair

  Poor

  N/A

• Chains + Straps Intact

  Good

  Fair

  Poor

  N/A

• Rigger Certification Up-to-Date

  Good

  Fair

  Poor

  N/A

LADDERS

• In Good-Working Condition

  Good

  Fair

  Poor

  N/A

• Labeled

  Yes

  No

  N/A

• Fastened at Top & Bottom (Extension)

  Yes

  No

  N/A

• Properly Used

  Yes

  No

  N/A

TOOLS

• In Good-Working Condition

  Good

  Fair

  Poor

  N/A

• Protective Components Attached

  Yes

  No

  N/A

• GFCI Cords Intact

  Good

  Fair

  Poor

  N/A

EXCAVATION (PRN)

• Compliant Access + Egress

  Yes

  No

  N/A

• Water Accumulation

  Safe

  At Risk

  N/A

• Proper Shoring (PRN)

  Yes

  No

  N/A

• Emergency Rescue Plan

  Yes

  No

  N/A

CONFINED SPACES (PRN)

• Certified Personnel

  Yes

  No

  N/A

• Sign-In Sheet

  Yes

  No

  N/A

• Permit On-Hand

  Yes

  No

  N/A

• Air Monitroing

  Yes

  No

  N/A

• Emergency Rescue Plan

  Yes

  No

  N/A

• COMMENTS

• SIGNATURE

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