Information

  • Conducted on

  • Project Name:

  • Location:
  • WBS Number:

  • Statoil Site Representative:

  • Contractors on Location:

  • Equipment on Location:

REQUIRED DOCUMENTATION

  • OSHA Postings in Place

  • Worker's Comp Posters

  • Safety Program

  • Haz.Com / MSDS

  • Certificates of Insurance

  • Emergency Telephone List

  • Emergency Action Plan

  • Safety Meetings Documented

  • HAZCOM Training Documented.

  • Specialized Training Documented

SITE / MISCELLANEOUS

  • First Aid Kit on Site

  • Persons Trained in First-aid/CPR

  • Fire Extinguishers in Place and Charged (Around Site and Near to any Flammable Source)

  • Chemicals / Flammable Materials Properly Stored

  • All Hazardous Materials Properly Labeled

  • Warning Signs Prominently Displayed

  • Notices Posted at Entrances

  • Fuel Containments being Used and Kept Up

  • High Pressure Gas Cylinders Chained in Place

  • Fences Intact and Gates Lockable

PERSONAL PROTECTIVE EQUIPMENT

  • Everyone Wearing Hardhats

  • Safety / Work / Hard Toe Boots

  • Safety Glasses / Goggles / Face Shields as Required

  • Respirators / Dust Masks

  • Hearing Protection if Required

HOUSEKEEPING

  • Job Site Free of Accumulated Trash and Debris

  • Dumpsters on Site for Waste

  • Passageways and Walkways Clear

  • Forms and Materials Free of Protruding Nails and Screws

  • Portable Toilets Clean

  • Construction Materials Properly Stacked and Not Scattered

  • Spills, Leaks or Other Hazards

EXCAVATIONS

  • Competent Person on Site

  • Have Underground Utilities Been Located

  • Trenches / Excavations Properly Barricaded or Covered

  • Trench Protection for Excavations 5' Deep or Over

  • Ladders Properly Located to Surface (No more than 100' apart)

ELECTRICAL

  • Ground Fault System Operational and Being Used by All Contractors

  • Portable Generators GFCI Protected

  • All Extension Cords Marked With Owner's Name

  • Extension Cords in Good Condition

  • Power tools in Good Condition / Ground Prong in Place

  • Lighting Suitable for Work Areas

  • All Electrical Boxes Properly Covered

PORTABLE HAND TOOLS

  • Operators Properly Trained (Including powder actuated tools)

  • Powder Strips Picked Up

  • Cord and Tool in Good Condition

  • Guards In Place Where Required

  • Operators Wearing Personal Protective Gear

MATERIAL HANDLING / FORKLIFTS / HEAVY EQUIPMENT

  • Forklifts / Loaders in Operational Condition

  • Back-Up Alarms Working

  • Operators Properly Trained

  • Seat Belts Being Used by All Operators

  • Only Operator Riding on Equipment

  • Rollover Protection

  • Hoists / Elevators in Operational Condition

CRANES

  • Daily Crane Inspections

  • Operator Properly Trained

  • Swing Radius Properly Identified

  • Tag Line in Use

  • Chokers, Cables, Hooks in Good Condition

FALL PROTECTION (HEIGHTS OF 6 FT. OR MORE)

  • Guardrails in Place

  • All Guards and Rails Sufficient for Weight

  • Personal Fall Arrest System Being Used When Required

  • Harnesses in Good Condition with Proper Label

  • Openings in Floors and Roof Protected

  • Handrails on Stairs

  • Openings in Walls Protected

  • Impalement Prevention Devices in Place

LADDERS

  • Ladders extended 3 ft. Above landing

  • Ladder Tied Off

  • Field Ladders Properly Constructed

  • Commercial Ladders in Working Condition

  • Ladder Suitable for Job

  • Extension Ladders Properly Joined, Secured in Place at Top and Bottom

  • Adequate to Support Intended Use

SCAFFOLDS

  • Competent Person on Site

  • All Components Appear Damage Free

  • Ladder Provided

  • Proper Foundation and Footing

  • Working Levels Fully Planked / Proper Planking

  • Properly Secured - Tied Off at Required Intervals

  • Rails and Toe Boards Where Required

  • Rolling / Moveable Units Properly Supported

WELDING & CUTTING

  • Leads and Connections in Good Condition

  • Hoses in Operational Condition

  • Compressed Gas Cylinders Properly Stored

  • Gauges / Regulators in Working Order

  • Fire Extinguisher at all Welding/Cutting Locations

Conclusion

Additional Findings:

  • Additional Findings:

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  • Additional Findings:

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  • Additional Findings:

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Signatures:

  • Contractor Foreman / Supervisor:

  • Statoil Site Representative:

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