Statoil SOHO Office Project

• Conducted on

  Date

• Project Name:

• Location:
  Address

• WBS Number:

• Statoil Site Representative:

• Contractors on Location:

• Equipment on Location:

REQUIRED DOCUMENTATION

• OSHA Postings in Place

  Yes

  No

  N/A

• Worker's Comp Posters

  Yes

  No

  N/A

• Safety Programs on site

  Yes

  No

  N/A

• Haz.Com / SDS

  Yes

  No

  N/A

• Emergency Telephone List

  Yes

  No

  N/A

• Emergency Action Plan and Routes posted

  Yes

  No

  N/A

• JSA's are completed / reviewed for accuracy

  Yes

  No

  N/A

• Safety Meetings Documented

  Yes

  No

  N/A

• Specialized Equipment Training Documented

  Yes

  No

  N/A

SITE / MISCELLANEOUS

• Food and waste controlled

  Yes

  No

  N/A

• Restrooms in order

  Yes

  No

  N/A

• First Aid Kit on Site

  Yes

  No

  N/A

• Persons Trained in First-aid/CPR

  Yes

  No

  N/A

• Eye Wash Station

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Chemicals / Flammable Materials Properly Stored

  Yes

  No

  N/A

• All Hazardous Materials Properly Labeled

  Yes

  No

  N/A

• Warning Signs Prominently Displayed

  Yes

  No

  N/A

• Notices Posted at Entrances

  Yes

  No

  N/A

• Water, cups and trash can provided

  Yes

  No

  N/A

• Smoke Detectors Protected / Heat Sensors

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Everyone Wearing Hardhats

  Yes

  No

  N/A

• Safety Toe Boots

  Yes

  No

  N/A

• Safety Glasses / Goggles / Face Shields as Required

  Yes

  No

  N/A

• Respirators / Dust Masks

  Yes

  No

  N/A

• Hearing Protection if Required

  Yes

  No

  N/A

• Hand protection / Arm Protection

  Yes

  No

  N/A

HOUSEKEEPING

• Job Site Free of Accumulated Trash and Debris

  Yes

  No

  N/A

• Dumpsters on Site for Waste

  Yes

  No

  N/A

• Passageways and Walkways Clear

  Yes

  No

  N/A

• Materials Free of Protruding Nails and Screws

  Yes

  No

  N/A

• Construction Materials Properly Stacked and Not Scattered

  Yes

  No

  N/A

• Spills, Leaks or Other Hazards

  Yes

  No

  N/A

ELECTRICAL

• Ground Fault System Operational and Being Used by All Contractors

  Yes

  No

  N/A

• All Extension Cords Marked With Owner's Name

  Yes

  No

  N/A

• Extension Cords in Good Condition

  Yes

  No

  N/A

• Power tools in Good Condition / Ground Prong in Place

  Yes

  No

  N/A

• Lighting Suitable for Work Areas

  Yes

  No

  N/A

• All Electrical Boxes Properly Covered

  Yes

  No

  N/A

• LOTO implemented correctly / responsible

  Yes

  No

  N/A

• Color code system in place ( Assured Grounding Program)

PORTABLE HAND TOOLS

• Operators Properly Trained (Including powder actuated tools)

  Yes

  No

  N/A

• Powder Strips Picked Up

  Yes

  No

  N/A

• Cord and Tool in Good Condition

  Yes

  No

  N/A

• Guards and handles In Place Where Required

  Yes

  No

  N/A

• Operators Wearing Personal Protective Gear ( face shield , ear plugs, safety glasses)

  Yes

  No

  N/A

• Powder actuator gun stored properly

  Yes

  No

  N/A

MATERIAL HANDLING / FORKLIFTS / HEAVY EQUIPMENT

• Forklifts / Loaders in Operational Condition

  Yes

  No

  N/A

• Back-Up Alarms Working

  Yes

  No

  N/A

• Operators Properly Trained

  Yes

  No

  N/A

• Seat Belts Being Used by All Operators

  Yes

  No

  N/A

• Only Operator Riding on Equipment

  Yes

  No

  N/A

• Rollover Protection

  Yes

  No

  N/A

• Hoists / Elevators in Operational Condition

  Yes

  No

  N/A

FALL PROTECTION

• Guardrails in Place

  Yes

  No

  N/A

• All Guards and Rails Sufficient for Weight

  Yes

  No

  N/A

• Personal Fall Arrest System Being Used When Required

  Yes

  No

  N/A

• Harnesses in Good Condition with Proper Label

  Yes

  No

  N/A

• Openings in Floors and Roof Protected

  Yes

  No

  N/A

• Openings in Walls Protected

  Yes

  No

  N/A

• Impalement Prevention Devices in Place

  Yes

  No

  N/A

LADDERS

• Ladder permits attached

  Yes

  No

  N/A

• Ladders extended 3 ft. Above landing

  Yes

  No

  N/A

• Ladder Tied Off

  Yes

  No

  N/A

• Commercial Ladders in Working Condition

  Yes

  No

  N/A

• Correct Ladder Suitable for Job

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Adequate to Support Intended Use

  Yes

  No

  N/A

SCAFFOLDS

• Competent Person on Site

  Yes

  No

  N/A

• All Components Appear Damage Free

  Yes

  No

  N/A

• Ladder Provided

  Yes

  No

  N/A

• Proper Foundation and Footing

  Yes

  No

  N/A

• Working Levels Fully Planked / Proper Planking

  Yes

  No

  N/A

• Rails and Toe Boards Where Required

  Yes

  No

  N/A

• Rolling / Moveable Units Properly Supported

  Yes

  No

  N/A

Additional Findings:

• Additional Findings:

• Add media

  Media

• Additional Findings:

• Add media

  Media

• Additional Findings:

• Add media

  Media

Signatures:

• Contractor Foreman / Supervisor:

  Sign

• Statoil Site Representative:

  Sign