Information
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Client / Site
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Conducted on
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Prepared by
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Location
Administrative/Housekeeping/PPE
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Daily Tailboard completed and signed
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Project JHA signed
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Clinic / Hospital Directions Posted
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SDS's available on site (hard copy or electronic)
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Spill Kit on site
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State Labor Law Poster is displayed
Housekeeping
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Work Areas clean and unobstructed
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Cords/leads/hoses elevated or protected
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Cones and/or tape around floor openings
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Cones and/or tape around open Trenwa
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Crating material stacked neatly with nails removed or bent over
PPE
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Cut resistant gloves worn as needed
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Hearing protection worn above 90 dBa
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Safety Glasses (including prescription) with side shields
Hand and Power Tools
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Power tools / cords GFCI protected
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Manufacturer guards are in place and functioning
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Cords are in good shape - no tears or cuts in the outer jacket, ground prong present
Falls/Work at Heights
Ladders
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Ladder inspection reveals spreaders locked, no cracks in the fiberglass or bent/missing hardware
Fall Protection
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PFA equipment inspected annually
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PFA equipment worn with all buckles, snaps and fasteners secure and snug
Hot Work Operations
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Hot Work permit completed and posted
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Welding curtains/screens are used in high traffic areas
Excavations
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Soil is sloped 1 1/2 (Horizontal) to 1 (Vertical) when deeper than 5 feet
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One Call or GPR markings are visible?
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Egress no more than 25' away when the excavation is deeper than 4'
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Visual indicators (e.g. cones/flagging) are along trenches, trenwa or other steep sided excavations.
Aerial LIfts / Cranes
Aerial LIfts (Articulating Booms & Scissors)
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Aerial Iift floors are free from excess materials and debris
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Equipment Grounds are installed
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Workers tied off to the manufactured anchor points, using SRL's.
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Workers feet are on the floor of the platform
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Operator has training certification for the equipment being operated
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Spotter used in congested areas
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Workers are maintaining the required minimum approach distances
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Physical protection set up to protect equipment located below the work area.
Cranes
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Crane swing radius cordoned off
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No one is working below a suspended load
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Crane cribbing or outrigger pads are level and 3-5 times the size of the oputrigger floats
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Crane has functioning anti-two block device
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A spotter is used when working around energized lines
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Monthly crane inspection is complete and documented
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Crane paperwork is current (3rd party inspection, operators license, crane registration, etc)
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Rigging tags are legible and slings are free from deficiencies
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Equipment grounds are installed on the crane
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Hooks for all rigging have functioning safety latches
Manual & Mechanical Material Handling
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Workers are using mechanical lifting aids where feasible
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Workers position themselves to avoid getting caught between equipment and fixed objects
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Forklift operators have valid certifcates/training for the equipment being operated
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Manufacturer approved attachment is used for rigging material & equipment below the forks
Miscellaneous
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Comments
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