TCEPA Field Safety Observations

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Job Site Information

• Person conducting inspection

• Date and Time of Visit

  Date

• Crew Leader or person in charge

• Location of job site

• Service area

• Work Order #

Job Communications

• Is the job briefing complete and correct?

  Yes

  No

  N/A

• Are job assignments clearly communicated?

  Yes

  No

  N/A

• Ground watchman assigned?

  Yes

  No

  N/A

• Is work to be performed energized or de-energized?

  Energized

  De-energized

• Job Breifing

  Media

• Crew Members and Assignments

  Media

• Work Order Drawing

  Media

Personal Protective Equipment

• Are hard hats being worn at all times?

  Yes

  No

  N/A

• Is eye protection being worn at all times?

  Yes

  No

  N/A

• Are rubber gloves being used when required?

  Yes

  No

  N/A

• Were rubber gloves tested prior to use?

  Yes

  No

  N/A

• Is FR clothing policy being followed?

  Yes

  No

  N/A

• Are leather work gloves being used at all times?

  Yes

  No

  N/A

• Are there any other forms of PPE needed?

  Yes

  No

  N/A

Personal Tools and Climbing Gear

• Was climbing gear inspected prior to use?

  Yes

  No

  N/A

• Are gaff guards in use while hooks are not in use?

  Yes

  No

  N/A

• Are all hand tools being used properly?

  Yes

  No

  N/A

Energized Work Observations

• Is "hot work" being observed and conducted with care?

  Yes

  No

  N/A

• Has a "one shot" been applied?

  Yes

  No

  N/A

• Are "hold" cards in place?

  Yes

  No

  N/A

• Has the service area dispatch been notified?

  Yes

  No

  N/A

• Is adequate cover-up being used?

  Yes

  No

  N/A

• Has the line been de-energized?

  Yes

  No

  N/A

• Has a visual opening been achieved?

  Yes

  No

  N/A

• Has the line been tested?

  Yes

  No

  N/A

• Are crew members working between grounds?

  Yes

  No

  N/A

• Has the service area dispatch been informed?

  Yes

  No

  N/A

General Site Evaluations

• Were all poles inspected and sounded prior to climbing?

  Yes

  No

  N/A

• Is proper fall protection being used?

  Yes

  No

  N/A

• Are all slings and hand lines in good condition?

  Yes

  No

  N/A

Overhead Construction and Tools

• Are all tools and equipment inspected prior to use?

  Yes

  No

  N/A

• Are all tools and equipment being used properly?

  Yes

  No

  N/A

• Is adequate cover-up being used?

  Yes

  No

  N/A

• Are all grounds in good condition?

  Yes

  No

  N/A

• Is good housekeeping being observed?

  Yes

  No

  N/A

Underground Construction and Tools

• Are all sources of primary feed isolated and grounded?

  Yes

  No

  N/A

• Are all sources of secondary feed isolated and grounded?

  Yes

  No

  N/A

• Are all tools inspected prior to use?

  Yes

  No

  N/A

• Are all tools and equipment being used properly?

  Yes

  No

  N/A

• Is proper cover-up being used?

  Yes

  No

  N/A

• Has excavation been evaluated and safe for work?

  Yes

  No

  N/A

• Is adequate shoring and/or sloping being used?

  Yes

  No

  N/A

• Is good housekeeping being observed?

  Yes

  No

  N/A

Vehicle Info and Set Up

• Have all pre-trip inspections been performed?

  Yes

  No

  N/A

• Are all vehicles set up properly for the job?

  Yes

  No

  N/A

• Are all vehicles coned off where required?

  Yes

  No

  N/A

• Are wheel chock being used properly?

  Yes

  No

  N/A

• Are all vehicles properly grounded where required?

  Yes

  No

  N/A

• Are vehicle grounds in good condition?

  Yes

  No

  N/A

• Is good housekeeping being observed?

  Yes

  No

  N/A

Traffic Control

• Are all forms of flashing lights in operation?

  Yes

  No

  N/A

• Is traffic cone placement adequate for traffic conditions?

  Yes

  No

  N/A

• Are work zone signs adequate for traffic conditions?

  Yes

  No

  N/A

• Are crew members wearing reflective vests while in road ROW?

  Yes

  No

  N/A

• Is a flagman assigned to control and monitor traffic?

  Yes

  No

  N/A

Documentation of Job Site Conditions

• Pictures

  Media

• General notes, corrections, and warnings.

• Issues that need to be corrected and/or addressed at a later date.

• Overall evaluation of job site.

  Safe

  Passable

  Needs Improvement

  Unsafe

• Overall evaluation of crew members.

  Working Safely

  Needs Some Improvement

  Working Un-safely

• Certification of Crew Leader in Charge

  Sign

• Certification of Field Observer

  Sign