TDPM JOINT VENTURE

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Select date

  Date

• Add signature

  Sign

Program Administration

• OSHA POSTINGS

  Yes

  No

  N/A

• Emergency contacts and numbers posted?

  Yes

  No

  N/A

• Safety manual and MSDS on site and available?

  Yes

  No

  N/A

• Have toolbox talks been conducted and documented?

  Yes

  No

  N/A

• First aid kits on site and stocked?

  Yes

  No

  N/A

• Is emergency action plan up to date?

  Yes

  No

  N/A

• Has training been conducted and documented?

  Yes

  No

  N/A

• Are JHA's completed and satisfactory?

  Yes

  No

  N/A

Housekeeping/Sanitation

• Work areas clean and orderly?

  Yes

  No

  N/A

• Is there adequate lighting?

  Yes

  No

  N/A

• Is area clear of slip, trip, and fall hazards?

  Yes

  No

  N/A

• Are stairs and walkways clear?

  Yes

  No

  N/A

• Is trash and debris removed daily?

  Yes

  No

  N/A

• Is drinking water available?

  Yes

  No

  N/A

• Are cups and trash recepticales available?

  Yes

  No

  N/A

• Are port-a-johns available and clean?

  Yes

  No

  N/A

Electrical

• Is insulation intact on cords and is ground prong in place?

  Yes

  No

  N/A

• Are extension cords inspected daily?

  Yes

  No

  N/A

• Are GFCI's being utilized?

  Yes

  No

  N/A

• Are lockout procedures in place and utilized?

  Yes

  No

  N/A

Hand and Power Tools

• Are hand tools in good working order?

  Yes

  No

  N/A

• Are electrical cords in good condition?

  Yes

  No

  N/A

• Are all guards and handles in place?

  Yes

  No

  N/A

• Are handles in good condition and splinter free?

  Yes

  No

  N/A

Equipment

• Are breaks, lights, signals, and alarms operative?

  Yes

  No

  N/A

• Have daily inspection been filled out?

  Yes

  No

  N/A

• Seat belts being worn?

  Yes

  No

  N/A

Barricades and Fencing

• Are floor openings covered or barricaded?

  Yes

  No

  N/A

• Are wall and roof openings covered or barricaded?

  Yes

  No

  N/A

• Is the leading edge guarded?

  Yes

  No

  N/A

• Are roadways and sidewalks protected?

  Yes

  No

  N/A

• Are pedestrians protected?

  Yes

  No

  N/A

Excavations

• Has competent person inspected excavation?

  Yes

  No

  N/A

• Are ladders provided at depths of 4' and greater?

  Yes

  No

  N/A

• Do ladders extend 3' above the excavation?

  Yes

  No

  N/A

• Are the proper access and egress provided?

  Yes

  No

  N/A

• Are spoils set back at least 2'?

  Yes

  No

  N/A

• Is excavation protected from cave-ins at 5' or greater?

  Yes

  No

  N/A

• Is the competent person on site?

  Yes

  No

  N/A

• Is the soil classified properly?

  Yes

  No

  N/A

• Is rebar protection in place?

  Yes

  No

  N/A

Ladders

• Are ladder inspection stickers currant?

  Yes

  No

  N/A

• Are ladders in good condition?

  Yes

  No

  N/A

• Side rails extend 36" above landing and is it secured?

  Yes

  No

  N/A

• Is it proper ladder for the job?

  Yes

  No

  N/A

• Is step ladder's spreader bar fully extended and locked?

  Yes

  No

  N/A

• Is ladder placed on level and flat ground?

  Yes

  No

  N/A

• Are ladders or steps provided for access points 19" or higher?

  Yes

  No

  N/A

Scaffolding

• Are scaffolds plumed and level as erections proceeds?

  Yes

  No

  N/A

• Are adequate sills and base plates being used?

  Yes

  No

  N/A

• Are power lines near the scaffold? If yes, are the necessary precautions being taken?

  Yes

  No

  N/A

• Do scaffold planks extend past their end supports? Not less than 6"and not more than 12"

  Yes

  No

  N/A

• Are guardrails and end rails in place?

  Yes

  No

  N/A

• Are toe boards in place or is area barricaded below to protect from falling objects?

  Yes

  No

  N/A

• Are frames and panels braced by cross, horizontal, or diagonal braces? Which ones?

  Yes

  No

  N/A

• Are scaffolds with a (4:1) bade to hight ratio?

  Yes

  No

  N/A

• Is fall protection being used in areas where required?

  Yes

  No

  N/A

• Are scaffolds securely anchored at lease every 30' in length and 25' in height?

  Yes

  No

  N/A

• Is there safe access and egress for the ladder?

  Yes

  No

  N/A

• Is the scaffold within its weight capacity?

  Yes

  No

  N/A

Crane/Hoist

• Is operators manual avalible?

  Yes

  No

  N/A

• Are crane signals posted?

  Yes

  No

  N/A

• Is the swing radius barricaded?

  Yes

  No

  N/A

• Is the daily, monthly, and annual inspection available?

  Yes

  No

  N/A

• Is a qualified rigger and signal man on site?

  Yes

  No

  N/A

• Has all rigging been inspected?

  Yes

  No

  N/A

Fire Prevention

• Are safety cans being used and are they properly labeled?

  Yes

  No

  N/A

• Are compressed gas cylinders secured, upright, and are safety caps on and separated by 20'?

  Yes

  No

  N/A

• Do oxygen/ acetylene torch rigs have flash arrestors?

  Yes

  No

  N/A

• Is the proper signage in place?

  Yes

  No

  N/A

• Are fire extinguishers in place and inspections current?

  Yes

  No

  N/A

• Is their a fire watch in place?

  Yes

  No

  N/A

• Have burn permits been issued?

  Yes

  No

  N/A

Personal Protection Equipment

• Hard hats

  Safe

  At Risk

  N/A

• Gloves

  Safe

  At Risk

  N/A

• Proper work boots

  Safe

  At Risk

  N/A

• High visible vest

  Safe

  At Risk

  N/A

• Mono goggles

  Safe

  At Risk

  N/A

• Eye protection

  Safe

  At Risk

  N/A

• Hearing protection

  Safe

  At Risk

  N/A

• Safety harness and lanyards utilized with adequate anchorage

  Safe

  At Risk

  N/A

• Are respirators being utilized?

  Yes

  No

  N/A

Confined Space

• Has per entry check list been completed?

  Yes

  No

  N/A

• Permit requred

  Yes

  No

  N/A

• Training in place

  Yes

  No

  N/A

• Air quality testing

  Yes

  No

  N/A

• Rescue plan in place?

  Yes

  No

  N/A

• Rescue equipment in place?

  Yes

  No

  N/A

• Rescuers trained?

  Yes

  No

  N/A

JHA's

• Did you or your supervisor fill out the JHA for this task?

  Yes

  No

  N/A

• Has the JHA been reviewed with the entire crew?

  Yes

  No

  N/A

• What are two recognized hazards on your JHA?

  Yes

  No

  N/A

• What are the control measures for those hazards?

  Yes

  No

  N/A

• What do you do if you or a fellow worker is injured while working? Who do you tell or call?

  Yes

  No

  N/A

• Who is your supervisor? Who do you contact if your supervisor in not on site?

  Yes

  No

  N/A

• Is JHA complet and satisfactory?

  Yes

  No

  N/A