Technology Construction Hazard Identification and Risk Assessment

• Project Name

• Customer/GC

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1. Fall Protection (OSHA Subpart "M")

• 1.1. All employees trained in fall protection?

  Yes

  No

  N/A

• 1.2. Lack of leading edge protection?

  Yes

  No

  N/A

• 1.3. Unsafe or incomplete edge protection?

  Yes

  No

  N/A

• 1.4. All body harness, lanyard and SRL been inspected?

  Yes

  No

  N/A

• 1.5. Are all anchor points rated at least 5,000 pounds?

  Yes

  No

  N/A

• 1.6. Are all body harnesses fitted properly?

  Yes

  No

  N/A

2. Ladders (OSHA Subpart "X")

• 2.1. All employees trained in ladder safety?

  Yes

  No

  N/A

• 2.2. Any unsafe or damaged ladders on the project?

  Safe

  At Risk

  N/A

• 2.3. Any unsafe positioning of a ladder?

  Safe

  At Risk

  N/A

• 2.4. Extension ladder tied off at top of ladder?

  Yes

  No

  N/A

• 2.5. Is there 3' of the extension ladder extended above the next elevation?

  Yes

  No

  N/A

• 2.6. Ladder being used on level ground?

  Yes

  No

  N/A

• 2.7. Are all labels on ladders?

  Yes

  No

  N/A

• 2.8. All ladders been inspected?

  Yes

  No

  N/A

3. PPE (OSHA Subpart "E")

• 3.1. All employees wearing hard hats, safety glasses, vests and gloves?

  Yes

  No

  N/A

• 3.2. Hearing protection being worn when needed?

  Yes

  No

  N/A

• 3.3. Are there face shields, goggles on site and being worn when performing overhead work?

  Yes

  No

  N/A

• 3.4. Any PPE needed to be ordered?

  Yes

  No

  N/A

4. Confined Space (OSHA Subpart "AA")

• 4.1. All employees trained in confined space awareness?

  Yes

  No

  N/A

• 4.2. Has a confined space permit been completed?

  Yes

  No

  N/A

• 4.3. Is there a trained confined space competent person on site?

  Yes

  No

  N/A

• 4.4. Is there an air quality monitor on site?

  Yes

  No

  N/A

• 4.5. Is there a tri pod, wench, body harness and blower on site per confined space?

  Yes

  No

  N/A

• 4.6. Is there an emergency rescue person at each confined space?

  Yes

  No

  N/A

• 4.7. Is there an E.A.P. developed and understood by all personnel?

  Yes

  No

  N/A

• 4.8. Has there been a JHA developed for the work explaining the risk?

  Yes

  No

  N/A

• 4.9. Are there any known hazards in the confined space?

  Yes

  No

  N/A

5. Hazard Communication (OSHA Subpart "Z")

• 5.1. All employees been trained in Haz-com?

  Yes

  No

  N/A

• 5.2. Is there a MSDS binder on site?

  Yes

  No

  N/A

• 5.3. Do employees know what Haz-com means and where the Haz-com manual is?

  Yes

  No

  N/A

• 5.4. If we have chemicals on site is there a spill kit on site?

  Yes

  No

  N/A

• 5.5. Right PPE on site to deal with a chemical spill (chemical gloves,goggles)?

  Yes

  No

  N/A

• 5.6. Any unsafe storage of chemicals?

  Yes

  No

  N/A

• 5.7. Are all chemicals in labeled containers?

  Yes

  No

  N/A

6. Excavations (OSHA Subpart "P")

• 6.1. Have all employees been trained in excavation awareness?

  Yes

  No

  N/A

• 6.2. Has all existing utilities been located?

  Yes

  No

  N/A

• 6.3. Does heavy equipment have working back up alarms?

  Yes

  No

  N/A

• 6.4. Is there a trench ladder every 50'? On

  Yes

  No

  N/A

• 6.5. Is there an excavation permit completed?

  Yes

  No

  N/A

• 6.6. Any excavation over 4' deep?

  Yes

  No

  N/A

• 6.7. Is the sloping correct?

  Yes

  No

  N/A

• 6.8. Are the spoils at least 2' away from the excavation?

  Yes

  No

  N/A

• 6.9. Is there a possibility of carbon monoxide build up in the excavation?

  Yes

  No

  N/A

• 6.10. Will shoring be required in the excavation?

  Yes

  No

  N/A

• 6.11. Is the heavy equipment near excavation that may cause the walls to collapse?

  Yes

  No

  N/A

• 6.12. Is there a trained competent person on site?

  Yes

  No

  N/A

7. Housekeeping (OSHA Subpart "C")

• 7.1. General appearance of project (all trades)?

  Safe

  At Risk

  N/A

• 7.2. Are passageways and walkways clear of trash and debris (Jetline)?

  Yes

  No

  N/A

• 7.3. Any protruding nails in scrap lumber laying around?

  Yes

  No

  N/A

• 7.4. Is there fresh water on site (cups,trash can, tape around lid with date)?

  Yes

  No

  N/A

• 7.5. Are the FSG conex's clean and orderly?

  Yes

  No

  N/A

• 7.6. Is all FSG stored materials neatly stacked and orderly?

  Yes

  No

  N/A

• 7.7. Is all of FSG's trash picked up off of the floor and site?

  Yes

  No

  N/A

• 7.8. Are all FSG materials at a minimum of 15' from all leading edges?

  Yes

  No

  N/A

8. Signs and Barricades (OSHA Subpart "G")

• 8.1. Holes 2" and larger in floors covered and marked?

  Yes

  No

  N/A

• 8.2. All leading edge guard rails up and secure?

  Yes

  No

  N/A

• 8.3. Correct use of caution or danger signs / tape in place?

  Yes

  No

  N/A

• 8.4. Hazard warning signage posted as needed?

  Yes

  No

  N/A

• 8.5. Traffic cones or barricades in place if needed?

  Yes

  No

  N/A

• 8.6. All hazard signage in place? Temp panels, laser in use,etc?

  Yes

  No

  N/A

• Yes

  No

  N/A

• 8.7. Sufficient ventilation?

  Yes

  No

  N/A

9. Electrical Safety (OSHA Subpart "K")

• 9.1. Do all extension cords have the ground prong and in good condition?

  Yes

  No

  N/A

• 9.2. If the job site is using the assured grounding program, have all extension cords been inspected and labeled with the correct color for the month?

  Yes

  No

  N/A

• Has a Safety form packet been issued?

  Yes

  No

  N/A

• Was there any Safety Violations found?

  Yes

  No

  N/A

Sign Off

• Notes

• Signature for Safety form packet

  Sign

• Signature of on site Representative

  Sign

• Inspector Signature

  Sign