Information

  • Jobsite Name:

  • Superintendent

  • Project Manager

  • Project Executive

  • Conducted on

  • Prepared by

TCC FIELD OFFICE AND SAFETY ADMINISTRATION

  • OSHA, DOL and all mandatory posters posted?

  • Emergency phone numbers posted?

  • Hospital / clinic information posted?

  • OSHA 300 forms completed and posted from February 1 to April 30?

  • Site safety / evacuation plan posted?

  • Emergency Procedures posted? Plan shows shut off valves?

  • TCC Code of Safe Work Practices / General safety rules posted?

  • TCC Injury and Illness Prevention Program (IIPP) on site?

  • TCC Heat Illness Prevention Program (HIPP) on site?

  • TCC Safety inspections being conducted, documented, and current?

  • TCC Daily Reports current and safety section completed?

  • TCC Tailgate meetings up to date?

  • Cal/OSHA required permits current and posted for - Building Height/Scaffold<br><br>A) Construction of any building, structure, scaffolding or falsework more than three (3) stories high or the equivalent height of (36 feet)

  • Cal/OSHA permit current and posted for - Trench/Excavation?<br><br>A) Construction of trenches or excavations which are five feet (5ft) or deeper and into which a person is required to descend.

  • Cal/OSHA permit current and posted for - Demolition <br><br>A) Demolition of any building or structure, or dismantling of scaffolding or falsework more than three stories high or the equivalent height (36 feet)

  • Cal/OSHA permit current and posted for - Vertical Shoring Systems<br><br>A) Erecting or dismantling of vertical shoring systems more than three stories high, or equivalent height (36 feet).

  • TCC first aid kit present, stocked, and within expiration date?

  • TCC - Fire Extinguisher in the field office (at least one 2A-10B-C extinguisher).

  • Subcontractor(s) IIPP filed?<br>

  • Sub contractor(s) MSDS filed?

  • Sub contractor(s) tailgate meetings up to date?

  • Sub contractor(s) Competent person(s) identified (e.g. Fall Protection, Scaffolding, Trench/Excavation, Confined Space) and a copy of certification(s) provided to TCC and filed?

  • Sub contractor(s) person identified for first aid/CPR and copy of certification provided to TCC and filed?

COMPRESSED GASSES

  • Oxygen and fuel (eg. Acetylene) cylinders are stored at least 20 feet apart or in a cart that has a 5 foot high barrier rated for 30 min.?

  • Are cylinders secured from movement (tied up)?

  • Cylinders are secured and transported in an up-right position?

  • Is there a flash arrestor on the fuel gas? (regulators do not have built in arrestors)

CONFINED SPACES

  • Sub contractor(s) - Permit Required Confined space written program on site?

  • Are all confined spaces identified and labeled?

  • If the space has been labeled as permit required confined space, does the trade have a permit? Is it completely filled out and kept at the confined space entrance?

  • Air monitoring results provided to support the designation of non-permitted / permitted confined space? Documented and provided to TCC?

  • Is the Crew entering the confined space following their Confined Space Entry Permit?

  • Ventilation properly set up and being used in a Permit Required Confined Space?

  • Rescue team trained, equipment set up (e.g. tri-pod) and being utilized?

CRANES

  • Certificates of insurance filed, TCC listed as certificate holder?

  • Certified riggers and signalmen identified and certificates on file?

  • Lift plan reviewed and on file?

  • Pre-lift inspection conducted and a copy on file?

  • Outriggers extended on a firm surface (e.g. floats on an outrigger pad)?

  • Swing radius barricade (e.g. "Danger" tape) in place?

  • Employees kept from under loads?

  • Tag lines used to guide loads?

  • Rigging (e.g. slings, wire cables, chain) inspected and are in good condition (no "red" thread or other visible damage), and have capacity labels/tags?

ELECTRICAL

  • Cords are free of damage and repairs?

  • Electrical cords have ground posts?

  • All cords (extension and bull cords) protected from roll over

  • Ground fault circuit interrupters (GFCI) being used when plugged directly into structures?

  • All outlets and panel boxes are covered with an approved cover?

  • All outlets being used correctly and not overloading?

  • All powerstrips are rated for construction?

  • Temporary lighting adequate (5 foot candles) in corridors, hallways and stairwells?

  • Temporary lighting is being suspended by the eyelet (not the cord)?

  • Temporary lighting cages are in place and protecting bulbs (no bare bulbs)?

ELECTRICAL - "Energized"

  • All "Live" electrical panels are protected (e.g. Dead-front secured - no exposed conductors) and properly labeled (e.g. "Danger - Live Wires")?

  • Lockout/Tagout (LOTO) procedure in place? De-energized circuits have tag(s) (filled out) and lock(s)?

  • PPE - Proper Arc Flash PPE being worn based upon Arc Flash Hazard Evaluation and/or NFPA 70E (e.g. Arc Rated arc flash suit, hard hat, face shield, safety glasses, hearing protection, electrical rated gloves)?

  • All electrical lines minimum distance of at least 10 feet being maintained?

EQUIPMENT / EQUIPMENT OPERATIONS

  • Forklift Operators have been identified and a current certification has been provided to TCC and is on file?

  • Equipment (e.g. Scissor lift, Boom lift, Backhoe, Excavator, Blade, Earth mover, etc.) inspected daily and documentation provided to TCC?

  • Equipment being used in good condition? Equipment does not have any modifications.

  • Operators driving at a safe speed? Adhering to job site posted speed limit?

  • Seat belts being used when applicable?

  • Boom lifts - PPE - Workers are wearing Personal Fall Arrest Systems (PFAS - e.g. Harness, and Lanyard), and are tied-off to an appropriate anchor point?

  • Scissor lifts are not being overloaded with materials?

  • Scissor lift and Boom lift operators staying in the basket? Operators staying off mid rails or guardrails?

FALL PROTECTION

  • Rod busters utilizing fall protection (above 6 feet - except for point-to-point travel)?

  • Ramps are at least 20 inches wide (foot ramps), or 30 inches wide if used for wheelbarrows?

  • Ramps made of material that can handle 2 times the maximum intended load?

  • Ramps are secured / tied down to assure ramps do not move?

  • Work being performed over 6 feet (e.g. windows, balconies, roof, wall openings, leading edge, floor openings, etc.) protected by the use of guardrail or other fall protection system?

  • Guardrails (Wood or Cable) - top rails (42-45 inches), mid rails (21-23 inches), and toe boards are in place? If Cable, at least 2 wire clamps properly used (never saddle a dead horse)?

  • Skylights, roof holes, floor openings (2 inches or greater in diameter), and wall openings (wider than 16 inches) are completely covered or protected?

  • Covers are secured (e.g. cleated or nailed) to prevent easy displacement?

  • Covers are capable of supporting 400 lbs. or twice the anticipated load, and are clearly marked "Hole" or "Cover"?

  • Implement hazards (e.g. rebar, flat stakes, EMT conduit, anchor bolts, etc.) protected?

  • Fall Protection Plan (includes rescue plan) developed by each Subcontractor working over 6 feet, and submitted to TCC for review?

  • Training - Subcontractor(s) have trained their employees on proper use of fall protection (e.g. harness and lanyard) and have provided a copy of their training certification to TCC and is on file?

  • PPE - Subcontractor(s) working over 6 feet are properly wearing Personal Fall Arrest Systems (PFAS - e.g. Harness, and Lanyard), and are tied-off to an appropriate anchor point or are following Cal/OSHA fall protection guidelines (e.g. Connectors, roofers, Iron workers, frames - see trigger heights on the below questions)

  • Iron workers (Connectors only) utilizing fall protection (above 30 feet) per Cal-OSHA standards?

  • Roofers utilizing fall protection (above 20 feet) per Cal/OSHA standards?

  • Iron workers and/or Framers utilizing fall protection (above 15 feet) and on 4 inch nominal or wider structural members?

FIRE PREVENTION

  • No Smoking signs posted at flammable or combustible liquids are stored?

  • No smoking being enforced?

  • Fire extinguisher(s) present (2A-10B:C), inspected (monthly) and accessible? (Every 3000 sq feet or 75 feet of work, and/or at least 1 located adjacent to the stairway at each floor)?

  • Fire extinguishers present during hot work?

  • Hot work permit filled out completely and a copy provided to TCC?

HAND AND POWER TOOLS - POWDER ACTIVATED TOOLS (P.A.T.)

  • Tools are being used per manufacturers specifications?

  • Tool guards (e.g. grinders) in place and being used correctly?

  • The correct tool being used for the job?

  • Tools are unaltered, no repairs and maintain ground posts on cords?

  • All Powder Actuated Tools (P.A.T) operators are certified? Operator has the certificate on them?<br>

  • P.A.T. signs are properly displayed when being used?

HOUSEKEEPING

  • Work areas clear of obstructions?

  • Paths of travel clear of all trash, materials, and debris

  • Access and egress, ladders and stairways are clear of all trash, material, debris, or other trip hazards?

  • Trash bins are being provided, and trash and/or debris are being removed on a regular basis?

  • Staging / lay down areas orderly?

  • Projecting nails / screws bent over or backed out?

LADDERS

  • Extension ladders extend at least 3 feet above the landing and tied off?

  • "A" frame ladders are being used per manufacturer specifications? Open with spreaders locked?

  • Subcontractor(s) are refraining from utilizing the top two steps of an "A" frame ladder?

  • Subcontractor(s) are using proper height ladders for the job?

  • Subcontractor(s) are using like new ladders free of damage?

PERSONAL PROTECTIVE EQUIPMENT

  • Hard Hats being worn 100% of the time?

  • Safety glasses being worn when exposed to an eye hazard?

  • Face shields being used (with safety glasses) when cutting block, using a chop saw or other activity which could cause injury to the face?

  • Hearing protection being used when required / necessary?

  • Foot protection being used while using jack hammer or soil compactor (e.g. wacker)?

SCAFFOLDS

  • Scaffold(s) inspected by competent person daily, and documentation is provided at all access points ("Green" tag), and a copy provided to TCC?

  • Scaffold footings and mud sills visible? Footing nailed to the mud sills? Mud sill not being undermined.

  • Scaffold tied off (double-looped No. 12 iron wire, or single-looped No. 10 iron wire or equivalent) to structure as required?

  • Guardrails, mid rails and toe boards in place and at the proper height?

  • Planks have been inspected, and any split or damaged planks are removed?

  • Proper access provide to all levels?

  • Person(s) working below scaffold system are protected from falling objects (e.g. toe board, orange fencing, etc.)?

  • Scaffold are kept clear of trash and material?

  • Mobile Scaffold (e.g. Perry/Baker scaffold) are built and used per manufacturers recommendations?

  • Mobile Scaffold wheels are locked when in use?

SITE PERIMETER

  • Perimeter fence in good condition, gates closed, graffiti removed?

  • TCC Safety Requirement Board is located at entry point(s)?

  • Perimeter fence has signage such as "Caution - Keep out - Construction area", at all access locations and periodically around the jobsite?

  • Pedestrian walk areas clear of construction related hazards (i.e. rocks, dirt, construction material)?

TRAFFIC CONTROL and FLAGGERS

  • Traffic control plan has been developed and a copy has been provided to TCC?

  • Traffic control devices (TCD's) are set-up according to the Traffic Control Plan or Cal/MUTCD?

  • TCD's are inspected at least daily and documentation of the inspection is completed and provided to TCC?

  • Flaggers have been trained and a copy of training certificate has been provided to TCC?

  • Flaggers are using proper signs and hand signals?

TRENCHES, EXCAVATIONS AND PROTECTIVE SYSTEMS

  • Competent person identified and present?

  • Dig Alert has been contacted, work area has been marked, and their is an active Dig Alert ticket?

  • Pot-holing has been done by hand (i.e. hand dig with flat shovel, or vacuum truck) to locate existing underground utilities?

  • Trench/Excavation inspections being conducted daily prior to entry, and a copy of the inspection is provided to TCC daily?

  • Trench/Excavation soil properly identified (A,B,C)?

  • Trench/Excavation properly shored, benched, or slopped?

  • Ladders (extension or straight, NO step ladders) are in place and within 25 feet of workers in a trench/excavation 4 feet or greater?

  • Spoils pile and material(s) (e.g. trucks, unnecessary material) are stored at least 2 feet away from trench/excavation edge?

  • Equipment operating at a safe distance from trench or excavation?

WELDING

  • Welding leads are in good condition? No splicing or repairs within 10 feet from the cable end.

  • Welding shields being used to protect other trades?

GENERAL

  • List any imminent danger conditions

  • General notes on conditions

  • Miscellaneous Pictures

  • Please draw any clarifying pictures

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