Information

  • Jobsite Name:

  • Superintendent

  • Project Manager

  • Project Executive

  • Conducted on

  • Prepared by

Disclaimer

  • The information contained within this assessment report are believed to be correct at the time of our observation. We do not accept responsibility for any consequences arising from the use of the information herein. The report is based on matters which were observed or came to our attention during the period of the assessment and should not be relied upon as an exhaustive record of all possible risks or hazards that may exist or potential improvements that can be made.

TCC FIELD OFFICE and SAFETY ADMINISTRATION

  • TCC - Posting - OSHA & DOL (All-in-One) posters posted?

  • TCC - Safety Board - Cal/OSHA permit for - Trench/Excavation?

  • TCC - Safety Board - Cal/OSHA permits for - Building Height - 36ft or higher (if required)

  • TCC - Safety Board - Injury and Illness Prevention Program (IIPP)?<br>

  • TCC - Safety Board - Heat Illness Prevention Program (HIPP)?

  • TCC - Safety Board - Code of Safe Work Practices posted?

  • TCC - Safety Board - Emergency phone numbers posted?

  • TCC - Safety Board - Emergency Procedures posted?

  • TCC - Safety Board - Evacuation plan with the location of shut-off valves posted?

  • TCC - Safety Board - Hazard Communication Plan posted?

  • TCC - Hospital and clinic phone number, map and written directions posted?

  • TCC - OSHA 300 forms posted from February 1 to April 30?

  • TCC - Safety inspection (iAuditor) being conducted (at least weekly) and uploaded (Prolog)?

  • TCC - Daily Safety Comments completed daily and current (Prolog)?

  • TCC - Safety Topic discussed in Foreman's meeting (Prolog)?

  • TCC - First Aid kit present, stocked, and within expiration date?

  • TCC - Fire Extinguisher in the field office [at least one 10lb - 2A-10B-C extinguisher]

  • Contractor - Cal/OSHA permit current and posted for - Scaffold (3 stories or 36 ft) - (Prolog)

  • Contractor - Cal/OSHA permit current and posted for - Demolition - (3 stories or 36 ft) - (Prolog)

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

  • Contractor(s) - IIPP filed (Prolog)?

  • Contractor(s) - HIPP files (Prolog)?

  • Contractor(s) - Site Specific Safety Program (SSSP) - (Prolog)?

  • Contractor(s) - SDS filed (Prolog)?

  • Contractor(s) - daily pre-shift meeting submitted to Tilden-Coil?

  • Contractor(s) - tailgate meetings submitted to Tilden-Coil and up to date (Prolog)?

  • Contractor(s) - Competent person(s) Designation form (e.g. Fall Protection, Scaffolding, Trench/Excavation, Confined Space, CPR/First Aid) filed (Prolog)?

COMPRESSED GASES - BURNING - WELDING - HOT WORK (Grinding, cutting, welding, burning, brazing, soldering, heating, hot air welding, or other operation that generate heat, flames, arc, sparks or other source of ignition)

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

  • Cylinders secured from movement (tied up)?

  • Cylinders are in an up-right position?

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

  • Welding leads appear to be in good condition?

  • Good ventilation during welding operations?

  • Fire extinguisher within 25ft of the hot work activity?

  • Hot work permit filled out completely and attached to the fire extinguisher?

CONFINED SPACES

  • Competent Person for Confined Space identified and present during confined space acitivy?

  • Contractor(s) - Confined space written program on file (Prolog)?

  • Air monitoring results documented to support the designation of non-permitted / permitted confined space? (Typically these will be located at the confined space entrance).

  • Permit Required Confined Space - Contractor has filled out their confined space entry permit and kept at the confined space entrance?

  • Permit Required Confined Space - Ventilation set up and being used?

  • Permit Required Confined Space - Equipment set up (e.g. tri-pod, ventilator, guardrails around opening) for self-rescue?

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

CRANES and RIGGING

  • Crane - Annual and Quadrennial inspection documents submitted to TCC and on file (Prolog)?

  • Crane Operator - Crane Operators Certification submitted to TCC and on file (Prolog)?

  • Signalman identified?

  • Qualified Rigger(s) identified?

  • Lift plan produced for the activity submitted to TCC and on file (Prolog)?

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

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

  • Rigging (e.g. slings, wire cables, chain, shackles, etc.) appear to be in good condition (no "red" thread or other visible damage)?

  • Rigging has capacity labels/tags attached and legible?

  • Tag lines used to guide loads?

  • Workers kept from under loads?

ELECTRICAL

  • Extension cords appear to be free of damage (i.e. damaged outer insulation, strain relief, missing ground post, etc.) and improper repairs (i.e. duct tape, electrical tape, wire nuts, etc.)?

  • Electrical cords (i.e. extension and bull cords) protected from roll over (equipment or pedestrians)

  • Ground fault circuit interrupters (GFCI) being used for temporary power locations (i.e. spider box, existing receptacle, etc.)?

  • Temp Power Box (Spider Box) - Periodic inspection being done.

  • Power-strips are used only as battery charging station?

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

  • Temporary lighting appears adequate (5 foot candles) in stairwells?

  • Temporary lighting appears to be properly suspended (i.e. eyelet, non-conductive material)?

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

ELECTRICAL - "Energized"

  • "Live" electrical panels are protected (e.g. Dead-front secured - no exposed conductors)?

  • Signage in place notifying of the danger (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)?

  • Electrical lines minimum distance of at least 10 feet from equipment (i.e. crane, scaffold systems, ladders, etc.)

  • Sign - Overhead Powerline sign present at locations where equipment/vehicles can pass under powerline..

EQUIPMENT and OPERATORS

  • Forklift Operators have current certification (Prolog)?

  • Forklift has boom, truss or hook, attachment for suspended load. NO "free rigging"

  • Seat belt being worn on equipment (i.e. forklift, backhoe, earthmover, etc.)?

  • Back-up alarm on equipment (i.e. backhoe, excavator, earth mover, boomlift, skid steer, etc.) is audible and appear to be heard from at least 200 feet away.

  • Operators appear to be driving at a safe speed?

  • Equipment being used appear to be in good condition?

  • Scissor lift mid-chain engaged?

  • Scissor lift and Boom lift operators staying in the lift (staying off mid rails)?

  • Boom lifts - PPE - Workers are wearing Personal Fall Protection Systems (i.e. Harness, and Lanyard)?

  • Boom lift - Workers are tied-off to appropriate anchor point in the boom-lift?

FALL PROTECTION

  • Competent Person for Fall Protection identified and present?

  • Contractor(s) have trained their employees on proper use of fall protection (i.e. harness, lanyard, anchor points, etc.) ?

  • Fall Protection Plan (includes rescue plan) developed by Contractor if they can show that the use of conventional fall protection is impractical or creates a greater hazard (Prolog).

  • Fall Protection Plan being followed?

  • Contractor(s) employees appear to be properly using fall protection equipment (i.e. harness, anchor point, attached to anchor point, lanyard, etc.)

  • 6ft fall protection being followed by all trades?

  • Guardrails (Wood or Cable) - top rails (42-45 inches), mid rails (21-23 inches)?

  • Cable Guardrail - at least 2 wire clamps used (never saddle a dead horse)?

  • Cable Guardrail - top rail height being maintained (can not deflect below 39 inches)

  • Toe boards are provided for interior floor, roof and shaft openings (i.e. duct shaft), and/or along edge of exterior elevated floor (i.e. along perimeter of 2nd floor).

  • Wall openings (wider than 16 inches) are protected (e.g. guard rail)

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

  • Covers - appear to be secured (e.g. cleated, nailed, screwed or bolted) to prevent easy displacement?

  • Covers - appear to be capable of supporting 400 lbs. or twice the anticipated load.

  • Covers - clearly marked "Hole" or "Cover" or painted hi-viz (for smaller covers)?

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

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

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

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

FIRE PREVENTION

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

  • No smoking being enforced?

  • Fire extinguisher(s) present (10 lbs - 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)?

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

  • Tools appear to be used per manufacturers specifications?

  • Power tool guards (e.g. grinders) in place and being used?

  • Power tools cords - appear to be free of damage (i.e. damaged outer insulation, strain relief, missing ground post, etc.) and improper repairs (i.e. duct tape, electrical tape, wire nuts, etc.)?

  • P.A.T. - Powder Actuated Tools (P.A.T.) operator(s) have certification?<br>

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

  • P.A.T. - secured when not in use?

  • P.A.T. - spent charges are disposed of - not on the ground.

HOUSEKEEPING

  • Work areas clear of excess trash, material, and debris?

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

  • Staging / lay down areas orderly?

  • Protruding nails and/or screws bent over or backed out?

  • Trash bins are being provided?

  • Trash and/or debris are being removed on a regular basis?

  • Portable toilets are clean and free of graffiti?

  • Portable toilets available - 1 per 20 worker (cleaned at least twice per week)?

  • Hand-wash station available - 1 per 2 portable toilets?

  • Hand-wash stations have soap and towels?

  • Trash receptacle located next to Portable toilets and hand-wash station?

  • Trailer - Exterior - trash and debris around trailer being removed?

  • Trailer - Interior - Areas are well organized, periodically cleaned and disinfected?

  • Trailer - Interior - Floors are periodically swept and mopped or vacuumed?

  • Trailer - Interior - Maintenance - Vents, ledges, door jambs and windowsills are being cleaned periodically?

LADDERS and STAIRS

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

  • Extension ladder tied-off at the top to prevent displacement?

  • Contractor(s) are using ladders that appear to be in good condition?

  • "A" frame ladders appear to be set-up and used per manufacturer specifications?

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

  • Stairways (4 or more risers) equipped with handrail(s) and guardrail(s) (unprotected side or edge)

  • Stairways (pan stair) are fitted with wood or other solid material at least to the top edge of each pan?

  • Stairway access (temporary or permanent) present for any building or structure 2 or more stores or 24ft or more in height or depth?

PERSONAL PROTECTIVE EQUIPMENT (PPE)

  • Hard Hats being worn 100% of the time (no cowboy style hard hat)?

  • Safety glasses being worn 100% of the time?

  • Prescription glasses - Prescription safety glasses, goggles, or over-the-glasses safety glasses being worn 100% of the time?

  • Hi-viz vest (worn as outer most garment) being worn 100% of the time?

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

  • Hearing protection being used when required / necessary (90 decibels or greater)?

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

  • Hand protecting being used when required / necessary?

  • Respiratory protection being used when required / necessary? (i.e. half mask, N95 particulate mask)

SCAFFOLDS

  • Fixed Scaffold(s) - inspected by competent person daily, and documentation is provided at all access points ("Green" tag)?

  • Fixed Scaffold - appear to be tied off (double-looped No. 12 iron wire, or single-looped No. 10 iron wire or equivalent) to structure (3:1 base to height ratio, vertical spacing max 26ft, horizontal spacing max 30ft)?

  • Fixed Scaffold - footings nailed to the mud sills (i.e. 2'x10'x10')?

  • Guardrails - Top-rails and mid-rails appear to be in place and at the proper height?

  • Toe-Boards or other protective system - in place at designated access/egress locations (e.g. toe board, orange fencing, etc.)?

  • Toe-boards or other protective system - in place for person(s) working below scaffold system protected from falling objects (e.g. toe board, orange fencing, etc.)?

  • Scaffold Planks - appear to be free of visible splits or damages?

  • Scaffold Access - fully planked at all levels where work activities will occur?

  • Scaffold appear to be kept clear of trash and material?

  • Person(s) working on scaffold refraining from climbing on guardrails and x-bracing

  • Mobile Scaffold (i.e. Perry/Baker scaffold) appear to be built and used per manufacturers recommendations (i.e. guardrails, outriggers, cross brace, etc.)?

  • Mobile Scaffold wheels locked when in use?

  • Mobile Scaffold - Guardrails - Top-rails and mid-rails appear to be in place and at the proper height?

  • Mobile Scaffold - Outriggers in place (3:1 base to height ratio)

  • Mobile Scaffold - "Surfing" - contractor has submitted a written scaffold 'surfing' program to TCC and filed (Prolog)?

  • Mobile Scaffold - "Surfing" - contractor has conducted on-site documented training on 'surfing' scaffold. Copy of documented training submitted to TCC and filed (Prolog)?

  • Mobile Scaffold - "Surfing" - top-lock being use to prevent scaffold from moving while in use?

  • Mobile Scaffold - "Surfing" - platform no more than 4ft above the floor level

SILICA

  • Competent Person for Silica identified and present?

  • Written Silica Exposure Control program provided to Tilden-Coil and filed (Prolog)?

  • Contractor(s) employees exposed to Silica have been trained (e.g. Hazards of silica dust, Controlling silica dust, protecting themselves from silica, etc.)?

  • Engineering controls - Primary Control - being used (e.g. HEPA vacuum or continuous spray of water at the source)?

  • Personal Protective Equipment (PPE) - Secondary Control - being used (e.g. N-95 particulate mask, half-mask) in conjunction with Engineering controls when required by Table 1 or engineering controls cannot adequately limit exposure?

  • Housekeeping - Sweeping is being done using sweeping compound or other method to control airborne dust/silica (No dry sweeping).

SITE PERIMETER

  • Perimeter fence - appears to be in good condition, gates closed, graffiti removed?

  • Perimeter fence - appears to be adequately secured to prevent tipping?

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

  • Tilden-Coil Safety Requirement Banner is located at each entry point?

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

  • Perimeter fence - vegetation has been trimmed and maintained?

  • Stabilized construction entrance being maintained?

  • Track-out at construction entrances being maintained?

TRAFFIC CONTROL and FLAGGERS

  • Traffic control plan has been developed or will follow Cal/MUTCD requirements for traffic control (Prolog)?

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

  • TCD's are inspected periodically?

  • Flaggers have been trained?

  • Flaggers appear to be using proper signs and hand signals?

TRENCH and EXCAVATION

  • Competent person identified and present during all trench/excavation work activities?

  • Dig Alert has been contacted and have a current ticket (must be renewed every 28 days)?

  • Dig Alert - Work area appears to have been marked by contractor and Dig Alert

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

  • Pot-Holing - Utility lines exposed to the point of no conflict within the tolerance zone (24 inches on either side of the utility)?

  • Trench/Excavation inspections being conducted daily prior to entry?

  • Trench/Excavation properly shored, benched (No benching in C type soil), or slopped? (A - 3/4:1, B - 1:1, C - 1 1/2:1).

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

  • Perimeter protection around open trench/excavation (i.e. delineator and "caution" or "danger" tape).

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

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

Additional observations - Positive activities or area of improvement - Provide detailed information:

  • 10 pts

  • 25 pts

  • 50 pts

GENERAL

  • General Comments

  • Miscellaneous Pictures

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