TRIPLE T'S LININGS JOB SITE SAFETY INSPECTION

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Supervisor

Activity Hazard Analysis AHA

• Were last weeks goals accomplished?

  Yes

  No

  N/A

• What are the goals for this week -for the day?

Site overview

• Weather

  Select raining sprinkling hot sunny cloudy humid windy chilly cold sunny

  • raining
  • sprinkling
  • hot sunny
  • cloudy
  • humid
  • windy
  • chilly
  • cold
  • sunny

• Crew members in site

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
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  • 12
  • 13
  • 14
  • 15

• Permits required

  Select hot work permit confine space entry permit Excavation (dig test CP, Inspection.) inspections hazard comm. MSDS lockout/tag out procedures Site job orientation

  • hot work permit
  • confine space entry permit
  • Excavation (dig test CP, Inspection.)
  • inspections
  • hazard comm. MSDS
  • lockout/tag out procedures
  • Site job orientation

• Vehicles in site

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15

Type of task being done?

• Tasks

  Select secondary containments tank pads tank linings backhoe services welding dirt work drill truck and anchors Frac pond trucking powder coating sandblasting and painting foam insulation hot shot services truck bed linings tower bases

  • secondary containments
  • tank pads
  • tank linings
  • backhoe services
  • welding
  • dirt work
  • drill truck and anchors
  • Frac pond
  • trucking
  • powder coating
  • sandblasting and painting
  • foam insulation
  • hot shot services
  • truck bed linings
  • tower bases

safety hazards

• Cave-in

• Chemical burn

• Driving hazard

• Dropping materials/tools

• Dust/flying debris

• Electrical shock

• Eye irritants

• Flammable/explosive atmosphere

• Flash burns to eyes(welding)

• Heat/cold stress

• Housekeeping

• H2S

• Impact/compression

• Inadequate lighting

• Loud noises

• Norm

• Overexertion/strains

• Overhead and underground obstructions

• Pedestrian traffic

• Penetration

• Potential release of energy

• Pressure release (hydro test )

• Pressure related

• Radiation (x-Ray)

• Sharp surfaces

• Short service employees

• Skin irritant

• Spills

• Thermal burn

• Toxic material

• Unsecure load

• Vehicular traffic

• Vibration

• Weather conditions

• Wet surfaces

• Environmental concerns

• Struck by

• Slips ,trips, and falls

• Strains and sprains

• Cuts and lacarations

• Flying particles

• Lifting hazards

• Exposure to hazardous atmosphere

• Fire

• Water/drowning

• Other

Hierchary controls

• Hierchary controls for hazards

• Elimation

• Substitution

• engineering controls

• Admistrative controls

• PPE

Materials , Tools and Equipment need?

• List of all PPE Required for task

  Select hard hat safety glasses face shield goggles welding hood earplugs dust mask air-purifying atmosphere -supplying safety harness FR spray suits gloves steel toe boots rubber boots h2s monitor 4 gas monitor

  • hard hat
  • safety glasses
  • face shield
  • goggles
  • welding hood
  • earplugs
  • dust mask
  • air-purifying
  • atmosphere -supplying
  • safety harness
  • FR
  • spray suits
  • gloves
  • steel toe boots
  • rubber boots
  • h2s monitor
  • 4 gas monitor

• Techniques and tools used for mitigating task specific hazards

  Select 360 Walk around barricades change method/procedure contain sparks fit test/ medical evaluation flash arresters get expert help-p engineer GCFI protection guards(grinders,circular saws) hearing protection hoses/Fire Entiguisher increased awareness ladder securement one calls placed PPE proper load securement remove hazard required training scaffold/safety harness secondary containment sloping/shoring traffic control plan wind indicator

  • 360 Walk around
  • barricades
  • change method/procedure
  • contain sparks
  • fit test/ medical evaluation
  • flash arresters
  • get expert help-p engineer
  • GCFI protection
  • guards(grinders,circular saws)
  • hearing protection
  • hoses/Fire Entiguisher
  • increased awareness
  • ladder securement
  • one calls placed
  • PPE
  • proper load securement
  • remove hazard
  • required training
  • scaffold/safety harness
  • secondary containment
  • sloping/shoring
  • traffic control plan
  • wind indicator

• Mitigation by positioning

  Select caught in between hazards do not work between pipe and ditch egress trailer when off -loading electrical line spotters equipment spotters keep clear of suspended loads pinch loads roadway flaggers stay clear of the line of fire use three point contact use taglines other

  • caught in between hazards
  • do not work between pipe and ditch
  • egress trailer when off -loading
  • electrical line spotters
  • equipment spotters
  • keep clear of suspended loads
  • pinch loads
  • roadway flaggers
  • stay clear of the line of fire
  • use three point contact
  • use taglines
  • other

Recommendations :: Ways to improve work area an make it safer and to Eliminate hazards

• Ways to improve work area an make it safer

Photos

• Photos of site

  Media

Report of site

• Report

Safety starters

• Does everyone have their training card ?

  Yes

  No

  N/A

• Does everyone have respirator fit test card?

  Yes

  No

  N/A

• Did everyone start day by stretching

• Is everyone injury free

Emergency procedures

• Emergency numbers and procedures posted?

  Yes

  No

  N/A

• Nearest medical center in case of emergency

Job safety analysis and tailgate meeting

• JSA perform prior start work?

  Yes

  No

  N/A

• Tailgate meeting done prior working?

  Yes

  No

  N/A

FIRST AID

• Is first aid equipment available on site.

  Yes

  No

  N/A

• Are first aid kit properly stocked?

  Yes

  No

  N/A

• Are first aid trained coworkers on site?

  Yes

  No

  N/A

• Are CPR trained coworkers on site

  Yes

  No

  N/A

• Are coworkers aware of the address of the site and capable of giving directions to emergency crew

  Yes

  No

  N/A

HOUSEKEEPING & SANITATION

• Is general neatness of working areas aceptable?

  Yes

  No

  N/A

• Is good housekeeping observed?

  Yes

  No

  N/A

• Are passageways and walkways clear and free of debris?

  Yes

  No

  N/A

• Are waste and trash containers provided and used?

  Yes

  No

  N/A

• Is there and adequate number of clean sanitary facilities?

  Yes

  No

  N/A

• Is temporary storage of materials and supplies done in a organized fashion?

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT (PPE)

• Workers dress properly for the job?

  Yes

  No

  N/A

• Are hard hats being worn?

  Yes

  No

  N/A

• Are proper leather boots utilized for foot protection?

  Yes

  No

  N/A

• Is eye protection used when grinding, sawing, chipping, placing concrete

  Yes

  No

  N/A

• Is respiratory protection being used when conditions require them?

  Yes

  No

  N/A

• Is hearing protection being used by coworkers that may be exposed to noisy conditions?

  Yes

  No

  N/A

• Are coworkers using proper hand protection?

  Yes

  No

  N/A

• Are all staff and visitors are wearing Hi-Viz vests or jackets.<br>Ensure Hi-Viz clothing is not damaged.

  Yes

  No

  N/A

• Are all crew members wearing FR clothing?

  Yes

  No

  N/A

FIRE PROTECTION & PREVENTION

• Are extinguishers readily accessible?

  Yes

  No

  N/A

• Do fire extinguishers have current inspection tags?

  Yes

  No

  N/A

• Is there a clear path to fire hydrants for the fire deparment?

  Yes

  No

  N/A

• Are "No Smoking" signs posted where needed?

  Yes

  No

  N/A

• Are all flammable liquid containers clearly identified?

  Yes

  No

  N/A

• Are all flammable liquid containers metal cans that are UL or FM listed?

  Yes

  No

  N/A

• Have proper storage practices for flammables been observed?

  Yes

  No

  N/A

• Have gas cylinders been chained upright with valve caps securely fastened?

  Yes

  No

  N/A

• Are temporary heaters located at a safe distance from combustibles?

  Yes

  No

  N/A

• Is ventilation adequate for temporary heaters?

  Yes

  No

  N/A

HAZARD COMMUNICATION

• Do the coworkers know the location of the master MSDS book?

  Yes

  No

  N/A

• Are MSDS sheets maintained on each product in use?

  Yes

  No

  N/A

• Are MSDS labels on each chemical container that is unmarked.?

  Yes

  No

  N/A

• Are coworkers properly trained on hazardous chemicals present?

  Yes

  No

  N/A

DUST, GASES, VAPORS, FUMES & MISTS

• Is adequate ventilation provided?

  Yes

  No

  N/A

• Is protective equipment used to protect against over-exposure?

  Yes

  No

  N/A

• Are coworkers made knowledgeable of the hazards when working with harmful agents?

  Yes

  No

  N/A

HANDLING & STORAGE OF MATERIALS

• Are materials properly stored and stacked?

  Yes

  No

  N/A

• Are passageways clear?

  Yes

  No

  N/A

• Proper number of workers for each operations?

  Yes

  No

  N/A

FLAMMABLE GASES & LIQUIDS

• Has there been proper segregation between flammable gas cylinders?

  Yes

  No

  N/A

• Proper labeling of full and empty flammable gas cylinders?

  Yes

  No

  N/A

• Are proper type and number of fire extinguishers nearby?

  Yes

  No

  N/A

HAND TOOLS

• Are tools neatly stored and accessible when not in use?

  Yes

  No

  N/A

• Are tools being carried safely?

  Yes

  No

  N/A

• Is the proper hand tool used for the task?

  Yes

  No

  N/A

• Are hand tools and other equipment regularly inspected for safe conditions?

  Yes

  No

  N/A

• Are the handles on hand tools in good condition, not bent, splintered or broken?

  Yes

  No

  N/A

• Are the heads of chisels or punches ground periodically to prevent mushrooming?

  Yes

  No

  N/A

• Are cutting edges kept sharp so the tool will move smoothly without binding or skipping?

  Yes

  No

  N/A

POWER TOOLS & POWDER ACTUATED TOOLS

• Are power tools inspected before use?

  Yes

  No

  N/A

• Are tools inspected for frayed and damaged cords?

  Yes

  No

  N/A

• Are tools and cords properly grounded and are ground pin in good condition?

  Yes

  No

  N/A

• Are double insulated tools in use and in good condition?

  Yes

  No

  N/A

• Are tools neatly stored and accessible when not in use?

  Yes

  No

  N/A

• Are tools being carried safely?

  Yes

  No

  N/A

• Is the proper power tool being used for the task?

  Yes

  No

  N/A

• Are guards in place on the tool and in good condition?

  Yes

  No

  N/A

• Are portable circular saws equipped with guard above and bellow the base or shoe?

  Yes

  No

  N/A

• Are rotating or moving parts of equipment guarded to prevent contact by coworker?

  Yes

  No

  N/A

• Are all hoses on air or hydraulic tools in good condition?

  Yes

  No

  N/A

ELECTRICAL

• Are extension cords free of nicks, gouges or cuts?

  Yes

  No

  N/A

• Are cords ends inspected for proper grounded prongs?

  Yes

  No

  N/A

• Are power cords protected in traffic ways?

  Yes

  No

  N/A

• Are GFCI's and/or assured equipment grounding conductor programs being used?

  Yes

  No

  N/A

• If temporary lighting is provided, are bulbs protected against accidental breackage?

  Yes

  No

  N/A

EXCAVATING & TRENCHING

• Have utilities companies been notified of proposed excavation work?

  Yes

  No

  N/A

• Is the spoil pile at least two feet from the edge of the excavation?

  Yes

  No

  N/A

• If needed, are barricades, stop logs, properly placed?

  Yes

  No

  N/A

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