TZC Safety Assessment

• Supervisor/Crew:

• Conducted on

  Date

• Auditor

  Select Caroline Diaz Daryl Lloyd David Stanford Ricky Gorley Nate Flowers Peter Hamilton David Colagiovanni John Glinski

  • Caroline Diaz
  • Daryl Lloyd
  • David Stanford
  • Ricky Gorley
  • Nate Flowers
  • Peter Hamilton
  • David Colagiovanni
  • John Glinski
• Location
  Address

1.0 Work at height

• Guardrails/rigid barricades in place and adequate

  Yes

  No

  N/A

• Hole covers in place and adequate

  Yes

  No

  N/A

• Scaffolding- tagged, signed off, contact name and number

  Yes

  No

  N/A

• 100% tie off being followed

  Yes

  No

  N/A

2.0 Scaffolds/ ladders/ gang planks

• Scaffolding- tagged, signed off, contact name and number

  Yes

  No

  N/A

• Ladders- good condition, secured, correct angle, extended past landing

  Yes

  No

  N/A

• Gang planks- secured at one end, correct angle, proper handrails

  Yes

  No

  N/A

3.0 Motorized heavy equipment

• Pedestrian and vehicle traffic seperated

  Yes

  No

  N/A

• Flaggers in place

  Yes

  No

  N/A

• High-visibility clothing used

  Yes

  No

  N/A

• No approach of equipment until acknowledgement by operator

  Yes

  No

  N/A

• Swing radius barricades as appropriate

  Yes

  No

  N/A

4.0 Material handling

• Worker's clear of line of fire when loads moved

  Yes

  No

  N/A

• Loads are stable prior to unstrapping

  Yes

  No

  N/A

• Loads are secured before transit

  Yes

  No

  N/A

• Materials are stored properly, as required

  Yes

  No

  N/A

5.0 Confined space entry

• Permit requirements followed and signed permit available

  Yes

  No

  N/A

• Forced ventilation in place

  Yes

  No

  N/A

• Atmospheric testing done

  Yes

  No

  N/A

• Attendants in place

  Yes

  No

  N/A

6.0 Cranes and rigging

• Crane and suspended load area is clear of unauthorized personnel

  Yes

  No

  N/A

• Swing radius barricaded

  Yes

  No

  N/A

• Tag lines in use

  Yes

  No

  N/A

• Daily rigging inspection documented in team book

  Yes

  No

  N/A

7.0 Trenching and excavations

• Competent person available and daily inspection in team book

  Yes

  No

  N/A

• Benched, sloped, shared properly when deeper than 5 feet

  Yes

  No

  N/A

• Spill dirt, equipment and material storage at least 2 feet from edge

  Yes

  No

  N/A

• No water accumulation in excavations

  Yes

  No

  N/A

• Access and egress provided every 25 feet

  Yes

  No

  N/A

8.0 Electrical work

• Working on live equipment to be avoided unless not possible

  Yes

  No

  N/A

• Proper PPE in place such as flame resistant clothing and voltage rated gloves as needed for live work

  Yes

  No

  N/A

• Work area properly barricaded

  Yes

  No

  N/A

• Live work permits in place

  Yes

  No

  N/A

• All equipment, tools and materials kept minimum 20 feet from overhead lines (up to 350 kV)

  Yes

  No

  N/A

9.0 Hazardous energy control/ line breaking

• Identify and isolate potential energy sources and stored energy such as electrical, hydraulic, pressure and chemical

  Yes

  No

  N/A

• Lockout, tag, verify zero energy prior to working on systems, or equipment

  Yes

  No

  N/A

Signatures

• Supervisor

  Sign

• Auditor

  Sign