UCONN Onsite Safety Consultation Services

• Project Name

• Project Manager

• Construction Manager

• Project Superintendent

• Conducted on

  Date

• Prepared by:

  Select Scott Pipicelli Justin Miller Peter Shackford

  • Scott Pipicelli
  • Justin Miller
  • Peter Shackford

• Scope of Work:

Hazard Assessment

• Crane / Hoisting Operations

  Yes

  No

• Third Party Inspection on file?

  Yes

  No

  N/A

• Is Lift Plan available?

  Yes

  No

  N/A

• Unauthorized personnel removed from hoisting radius?

  Yes

  No

  N/A

• Scaffolding

  Yes

  No

• Daily Inspection Documented?

  Yes

  No

  N/A

• Scaffold Design Meets OSHA Criteria (access, fully decked, fall protection, toe boards)

  Yes

  No

  N/A

• Scaffold Free of Accumulated Debris

  Yes

  No

  N/A

• Permit Required Confined Spaces

  Yes

  No

• Permit Completed and Visible

  Yes

  No

  N/A

• Fresh Air Ventilation

  Yes

  No

  N/A

• UCONN Fire Department Notified of PRCS Entry Location.

  Yes

  No

  N/A

• Working from Heights

  Yes

  No

• Perimeter Edge Protection

  Yes

  No

  N/A

• Holes / Openings / Skylight Protection

  Yes

  No

  N/A

• Personal Fall Arrest / Restraint Systems

  Yes

  No

  N/A

• Hot Work

  Yes

  No

• Hot Work Permit Posted

  Yes

  No

  N/A

• Fire Extinguishers Available?

  Yes

  No

  N/A

• Flammable / Combustible Material Storage

  Yes

  No

  N/A

• Environmental Abatement

  Yes

  No

• Asbestos

• Lead

• PCB's

• Mold

Safe Work Practices

• Unsafe Conditions and/or Behaviors

Observation & Corrective Action

• Positive Findings

Note / Observation

• Student / Faculty Protection

Notes / Observationa

Signatures

• HC&A Representative

  Sign

Pictures

• Add media

  Media

• Add media

  Media

• Add media

  Media