Information
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Document Title
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Job Site Builder/Name
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Conducted on
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What is the Address of the jobsite
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Weather
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Foreman
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Additional Attendees (Besides Foreman + # of EE's on site)
Documentation
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Will you be checking Documentation on this site?
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A "Tailgate" safety meeting was held at least once this week? [1504] (21e)
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Is the Health and Safety Form filled out and accurate?
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Is a Stretch and Flex Picture being submitted?
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Readily available Safety Binder Containing: COSP [1509](21c), IIPP [1509,3203](90), HIPP [3395](81), HAZCOM [5194](77a), CPP [3205]
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Safety Data Sheets (SDS) Binder on site
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Readily Available (EMS) Emergency Medical Services Plan [1512](69b)
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Posted: Labor Board Poster, Emergency Phone Numbers, UPF Safety Postings
First Aid / Fire Extinguishers
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First Aid Kit is fully stocked and readily available [1512(c)](69A)
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Trained person(s) in possession of current First Aid Certification (on Competent Person)[1504,1512](69b)
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Fire Extinguishers have tags indicating they are being inspected monthly and Serviced annually (must be 5IBs.) [1922](68c)
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Fire Extinguishers on-site
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All Gasoline stored in Safety cans with spark arresters?
Personal Protective Equipment (PPE)
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Hard Hats worn by crew and meet ANSI Rating Z89.1 [1514,3381(a-e),3384(a)](108F4)
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Safety Glasses meeting ANSI Rating Z87.1 [3382](107A)
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Foot Protection worn by crew and in safe condition [3385](107B) [(ASTM) F 2412-05 / ASTM F 2413-05]
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Hearing Protection is readily available and worn accordingly [5097](108E)(Table 3)
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Suitable clothing for the job worn by crew [1522(a)](107D)
Heat Illness
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Sufficient amounts of clean, cool, water is available to all employees [1524(a1B),3395(c)](82E1) (Foreman know where to replenish when necessary?)
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Daily high temperature under 80 degrees?
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Shade available upon request (83F1a)
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Daily high temperature between 80-94 degrees?
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Employees can point out where shade is readily available for rest (83F2a)
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Foreman is encouraging employees to take 5 minute "cool down" breaks (83F9)
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Daily high temperature 95 degrees or higher?
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Supervisor conducted pre-shift meeting to reminding employees to drink plenty of water throughout the day (842G9)
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Employees are trained and vigilant of signs and symptoms of heat illness (842G3)
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Observation and regular contact with employees is being used by supervisor (842G5)
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Supervisor is paying extra attention to employees that have less that 2 years of experience (842G8)
Housekeeping/Material Handling
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Are workers using proper lifting techniques?
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Work areas neat and orderly?
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Walkways are free of debris and obstructions (90)(A)
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Holes/Floor Openings have guardrails and toeboards or covers (76)(B)(1)(a)
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Trip hazards (such as post tension cables) are painted for high visibility or sectioned off (90)(B)
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Nails in scrap material are bent down to prevent puncture/laceration injury exposure (90)(D)
Fall Protection
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Was fall Protection Observed?
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Are there Safety Nets? and are they installed correctly? [1671](65B5)
Scaffolding
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Was Scaffolding/Frame Pro observed?
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Fall Protection Inspection Sheet filled out each morning and readily available
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Scaffolding set up completely and the correct height
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All Guardrails are installed on open sides and ends of platforms [1621(a)](122A10)
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Is Scaffolding fully planked?
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Safe Access available for Scaffolding
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Toeboards are required on all railed sides of work surfaces where employees work or pass below [1621(b)](122A11)
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Scaffolding a safe distance from building
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Planks not over extending past support (6"-18") or blocked off
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Fall Protection was used properly by crew where applicable
Personal Fall Arrest (PFA)
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Was PFA observed?
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PFA system is in place when a fall distance of 15 ft or greater during framing activities [1716(c1)1716.2(e)](65C3c)
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Anchorage Points are correctly attached to the structure [1670](64B3c)
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PFP have tags and inspections documented and up to date? [1670(b19)]
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Employees are connected at Anchor Points that do not allow them to free fall 6 ft or fall onto the lower level [1670](64B3b)
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Employees are wearing safety harness correctly and the correct size (Can pass hand through leg strap not fist)
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Each employee is attached separately [1670(b4)](64B3d2)
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Fall Protection was used properly by crew where applicable
Guardrails - Personal Fall Protection (PFP)
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Guardrails
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Top Rails at 42"-45" (2"x4" or larger) (75)(1)(a)
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Mid Rails (1"x6") halfway between top rail and floor are required when there is no wall or parapet wall is less than 21" high (75)(1)(b)
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Wood posts are not less than 2"x4" and spaced at 8 ft or closer intervals (75)(1)(d)
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Wall Openings must be guarded if there is a drop of more than 4 ft and the bottom of the opening is less than 3 ft above the working surface (76B2)
Stairs / Stairways
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Were stairs observed?
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Employees are accessing 2nd floor stairwells/temporary stairwells (Required prior to framing 2nd floor walls or higher) (134)(C)
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Stairs are equipped with handrails at 34" - 38" that run the full length of the stairs (134)(H)
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Stairwells have fully installed Guardrails and toeboards (134)(J)
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do empty stairwells have platforms or is properly guarded against falls?
Forklift
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Were Forklift(s) observed?
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Forklift Drivers wearing Seatbelts properly while machine is being used [3664(b)]
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Forklift driver Certified [3650](72j) and Forklift Inspected (Form Completed)[3668(d)]
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Are forklift outriggers working as needed/available?
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Lumber piles are not stacked higher than 20 feet and are stable?
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Is there a grease gun on site and being used?
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Does the forklift have sufficient oil/fluids?
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Are all tags and/or rating plates in place?
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Is there an Operations/safety Manual readily available?
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Is there a trash hopper on site? If yes, what is/are the Man Basket(s) #?
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Is there a man basket on site?
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Is there at least one harness and lanyard available to be used?
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What is the man basket number?
Tools and Equipment
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were proper tools being used for the task?
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Tools being used Safely?
Circular Saws
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Were Circular Saws observed? ^
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Properly equipped with blade guard in working condition [4307(a-c)](140G1,b&c)
Ground-fault circuit interrupters (GFCIs)
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GFCIs are in use and in good working order [2405.4(c)](44G.1)
Electrical Cords
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Extension cords adequate size for the tools plugged into them?
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Tool and extension cords have no exposed wiring [1699](137)(Item 1)
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Tool and extension cords are not missing ground post or are double insolated (a square within a square) [2395.45] (137)(Item 3)
Pneumatic Tools
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Were Pneumatic Tools observed?
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Employees were observed carrying nail guns with fingers OFF the trigger mechanism
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Tools have proper safety functions (springs)
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Pneumatic Nailers and Staplers NOT modified to prevent the tool from operating when the muzzle is not in contact with work surface [1704(b)](142N2)
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Pneumatic Nailers and Staplers are unplugged from air hose when employee is out of sight of their tool.
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Air compressor's air gauge working and legible?
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Gas powered compressors have necessary protection guards
Ladders
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Were Ladders Observed?
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Employees are using ladders correctly and not climbing the building structure [3276]
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Ladders are well maintained and in good working condition (95)(I)(1)(b) (if company ladder, what's the ladder number?)
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Ladders have the manufacturer's safety labels (95)(I)(1)(b)
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Ladder set-up, base, and footing is to standard (95)(I)(3)(c)
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Employees are not reaching an excessive distance from their body while using ladders (96)(I)(3)(n) (EE's Body staying between ladder side rails)
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Employees are not carrying equipment or materials while on ladders that prevent them from using the ladder safely (96)(I)(3)(o)
Powder Actuated Tools (PATs)
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Were PATs observed?
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Only trained workers holding a valid operator's card on them may use a PAT [1685](138D1)
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live shots being disposed of accordingly[1689(c),1691(as)](139j)
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PATs were never left unattended [1690(b)(139D4a)
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Warning signs that say POWDER-ACTUATED TOOLS IN USE are displayed within 50 ft of a PAT operation [1691](139D5i)
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PATs must be kept in lockable storage container [1687(a)](138D2)
Radial Arm (Horizontal Pull) Saws
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Were Radial Arm Saws observed?
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The upper half of the saw blade and arbor ends are completely covered [4309(a)](141J1)
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The sides of the lower exposed portion of the blade shall be guarded [4309(a)2](141J2)
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Anti-kickback device must be used during ripping operations [4309(c)](141J3)
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Saws must return automatically to the tables back when released [4309(d)](141J4)
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Saws must have a stop provided to prevent the saw blade from passing the front edge of the table [4309(b)](141J5)
Chain Saws
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Where Chain saws observed?
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Is EE wearing all necessary PPE? (Safety glasses, Hard hat, protective clothing, ear plugs, and gloves)
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Does the Chain Saw have all necessary Safety guards
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EE is trained and experienced on the use of the chain saw?
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Is the EE starting and using the Chainsaw on the ground? (Not on the top plate) Is EE using Chain saw safely?
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Does owner have a manufacturer’s manual and is keeping up on maintenance?
Silica Dust
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Were objects that could produce Silica Dust being worked on?
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Readily available Written Control Plan for Silica Dust Exposure (133)(G)
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Voluntary Respirator Request Signature for the employee wearing a mask
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Circular Saws have silica designed blades with Vacuum Adapter (Engineering/Administrative Controls in Written Plan) (133)(B)
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Employees are not dry sweeping these areas (133)(B)
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Vacuum Adapters are being properly emptied in the Concrete Wash Out Basin to contain Silica Dust (133)(B)
Power Lines / Excavations
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Did you examine Powerlines on this safety walk?
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Power Lines are 6 ft from people working near overhead lines [2946](45)(H)(2)(c)
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Power Lines are 10 ft from forklifts working near overhead lines [2946](45)(H)(2)(b)
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Did you examine Excavations on this safety walk?
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Hazard awareness barriers in place as required (58)(c)(9&14)
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If at risk, was Builder, Area Manager, and Safety contacted to mitigate hazard?
Builder/General Contractor
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is there an adequate number of toilets and hand wash stations per 20 persons? And are they clean and serviced regularly? If not, has the Foreman communicated with builder and or safety? (text or email documented) [1526]
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Trash containers provided and emptied, or other means to have trash piles picked up and Jobsites maintained. If not, has the Foreman communicated with builder and or safety? (text or email documented)
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Impalement hazards mitigated with protective covers? If not, has the Foreman communicated with builder and or safety? (text or email documented) [1712c1]
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Are temporary lights installed and have bulb guards installed?
General Comments
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Add any additional relevant photos
Sign Off
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Name & Signature of Foreman
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Name & Signature of Inspector
