GENERAL SAFETY

  • Safety Planning (pre-con meetings, safety plan, JSA, morning huddles, pre-task plans)

  • Postings (State, Federal, Emergency #'s, Incident Reporting & Crisis Management)

  • Material Safety Data Sheets (3E MSDS on Demand Posting & Subcontractor MSDS's)

  • First Aid Kit / Eyewash Replenished

  • Sanitation (1 toilet per 20 workers)

  • Housekeeping (trash & debris removed, proper material storage)

  • Date Corrected:

Personal Protective Equipment

  • Proper Attire (shirts 4" sleeves, pants, boots, hard hat)

  • Date Corrected:

  • Eyes (glasses, goggles, face shield)

  • Date Corrected:

  • Other (hearing, gloves, respirators, chemical protection, metatarsal guards)

  • Date Corrected:

Fall Protection System

  • Guardrails (200#, 42" +/- 3", toeboards, wire rope flagged every 6')

  • Date Corrected:

  • Holes (guarded, covered, secured, labeled)

  • Date Corrected:

  • Protection @ 6' (anchor point, harness, lanyard, retractable, rope grab, positioner)

  • Date Corrected:

  • Other (falling object protection, safety nets, warning lines minimum of 15' from edge)

  • Date Corrected:

Fire Protection/Prevention

  • Fire Extinguishers (accessible, identified, charged, w/in 100' of travel, @ stairways)

  • Date Corrected:

  • Fuel Storage (location, container, extinguisher, traffic protection)

  • Date Corrected:

  • Hot Work (fire watch, fire blankets, permit, extinguisher present, debris clear)

  • Date Corrected:

Cranes

  • Daily Lift Plan (Qualified Operator, Signal Person, Rigger, Daily, Periodic and Annual Inspections)

  • Date Corrected:

  • Set-Up (barricaded, level, powerlines 20' minimum clearance)

  • Date Corrected:

  • Outriggers (extended, pads adequate & level per Daily Lift Plan)

  • Date Corrected:

  • Operation (load path, taglines, signal person)

  • Date Corrected:

  • Capacity (charts available, critical lift plan, object weights identified)

  • Date Corrected:

  • Sling Condition (wire rope, synthetic, hardware)

  • Date Corrected:

Access Equipment

  • Extension Ladders (4V:1H, secured at top and base, 3' above landing, 3 points of contact)

  • Date Corrected:

  • Step Ladders (stable, proper use, inspected, non-conductive)

  • Date Corrected:

  • Stairs (metal pan treads filled, uniform w/in 1/4", rails @ 36", unobstucted, illuminated)

  • Date Corrected:

  • Aerial & Scissor Lifts (proper use, fall protection, condition, rails, operator training)

  • Date Corrected:

Electricity

  • Panels (covers in place, circuits identified, weatherproof, secured, breakers/holes filled)

  • Date Corrected:

  • GFCI (@ breakers, outlets, pigtails, electrician weekly testing log)

  • Date Corrected:

  • Electrical Cords (ground, strain relieve, condition, protected from traffic, proper use)

  • Date Corrected:

  • Romex (protected to 8', proper splices taped, fastened every 10' with non-conductive fastener, protected from physical damage)

  • Lighting (adequate- 5 ft candles, protected, secured, sockets filled, separate circuit)

  • Date Corrected:

Excavation

  • Daily Dig Permit (Competent Person Inspection, utilities located, cracks, spalling, water accumulation, changed conditions)

  • Date Corrected:

  • Access/Egress @ 4' (ladder, ramp, stairs within 25' of travel)

  • Date Corrected:

  • Protection @ 5' (slope, bench, shield, shore)

  • Date Corrected:

  • Other (spoils 2' back, vibration, hazardous atmosphere potential)

  • Date Corrected:

Scaffolding

  • Base (sills/plates/jacks/casters, secured, level, locked)

  • Date Corrected:

  • Braces (installed, secured, condition)

  • Date Corrected:

  • Frames (compatible, pinned, condition)

  • Date Corrected:

  • Platform (fully planked, overhang 6"-12" or cleated, plank condition)

  • Date Corrected:

  • Access (integral frame - 16 3/4" rung spacing, ladder w/ gate, stairtower)

  • Date Corrected:

  • Other (secured @ 4V:1H, level, tagged, competent person inspected, tarp/debris net engineer approval)

  • Date Corrected:

Other

  • Concrete (pump 20' from power lines, impalement protection - flat rebar caps)

  • Date Corrected:

  • Motorized Equipment (qualified operator identified, backup alarms, seat belts, equipment condition acceptable)

  • Date Corrected:

General Observations (items not referenced in inspection form and / or add positive comments)

  • Date Corrected:

"ALL IN"

  • Is this Project Team "ALL IN"?

Inspector Signature

  • Add signature

Project Superintendent Signature

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