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Comprehensive Site Safety Observation Form

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Comprehensive Site Safety Observation Form

FOR INTERNAL USE ONLY.ALL ITEMS PERTAIN TO STELLAR J AND ALL SUBCONTRACTORS.

1. Work at Heights and Fall Protection

1.1. Critical - Improper, or failure to use of fall protection equipment?

1.2. Critical - Lack of edge protection (guard rails and barricades)?

1.3. Unsafe or incomplete edge protection (guard rails and barricades)?

1.4. Lack of, or inadequate, formal training for affected employees?

1.5. Unsafe or damaged harness or equipment?

1.6. Incompatible hooks/equipment?

1.7. Unlabelled or does not meet regulations?

1.8. Unsafe or uncertified anchor points?

1.9. Lack of inspection protocol for equipment?

2. Tools and Heavy Equipment

2.1. Unsafe or damaged tools? (including missing or damaged guards)

2.2. Incorrect tool/equipment for job? (e.g. grinding discs for cutting, including incompatible attachments used with tool/equipment?

2.3. Unauthorized operator of powder actuated tools?

2.4. Unsafe or damaged heavy equipment? (including missing or damaged glass, etc)

2.5. High Risk - Unqualified operators or unsafe operation (including use of cell phone or failure to use seatbelt)?

2.6. Lack of operators manual?

2.7. Lack of training in safe operation, clean-up and maintenance?

2.8. Lack of LOTO procedures for cleaning, servicing and maintenance?

2.9. Lack of inspection regime?

2.10. Lack of, or inadequate backup alarm?

3. Scaffolds

Does this project have any scaffolding?

3.1. Critical - Unsafe or incomplete scaffold?

3.2. High Risk - Lack of competent persons supervision for erection of scaffold?

3.3. Lack of inspection protocol for scaffold?

3.4. Incompatible scaffold components? Unlabelled or do not meet code?

3.5. Safe Work Load (SWL) exceeded? (tools, stored materials, number of persons)

4. Lifting Equipment - Rigging and Cranes

4.1. High Risk - Unsafe or damaged lifting equipment, including ropes, slings, chains, hooks?

4.2. Lack of daily inspection protocol for rigging?

4.3. Lifting equipment unlabelled, no Safe Working Load (SWL) information displayed?

4.4. Unsafe or improper storage of lifting equipment?

4.5. SWL of any lifting equipment exceeded?

4.6. Does this project have a crane on site?

Critical - Improper operation of crane?

Lack of daily inspection protocol for cranes?

Lack of monthly inspection protocol for cranes (documentation)?

Lack of current Annual Inspection Documentation?

Lack of certified crane operators, qualified riggers, or qualified signal person?

Loads lifted over persons, close proximity to obstacles incl. overhead power lines?

Are any pinch/crush hazards created by swing radius barricaded properly?

Lack of LOTO procedures for cleaning, servicing and maintenance?

SWL of crane exceeded (does the operator know the weight of the load)?

If crane is in use, are ground conditions adequate for support of crane, outriggers and load?

Lack of, or inadequate, appropriate equipment used to hoist personnel?

5. Excavation and Trenching

5.1. Does this project have any trenching 4' or greater?

Critical - Lack of, or inadequate, trench shoring/benching?

Lack of competent person (in writing in job file)?

Failure to properly assess soil condition and type?

Lack of, or inadequate, appropriate access to trench?

Lack of daily inspection protocol for safety equipment, soil conditions and atmosphere monitoring?

Lack of, or inadequate trench edge protection?

Spoils or equipment located too close to trench?

Lack of engineering design for trenches 20' or deeper?

Lack of, or inadequate, appropriate rescue plan?

5.2. Does this project have any excavation 4' or greater?

Critical - Lack of, or inadequate, excavation shoring/benching?

Lack of competent person (in writing in job file)?

Failure to properly assess soil condition and type?

Lack of, or inadequate, appropriate access to excavation??

Lack of daily inspection protocol for safety equipment, soil conditions and atmosphere?

Lack of, or inadequate excavation edge protection?

Spoils or equipment located too close to excavation?

Lack of engineering design for excavations 20' or deeper?

Lack of, or inadequate, appropriate rescue plan?

6. Ladders

6.1. Critical - Improper use of ladder?

6.2. Unsafe positioning of ladders?

6.3. Ladder not properly secured?

6.4. Ladder unsuitable for job? (e.g. metal ladder used for electrical work)

6.5. Unsafe or damaged ladders?

6.6. Improper storage of ladder?

6.7. Lack of ladder load rating information?

7. Hazardous Manual Tasks

7.1. Lack of identification hazardous manual tasks (Site Specific JSA)?

7.2. Lack of assessment of hazardous manual tasks?

7.3. Inadequate risk controls? (examples: no job rotation, lighter loads, trolleys, lifting equipment, etc)

7.4. Lack of training in risk controls and safe lifting/ team lifting techniques?

8. Hazardous Chemical (including fuel and oil)

8.1. Unsafe storage location? (e.g. flammables near ignition sources, spills could enter stormwater drains, etc)

8.2. Incompatible chemicals stored near each other?

8.3. Incomplete, or not posted, Hazard Communication List and training?

8.4. Material Safety Data Sheets not accessible on site?

8.5. Lack of emergency procedures for injury/spills/fire etc?

8.6. Excessive quantities stored on site or in vehicles?

8.7. Insufficient ventilation?

8.8. Insufficient, or incorrect, PPE?

8.9. Unsuitable storage containers? (unlabeled or stored in improper containers)

8.10. Are fire extinguishers available, properly mounted, fully charged and inspected routinely?

9. Emergency Response

9.1. Lack of, or inadequate, Emergency Plan posted (including directions to nearest emergency room and occupational health clinic and Superintendent's Injury Checklist)?

9.2 Lack of, or inadequate, Evacuation Plan (posted, including designated safety zones)?

9.3. Lack of training/rehearsal of emergency plans?

9.5. Insufficient access to formally trained First Aid Responders for all shifts?

9.6. Unsuitable or inadequate communication equipment?

10. Traffic Management

10.1. Lack of, or inadequate, Traffic Control Plan in place?

10.2. Lack of training in TCP for all persons on site? (contractors and visitors)

10.3. Inadequate controls for TCP? (physical barriers, bollards, speed limits, flashing lights, spotters, etc)

11.Personal Protective Equipment (PPE) and Engineering Controls

11.1. Critical - Failure to properly use minimum PPE (100% utilization: hard hat, safety glasses, work shoes)?

11.2. Lack of system to issue, inspect, replace and monitor PPE?

11.3. Lack of training in safe use, clean-up and inspection of PPE?

11.4. Lack of, or inadequate PPE available on site (including sun and heat stress protection)?

11.5. Failure to properly use situational PPE (as needed utilization: hearing protection, face shield, coveralls)?

11.6. Failure to use wet grinding on concrete?

11.7. Respiratory Protection in compliance with program?

12.Work Environment

12.1. Lack of, or inadequate, amenities? (toilets, wash areas, lunch rooms, etc)

12.2. Insufficient lighting?

12.3. Inadequate housekeeping?

12.4. Lack of, or inadequate noise/ vibration control?

12.5. Unmarked confined space?

12.6. Lack of, or inadequate, site safety signage and postings?

12.7. Lack of, or inadequate materials handling?

12.8. Uncovered or unmarked holes?

12.9. Unprotected implement hazards (rebar, etc)?

12.10. Lack of, or inadequate masonry or concrete wall bracing?

12.11. Lack of, or inadequate Limited Access Zone during masonry wall construction?

13.Electrical Hazards

13.1. Unsafe electrical cords or spider boxes? (damaged, out of date tape or untested)

13.2. Lack of GFC protection?

13.3. Potential contact with underground assets?

13.4. Potential contact with overhead electrical lines?

13.5. Overloading outlets?

13.6. Cords placed on over sharp edges, in area with high probability of damage or on metal structures?

13.7. Electrical equipment near water?

13.8. Electrical equipment near flammables?

13.9. Electrical equipment near chemicals that could cause damage?

13.10. Electrical cords that may be damaged from contact with moving machinery parts?

13.11. Electrical cords on work surfaces?

13.12. Lack of Lock-out/tag-out (LOTO) procedures for electrical equipment?

13.13. Lack of, or inadequate, labeling of electrical breaker panel?

14.Environmental Hazards

14.1. Lack of, or inadequate, dust suppression system?

14.3. Lack of, or inadequate, systems to prevent contaminants entering stormwater drains?

14.4. Lack of, or inadequate erosion control measures (silt fence, rock access areas etc)?

14.5. Lack of, or inadequate, protection of access/egress due to weather (snow, ice, etc)?

14.6. Lack of, or inadequate, protection of Outsiders (public, owners, etc)?

15. Administrative Procedures

15.1. Lack of/or inadequate Site Specific Safety Plan?

15.2. Failure to obtain permits (Hot Works, Confined Space, etc.)

15.3. High Risk - Not all employees and subcontractors received a Site Specific Orientation (completed form in file and stickers on hard hat)?

15.4. Lack of, or inadequate, current weekly toolbox meeting minutes?

15.5. Lack of, or inadequate, training, licenses, skills, experience?

15.6. Lack of, or inadequate, Fall Protection Work Plan with rescue plan (up to date for current work and posted where employees can review it)?

15.7. Critical - Failure to follow Lock Out/Tag Out program (overall)?

15.8. Critical - Failure to comply with Confined Space Program?

15.9. Lack of, or inadequate, routine inspections, monitoring, audits?

15.10. Lack of, or inadequate two week schedule?

15.11. Failure to post OSHA 300 log?

15.12. Failure to post Fire Prevention Plan?

15.13. Failure to post most recent safety committee meeting minutes?

15.14. Failure to post superintendent's Injury Instructions?

Corrective Actions

Critical - Were any of the current deficiencies a repeat violation from previous inspections?

Have all corrections been completed from most recent inspection?

Have all deficiencies found during this inspection been corrected immediately?

Enter corrective actions that remain to be completed.

Enter date by which all corrections must be completed.

Sign Off

On site representative

Auditor's signature

For final copy, attach additional photos and distribute.Distribution List: President, Vice President, Project Manager, Superintendent, General Superintendent, a safety Officer, Project Engineer, Shop Superintendent.

Other Comments

(check name not set)