CG Schmidt, Inc.

WEEKLY SAFETY AND HEALTH INSPECTION REPORT

Project Superintendent: Project Name: Job # Date:

1. Paperwork Requirements 8. Tools, Hand and Power 14. Motor Vehicles, Skid Loaders, Forklifts, Backhoes
Copies of OSHA construction standards Inspection and maintenance Regular inspection and maintenance
Emergency telephone numbers Damaged tools repaired/replaced promptly Qualified operators
Maintenance records for equipment Proper grounding Local and state vehicle laws & regulations observed
Required signs and posters Proper instruction in use Brakes, lights, warning devices operative
Material Safety Data Sheets All Mechanical safeguards in use Weight limits and load sizes controlled
Written hazard communication program Tools neatly stored when not in use Seat belts used
Administrative Guide Proper tool being used for the job
Power-actuated tools have required safeguards 15. Excavation and Trenching
2. First aid and are operated only by trained personnel Shoring of adjacent structures
First aid supplies Public roads and sidewalks supported & protected
First aid instruction on the job 9. Welding and Cutting Materials at a minimum of 2 from the edge of excav.
Telephone number & location of nearest hospital Qualified operators Water controlled
First aid provisions made for prompt medical attention Screens, shields, goggles, gloves and clothing Equipment at safe distance from edge
Electrical equipment grounded Ladders or stairs provided where needed
3. Housekeeping and Sanitation Fire extinguishers of proper type nearby Equipment ramps adequate
General neatness of working areas Inspection of fire hazards Frequent inspection
Passageways and walkways clear Flammable materials protected Shored, sloped or bench
Adequate lighting Gas cylinders chained upright
Projecting nails removed Gas lines protected and in good condition 16. Concrete Construction
Waste containers provided and used Concrete buggies, buckets, pumping systems, trowels
Sanitary facilities adequate and clean 10. Electrical and equipment used according to standards
Adequate supply of drinking water Adequate wiring, well insulated, and grounded Reinforcing steel placing/ tying according to stds.
Harmful dusts, fumes, vapors or gases controlled GFCI and assured equipment grounding provided Shoring and storing equipment according to stds.
Electrical dangers posted Drawing & plans for formwork, shoring, etc. on site
4. PPE Tools and cords in good condition
Hard hats, high visibility traffic vests Temporary lighting per standard 17. Steel Erection
Safety glasses Location of overhead electric lines observed Fall protection 6 rule
Dust masks Diggers Hotline has been called Floor opening covered and barricaded
Ear Plugs Ladders, stairs or other access provided
PPE for visitors 11. Scaffolding Structural steel assembly according to standards
Safety belts, lifelines, lanyards Erection under proper supervision
Secured to structure and proper footing provided 18. Demolition
5. Fire Protection and Prevention Ladders & working areas free of debris/snow/ice & grease Survey made prior to start of demolition
Fire protection program Passerby protected from falling objects Chutes provided where required
Fire extinguishers provided Supports plumb, adequate crossbracing provided Utility service lines cut off or controlled
Emergency exits given priority Guardrails & toeboards in place Systematic removal according to standards
No Smoking/Open Flame-signs posted where needed Ropes and cables in good condition
Storage use and handling of flammable liquids Properly inspected 19. Ladders
Proper use of temporary heating Ladders inspected and in good condition
12. Fall Protection Properly secured
6. Flammable Gasses and Liquids Floor & roof openings have standard guardrails/covers Siderails on fixed ladders extend 3 above top landing
All containers clearly identified Open sided floors, platforms, & runways more than 6 Job built ladders constructed of sound materials
Proper storage practices observed high are equipped with standard guardrails Stepladders fully open when in use
Fire hazards checked Stairways equipped with railings and handrails Metal ladders not used around electrical hazards
Proper storage temperatures and protection Fall protection guidelines enforced - 6 rule
Proper types & number of extinguishers nearby
Carts for moving cylinders 13. Cranes
Inspect crane, cables and sheaves daily Tool Box Talks
7. Handling and Storage of Materials Check slings and chains, hooks and eyes
All material stored and stacked properly Equipment firmly supported Pretask Planner
Safe load limits of floor observed Outriggers used if needed
Aisles and passageways kept clear Power lines de-energized, removed or at a safe distance Near Miss Report
Rigging equipment inspected Proper loading for capacity Date
Proper handling & disposal of waste materials Signaler provided where needed, understood & observed
SAFETY INSPECTIONS/ COMMENTS
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Revised 10-2011 Page 1 of 1

CGS Safety Form: 6.C3