Safety Observation Summary Report Start Date: End Date: Select User:

01/01/2012 03/30/2012 All

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Aerial Lifts Workers tied off to boom or basket? (1926.453) Workers not tied off to adjacent structure/equipment? (1926.453) Operator(s) trained and authorized? (1926.453) Both feet on floor of basket? (1926.453) Boom/basket load limits not exceeded? (1926.453) Aerial lift not moved with boom elevated? (1926.453) Aerial lift has both upper and lower controls? (1926.453) Midrail chain/gate used when working in aerial lifts? (1926.501) Category Total

Pos 15 9 10 10 6 4 2 6 62

Neg 0 0 1 2 0 0 0 0 3

Total 15 9 11 12 6 4 2 6 65

% 100% 100% 91% 83% 100% 100% 100% 100% 95%

Behaviors Eyes on path/looks in direction of travel? Looks back when stepping backwards? Pushes instead of pulls when possible? Avoids overhead work when possible? Lifts with legs not back when possible? Forms a bridge with free hand when lifting? Does not lift more than one can lift safely? Keeps load close to body when lifting? Uses lift assist device for heavy loads? Avoids lifting unstable loads? Does not subject coworker(s) to injury?

Pos 1 1 0 1 1 1 1 1 1 1 1 10

Neg 0 0 1 0 0 0 0 0 0 0 0 1

Total 1 1 1 1 1 1 1 1 1 1 1 11

% 100% 100% 0% 100% 100% 100% 100% 100% 100% 100% 100% 91%

Pos 2 3 3 3 2 0 1 1 3 2 2 2 2

Neg 1 1 1 1 1 2 0 0 1 1 2 1 0

Total 3 4 4 4 3 2 1 1 4 3 4 3 2

% 67% 75% 75% 75% 67% 0% 100% 100% 75% 67% 50% 67% 100%

Category Total Concrete/Masonry Rebar guarded to eliminate impalement hazard? (1926.701) Workers avoid working under buckets? (1926.701) Troweling machines equipped with auto shut-off? (1926.702) Handles on concrete buggy within wheel width? (1926.702) Connectors used to secure pressurized air hoses? (1926.702) Safety latches prevent accidental dumping of buckets? (1926.702) Bull float handles nonconductive or insulated? (1926.702) Shoring equipment inspected? (1926.703) Base plates secured to foundation/formwork? (1926.703) Jacks/supports do not exceed rated capacity? (1926.703) Rebar adequately supported to prevent collapse? (1926.703) Jacking synchronized to ensure level/uniform lifting? (1926.705) Maximum jacks per slab does not exceed 14? (1926.705)

Temporary connections secured by tack welding? (1926.705) Limited access zone equal to wall height plus 4 feet? (1926.706) Limited access zone strictly enforced? (1926.706) Walls over 8 feet braced to prevent collapse? (1926.706) Category Total

2 3 3 2 36

0 0 1 1 14

2 3 4 3 50

100% 100% 75% 67% 72%

Cranes/Rigging No visible defects affecting safe operation? (1926.1412) Workers not allowed under suspended load? (1926.1501) Outriggers/cribbing used when needed? (1926.1501) Proper clearance maintained from power lines? (1926.1501) Radius guard installed on crane? (1926.1501) Tag lines used on loads that swing freely? (1926.1501) Rated load capacities available? (1926.1501) Hand signal chart available? (1926.1501) Fire extinguisher located in cab? (1926.1501) Rigging equipment in good condition? (1926.1501) Lift capacities marked on rigging equipment? (1926.1501) Crane operator(s) meet certification requirements? (1926.1427) Rigger(s) trained, qualified and authorized? (1926.1425) Signal person(s) trained, qualified and authorized? (1926.1428) Category Total

Pos 8 6 7 2 3 6 0 1 1 4 2 2 3 3 48

Neg 1 1 1 2 3 1 1 1 1 0 1 0 1 1 15

Total 9 7 8 4 6 7 1 2 2 4 3 2 4 4 63

% 89% 86% 88% 50% 50% 86% 0% 50% 50% 100% 67% 100% 75% 75% 76%

Electrical Equipment installed/used as listed or labeled? (1926.403) Path to ground permanent and continuous? (1926.403) GFCI on 120V, single-phase, 15/20 amp receptacle outlets? (1926.404) Flexible cords continuous/without splice or tap? (1926.404) Worn/frayed extension cords not used? (1926.416) Light bulbs protected from accidental contact/breakage? (1926.405) Temporary lights not suspended by electric cords? (1926.405) Breakers/switches legibly marked to indicate purpose? (1926.403) Cords protected/kept clear of work areas or walkways? (1926.416) Employees not allowed to work near unprotected circuits? (1926.416) Deenergized circuits tagged out? (1926.417) Access to electrical rooms limited/restricted? (1926.416) Electrical panels/circuits fully enclosed? (1926.405) Category Total

Pos 6 9 7 5 3 4 2 5 3 1 1 1 2 49

Neg 1 1 1 1 4 0 0 0 0 0 0 0 0 8

Total 7 10 8 6 7 4 2 5 3 1 1 1 2 57

% 86% 90% 88% 83% 43% 100% 100% 100% 100% 100% 100% 100% 100% 86%

Fall Protection Fall protection provided when working above 6 feet? (1926.501) Guardrail height at 42 inches (+/-3)? (1926.502) Guardrails capable of withstanding 200 lb. force? (1926.502) Toeboards erected to prevent falling objects? (1926.502) Harnesses maintained in good condition? (1926.502) Harnesses worn/fitted properly? (1926.502) Lanyards in good condition/no defects? (1926.502) Correct lanyard used for the job? (1926.502) Suitable anchorage provided for personal fall arrest system? (1926.502) Safety monitor performs only monitoring duties? (1926.502) Safety monitor on same surface with visual/oral contact? (1926.502) Holes/skylights covered or barricaded? (1926.501) Warning line 6 feet back from roof edge? (1926.502) Warning line erected on all open sides? (1926.502) Warning line flagged and suspended at proper height? (1926.502)

Pos 6 7 6 6 7 7 5 5 5 1 1 1 1 1 1

Neg 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0

Total 6 7 7 6 7 7 5 5 5 1 1 1 1 1 1

% 100% 100% 86% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

Hoisting area adequately guarded? (1926.502)

1 61

0 1

1 62

100% 98%

Fire Safety Fire extinguishers maintained in operating condition? (1926.150) Fire extinguisher readily accessible/within 100 feet? (1926.150) Fire extinguisher within 50 feet of flammable liquids? (1926.150) Minimum one fire extinguisher per floor? (1926.150) Approved/UL listed fire extinguishers provided? (1926.150) Flammables stored in approved/closed containers? (1926.152) Smoking prohibited where fire hazard exists? (1926.151) Category Total

Pos 7 8 3 3 5 2 1 29

Neg 1 0 0 0 0 0 0 1

Total 8 8 3 3 5 2 1 30

% 88% 100% 100% 100% 100% 100% 100% 97%

Forklifts Lift trucks inspected daily and documented? (1910.178) Lift trucks free of known defects/damage? (1910.178) Only trained personnel allowed to operate forklifts? (1910.178) No modifications affecting lift capacity? (1910.178) Forks lowered when truck is unattended? (1910.178) Nameplate/markings in place and legible? (1910.178) Category Total

Pos 1 1 1 1 1 1 6

Neg 0 0 0 0 0 0 0

Total 1 1 1 1 1 1 6

% 100% 100% 100% 100% 100% 100% 100%

Fueling Operations Dispensing unit protected against vehicle damage? (1926.152) Containers/tanks bonded when transferring fuel? (1926.152) No Smoking signs posted in fuel dispensing area? (1926.152) Motors shut off during fueling operation? (1926.152) Fire extinguisher located 25 to 75 ft of fueling area? (1926.152) Fuel storage area free of combustibles? (1926.151) Tank(s) secured to prevent access during off-work hours? (Best Practice) Dispensing nozzle automatic-closing type? (1926.152) Fuel tanks properly labeled? (NFPA 30) Methods provided to control spills? (1926.152) Category Total

Pos 2 2 1 1 3 3 2 1 0 1 16

Neg 0 1 0 0 0 0 0 1 1 0 3

Total 2 3 1 1 3 3 2 2 1 1 19

% 100% 67% 100% 100% 100% 100% 100% 50% 0% 100% 84%

Housekeeping Worksite reasonably organized/good housekeeping? (1926.25) Combustible scrap/debris removed at regular intervals? (1926.25) Job trailer clean and reasonably organized? (1926.25) Material staging area kept reasonably organized? (1926.25) Gang box(es) reasonably clean and organized? (1926.25) Garbage/waste disposed of at frequent/regular intervals? (1926.25) No protruding nails on unused lumber? (1926.250) Category Total

Pos 7 3 5 5 1 2 0 23

Neg 1 0 0 0 0 0 1 2

Total 8 3 5 5 1 2 1 25

% 88% 100% 100% 100% 100% 100% 0% 92%

Ladders/Stairs Ladders inspected/no visible defects? (1926.1053) Side rails extend 3 feet above landing surface? (1926.1053) Ladders set up at 4:1 angle? (1926.1053) Ladders set up on firm/level base? (1926.1053) Ladders secured to prevent side slip? (1926.1053) Base of ladder secured when conditions warrant? (1926.1053) Ladders used for intended purpose? (1926.1053) Stairs/ladder/ramp used at elevation break of 19+ inches? (1926.1051) Handrails on stairs with 4 or more risers? (1926.1052)

Pos 9 8 10 6 6 2 5 2 2

Neg 1 1 0 0 2 0 0 0 0

Total 10 9 10 6 8 2 5 2 2

% 90% 89% 100% 100% 75% 100% 100% 100% 100%

Category Total

Spreaders used/fully engaged on stepladders? (1926.1053) Area at top and bottom of ladder kept clear? (1926.1053) At least one hand free to grasp ladder? (1926.1053)

1 3 1 55

0 0 0 4

1 3 1 59

100% 100% 100% 93%

Mechanized Equipment Equipment in good condition/no obvious defects? (1926.601) Seat belts provided on equipment with ROPs? (1926.602) Seat belts worn on equipment with ROPs? (1926.602) Parking brake set when equipment is parked? (1926.600) Wheels chocked when parked on incline? (1926.600) Bidirectional machines equipped with functional horn? (1926.602) Reverse alarm on equipment with obstructed rear view? (1926.601-602) No passengers allowed on single-operator equipment? (1926.601) Operator(s) competent/familiar with equipment controls? (1916.20) Category Total

Pos 1 1 0 1 1 1 1 1 1 8

Neg 0 0 1 0 0 0 0 0 0 1

Total 1 1 1 1 1 1 1 1 1 9

% 100% 100% 0% 100% 100% 100% 100% 100% 100% 89%

Medical/FA Services First aid supplies easily accessible when required? (1926.50) Adequate first aid supplies provided? (1926.50) Certified FA provider available at remote worksites? (1926.50) Emergency numbers conspicuously posted? (1926.50) Location of nearest medical facilities known/posted? (1926.50) Category Total

Pos 6 5 2 4 1 18

Neg 0 1 0 1 0 2

Total 6 6 2 5 1 20

% 100% 83% 100% 80% 100% 90%

MSDS/HazCom MSDS for hazardous chemicals readily available? (1910.1200) Hazardous chemicals properly labeled? (1910.1200) Chemical inventory list maintained? (1910.1200) Category Total

Pos 6 6 6 18

Neg 0 0 0 0

Total 6 6 6 18

% 100% 100% 100% 100%

PPE PPE provided/used as required? (1926.28) PPE maintained in sanitary/reliable condition? (1926.28) Replacement PPE readily available? (1926.28) Eye protection used as required? (1926.102) Hard hats worn as required? (1926.100) Hand Protection worn when needed? (1926.28) Safety footwear worn as needed? (1926.96) Respirators provided/used as required? (1926.103) Hearing protection provided/used as required? (1926.52) High-visibility clothing worn as required? (1926.28) Face protection used when required? (1926.102) Category Total

Pos 6 6 4 5 7 4 4 1 1 5 1 44

Neg 0 0 0 2 0 0 0 0 0 0 1 3

Total 6 6 4 7 7 4 4 1 1 5 2 47

% 100% 100% 100% 71% 100% 100% 100% 100% 100% 100% 50% 94%

Category Total

Pos 2 2 1 5

Neg 0 0 1 1

Total 2 2 2 6

% 100% 100% 50% 83%

Pos 0 3 2

Neg 1 1 2

Total 1 4 4

% 0% 75% 50%

Category Total

Postings/Safety Signs OSHA Workplace Poster posted? (1903.2) Emergency numbers/contacts posted? (Best Practice) Danger/warning signs posted as needed? (1926.200)

Safety Training Toolbox talks completed daily? (1926.21) Toolbox talks completed weekly? (1926.21) Toolbox talks documented? (Best Practice)

Only qualified equipment/machinery operators? (1926.20) Equipment/machine operator training documented? (1926.20) Job-specific safety training provided/documented? (1926.21) Safety Orientation Training provided? (1916.21) Good compliance/no safety violations? (1926.20-.21) Category Total

3 1 1 1 0 11

1 1 1 1 1 9

4 2 2 2 1 20

75% 50% 50% 50% 0% 55%

Sanitation Adequate supply of potable water provided? (1926.51) Containers for drinking water marked/not used for other purpose? Common drinking cup prohibited? (1926.51) 1 toilet/urinal per 40 workers when more than 20 at jobsite? (1926.51) Category Total

Pos 1 1 1 1 4

Neg 0 0 0 0 0

Total 1 1 1 1 4

% 100% 100% 100% 100% 100%

Scaffolds (Supported) Working platforms fully planked/decked? (1926.451) Fall protection provided above 10 feet? (1926.451) Legs/frame bear on base plates/mud sills? (1926.451) Scaffolds inspected/free of defects? (1926.451) Footings level and rigid with no visible settling? (1926.451) Cross braces not used for access or egress? (1926.451) Debris not allowed to accumulate on platforms? (1926.451) When platforms overlap, overlap is 12 inches or more? (1926.451) Platform supports plumb/braced to prevent swaying? (1926.451) Toeboards used to prevent tools/materials falling on employees? Makeshift devices not used to gain additional height? (1926.451) Platforms 10 ft or less do not extend more than 12 in. past support? Platforms (10+ feet) not extended more than 18 in. past support? Front end loader not used to support platform? (1926.451) Guys/ties/braces installed per manufacturers recommendations? Lifelines fastened to fixed safe point of anchorage? (1926.451) Toprail crossbracing midpoint between 38-48 inches? (1926.451) Category Total

Pos 2 2 2 2 2 1 2 1 1 1 1 1 2 1 1 1 1 24

Neg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Total 2 2 2 2 2 1 2 1 1 1 1 1 2 1 1 1 1 24

% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

Tools (Hand & Power) Hand and power tools in safe operating condition? (1926.300) Tools not suspended by electric cord or air hose? (1926.302) Guards in place/functional on power tools? (1926.300) Power tools stopped during refueling/maintenance? (1926.302) Power tools double-insulated or grounded? (1926.302) Handles free of splinters/cracks and kept tight in tool? (1926.301) Grinders equipped with safety guards? (1926.303) Circular saws adequately guarded? (1926.304) Hand-fed ripsaw adequately guarded? (1926.304) Category Total

Pos 5 1 4 1 5 2 2 1 1 22

Neg 0 0 1 0 0 0 0 0 0 1

Total 5 1 5 1 5 2 2 1 1 23

% 100% 100% 80% 100% 100% 100% 100% 100% 100% 96%

Trenching/Excavation Competent Person completes daily inspection? (1926.651) Sloping/benching adequate for soil type? (1926.652) Spoils/material/equipment set back 2 feet from edge? (1926.651) Travel distance to egress no more than 25 feet? (1926.651) Utilities located/identified prior to start of excavation? (1926.651) Signs/barricades provided when trench is unoccupied? (5a1) Manual/visual test used to confirm soil classification? (1926.651) Category Total

Pos 1 1 1 1 1 1 1 7

Neg 0 0 0 0 0 0 0 0

Total 1 1 1 1 1 1 1 7

% 100% 100% 100% 100% 100% 100% 100% 100%

Welding & Cutting Regulators/gauges in proper working order? (1926.350) Welding hoses in good condition? (1926.350) Fire extinguishing equipment in close proximity? (1926.352) Fuel gas cylinders separated from oxygen cylinders? (1926.350) Valve caps in place when stored/transported? (1926.350) Cylinders secured in upright position? (1926.350) Cylinders in transportation secured in vertical position? (1926.350) Cylinder valves closed when work is finished? (1926.350) Cylinders maintained in good condition? (1926.350) Category Total

Pos 6 6 6 5 5 3 0 3 5 39

Neg 0 0 0 0 0 1 1 0 0 2

Total 6 6 6 5 5 4 1 3 5 41

% 100% 100% 100% 100% 100% 75% 0% 100% 100% 95%

Miscellaneous Construction areas properly illuminated? (1926.56) Protruding rebar ends guarded? (1926.701) Frequent/regular inspections of the jobsite completed? (1926.20) Category Total

Pos 2 1 1 4

Neg 0 0 0 0

Total 2 1 1 4

% 100% 100% 100% 100%

Grand Total

600

71

671

89%