Safety Audit
Safety Audit
Date of Audit
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Auditor Name
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Name of SSHO or Employee Contacted
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Was this an in-person audit or a virtual audit?
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In-Person Safety Audit
Virtual Safety Chat
Project Number
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Project Manager Email
Project Name
Description of Job
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Location
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Weather Conditions
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Is the Site Safety & Health Plan (SSHP), Accident Prevention Plan (APP) or Incident Action Plan (IAP) on site?
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Yes
No
N/A
Are all site personnel have signed the safety plan?
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Yes
No
N/A
Are all site personnel knowledgeable of safety plan contents?
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Yes
No
N/A
Are all site personnel properly wearing basic PPE?
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Yes
No
N/A
Is the site kept clean and orderly (good housekeeping)?
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Yes
No
N/A
Is there adequate drinking water available?
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Yes
No
N/A
Which of the below apply to this job?
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Potential Chemical Exposure
Confined Space Entry
Potential Exposure to Hazardous Energy (Energy Control)
Drill rig or Excavating Operations
Excavation Entry
Bloodborne Pathogens
Potential Exposure to Fall Hazards
Heat or Cold Stress Concerns
Working Near Traffic or Moving Equipment
Vacuum Truck Operation
Potential for Inclement Weather
Respiratory Protection
Hearing Conservation
Right-to Know
Hoist and Auxiliary Equipment
Hand Tools and Equipment
Portable Power tools and equipment
Abrasive Wheel and Equipment - Grinders
Powder-Actuated Tools
Abrasive Blasting
None of the Above
Chemical Hazards: What mitigations are to be used for the chemical hazards?
PPE
Air Monitoring
Eye Wash Station
Chemical Hazards: Are employees wearing correct PPE for the chemical exposure hazard? (body protection, respirator cartridges, gloves, etc.)
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Yes
No
PPE Usage for Chemical Hazards: Are employees wearing the PPE properly? (respirator properly strapped, chemical suit sealed, clean shaven with respirator, etc.)
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Yes
No
Air Monitoring for Chemical Hazards: Is the air monitor operational, and has been bumped and calibrated?
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Yes
No
Eyewash Station for Chemical Hazards: Is the eyewash station on-site and near the area where exposure could occur?
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Yes
No
Drilling: Is the drill rig a safe distance from overhead lines? (10 ft. for systems 50 kV and increasing 4 inches for every 10 kV over 50 kV.)
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Yes
No
N/A
Drilling/Excavating: Have underground utilities been located?
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Yes
No
Excavation Entry: Has an excavation inspection form been completed for the day?
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Yes
No
Excavation Entry: Are methods of egress (ladders, etc.) within at least 25' of the work?
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Yes
No
Excavation Entry: If the excavation is over 4' deep, is air monitoring inside the space being performed?
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Yes
No
N/A
Excavation Entry: If the excavation is over 5' deep, is there proper protection to guard against cave-ins (sloping, shoring, shielding)?
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Yes
No
N/A
Fall Protection: What fall protection methods are implemented?
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Guardrails
Fall Restraint
Fall Arrest
None
Fall Restraint: Is the fall restraint equipment set up in a way that employees can't fall?
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Yes
No
Fall Arrest: Are employees wearing fall protection correctly and tied off to suitable anchor point?
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Yes
No
N/A
Guardrails: Are the guardrails designed to be guardrails and/or capable of withstanding 200 lbs of outward force?
Yes
No
Working Near Traffic/Heavy Equipment: Are employees wearing high visibility apparel?
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Yes
No
Confined Space Entry: Is the confined Space permit available and completed correctly?
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Yes
No
Confined Space Entry: Was initial air monitoring performed and results were within safe levels?
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Yes
No
Confined Space Entry: Is the confined space attendant at the space and performing no other duties?
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Yes
No
Confined Space Entry: Can entrants communicate with the attendant?
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Yes
No
Energy Control: Can employees show how the equipment was proven to be depressurized?
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Yes
No
Energy Control: Do all potentially affected employees have personal energy control (lock on lockbox)?
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Yes
No
Heat/Cold Stress: What heat/cold stress mitigations are to be utilized?
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Heat/Cold Stress: Does the crew have the necessary personnel, clothing, equipment, shelters to implement heat/stress mitigations?
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Yes
No
Vacuum Truck Operations: Is the truck clear of any residual non-compatible materials?
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Yes
No
Vacuum Truck Operations: Is the complete vacuum system properly bonded and grounded?
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Yes
No
Vacuum Truck Operations: Is a fire extinguisher available?
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Yes
No
Vacuum Truck Operations: Are the employees working near the vacuum truck wearing hearing protection?
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Yes
No
Vacuum Truck Operations: Does the vacuum truck operator have a means to communicate with individuals working vacuum truck hose?
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Yes
No
Inclement Weather: Do field staff have knowledge and ability to properly respond to the inclement weather?
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Yes
No
What does the employee consider to be the top 3 hazards on the job?
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What mitigations are in place for the highest hazards or most significant risks? Are they sufficient?
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Is any specialty PPE required for the job? If so, what is it, and what hazards is it mitigating?
Are all tools and equipment to be used in good working order?
Does the employee feel they have all the necessary personnel, equipment, and training to complete the work tasks?
Any other notes from the call?
Notes on any identified gaps and corrective actions.
Respiratory Protection - Has a medical evaluation been completed for all participating employees?
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Yes
No
Respiratory Protection - Have participating employees received annual respirator training and fit testing within the past 12 months?
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Yes
No
Respiratory Protection - Are employee medical evaluations, training, and fit testing documentation records available?
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Yes
No
Respiratory Protection - Are all respirators used by employees NIOSH approved?
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Yes
No
Respiratory Protection - Are respirators inspected and cleaned, sanitized and maintained on a regular basis?
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Yes
No
Respiratory Protection - Have appropriate respirators been selected for the identified hazard?
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Yes
No
Respiratory Protection - Does the facility have atmosphere supplying respirators that use compressors or compressed air cylinders as the breathing source?
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Yes
No
Respiratory Protection - Does breathing air supplied by a compressor meet CGA G-7.1-1989Grade D requirements?
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Yes
No
Hearing Conservation - Are there facility employees that are included in the hearing conservation program?
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Yes
No
Hearing Conservation - Has annual employee training been completed within the past 12 months?
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Yes
No
Hearing Conservation - Has annual employee audiometric testing been completed within the past 12 months?
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Yes
No
Hearing Conservation - Is training documentation, including list of attendees available?
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Yes
No
Hearing Conservation - Are there employees identified with standard threshold shift (STS)?
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Yes
No
Hearing Conservation - Is adequate follow-up completed for STS employees including notification, counseling and re-testing?
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Yes
No
Hearing Conservation - Do employees know when and where hearing protection devices should be worn?
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Yes
No
Hearing Conservation - Is there an adequate selection of hearing protection devices (type and model) available to employees?
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Yes
No
Hearing Conservation - Do employees know how to fit hearing protection devices?
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Yes
No
Hearing Conservation - Has a noise monitoring survey been completed for the facility?
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Yes
No
Hearing Conservation - Are noise levels considered when purchasing new equipment or making facility modifications?
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Yes
No
Bloodborne Pathogens - Does the facility have employees participating in the Exposure Control Plan?
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Yes
No
Bloodborne Pathogens - Has the facility documented an exposure incident within the past 3 years?
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Yes
No
Bloodborne Pathogens - Has the Hepatitis B vaccination been made available to Category Employees pre-exposure and Category II employees’ post-exposure?
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Yes
No
Bloodborne Pathogens - Have employees who decline the Hepatitis B vaccination signed the waiver form?
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Yes
No
Bloodborne Pathogens - Have affected employees received training on bloodborne pathogens?
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Yes
No
Right-to Know - Have facility employees received RTK training within the past 12 months that includes GHS new label elements and SDS format?
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Yes
No
Right-to Know - Is there an inventory list of hazardous chemicals that are in the facility?
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Yes
No
Right-to Know - Do employees know how to find hazardous chemical MSDS/SDS?
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Yes
No
Right-to Know - Do hazardous chemicals containers and harmful physical agents have appropriate labels?
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Yes
No
Hoist and Auxiliary Equipment - Is each overhead electric hoist equipped with a limit device to stop the hook travel at its highest and lowest points of safe travel?
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Yes
No
Hoist and Auxiliary Equipment - Will each hoist automatically stop and hold any load up to 125 percent of its rated load if its actuating force is removed?
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Yes
No
Hoist and Auxiliary Equipment - Is the rated load of each hoist legibly marked and visible to the operator?
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Yes
No
Hoist and Auxiliary Equipment - Are stops provided at the safe limits of travel for hoists? Are they tested daily?
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Yes
No
Hoist and Auxiliary Equipment - Are controls of the hoists plainly marked to indicate the direction of travel or motion?
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Yes
No
Hoist and Auxiliary Equipment - Is each cage-controlled hoist equipped with an effective warning device?
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Yes
No
Hoist and Auxiliary Equipment - Are close-fitting guards or other suitable devices installed on hoists to assure that hoist ropes will be maintained in the sheave grooves?
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Yes
No
Hoist and Auxiliary Equipment - Are all hoist chains or ropes of sufficient length to handle the full range of movement of the application while still maintaining two full wraps on the drum at all times?
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Yes
No
Hoist and Auxiliary Equipment - Are nip points or contact points between hoist ropes and sheaves that are permanently located within 7 feet of the floor, ground, or working platform guarded?
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Yes
No
Hoist and Auxiliary Equipment - Is it prohibited to use chains or rope slings that are kinked or twisted?
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Yes
No
Hoist and Auxiliary Equipment - Is it prohibited to use the hoist rope or chain wrapped around the load as a substitute for a sling?
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Yes
No
Hoist and Auxiliary Equipment - Are operators instructed to avoid carrying loads over people?
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Yes
No
Hoist and Auxiliary Equipment - Are hooks with safety latches or other arrangements used when hoisting materials so that slings or load attachments will not accidentally slip off the hoist hooks?
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Yes
No
Hoist and Auxiliary Equipment - Are securing chains, ropes, chokers, or slings adequate for the job to be performed?
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Yes
No
Hoist and Auxiliary Equipment - Are hooks in good condition (not stretched, or safety latches in place if manufactured that way)?
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Yes
No
Hoist and Auxiliary Equipment - Are slings and chains in good condition (no broken or stretched links, no broken threads on slings)?
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Yes
No
Hoist and Auxiliary Equipment - When hoisting material or equipment, are provisions made to ensure that no one will be passing under the suspended loads?
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Yes
No
Hoist and Auxiliary Equipment - Do hoists and overhead cranes receive annual inspections, and frequent inspections in writing?
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Yes
No
Hoist and Auxiliary Equipment - Are all pelican hooks equipped with spring-loaded safety clips to prevent accidental load release?
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Yes
No
Hoist and Auxiliary Equipment - Are only employees who have been trained in the proper use of hoists allowed to use them?
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Yes
No
Hand Tools and Equipment - Are all tools and equipment maintained in good condition?
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Yes
No
Hand Tools and Equipment - Are hand tools such as chisels and punches, which develop mushroomed heads during use, reconditioned or replaced as necessary?
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Yes
No
Hand Tools and Equipment - Are broken or fractured handles on hammers, axes, and similar equipment replaced promptly?
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Yes
No
Hand Tools and Equipment - Are worn or bent wrenches replaced regularly?
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Yes
No
Hand Tools and Equipment - Are appropriate handles used on files and similar tools?
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Yes
No
Hand Tools and Equipment - Are employees made aware of the hazards caused by faulty or improperly used hand tools?
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Yes
No
Hand Tools and Equipment - Are safety glasses, face shields, or other appropriate protective equipment used while using hand tools or equipment that might produce flying materials or be subject to breakage?
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Yes
No
Hand Tools and Equipment - Are jacks checked periodically to ensure they are in good operating condition?
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Yes
No
Hand Tools and Equipment - Are tool handles wedged tightly in the heads of all tools?
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Yes
No
Hand Tools and Equipment - Is tool cutting edges kept sharp so the tool will move smoothly without binding or skipping?
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Yes
No
Hand Tools and Equipment - Are tools stored in dry, secure locations?
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Yes
No
Portable Power tools and equipment - Are grinders, saws, and similar equipment provided with appropriate safety guards and are they used as recommended by the manufacturer?
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Yes
No
Portable Power tools and equipment - Are portable electric tools and extension cords inspected regularly with the results documented and the tools marked with a dated “OK” tag?
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Yes
No
Portable Power tools and equipment - Are portable circular saws equipped with guards above and below the base shoe?
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Yes
No
Portable Power tools and equipment - Are circular saw guards checked to assure they are not wedged up, thus leaving the lower portion of the blade unguarded?
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Yes
No
Portable Power tools and equipment - Are rotating or moving parts of equipment guarded to prevent physical contact?
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Yes
No
Portable Power tools and equipment - Are all cord-connected, electrically operated tools and equipment effectively grounded or of the approved double insulated type?
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Yes
No
Portable Power tools and equipment - Are effective guards in place over belts, pulleys, chains, and sprockets?
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Yes
No
Portable Power tools and equipment - Are portable fans provided with full guards or screens having openings of 1/2 inch or less?
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Yes
No
Portable Power tools and equipment - Is hoisting equipment available and used for lifting heavy objects, and are hoist ratings and characteristics appropriate for the task?
*
Yes
No
Portable Power tools and equipment - Are pneumatic and hydraulic hoses on power-operated tools checked regularly for deterioration or damage?
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Yes
No
Abrasive Wheel and Equipment - Grinders - Are work rests installed and kept adjusted to within 1/8 inch of the wheel?
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Yes
No
Abrasive Wheel and Equipment - Grinders - Is the adjustable tongue on the top side of the grinder used and kept adjusted to within 1/4 inch of the wheel?
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Yes
No
Abrasive Wheel and Equipment - Grinders - Do side guards cover the spindle, nut, and flange and 75 percent of the wheel diameter?
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Yes
No
Abrasive Wheel and Equipment - Grinders - Are bench and pedestal grinders permanently mounted?
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Yes
No
Abrasive Wheel and Equipment - Grinders - Are goggles or face shields always worn when grinding?
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Yes
No
Abrasive Wheel and Equipment - Grinders - Is the maximum RPM rating on each abrasive wheel compatible with the RPM rating of the grinder motor?
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Yes
No
Abrasive Wheel and Equipment - Grinders - Are fixed or permanently mounted grinders connected to their electrical supply system with metallic conduit or other permanent wiring methods?
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Yes
No
Abrasive Wheel and Equipment - Grinders - Does each grinder have an individual on/off control switch?
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Yes
No
Abrasive Wheel and Equipment - Grinders - Is each electrically operated grinder grounded effectively?
*
Yes
No
Abrasive Wheel and Equipment - Grinders - Before new abrasive wheels are mounted, are they visually inspected, and ring tested?
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Yes
No
Abrasive Wheel and Equipment - Grinders - Are dust collectors and powered exhausts provided on grinders used in operations that produce large amounts of dust?
*
Yes
No
Abrasive Wheel and Equipment - Grinders - Are splash guards mounted on grinders that use coolant to prevent it from reaching employees?
*
Yes
No
Powder-Actuated Tools - Are employees who operate powder-actuated tools trained in their use, and do they carry a valid operator card?
*
Yes
No
Powder-Actuated Tools - Is each powder-actuated tool stored in its own locked container when not being used?
*
Yes
No
Powder-Actuated Tools - Is a sign at least 7 inches by 10 inches with bold-face type reading “POWDER-ACTUATED TOOL IN USE” clearly posted when tools are being used?
*
Yes
No
Powder-Actuated Tools - Are powder-actuated tools left unloaded until they are ready to be used?
*
Yes
No
Powder-Actuated Tools - Are powder-actuated tools inspected for obstructions or defects each day before use?
*
Yes
No
Powder-Actuated Tools - Do powder-actuated tool operators have and use appropriate personal protective equipment?
*
Yes
No
Abrasive Blasting - Blasting area covered to prevent the escape of grit or dust?
*
Yes
No
Abrasive Blasting - Is Blasting area barricaded to keep out personnel not involved in the job?
*
Yes
No
Abrasive Blasting - Is operator wearing blasting hood supplied with clean air, coveralls, hearing protection and footwear?
*
Yes
No
Abrasive Blasting - Is blasting gun fitted with Dead-man switch?
*
Yes
No
Abrasive Blasting - Is air compressor located upwind direction and away from blasting area?
*
Yes
No
Abrasive Blasting - All air supply and blasting hoses are provided with coupling pins and hose whip checks?
*
Yes
No
Abrasive Blasting - Is blast hose free from wear and soft spots?
*
Yes
No
Abrasive Blasting - Are the base materials secured for free moving or rolling?
*
Yes
No
Abrasive Blasting - Abrasive materials are free from moisture?
*
Yes
No
Abrasive Blasting - Operator is trained and competent for blasting operation
*
Yes
No
Abrasive Blasting - A positive means of communication shall be established between the operator and the pot attendant, when working in confined space?
*
Yes
No
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