SITE SAFETY AUDIT

Job Name:

Fana Four

Foreman

Jsaac Cullum

Job Address:

106 ne 8th
Bellevue Wa
United States
Map It

Inspected by:

Jennifer Moreau

Date

03/25/2024

Employees on site:

Name
Jsaac Cullum
Nghia Nguyen

Check the appropriate box and explain items that need attention in the comments section.

Personal Protective Equipment - PPE

Are employees wearing job and task appropriate PPE?

Yes

Are employees wearing hearing protection in areas where noise levels exceed 85db?

Yes

Are employees wearing respiratory protection in accordance with the manufacturers SDS?

Yes

Fall Protection

Are employees wearing appropriate fall protection where a fall hazard exceeds 4' or more?

N/A

Are Fall Protection Work Plans being completed for all fall hazards 10' and above?

N/A

Are fall protection devices and equipment in serviceable condition?

N/A

Are fall protection devices and equipment being used correctly?

N/A

Ladders

Are ladders in serviceable condition, and are the inspections documented on the Ladder Inspection Checklist?

N/A

Are extension ladders secured at the top and bottom, extending at least 36" above the landing point and set to a proper pitch of 4:1?

N/A

Are ladders being used correctly?

N/A

Have Scaffold components been inspected for visible defects by a competent person prior to use?

N/A

Comments:

No ladder in use

MEWP

Has the MEWP been inspected, and has the inspection been documented on the MEWP Pre Use Checklist?

N/A

Are the MEWPS being used appropriately?

N/A

Are employees using fall protection inside the MEWPS when required?

N/A

Are operators and occupants trained and authorized to use the MEWP?

N/A

Housekeeping

Are there clear and safe routes for ingress and egress to and from work areas?

N/A

Are floor holes/penetrations protected, marked and secured?

N/A

Are work areas clean and orderly?

Yes

Is material stored or positioned to prevent tipping or falling?

N/A

Have extension cords been inspected for visible defects and wear?

N/A

First Aid & Emergency Preparedness

Does the job box contain the following inspected and fully stocked items: BBP kit, First Aid Kit and 2 eve wash bottles?

N/A

Is the evacuation plan and rally point displayed and understood by all employees?

Yes

Are Emergency numbers posted?

Yes

File

Is there a jobsite First Aid Station?

Yes

File

Where is the nearest Hospital/Urgent Care facility?

Overlake

Does the job have an onsite medic?

If yes, name and phone number:

List all HBI employees who are certified in First Aid and CPR:

Jassac and Nghia

Administrative

Have all employees read and signed the Site-Specific Safety Plan?

N/A

Are Pre-Task Plans (PTP) being done daily?

Yes

Are Toolbox Talks/Safety Meetings being conducted weekly?

Yes

Have all employees been orientated to the jobsite?

Yes

Miscellaneous

Is there sufficient lighting on the job, and proper task lighting being used in work areas where necessary?

Yes

Are portable fire extinguishers in accessible locations and in serviceable condition?

Yes

File

Are the bathroom facilities, and hand washing stations operable and sanitary?

Yes

Are all employees participating in stretch and flex daily?

Yes

Comments:

Stretch and flex every day at 7am level 2

Comments/Corrective Action Taken

Comments/Corrective Action Taken:

The crew is working in the electrical rooms which are locked every morning. They must get a permit signed by both Mortensen and the electrician foreman going over the work and associated hazards. Naya will add a picture of this form on the pre-task plan moving forward there was a near miss on level six in the electrical room yesterday on one of the boxes I spoke with both the on-site safety person and the electrician foreman to ensure the safety of our crew they assured me the crew was safe to work in the rooms as the incident was isolated to level six and investigation is underway and they will submit an incident report to us when finished for our reference even though our crew was not working on the floor when it happened. Justin and Ryan are the electrituon foreman, and melody is the Mortinson safety of which I spoke to.

File

Inspector Signature:

Date:

03/25/2025