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ETIC SITE SAFETY CHECKLIST <br /> Project Number S L Jc/ Date <br /> � <br /> Project Task <br /> Completed by <br />' ( PSA C"Check that all workers Safe Performance Self Assessment have LPS cards (current) <br /> H­'Review HASP update as needed, ensure PPE. Hard hat, steel toe ["Traffic Safety Control. <br /> that It is signed and understood by all shoes, high visibility note traffic patterns, volume, <br /> Ea/Review Job Safety Analysis (JSA) vest/she, gloves, safety and visibility with respect to <br /> identify tasks, hazards, and glasses, hearing protection work location <br /> recommendations as needed <br /> R-Vehicle safety and drrving/road conditions E?r"Directions to hospital fatly work scope <br /> —'/OSHA&other training A ubsurface Work Complete <br /> ' fdsubsurface clearance forms, <br /> 3`Emergency protocol and equipment documentation on site fallow protocol for excavations <br /> 1 Emergency fuel shutoff switch-locate and First aid,safety, and PPE E3'Fire extinguisher locations <br /> know how to operate location <br /> Hot work permit note potential <br /> E�Shps,trips,and falls 0- Electrical ground fault /�nibon sources and fuels <br /> p�'6pen pits, excavations, and site hazards <br /> [2 Public safety and fences I) Strains and sprains <br /> W1 Excavator swing and loading Noise hazards <br /> ' 0-Equipment and machinery familiarization / <br /> [Workable tool safety and awareness E3'Orderly site and housekeeping dNo horseplay <br /> t� Smokin in designated areas E�Heat and cold stress <br /> Overhead utility kscations and clearance g <br /> E3'�arking and laydown Ea"Leather gloves for protection B/Backing up hazards <br /> [1 Sharp object, rebar, and scrap metal hazards E3""Effects of the night before E3/Anticipated visitors <br /> C3"Safety is everyone's responsibility @�Vibrabon related injuries C�Dust and vapor contra/ <br /> EY"Latex gloves inner/nitnle gloves outer dDecontarnination procedures WiRefueling <br /> procedures / <br /> CfExcavation/trenching inspections/documentation to Eye wash station location Confined space entry <br /> Er/Employee Right-To-Know/MSDS location O Flying debris hazards E�Accidents are costly <br /> ' Discussion/Comments/Follow-up Actions <br /> NAME <br /> NNR COMPAQ C <br /> • instructions Conduct a daily safety meeting prior to beginning each day's site activities <br /> Complete form by checking off specific topics and/or hazards <br /> G\5hared\Gco1ogy\He33th&Safety\ETIC Site Safety Chccklist doe <br />