Project Name:

Project Safety and Compliance Summary & Checklist

Project Workforce:

Material List:

Construction Start Date:

Project Description:

Project Location:

Construction End Date:

Engineer:

Project Manager:

Site Supervisor:

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Signature of Project Manager: Date:

Project Safety and Compliance Summary & ChecklistRevision 3 - March 4, 2015

Project Site - General

Yes No N/A ItemCheck Items Reviewed

Comments

Security fencing, barricades, tape needed?

Controlled access - guards/locks?

Storm water curb drains/grate protection?

Traffic management plan?

Silt fencing?

Project site signage (large/small) required/in place?

Lighting plan (portable or temporary wired)?

Restroom facilities - plumbed or portable?

Pedestrian management plan?

Lunch/break area identified?

Cooling area to avoid heat related injuries?

Safety shower/eyewash required?

First Aid kit stocked and available?

Smoking area identified?

Fire protection equipment in place?

Solid waste containers required?

MSDS/SDS sheets available on site?

Other?

Job trailer/utilities required?

Project Safety and Compliance Summary & Checklist Page 2 / 4Revision 3 - March 4, 2015

Stormwater permit location posted?

Will concrete work or a washout be necessary?

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ProceduresTailgate safety meetings/frequency?

Underground utility locates?

Asbestos?

Hot work?

Lock out/tag out?

Excavation?

Utility tunnel access?

Respiratory protection?

Confined space?

Hearing protection?

Spill response?

Fall protection?

Personnel lifts?

Hazard Communication?

Other?

Heat stress prevention (work/rest regimen)?

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ServicesAsbestos abatement? (notification required)

Sampling/testing for asbestos or lead? (notification)

Coring?

Boring or directional drilling?

Hot taps?

Underground utility location? (notification required)

Concrete?

Asphalt?

Electrofusing?

Compaction testing?

Sheet metal?

Welding?

Radiography and radiography monitoring?

Painting or coating?

Other?

Yes No N/A Item Comments

Project Safety and Compliance Summary & Checklist Page 3 / 4Revision 3 - March 4, 2015

EquipmentBackhoe?

Trackhoe?

HDPE pipe fusion machine?

Forklift (rough terrain or paved surface model)?

Compactor?

Front-end loader?

Light banks?

Street sweeper?

Generator(s)?

Dump trucks?

Cherry pickers/shuttle lift?

Cranes? (notification required)

Pumps?

Personnel lifts (JLG/Genie/scissor lift)?

Heaters?

Shoring boards and jacks?

Trench boxes?

Canopies?

Ladders?

Welding screens?

Other?

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Personal Protective EquipmentHard hat?

Safety glasses?

Face shields?

Fall protection harnesses and lanyards?

High visibility vest?

Hearing protection?

Dust masks or other respirators?

Protective/specialty clothing?

Flash suits/flame resistant clothing?

Other?

Yes No N/A Item Comments

Comments / Notes:

Project Safety and Compliance Summary & ChecklistRevision 3 - March 4, 2015 Page 4 / 4

NotificationsCranes (notice to EHS 72 hours prior to lift)?

Roadway closures - Transportation notified?

Service outages - AggieWorks notified?

Asbestos abatement (10-day notification)?

Sidewalk closures - Transportation notified?

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If site is greater than 5 acres (including laydown area), has an Notice of Intent been filed with TCEQ?

Has the required signage been posted and in a legible manner?

Has an SWPPP been created and reviewed by EHS?

Has permit been obtained from TCEQ prior to earthwork?

N.O.T. (Notice of Termination) for stormwater permit submitted upon project completion?

If permanent fuel storage for a generator, have EHS and the state been notified?

If new or replacement transformer installed, has EHS been notified re: secondary containment needs?