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\par }{\rtlch\fcs1 \ab\af1 \ltrch\fcs0 \b\f1\insrsid399161\charrsid6302439 No. of Employees}{\rtlch\fcs1 \af1 \ltrch\fcs0 \f1\insrsid399161\charrsid3039600  ________________
\par }{\rtlch\fcs1 \ab\af1 \ltrch\fcs0 \b\f1\insrsid399161\charrsid6302439 Date}{\rtlch\fcs1 \af1 \ltrch\fcs0 \f1\insrsid399161\charrsid3039600  ___________________________}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid399161\charrsid3039600 
\par }\pard\plain \ltrpar\s15\ql \li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\rtlgutter\itap0 
\rtlch\fcs1 \ab\ai\af0\afs20\alang1025 \ltrch\fcs0 \b\i\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 \i0\f39\insrsid399161\charrsid9320305 1. SITE ACCESS\tab \tab }{\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 
\i0\f39\insrsid3039600\charrsid9320305 \tab }{\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 \i0\f39\insrsid399161\charrsid9320305 OK       Not OK
\par }\pard\plain \ltrpar\ql \li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 
\af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid3039600 Clean, level ground\tab \tab ___   _________
\par Adequate ramps\tab \tab \tab ___   _________
\par Adequate stairs\tab \tab \tab ___   _________
\par Adequate ladders\tab \tab \tab ___   _________
\par }\pard\plain \ltrpar\s3\ql \li0\ri0\sl264\slmult1\keepn\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 
\wrapdefault\aspalpha\aspnum\faauto\outlinelevel2\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 \ab\ai\af0\afs20\alang1025 \ltrch\fcs0 \b\i\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 
\i0\f39\insrsid399161\charrsid9320305 2. PROTECTIVE EQUIPMENT\tab OK       Not OK
\par }\pard\plain \ltrpar\ql \li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 
\af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid3039600 Hard hats worn\tab \tab \tab ___   _________
\par Foot protection\tab \tab \tab ___   _________
\par Eye & face protection: Worn\tab ___   _________
\par \tab \tab  Available\tab ___   _________
\par Hearing protection:      Worn\tab ___   _________
\par }\pard \ltrpar\ql \fi720\li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\rtlgutter\itap0 {\rtlch\fcs1 
\af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid3039600                 Available\tab ___   _________
\par }\pard \ltrpar\ql \li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\rtlgutter\itap0 {\rtlch\fcs1 
\af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid3039600 Respiratory protection:}{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid3039600\charrsid3039600  }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid3039600 Worn}{
\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid3039600\charrsid3039600 \tab }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid3039600 ___   _________
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid3039600 \tab \tab   }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid3039600 Available\tab ___   _________
\par }\pard\plain \ltrpar\s3\ql \li0\ri0\sl264\slmult1\keepn\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 
\wrapdefault\aspalpha\aspnum\faauto\outlinelevel2\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 \ab\ai\af0\afs20\alang1025 \ltrch\fcs0 \b\i\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 
\i0\f39\insrsid399161\charrsid9320305 3. GUARDRAILS, BARRICADES\tab OK       Not OK
\par }\pard\plain \ltrpar\ql \li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 
\af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 Located where required\tab \tab ___   _________
\par Properly constructed\tab \tab ___   _________
\par Adequately secured\tab \tab ___   _________
\par }\pard\plain \ltrpar\s3\ql \li0\ri0\sl264\slmult1\keepn\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 
\wrapdefault\aspalpha\aspnum\faauto\outlinelevel2\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 \ab\ai\af0\afs20\alang1025 \ltrch\fcs0 \b\i\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 
\i0\f39\insrsid399161\charrsid9320305 4. LADDERS\tab \tab \tab OK       Not OK
\par }\pard\plain \ltrpar\ql \li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 
\af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 Secured\tab \tab \tab \tab ___   _________
\par Proper angle (extension)\tab \tab ___   _________
\par Proper size and type\tab \tab ___   _________
\par Safe, usable condition\tab \tab ___   _________
\par Properly used\tab \tab \tab ___   _________
\par Proper handrails and landings\tab ___   _________
\par Non-slip bases\tab \tab \tab ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid9320305 5. FIRE PREVENTION\tab \tab OK       Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 Extinguishers where required\tab ___   _________
\par Fully charged\tab \tab \tab ___   _________
\par Adequately identified\tab \tab ___   _________
\par Master emergency plan\tab \tab ___   _________
\par }\pard\plain \ltrpar\s3\ql \li0\ri0\sl264\slmult1\keepn\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 
\wrapdefault\aspalpha\aspnum\faauto\outlinelevel2\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 \ab\ai\af0\afs20\alang1025 \ltrch\fcs0 \b\i\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 
\i0\f39\insrsid399161\charrsid9320305 {\*\xmlopen\xmlns2{\factoidname Street}}{\*\xmlopen\xmlns2{\factoidname address}}6. PUBLIC WAY{\*\xmlclose}{\*\xmlclose} PROTECTION\tab OK       Not OK
\par }\pard\plain \ltrpar\ql \li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 
\af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 Properly located }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid10772796 \tab 
\tab }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 \tab ___   _________
\par Covered where required\tab \tab ___   _________
\par Min. height, width requirement\tab ___   _________
\par Proper rail on street side\tab \tab ___   _________
\par Proper lighting, where required\tab ___   _________
\par }\pard\plain \ltrpar\s3\ql \li0\ri0\sl264\slmult1\keepn\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 
\wrapdefault\aspalpha\aspnum\faauto\outlinelevel2\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 \ab\ai\af0\afs20\alang1025 \ltrch\fcs0 \b\i\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 
\i0\f39\insrsid399161\charrsid9320305 7. HOUSEKEEPING\tab \tab OK       Not OK
\par }\pard\plain \ltrpar\ql \li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 
\af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 Clear walkways\tab \tab \tab ___   _________
\par Clear work areas\tab \tab \tab ___   _________
\par Clear access and landing\tab \tab ___   _________
\par }\pard \ltrpar\ql \li0\ri0\sl264\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \ab\ai\af1\afs20 \ltrch\fcs0 \b\i\f1\fs20\insrsid399161\charrsid7798989 
\par }\pard \ltrpar\ql \li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9320305 {\rtlch\fcs1 
\ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid9320305 8. FALL PROTECTION\tab \tab OK       Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid10772796 NIOSH}{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305  approved\tab \tab \tab ___   _________
\par Properly worn\tab \tab \tab ___   _________
\par Safe, usable condition\tab \tab ___   _________ Working from:\tab Ladders\tab \tab ___   _________
\par \tab \tab Scaffolds\tab ___   _________
\par \tab \tab Swing stages\tab ___   _________
\par Unprotected openings and edges\tab ___   _________
\par }\pard\plain \ltrpar\s3\ql \li0\ri0\sl264\slmult1\keepn\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 
\wrapdefault\aspalpha\aspnum\faauto\outlinelevel2\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 \ab\ai\af0\afs20\alang1025 \ltrch\fcs0 \b\i\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 
\i0\f39\insrsid399161\charrsid9320305 9. STAIRWELLS & RAMPS\tab }{\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 \i0\f39\insrsid9320305 \tab }{\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 \i0\f39\insrsid399161\charrsid9320305 OK       Not OK
\par }\pard\plain \ltrpar\ql \li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 
\af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 Proper filler blocks in metal stairs\tab ___   _________
\par Proper cleats on ramps\tab \tab ___   _________
\par Adequate lighting in stairwells\tab ___   _________
\par Proper handrails or guardrails\tab ___   _________
\par }\pard\plain \ltrpar\s3\ql \li0\ri0\sl264\slmult1\keepn\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 
\wrapdefault\aspalpha\aspnum\faauto\outlinelevel2\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 \ab\ai\af0\afs20\alang1025 \ltrch\fcs0 \b\i\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 
\i0\f39\insrsid399161\charrsid9320305 10. SCAFFOLDS\tab \tab }{\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 \i0\f39\insrsid9320305 \tab }{\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 \i0\f39\insrsid399161\charrsid9320305 OK      Not OK
\par }\pard\plain \ltrpar\ql \li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\rtlgutter\itap0 \rtlch\fcs1 
\af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 Properly erected (all parts used)\tab ___   _________
\par Properly secured\tab \tab \tab ___   _________
\par Properly planked\tab \tab \tab ___   _________
\par Proper guardrails, toe boards\tab ___   _________
\par Proper access to platform\tab \tab ___   _________
\par Acceptable loading\tab \tab ___   _________}{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161 
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid15692704 Inspection Tag\tab \tab \tab ___   _________}{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid15692704\charrsid9320305 
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid9320305 11. POWER TOOLS, EQUIPMENT }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid9320305 \tab }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 
\b\f39\fs20\insrsid399161\charrsid9320305 OK       Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 General condition\tab \tab \tab ___   _________
\par Proper guards, cords, PPE\tab \tab ___   _________
\par Use of defective tags\tab \tab ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid9320305 12.}{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid13579552  }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid9320305 EXTENSION CORDS
\tab \tab OK       Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid10772796 Heavy Duty}{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 -type}{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid10772796  12 }{\rtlch\fcs1 \af39\afs22 
\ltrch\fcs0 \f39\fs22\insrsid15692704 Gauge}{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 \tab ___   _________
\par General condition of casing, }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid9320305 
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 ends, and connections\tab \tab ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid9320305 13. COMPRESSED GAS CYLINDERS  OK      Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 Properly located\tab \tab \tab ___   _________
\par Properly secured\tab \tab \tab ___   _________
\par Properly moved or lifted\tab \tab ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid9320305 14. WORKER EDUCATION\tab }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid9320305 \tab }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 
\b\f39\fs20\insrsid399161\charrsid9320305 OK       Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid10772796 HAZCOM}{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305  training\tab \tab \tab ___   _________
\par Company safety policy & program\tab ___   _________
\par Injury reporting\tab \tab \tab ___   _________
\par Hazard reporting\tab \tab \tab ___   _________
\par Personal H & S responsibilities\tab ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid15486009 15. FIRST AID REQUIREMENTS\tab OK       Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 Adequate number of qualified first
\par aiders on jobsite}{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid10772796 \tab }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 \tab \tab ___   _________
\par First aid boxes: Adequate number\tab ___   _________
\par \tab            Adequate contents\tab ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid3688838 
\par 
\par 
\par 
\par }\pard \ltrpar\ql \li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\rtlgutter\itap0\pararsid5835149 {
\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid15486009 16. CRANES, HOISTS, etc.\tab }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid15486009 \tab }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 
\b\f39\fs20\insrsid399161\charrsid15486009 OK       Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 Safe setup of equipment\tab \tab ___   _________
\par Maintenance log available\tab \tab ___   _________
\par Competent operator}{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid10772796 (s)}{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 \tab \tab ___   _________
\par Condition of slings, hardware\tab ___   _________
\par Safety clips on all hooks\tab \tab ___   _________
\par Proper use of tag lines\tab \tab ___   _________
\par Proper lifting containers\tab \tab ___   _________
\par Competent signaler\tab \tab ___   _________
\par }\pard\plain \ltrpar\s3\ql \li0\ri0\sl264\slmult1\keepn\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10 \brdrr\brdrs\brdrw10\brsp80 
\wrapdefault\aspalpha\aspnum\faauto\outlinelevel2\adjustright\rin0\lin0\rtlgutter\itap0\pararsid5835149 \rtlch\fcs1 \ab\ai\af0\afs20\alang1025 \ltrch\fcs0 \b\i\fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \ai0\af39 \ltrch\fcs0 
\i0\f39\insrsid399161\charrsid15486009 17. WELDING\tab \tab \tab OK       Not OK
\par }\pard\plain \ltrpar\ql \li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\rtlgutter\itap0\pararsid5835149 
\rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 Rods & cylinders properly labeled\tab ___   _________
\par MSDSs readily available\tab \tab ___   _________
\par Properly secured ground cables\tab ___   _________
\par Proper eye protection worn\tab ___   _________
\par Proper screens and exhaust\tab ___   _________
\par Cylinders upright and secured\tab ___   _________
\par Fire extinguisher readily available\tab ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid15486009 18. ELEVATING WORK PLATFORM }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid15486009 \tab }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 
\b\f39\fs20\insrsid399161\charrsid15486009 OK        Not OK}{\rtlch\fcs1 \af39\afs20 \ltrch\fcs0 \f39\fs20\insrsid399161\charrsid15486009 
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 Worker training\tab \tab \tab ___   _________
\par Properly used\tab \tab \tab ___   _________
\par Safe, useable condition\tab \tab ___   _________
\par Acceptable loading\tab \tab ___   _________
\par Manufacturer\rquote s operating manual\tab ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid15486009 19. TRAFFIC CONTROL\tab }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid15486009 \tab }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 
\b\f39\fs20\insrsid399161\charrsid15486009 OK       Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 Trained traffic controllers\tab \tab ___   _________
\par Properly located\tab \tab \tab ___   _________
\par Clean, regulation sign\tab \tab ___   _________
\par Properly dressed (including vest)\tab ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid15486009 20. TEMPORARY POWER SUPPLY\tab OK       Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid9320305 Properly identified\tab \tab ___   _________
\par Overhead lines flagged & secured\tab ___   _________
\par Surface cables buried or protected\tab ___   _________}{\rtlch\fcs1 \ab\ai\af39\afs22 \ltrch\fcs0 \b\i\f39\fs22\insrsid399161\charrsid9320305 
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid15486009 21. SIGNS & PRINT MATERIAL\tab OK       Not OK}{\rtlch\fcs1 \af39\afs20 \ltrch\fcs0 \f39\fs20\insrsid399161\charrsid15486009 
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid3688838 Required Posters\tab }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid15486009 \tab \tab ___   _________
\par MSDS copies\tab \tab \tab ___   _________
\par Warning signs\tab \tab \tab ___   _________
\par Emergency phone list\tab \tab ___   _________
\par Report forms\tab \tab \tab ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid15486009 22. MATERIALS STORAGE\tab }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid15486009 \tab }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 
\b\f39\fs20\insrsid399161\charrsid15486009 OK      Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid15486009 Properly located\tab \tab \tab ___   _________
\par Safely piled, stacked, bundled\tab ___   _________
\par Properly moved or lifted\tab \tab ___   _________
\par Properly labeled }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid3688838 \tab }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid15486009 \tab }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid15486009 \tab }{\rtlch\fcs1 
\af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid15486009 ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid15486009 23.}{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid13579552  }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid15486009 
TRENCHES & EXCAVATIONS\tab OK       Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid15486009 Properly angled, where required\tab ___   _________
\par Excavated materials properly placed___   _________
\par Appropriate shoring used\tab \tab ___   _________
\par Proper access to trench\tab \tab ___   _________
\par Proper storage of materials }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid5835149              }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid15486009 ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid13047119 
\par 
\par }\pard \ltrpar\ql \li0\ri0\sl264\slmult1\widctlpar\brdrt\brdrs\brdrw10\brsp20 \brdrl\brdrs\brdrw10\brsp80 \brdrb\brdrs\brdrw10\brsp20 \brdrr\brdrs\brdrw10\brsp80 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\rtlgutter\itap0 {\rtlch\fcs1 
\ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid5835149 
\par 
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid15486009 24.}{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid13579552  }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid15486009 
CONFINED SPACES\tab \tab OK       Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid15486009 Proper access\tab \tab \tab ___   _________
\par Air testing before entry\tab \tab ___   _________
\par Rescue equipment readily available\tab ___   _________
\par Safety harness, lifeline properly
\par    anchored and used\tab \tab ___   _________
\par Second person for rescue\tab \tab ___   _________
\par Outgoing air monitored\tab \tab ___   _________
\par Entry permit system\tab \tab ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid15486009 25. SUSPENDED SCAFFOLDS\tab OK       Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid15486009 Properly attached and capable of
\par    at least 4 times maximum load\tab ___   _________
\par Outrigger beam tied to fixed support
\par    with adequate counterweight\tab ___   _________
\par All mechanical/electrical devices
\par    in good working condition\tab ___   _________
\par Independent lifelines for each
\par    worker (extend to ground)\tab ___   _________
\par Engineers drawing on site if req\rquote d.\tab ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid15486009 26. FORMWORK\tab \tab }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid15486009 \tab }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 
\b\f39\fs20\insrsid399161\charrsid15486009 OK     Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid15486009 Guardrails and fall-arrest system\tab ___   _________
\par Design drawings kept on project\tab ___   _________
\par Inspection statement by engineer or 
\par    competent worker\tab \tab ___   _________
\par }{\rtlch\fcs1 \ab\af39\afs20 \ltrch\fcs0 \b\f39\fs20\insrsid399161\charrsid15486009 27. HYGIENE\tab \tab \tab OK      Not OK
\par }{\rtlch\fcs1 \af39\afs22 \ltrch\fcs0 \f39\fs22\insrsid399161\charrsid15486009 Cleanliness of facilities\tab \tab ___   _________
\par }}