Benchmark Cribbing Site Inspection Form

Name

First NameLast Name

Site*

Date*

Date

Email*

example@example.com

PPE - Personal protective equipment is worn to minimize exposure to hazards that cause serious workplace injuries and illnesses.

Rows	Yes	No	N/A
Eye protection provided and being utilized
Hearing protection provided
Hard hats are provided and being utilized
Work boots worn by employees (steel-toed where required)
Respirators/respiratory protection program in place. (fit test records available)

General Fall Protection - Fall protection is the use of controls designed to protect personnel from falling or in the event they do fall, to stop them without causing severe injury. Typically, fall protection is implemented when working at heights over 3m, but may be relevant when working near any edge, such as near a pit or hole, or performing work on a steep surface.

Rows	Yes	No	N/A
Floor openings covered or guarded (cover secured)
Workers exposed to falls 3m or more are protected

Excavations and Trenches - Employers must ensure that a competent person inspects all excavations, adjacent areas, and protective systems daily for possible cave-ins, indications of failures in protective systems and equipment, hazardous atmospheres, and other hazardous conditions. Inspections must be done prior to the start of work and as needed throughout the shift.

Rows	Not Satisfied	Somewhat Satisfied	Satisfied	Very Satisfied
Competent person assigned to supervise operations at all times
All excavations and trenches 4' or deeper equipped with protective system
Ladders or other means of quick exit within 25' of each worker
Spoil pile at least 2' from edge of excavation or trench

Electrical - Electrical hazards can cause burns, shocks and electrocution (death). Assume that all overhead wires are energized at lethal voltages.

Rows	Yes	No	N/A
GFCI or Assured Equipment Grounding Conductor Program in place
All outlets checked for proper wiring and GFCI checked if applicable
All tools and equipment inspected for defects in cords and plugs
All tools and equipment were inspected for defects in cords and plugs
Extension cords are in good condition
Sources of electricity such as panel boxes, overhead lines, etc. marked

Fire Prevention - A fire extinguisher is one of your first lines of defense in a small fire. If working on a multi-level structure, make sure there is access to an extinguisher on each floor. Extinguishers should be clearly-visible and easily accessible. According to OSHA 1926.150(c)(1)(i), an extinguisher shall be provided for every 3,000 square feet of the protected building.

Rows	Not Satisfied	Somewhat Satisfied	Satisfied	Very Satisfied
Flammable/combustible liquids stored away from ignition sources
Portable containers of such liquids are approved and have self-closing lids
Adequate number of properly charged fire extinguishers available
Extinguishers properly located with current inspection tag
Flammable/combustible, debris/trash kept from welding and cutting operations
Oily rags disposed of in approved self-closing waste containers

Tools and Equipment - Employees should be trained in the proper use of all tools. Workers should be able to recognize the hazards associated with the different types of tools and the safety precautions necessary.

Rows	Not Satisfied	Somewhat Satisfied	Satisfied	Very Satisfied
Tools and equipment in good condition
Defective equipment tagged as such and removed from the work area
Tool and equipment guards in place and in good condition

Hazard Communication - All employers with hazardous chemicals in their workplaces must have labels and safety data sheets for their exposed workers, and train them to handle the chemicals appropriately.

Rows	Yes	No	N/A
Written Hazard Communication Program in place
The written program includes a complete list of all chemicals
SDS is available for every chemical on the list
Chemical containers properly labeled

First Aid - Alberta workplaces must be equipped with first aid kits that meet CSA Z1220-17 standards. To ensure compliance, it is important to make sure the kits are checked and replenished on a regular basis.

Rows	Yes	No	N/A
First aid kits readily accessible to all workers
Contents of first aid kits approved by qualified health care provider
First aid kits include rubber gloves, eye protection, and CPR mask
Properly trained first aid provider on-site

Housekeeping - Construction sites can present many hazards to employees when they are performing construction-related activities. Keeping a construction site relatively clean of debris can further reduce hazards. The benefits of good housekeeping far exceed the small additional effort required to establish good housekeeping practices at a construction site.

Rows	Yes	No	N/A
Suitable containers available for disposal of trash and debris
Walkways, aisles, hallways, and passageways clear of trash, debris, and materials
Trash and debris containers are empty
Equipment is not use stored properly
Tools not in use stored in job boxes
Pipe, conduit, ductwork and other materials stored neatly

Other

Rows	Yes	No	N/A
Potable water readily accessible to all workers
Clean, private toilets accessible to all workers
OHS Legislation available (Digital or Physical Copy)
Emergency telephone numbers posted or made available to all workers
Safety training, SJP or SWP

Items that need corrective action

Signature*

Benchmark Cribbing Site Inspection Form

Action items