Capital Program Management

Safety Bulletin 2019-1, 5/29/19

Non-Right of Way Worksite Checklist
CONTRACT #: C-33942 - Design and Construction of MTA Railcar Acceptance and Testing Facility

LOCATION: 3rd Ave. & 38th St. Sunset Park, Brooklyn, N.Y.

WORK SHIFT: Day Shift

CSE/CSS/CSM/CSR ON
SITE:
Joshua Carp

CPM/CCM Rep. NAME &

TITLE:
Aleksandr Doljenko, Eric Anastasio, Rhytham Soni

SIGNATURE:

DATE: 11/07/2024

CHECK OFF
YES NO N/A
Did the CPM/CCM Field Engineer / Inspector witness the Contractor's Daily Safety Briefing? (Verify
that topics shown below were discussed) If "No," use the Notes section to indicate who verified that the RS
meeting was held.

a. Discussion of Fitness for Duty and PPE requirements RS

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b. Identifying CPM/ CCM Field Engineer / Inspector overseeing work activities RS

c. New Issues or Safety Advisories / Bulletins RS

Review of the task specific Safe Work Plan. (Discussions include - Communication and identification of
hazards; unusual hazards; hazard correction/mitigation; condition, usage and storage of tools and
d. RS
equipment; electrical protection; worksite access and egress; worksite maintenance; emergency
evacuation plans )

List work / tasks scheduled to be performed during this shift:

a. Insulation around domestic water pipe loop

2 b. Housekeeping of the inspection shop floor

PRIOR TO
BEGINNING OF c. Exterior trims for the inspection shop on the A-line
WORK
d. Window glazing installation for the inspection shop

If Access and Protection (A&P) is provided by NYCT personnel, did the CPM/CCM Field Engineer/Inspector
3
discuss the expected work activities with the personnel providing the A&P? RS

Prior to each work shift, did the Contractor's / Consultant's safety representative confirm that all their
4 personnel have the task training needed to perform the work, including the original qualification cards (e.g. RS
OSHA, scaffold user, welding, fire guard, fire watch, other certifications) on their person?

5 Is the Contractor Access Form on site and completed? RS

Are all required / necessary environmental metering equipment on site and available for immediate use
RS
(light, gas, noise)?

6 Have the environmental meters been calibrated? Noise and emission levels of equipment been
a. determined and OSHA required noise suppression provided? Carbon Monoxide (CO) - 35ppm; Nitrogen RS
Dioxide (NO2) -1ppm; Noise – variable refer to OSHA, CFR1926.52; Light - Min. 5fc throught work area.

Prior to each work shift, did the Contractor's / Consultant's safety representative confirm that properly sized
7 RS
and inspected fire extinguishers are on site and available for use?
8 Are "Competent Persons" identified and assigned for each trade? RS

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 Capital Program Management Safety Bulletin 2019-1, 5/29/19 CHECK OFF
Non-Right of Way Worksite Checklist
YES NO N/A
Did the CPM/CCM, Field Engineer / Inspector and the Contractor's / Consultant's safety
PRIOR TO
representative conduct a job site inspection prior to the start of work and verify required equipment /
BEGINNING OF 9 RS
tools and safety devices (i.e.: tool guards, material handling, GFCI, LOTO, Etc.) are on-site and in
WORK (CONT.)
good condition and permits / placards are current and posted?
Are all personnel observed (including NYCT/CPM); RS
a. Wearing proper basic PPE (e.g.: safety vest, hard hat, safety glasses, safety toe boots)? RS
10
In possession of appropriate PPE for specific job task hazards they are exposed to (e.g.: Respirators,
b. RS
Hearing Protection, Face Shield, Electrical Insulating Gloves, PFAS)?

Is job site housekeeping satisfactory and in accordance with Contract specifications / applicable
11 RS
safety standards?
Is Gasoline Powered Equipment (GPE) being used? If yes, verify a. and b. below; RS
12 a. Is the APPROVED SWP for the work involving GPE readily available for inspection? RS
b. Is the GPE equipment being operated in accordance with the APPROVED SWP? RS

Does the Gasoline Powered Equipment require a GPE Placard? If yes, verify a. and b. below; RS
13 a. Is the APPROVED GPE Placard , posted or readily available for inspection? RS
DURING WORK b. Is the GPE equipment being used in compliance with the APPROVED placard & SWP? RS
SHIFT
Confirmed with contractors/consultant safety representative that work areas are illuminated to 5 foot-candles
14
(minimum)? RS
15 Are all work activities being performed in accordance with the ACCEPTED SWP(s)? RS
Is/are the approved Contractor's / Consultant's safety representative(s) on the work site and ensuring that all
16
operations are conducted safely? RS
Have safety deficiencies identified by the CPM/CCM Field Engineer / Inspector been corrected by the
17
Contractor's/ Consultant's safety representative? RS

Have barriers/barricades/enclosures been approved for use on this project? If YES, verify a.- c. below; RS
Are barriers/barricades/enclosures installed and maintained as per the APPROVED
a.
SWP and drawings? RS
18

b. Have barriers/barricades/enclosures been inspected prior to the start of work and found free of defects? RS

c. Have any identified defects been corrected? RS

19 Are all project and work areas secured to prevent unauthorized access? RS

20 Has the worksite been cleared of debris, material and equipment? RS

AT THE END OF
WORK SHIFT 21 Has the work site, including equipment been secured to prevent unauthorized access and use? RS

22 Track D1 and Pocket Track D9 ROW clear of Material, Equipment and Debris? RS

Day Prior to Railcar 23 All loose Material along ROW and Track D1 properly secured? RS
Deliveries 24 Wheel Flange Gaps alongside running rail clear of debris? RS

25 Steel Plates removed over switch location? RS

NOTES:
The gate under 4th ave underpass remained closed at the end of the day shift.

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