181 Fremont Street

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Date Time

  Date

Personal Protective Equipment

• Hard Hats

  Safe

  At Risk

  N/A

• Add media

  Media

• Eye / Face Protection

  Safe

  At Risk

  N/A

• Add media

  Media

• Ear Protection

  Safe

  At Risk

  N/A

• Add media

  Media

• Dust Mask /Respirator

  Safe

  At Risk

  N/A

• Add media

  Media

• Safe Lifting Practices

  Safe

  At Risk

  N/A

• Add media

  Media

• Clothing / Knee Pads / class 2 / 3 vests

  Safe

  At Risk

  N/A

• Add media

  Media

• Footwear / Foot Protection

  Yes

  No

  N/A

• Add media

  Media

• Gloves / Hand Protection

  Safe

  At Risk

  N/A

• Add media

  Media

• Personal Fall Arrest / Restraint Equipment

  Yes

  No

  N/A

• Add media

  Media

Housekeeping

• Exit / Stairs / Walkways Clear

  Safe

  At Risk

  N/A

• Add media

  Media

• Piling & Stacking

  Safe

  At Risk

  N/A

• Add media

  Media

• Debris Removal

  Safe

  At Risk

  N/A

• Add media

  Media

• Nails Bent or Removed

  Safe

  At Risk

  N/A

• Add media

  Media

Ladders & Stairs

• Ladder Condition / Use

  Safe

  At Risk

  N/A

• Add media

  Media

• Ladder Tied Off /3' Above Landing

  Safe

  At Risk

  N/A

• Add media

  Media

Railings / Covers / Cables

• Perimeter / Stairs

  Safe

  At Risk

  N/A

• Add media

  Media

• Floor / Wall Openings

  Yes

  No

  N/A

• Add media

  Media

• Walkways

  Safe

  At Risk

  N/A

• Add media

  Media

• Cables Secured ( fall protection ) 3 Clips

  Safe

  At Risk

  N/A

• Add media

  Media

Scaffolding

• Railings

  Safe

  At Risk

  N/A

• Add media

  Media

• Tied to Building

  Safe

  At Risk

  N/A

• Add media

  Media

• Planks & Platforms

  Safe

  At Risk

  N/A

• Add media

  Media

• Access

  Safe

  At Risk

  N/A

• Add media

  Media

Fire Protection

• Extinguishers

  Safe

  At Risk

  N/A

• Add media

  Media

• Welding / Cutting Equipment

  Safe

  At Risk

  N/A

• Add media

  Media

First Aid / Sanitation

• Kits / Supplies

  Safe

  At Risk

  N/A

• Add media

  Media

• Sanitation / Hand Washing

  Safe

  At Risk

  N/A

• Add media

  Media

• Clean Cool Water / Shade

  Safe

  At Risk

  N/A

• Add media

  Media

Electrical

• Lighting / Covers

  Safe

  At Risk

  N/A

• Add media

  Media

• Power Cords, Plugs, Receptacles

  Safe

  At Risk

  N/A

• Add media

  Media

• Temporary Power Boxes / GFCI

  Safe

  At Risk

  N/A

• Add media

  Media

Tools

• Condition

  Safe

  At Risk

  N/A

• Add media

  Media

• Air Hose & Whip Check

  Safe

  At Risk

  N/A

• Add media

  Media

Site / Public & Environmental Protection

• Excavation / Trenches

  Safe

  At Risk

  N/A

• Add media

  Media

• Excavators / Forklifts / Cranes

  Safe

  At Risk

  N/A

• Add media

  Media

• Lighting / Fences

  Safe

  At Risk

  N/A

• Add media

  Media

• Posting Requirements / Signs

  Yes

  No

  N/A

• Add media

  Media

• Rebar Protection

  Safe

  At Risk

  N/A

• Add media

  Media

Programs / Information

• New Employee Orientation

  Yes

  No

  N/A

• Heat Illness

  Safe

  At Risk

  N/A

• Add media

  Media

• SWPP

  Safe

  At Risk

  N/A

• Add media

  Media

• Job site Safety Meeting

  Yes

  No

  N/A

• Per-Task Meeting

  Safe

  At Risk

  N/A

• Fall Protection Plans

  Yes

  No

  N/A

• Toolbox Meetings

  Yes

  No

  N/A

SSP

• Safety Coordinator Named / OSHA 10

  Yes

  No

  N/A

• Sub Safety Inspections

  Yes

  No

  N/A

Lifts ( scissor lifts, boom lifts )

• Operator Training Cards

  Safe

  At Risk

  N/A

• Equipment Inspection Records

  Safe

  At Risk

  N/A

• Fall Protection ( boom lift )

  Safe

  At Risk

  N/A

• Add signature

  Sign