390 Walking Working Surfaces Short Form

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Walkways

Hazards present (hoses,tools,product,water)

• Hazards present (hoses,tools,product,water)

  Safe

  At Risk

  N/A
Holes in floor/holes not covered/guarded

• Holes in floor/holes not covered/guarded

  Safe

  At Risk

  N/A

Fixed stairs

Hazards present (hoses,tools,product,water)

• Hazards present (hoses,tools,product,water)

  Safe

  At Risk

  N/A
Railing missing/needs repair

• Railing missing/needs repair

  Safe

  At Risk

  N/A
Top railing > 34 in.

• Top railing > 34 in.

  Safe

  At Risk

  N/A
Fixed stairs required

• Fixed stairs required

  Safe

  At Risk

  N/A
Width < 22 in.

• Width < 22 in.

  Safe

  At Risk

  N/A
Platform < 30 in. Long

• Platform < 30 in. Long

  Safe

  At Risk

  N/A
Slip resistant/nosings with nonslip finish

• Slip resistant/nosings with nonslip finish

  Safe

  At Risk

  N/A
Vertical clearance < 7 ft.

• Vertical clearance < 7 ft.

  Safe

  At Risk

  N/A

Standard railings

Handrails missing/needs repair

• Handrails missing/needs repair

  Safe

  At Risk

  N/A
Toe board missing/needs repair

• Toe board missing/needs repair

  Safe

  At Risk

  N/A
Missing middle rail

• Missing middle rail

  Safe

  At Risk

  N/A
Missing post

• Missing post

  Safe

  At Risk

  N/A
Top railing < 42 in.

• Top railing < 42 in.

  Safe

  At Risk

  N/A

Fixed ladders

Missing/broken gate

• Holes in floor/holes not covered/guarded

  Safe

  At Risk

  N/A
Metal rungs < 3/4 in. Diameter

• Metal rungs < 3/4 in. Diameter

  Safe

  At Risk

  N/A
Metal rungs > 12 in. Apart

• Metal rungs > 12 in. Apart

  Safe

  At Risk

  N/A
Cage/fastenings loose/missing/need repair

• Cage/fastenings loose/missing/need repair

  Safe

  At Risk

  N/A
Side rails < 42 in. Above the landing

• Side rails < 42 in. Above the landing

  Safe

  At Risk

  N/A
Less than 30 in. Clearance behind ladder

• Less than 30 in. Clearance behind ladder

  Safe

  At Risk

  N/A
Step over distance to ladder > 12 in.

• Step over distance to ladder > 12 in.

  Safe

  At Risk

  N/A
Not inspected

• Not inspected

  Safe

  At Risk

  N/A

Mezzanine

Not labeled with load capacity

• Not labeled with load capacity

  Safe

  At Risk

  N/A
Missing guard rails

• Missing guard rails

  Safe

  At Risk

  N/A

Walls/chute openings/windows

Openings > 4ft. Elevation not protected

• Openings > 4ft. Elevation not protected

  Safe

  At Risk

  N/A

Loading docks

Openings > 4ft. Elevation not protected

• Openings > 4ft. Elevation not protected

  Safe

  At Risk

  N/A

Roof

No fall protection, tie-off point, or warning perimeter

• No fall protection, tie-off point, or warning perimeter

  Safe

  At Risk

  N/A