ACI Job Site Safety Inspection

• Audit Title

• Crew

• Conducted on

  Date

• Prepared by

• Location & Job #
  Address

• Personnel

1.0 - Safety Basics

• 1.1 - MSDS (SDS) available on site for chemicals in use?

  Yes

  No

  N/A

• 1.2 - First-aid kit is readily available and properly supplied?

  Yes

  No

  N/A

• 1.3 - Fire extinguisher is readily accessible and in operating condition?

  Yes

  No

  N/A

• 1.2 - Utilities properly marked/identified?

  Yes

  No

  N/A

2.0 - Personal Protective Equipment

• 2.1 - High Visibility Vests are in use & Clean?

  Yes

  No

  N/A

• 2.2 - Hearing Protection is in Use during High Noise Operations?

  Yes

  No

  N/A

• 2.3 - Safety Glasses are in Use?

  Yes

  No

  N/A

• 2.4 - Hard Hats are Being Worn When Needed?

  Yes

  No

  N/A

• 2.5 - Gloves are Being used When Needed?

  Yes

  No

  N/A

• 2.6 - Proper Footwear is Being Worn?

  Yes

  No

  N/A

• 2.7 - Filtering Facepieces are available & Being Worn during Dusty Operations (Saw-cutting or Routing)?

  Yes

  No

  N/A

3.0 - DOT Compliance

• 3.1 - Drivers have their driver's license & current medical card?

  Yes

  No

  N/A

• 3.2 - Driver's have completed their DVIR (Daily Inspection)?

  Yes

  No

  N/A

• 3.3 - There are no apparent vehicle defects (Lights, Tires, Brakes)

  Yes

  No

  N/A

• 3.4 - Equipment is being transported using proper Load Securement?

  Yes

  No

  N/A

4.0 - Manual Tasks

• 4.1 - Safe Lifting & Safe Materials Handling?

  Yes

  No

  N/A

• 4.2 - Lockout/Tagout - Blocking/Chocking in Use during Equipment Repairs?

  Yes

  No

  N/A

• 4.3 - All Chemicals are Properly/Safely Stored?

  Yes

  No

  N/A

• 4.4 - Safety Data sheets are accessible On-Site?

  Yes

  No

  N/A

5.0 - Equipment Operation

• 5.1 - All Equipment is Operating Properly?

  Yes

  No

  N/A

• 5.2 - Guards are in place?

  Yes

  No

  N/A

• 5.3 - Back-Up Alarms are Working?

  Yes

  No

  N/A

• 5.4 - Seat Belts are being used?

  Yes

  No

  N/A

• 5.5 - Cell Phones are NOT being used during Equipment Operation?

  Yes

  No

  N/A

• 5.6 - Three (3) Points of Contact is in use while Entering & Exiting Equipment?

  Yes

  No

  N/A

• 5.7 - Equipment has been checked, Fluid Levels, Leaks, Filters, Tires, Belts, Lights, Grease?

  Yes

  No

  N/A

6.0 - Traffic Management

• 6.1 - Adequate Traffic Control Measures are used?

  Yes

  No

  N/A

• 6.2 - Adequate Public Safety Controls are in Place? Physical Barriers, Speed Limits, Flashing Lights.

  Yes

  No

  N/A

• 6.3 - If needed, are Trained Flaggers available with proper Equipment?

  Yes

  No

  N/A

Sign Off

• On Site Foreman's Signature

  Sign

• Auditor's Signature

  Sign