Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
1. Pre-Work
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1.1. Job Safety Analysis (JSA) completed, understood and signed by each employee in assigned work area?
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1.2. JSA posted in conspicuous place at task area?
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1.3. MSDS Sheets obtained, reviewed and understood?
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1.4. All required permits obtained and signed off?
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1.5. Lock Out / Tag Out needed / completed for work to be performed?
2. Personal Protective Equipment (PPE)
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2.1. Hard Hats worn by all employees
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2.2. Face Shields: Grinding / Overhead Drilling / Splash Hazards etc.
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2.3. Appropriate gloves for task(s)
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2.4. Safety Glasses - No shaded / tinted glasses indoors.
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2.5. Hearing Protection
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2.6. Appropriate work boots
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2.7. Reflective Vest or High Visibility Clothing
3. Fall Protection
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3.1. Fall Exposures greater than 6 feet
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3.2. Personal Fall Arrest System properly worn / inspected
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3.3. Floor openings greater than 2 inches in diameter protected with appropriate cover, secured and labeled "HOLE"
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3.4. Guardrail System in place, inspected and installed correctly
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3.5. Leading edge protected, controlled access zone set up 6 feet from edge, warning markers clearly visible and "FALL PROTECTION REQUIRED BEYOND THIS POINT" signage in place. Monitor with sign in / out log posted.
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3.6. Horizontal Life lines installed / used properly
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3.7. Wall openings guarded
4. Ladders and Scaffolding
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4.1. Ladder(s) in good condition, no accumulation of mud, oil, grease or other hazardous material
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4.2. Area at base of ladder(s) kept clear
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4.3. Extension Ladder(s) set up properly (4:1 ratio), secured (cleated, if need be and tied off), and if used as access to next level, extends 3 feet above platform or grab rails installed.
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4.4. Step ladder(s) used only in open, locked position
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4.5. Scaffold(s) complete
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4.6. Scaffold(s) inspected, current date and signed off by competent person
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4.7. Scaffold(s) in good repair, no damaged components or improper planking
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4.8. Access to scaffold(s) adequate
5. Housekeeping
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5.1. Material stacked and orderly
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5.2. Trash cans in work area(s), emptied daily or when full
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5.3. Debris removed
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5.4. Nails or other hazardous protrusions removed or hammered back to eliminate hazard(s)
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5.5. Cords, hoses, leads or other tripping hazards off the floor (7 feet up) or set up in such a way to not create a tripping hazard or damage cords
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5.6. Access / egress maintained.
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5.7. Other
6. Hot Work / Welding / Cutting / Grinding
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6.1. Proper permits obtained, complete and signed off
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6.2. Fire extinguisher no more than 10 feet away from work area, inspected, properly charged and correct type
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6.3. Adjacent work protected
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6.4. Hard Hats with Welding Hoods and Safety Glasses
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6.5. Combustibles removed / protected
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6.6. Burning goggles
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6.7. Grinding: full face shield with safety glasses
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6.8. Adequate ventilation
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6.9. Proper gas storage / protected
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6.10. Equipment in good condition
7. Mobile Equipment
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7.1. Operator(s) certified / trained on particular equipment being used
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7.2. Equipment inspected
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7.3. Fall Protection / seat belts used properly
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7.4. Work area below barricaded
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7.5. Spotters used
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7.6. Other
8. Excavations
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8.1. Competent person on site
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8.2. Excavation Daily Report Complete
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8.3. Employee(s) trained
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8.4. Shored / sloped / benched properly based on soil type and condition
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8.5. Proper access / egress
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8.6. Ladder(s) within 25 feet of all exposed employees
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8.7. Spoils piles and materials 2 feet back from top of excavation
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8.8. Excavation barricaded and signs posted
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8.9. Excavation illuminated if left open overnight in a pedestrian area
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8.10. Excavation atmosphere tested? Results:
9. Electrical
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9.1. Cords inspected and properly color coded for month
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9.2. GFCI(s) inspected and monthly record on file
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9.3. Cords routed to not create a trip hazard or 7 feet off ground
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9.4. Cords exposed to mobile equipment
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9.5. Cords hung by conductive materials such as nails, tie wire or welding rods
10. Hazardous Chemicals
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10.1. Unsafe storage location (flammables near ignition sources, sparks or flame, spills could enter storm drains)
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10.2. Spill Kit(s)
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10.3. Safety Data Sheets for all chemicals on site (including sub-contractors)
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10.4. Excessive quantities stored on site on in vehicle.
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10.5. Adequate / proper PPE
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10.6. Adequate storage containers (including gas cans, all chemicals labeled in accordance with GHS standards)
Corrective Actions and Date(s) to complete by
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All Corrective Action Items To Be Completed By:
Sign Off
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Inspection Performed By:
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On Site Representative
