Information
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Audit Title
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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. Working at Heights
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1.1. Employees properly protected from fall risks of 6 feet or more?
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1.2. Unsafe, missing, or incomplete edge protection?
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1.3. Guard rails installed properly and complete to include toe boards for overhead protection?
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1.4. Warning lines/Barricades installed properly and complete.
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1.5. Personal fall arrest equipment appropriate for exposure and used properly.
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1.5.1. Unsafe or damaged harness or equipment?
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1.5.2. Unsafe or uncertified anchor points?
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1.5.3. Personal fall arrest will not allow contact with next lower level or hazardous equipment and no swing fall?
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1.6. Fall exposure and mitigation appropriately addressed in ADM JSA?
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1.7. Fall protection/arrest components stored/stowed properly?
2. Equipment
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2.1. Unsafe or damaged tools/equipment?
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2.2. Tools/equipment in proper working order and used properly, with required guards and handles in place?
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2.3. Proper tools/equipment for job readily available and in use? (e.g. grinding discs for cutting)
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2.6. Operators trained in safe operation, clean-up and maintenance?
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2.7. LOTO procedures for cleaning, servicing and maintenance of tools/equipment conducted per policy and verified?
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Aerial work platform used properly / per manufacturer requirements?
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Aerial work platform has documented pre-use inspection?
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Proper fall protection in place for use of aerial work platform, including closed gate
3. Scaffolds
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3.1. Competent persons only erecting/altering scaffold?
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3.2. Scaffold provided as complete as conditions practically allow?
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3.3. Inspection for scaffold completed prior to use by competent person.
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3.4. Scaffold erected properly to include proper bracing and tie-back?
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3.5. Safe Work Load (SWL) provided and not exceeded? (tools, stored materials, number of persons)
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3.6. Scaffold tagged properly with appropriate use information.
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3.7. Scaffold provided with suitable access, to include swing gate and retractable where exposure exceeds 24'?
4. Lifting/Rigging Equipment
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4.1. Unsafe or damaged crane or other lifting device.
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4.2. Loads lifted over persons, close proximity to obstacles incl. overhead power lines?
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4.3. Maintenance, testing and inspection completed as required prior to use.
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4.4. Piece weights provided and load calculations conducted prior to lift?
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4.6. Unsafe or damaged lifting equipment, including ropes, slings, chains, hooks?
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4.7. Lifting equipment unlabelled, does not meet ANSI, no SWL displayed?
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4.8. Rigging equipment used per manufacturer requirements?
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4.9. Operator properly trained/certified?
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4.10. Safe rigging practices followed?
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4.11. Properly trained rigger?
6. Ladders
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6.1. Unsafe or damaged ladders?
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6.2. Unsafe positioning of ladders?
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6.3. Ladder not properly secured?
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6.4. Ladder unsuitable for job? (e.g. metal ladder used for electrical work)
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6.5. Ladder proper tool for job?
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6.6. Ladder provided with legible manufacturers labels and free of inspection obstructions (paint, stickers, etc.)?
7. Hazardous Manual Tasks
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7.1. Stretching conducted at beginning of shift?
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7.3. Inadequate risk controls? (examples: no job rotation, lighter loads, trolleys, lifting equipment, etc)
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7.4. Lack of training in risk controls and safe lifting/ team lifting techniques?
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7.5. Alternatives to manual material handling evaluated in JSA?
8. Hazardous Chemical (including fuel and oil)
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8.1. Unsafe storage location? (e.g. flammables near ignition sources, spills could enter stormwater drains, etc)
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8.2. Incompatible chemicals stored near each other?
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8.3. Inadequate spill containment equipment?
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8.4. Safety Data Sheets accessible on site?
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8.8. Insufficient, or incorrect, PPE?
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8.9. Unsuitable storage containers? (unlabeled or stored in food containers)
9. Confined space entry
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9.1. Entry policy followed?
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9.2. Emergency rescue available to require external rescue?
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9.3. Appropriate atmospheric testing conducted and documented?
11. Personal Protective Equipment (PPE)
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11.1. Required PPE available and in use (including sun protection)?
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11.2. PPE appropriate for exposure?
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11.3. Trainig in safe use, clean-up and inspection of PPE?
12. Work Environment
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12.1. Lack of/or inadequate amenities? (toilets, wash areas, lunch rooms, etc)
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12.2. Insufficient lighting?
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12.3. Inadequate housekeeping?
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12.4. Lack of, or inadequate noise/ vibration control?
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12.5. Site security and signage?
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12.6. Suitable overhead protection provided?
13. Electrical Hazards
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13.1. Unsafe electrical leads? (damaged, out of test date or untested)
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13.2. Assured grounding requirements acceptable and followed.
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13.3. Underground utilities located and uncovered by hand prior to excavating?
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13.4. Minimum distances from overhead electrical lines delineated and maintained.
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13.5. Temporary electrical panels without voids, labeled, and GFCI protected?
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13.6. Leads and cords properly suspended?
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13.7. Electrical equipment in wet conditions or conditions that can become wet GFCI protected?
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13.11. Electrical leads grounded directly to work?
15. Administrative Procedures
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15.1. ADM JSA completed and fully addresses exposures?
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15.2. Failure to obtain permits (Council, EPA, Hot Works, Confined Space etc)
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15.3. Suitable orientation for workers, contractors, visitors?
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15.4. Lack or, or inadequate, supervisory arrangements?
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15.5. Weekly safety meetings and OSHA required training conducted.
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15.6. Contractor Job Hazard Analysis (JHA) completed?
Corrective Actions
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Enter any corrective actions that will be undertaken
Sign Off
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On site representative
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Auditor's signature
