Administrator Safety Observance 1.0

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

OSHA BIG 4 - FALL HAZARDS

• A. Does the site have fall risks greater than 6 feet (including voids, pits and trenches)?
  B. Is the proper fall protection being used when needed?
  C. Are fall hazards protected by guard rails and are they properly installed?
  D. Are ladders set-up properly (tied off, secured and properly positioned)?
  E. Are ladders in good condition (legible labels, clean, no cracks or bent rungs)?
  F. Are ladders being used properly and for the right task?

• Did you find any fall hazards?

  Yes

  No

  N/A

• Approximately how many issues did you find? (If more than 10, contact the safety department for investigation.)

OSHA BIG 4 - STRUCK BY HAZARDS

• A. Did you observe any falling or flying objects?
  B. Is there any heavy equipment and/or vehicles operating on-site? (i.e. rough terrain forklifts, bull-dozers, excavators)
  C. Concrete or masonry walls properly braced? (Consider high winds)
  D. Material stored properly, not more than three boxes high when not bundled or banded?
  

• Did you find any struck by issues?

  Yes

  No

  N/A

• Approximately how many issues did you find? (If more than 10, contact the safety department for investigation.)

OSHA BIG 4 - CAUGHT IN OR BETWEEN HAZARDS

• A. Crane swing radius barricades in place?
  B. Safe distance from heavy equipment maintained?
  C. Do excavations have proper protection? (berming, trench boxes, slope/stepping, ladders, etc.)
  D. Do conveyors have proper protection to prevent accidentally being caught in?
  E. Do all machines have proper guarding?

• Did you find any Caught In/Between Hazards?

  Yes

  No

  N/A

• Approximately how many issues did you find? (If more than 10, contact the safety department for investigation.)

OSHA BIG 4 - ELECTRICAL HAZARDS

• A. Proper electrical tool used?
  B. Are employees using GFCI's?
  C. Electrical cords in good condition and proper size for job?
  D. Equipment a minimum of 10 feet from overhead electrical lines? (Distance increases with amount of voltage.)
  E. No electrical equipment near water or flammables?
  F. Electrical equipment is not near chemicals that could damage?
  G. Are LOTO procedures being followed?

• Did you find any electrical hazards?

  Yes

  No

  N/A

• Approximately how many issues did you find? (If more than 10, contact the safety department for investigation.)

PPE

• Have all employees been trained to use proper PPE and is it being used properly? (Company supplied hard hat, safety glasses, gloves, vest and boots)

  Yes

  No

  N/A

• Approximately how many issues did you find? (If more than 10, contact the safety department for investigation.)

HOUSEKEEPING

• A. Is material stored properly onsite?
  B. Are aisles and walkways clear of materials?
  C. Are exits clearly identified and unobstructed?
  D. Trash cleaned up and hauled to dumpsters?
  E. Break areas clean and tidy, lids on trashcans, tables wiped down?
  

• Did you witness any housekeeping hazards?

  Yes

  No

  N/A

• Approximately how many issues did you find? (If more than 10, contact the safety department for investigation.)

Safety Contact

• Name of Person Contacted & Comments

  Positive Comment

  Coaching

  Safety Infraction

Comments and Signatures

• Any comments/concerns about this site visit?

• Is there anything the safety department needs to follow-up on?

• Person performing this site audit

  Sign