Information

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • General Data:

  • Office

  • Supervisor

  • Work description

  • Subcontractors Onsite

  • Subs name

General Area

  • JSA complete and reviewed with workers

  • Workers instructed on site hazards and controls

  • Toolbox meeting conducted

  • Observations being conducted

  • Workers properly trained

  • Workers know Emergency Action Plan

  • Sufficient supply of PPE

  • SDS available or accessible

  • First Aid on site, workers know location

  • Fire Extinguisher Onsite

  • Workers have Health Bridge Number

  • Underground utilities identified by one call

Electrical

  • All extension cords inspected and tagged

  • Generators grounded

  • GFCI in use

  • LOTO equipment available

Equipment

  • Equipment inspections completed and documented

  • All guards installed

  • Derricks/booms lowered while moving equipment

  • Chains, tie downs, ropes inspected

  • Have PM's been completed on all equipment

  • Equipment is sufficient distance (min 20') from overhead lines

Personal Protective Equipment

  • Are all employees wearing required amount

  • Is it being worn correctly

  • Is it clean and in good order

  • Is it appropriate for the hazards

  • Working near navigation waterways

  • Respirators required

Hand Safety

  • Are employees aware of hazards

  • Have employees been trained in hand safety

  • The appropriate gloves available

  • Pinch points identified on JSA

  • During cutting activities are Kevlar gloves on non cutting hand

Fall protection

  • Equipment inspections completed

  • Fall plan required

  • Rescue plan verified

  • Is equipment appropriate

Excavation

  • Competent person on site

  • Excavation inspection completed

  • Excavation guarded appropriately

  • Adequate means of entry and egress

  • Excavation site secured

Confined Space Entry

  • Permit required?

  • Permit in place and completed?

  • Gas monitor available and calibrated

  • Rescue plan in place

Vehicle Safety

  • DOT logbooks up to date

  • Pre trip inspection completed

  • Vehicles clean and orderly

Other

  • Anything removed from service

  • Items requiring repair

  • Safety concerns

  • Comments

Sign Off

  • On site representative

  • Auditor's signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.