Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Weather conditions

  • Prepared by

  • Location
  • Personnel

Job Site Information

  • OSHA 300 Forms Complete and Posted Onsite?

  • Emergency Phone Number Posted?

  • Map to Closest Occupational Clinic (Including Hours of Operation and Telephone Number) Posted Onsite?

  • Map to Closest Hospital Posted Onsite?

  • EPC Services Company's Health, Safety, and Environmental Program Onsite?

  • Subcontractor's Health, Safety, and Environmental Program Onsite?

  • Site Specific Safety Plan?

Medical/Emergency

  • Emergency Action Plan documented?

  • Plan reviewed with employees?

  • Location and direction to nearest medical facility?

  • Procedure To follow in case of emergency?

  • Employees driven route to nearest medical facility?

  • First Aid Kits On the Job Site?

  • First Aid Kit Adequate for the Number of Workers on the Site?

  • First Aid Kit Restocked As Necessary?

  • Eye wash?

  • Work Areas Properly Signed and Barricaded?

  • Red = Danger

  • Yellow = Caution

Site Access / Safety and Health Training Information

  • Onsite Workers Completed 2014 AEP Transmission Contractor Safety Orientation?

  • Onsite Workers Displaying 2014 AEP Transmission Contractor Safety Orientation Sticker on Hard Hat?

  • Onsite Workers Completed the EPCS Sullivan 345 kV Station Project Specific Safety Plan?

  • Onsite Workers Displaying EPCS AEP Sullivan 345 kV Station Project Specific Safety Orientation Stick on Hard Hat?

  • Visitors to the Job Site Report to the Main Office and Sign Visitor's Log?

  • Visitors to the Job Site Escorted by a Supervisor and Task Hazard Analysis (THA) Briefing of Hazards Before Entering Job Site?

Task Hazard Analysis (THA) and Daily Safety Meeting

  • Task Hazard Analysis Complete?

  • EPCS Management Team, Subcontractors' Supervisors, Employees, Visitors, and Vendors Been Briefed on the THA and Sign THA After Tailgate Morning Briefing, Significant Break Briefing, Change in Scope of Work Briefing Stating Their Understanding?

  • Does the subcontractor have adequate control measures to eliminate or control potential risks/hazards?

  • Tailboard Meeting Conducted Before Work Started, After Significant Breaks (i.e. Lunch, etc.), and as the Scope of Work Changes?

  • Change in Scope of Work Occurred, Was a New THA Completed and a Tailboard Meeting Conducted?

  • Did the subcontractor list the consequences and how it could happen?

  • Hazards for the Job Site Covered?

  • Did the subcontractor break the job tasks into steps?

  • Is the subcontractor specific? (i.e. Subcontractor should not use generalizations like "Be careful, be safe.)

Hazard Communication

  • Hazardous Material Management Program Onsite?

  • MSDS / SDS Onsite for All Hazardous Products?

  • Universal Spill Kits Onsite and In Each Vehicle In Case of a Spill?

  • Is Emergency Response Information Onsite and in a Common Area for All Job Site Workers?

Housekeeping

  • Work Area Neat?

  • Adequate toilet and washing facilities?

  • Potable water?

  • Projecting Nails or Screws Bent Over or Removed?

  • Waste Containers Provided and Used?

  • Passageways and Walkways Clear?

  • If Not, Are Passageways and Walkways Properly Barricaded?

  • Walking surfaces clear of slip/trip hazards?

Fire Prevention

  • Adequate Fire Extinguishers?

  • Fire Extinguishers in Good Repair and Gauge "Green"?

  • Fire Extinguishers Checked Monthly and Annually?

  • Flammable Materials in Approved Containers and Properly Labeled?

  • Smoking Only In Designated Approved Areas?

Electrical

  • Extension Wires / Bare Wires or Missing Ground Prongs Taken Out of Service?

  • Ground Fault Circuit Interrupters (GFCI) Being Used?

Hand, Power, and Powder Actuated Tools

  • Hand Tools Inspected Before Use?

  • Guards in Place on Machines / Tools?

  • Correct Tool Being Used for Job At Hand?

  • Gloves and Proper PPE Worn?

  • Safety clips or retainers used on compressed air tools and hoses? 1926.302

Fall Protection

  • Safety Harness and Lanyard, etc. Inspected Before Use?

  • Safety Harness Worn Properly?

  • Employees Exposed to Fall Hazards Tied Off?

  • Employees Below Protected from falling Objects?

Ladders

  • Non-Conductive Ladder Used When Used In An Energized Environment?

  • Ladders Extended at Least 36" Above Landing?

  • Ladders Secure to Prevent Slipping, Sliding, or Falling?

  • Damaged Ladders Taken Out of Service?

  • Stepladder Used in Fully Open Position?

  • No Stepping at Top Two Rungs of Stepladder?

Equipment Operation

  • Operators of Equipment Properly License, Qualified, Competent, and Authorized?

  • All Equipment Inspected Daily Before Use?

  • Is annual inspection current? (Boom/DOT)

  • Have Pre-Use Inspections Been Completed for All Equipment In Use at the Site?

  • Users Manual / Manufacturers Manual and Inspection Sheet in the Equipment?

  • Fire Extinguisher in Each Piece of Equipment and in Proper Working Order?

  • Equipment Leaking Any Fluids, etc.?

  • Seat belts worn?

  • Back alarm working?

  • Haul roads maintained?

  • Dump beds lowered before traveling?

  • Drivers staying in trucks while being loaded/unloaded?

  • Spotters used when backing equipment or when operator/driver has limited visibility?<br>

  • Safety locks?

  • Blades, forks, buckets, dump beds,etc. lowered or blocked when being repaired or not in use? 1926.600

Trenching, Excavating, and Shoring

  • Operations Performed at the Proper Distance from Overhead Power Lines? (Refer to EPC Services Company Project Site Specific Safety Plan for Minimum Clearance Distances Located on Page 30).

  • Open excavation barricaded when unattended?

  • Trench or excavation inspected daily or after weather event?

  • Competent Person Identified and Present?

  • Excavations Shored or Sloped Back?

  • Materials Stored at Least 2 Feet Away from Trench?

  • Ladders provided every 25 Feet in Trench if Personnel In Trench?

  • Equipment at a Safe Distance from Edge of Trench or Excavation?

Aerial lifts, Bucket and boom-attached platforms

  • Gate or chain secured?

  • Ground where needed?

  • Personal Fall Protection worn? 1926.1431

  • Pre-use inspection?

  • Trial lift? 1926.1431(h)(2)

  • Proof testing at 125% of work platform when work platform is installed? 1926.1431(j)

  • Winds aloft within safe working speeds?

Material Handling

  • Materials Properly Stored or Stacked?

  • Employees Using Proper Lifting Techniques?

  • Materials stacked under Overhead Power Lines?

  • Tag Lines Used to Guide Loads?

  • "Unloading Trucks" form attached to THA when unloading trucks?

  • Proper Number of Workers for Each Operation?

  • Gloves and Proper PPE Worn?

  • Operator's view unhindered?

  • Weight and center of gravity on material to be lifted or computed?

  • Cable ends secured to reels before unreeling?

Welding and Burning

  • Gas Cylinders Stored Upright?

  • Gas Cylinders Properly Used and Stored?

  • Goggles and Shields Used?

  • Fire Extinguisher Readily Available?

  • Hoses in Good Condition?

  • Fire Watch when applicable?

Cranes-29CFR1910.180

  • Outrigger Extended and Swing Radius Barricaded?

  • Employees Kept from Under Suspended Loads?

  • Operator Licensed for Crane Used?

  • Chains and Slings Inspected and Tagged as Required?

  • Hand Signal Charts on Crane?

  • Rigging inspected/rated?

  • Damaged slings taken out of service?

  • Chains and slings have SWL tags or labels?

  • Hooks have safety latches?

  • Rigger Qualified?

  • Load left unattended except when operator is next to crane and not engaged in other duties and the load is to be suspended for a period of time,and he competent person determines it is safe to do so, and fall zone is adequately barricaded. DOES nOT apply to lifting gear and the gear is no suspended over entrance or exit. 1926.1417

  • Users Manual / Manufacturers Manual and Inspection Sheet in the Equipment?

  • Fire Extinguisher on board and inspected?

  • Crane Operator Log Up To Date?

  • Windows cracked or damaged?

  • Crane working near, or under, OHP?

  • Outrigger pads free of defects, strong enough to prevent crushing, sufficient width and length to prevent shifting or toppling under load?

  • Weight and center of gravity determined before lifting?

  • Winds aloft within safe working speeds?

  • Critical lift plan reviewed before lifting weight exceeding 75 % of rated lifting capacity of crane or derrick, or requires the use of more than one crane or derrick?

Concrete Construction

  • Employees Protected from Cement Dust?

  • Exposed Skin Covered to Protect from Burns?

  • Rebar/Pipe and Other Impalement Hazards Capped / Protected?

Personal Protective Equipment (PPE)

  • Hard Hats Worn?

  • Safety Glasses with Side Shields Worn?

  • Hearing Protection Worn When Required?

  • High Visibility Safety Vest Worn?

  • Safety-Toed Work Boots Worn?

  • Saw chaps/trousers worn when using chainsaw?

  • Face shield with hearing protection worn while operating chainsaw?

Electrical. 1926.950

  • Conductors properly grounded?

  • Lines and equipment de-energized before work? 1926.954

  • Minimum work distance and clear hot stick distances ? 345 kV 7 feet, 0 inches

  • De-energizing procedures followed?

  • Protective equipment inspected before use?

  • Lift trucks grounded, barricaded, or insulated for work being performed? 1926.952

  • Towers grounded?

  • Action plan reviewed before installing or removing wire or cable? 1926.955

  • Mobile cranes and derricks grounded when work near energized lines?

Other Information

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.