Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Record-keeping, Posters

  • OSHA Notice / 300 Log

  • Emergency Telephone #'s

  • Location of nearest Occupational Clinic

Communication

  • Stretching booklet

  • Pre-task Planning

  • Jobsite Pre-Plan On Site

  • TBT On Site

  • JHA

PPE

  • Hardhat, Safety Glasses, Work Gloves, Proper Boots

  • FR Clothing

  • High Visibility Vest

  • Respirator

  • Other PPE (ear plugs, dust mask, Ty-Veksuit, ect.)

  • First Aid Kit

Cranes, Riggers, Signal Person

  • Daily Inspection

  • Qualified Operator

  • Qualified Rigger/Signal Person

  • Swing Radius Controlled

  • Critical Lift Permit

Ladders

  • Properly Inspected

  • Properly Used

  • Necessary labels visible

Fall Protection

  • Proper fall protection at 6' or greater

  • Personnel below are protected from falling objects

  • Roof top work

  • Open sided floors or platforms 6' or more from ground equipped with proper guardrail

  • Openings properly barricaded or covered

Fire Protection & Housekeeping

  • Trash picked up and disposed of regularly

  • Aisles and passageways clear

  • Flammable and explosive materials stored and handled safely

  • Required number of fire ext. properly located and inspected

  • All vehicles & other mobile equipment provided with fire protection

Aerial Lifts

  • Daily Inspection

  • Proper Use

  • Fall Protection if required

Hot Work

  • Welding screens provided

  • Proper additional PPE provided

  • Equipment in good repair, insulators, grounding, welding leads

  • Adequate ventilation or respirator utilized

Electrical

  • Assured Grounding Program up to date

  • All electrical equipment in good condition

  • Proper GFCI

  • Good work practices (cords out of pathways, kept out of water, etc.)

  • Adequate Arc Flash Protection

  • Arc Flash Equipment inspected and in good condition

Confined Space

  • Declared Permit or non-permit

  • Air monitor on site (properly calibrated, properly used)

  • Atmosphere test results documented

  • Energy sources locked out

  • Adequate ventilation

Cylinders

  • Compressed gas cylinders stored and secured upright

  • Empty gas cylinders marked

  • Cylinders capped

Haz Com

  • 1-800 Number visible

  • Employees know about the subject

Excavations

  • Was one-call system contacted

  • Protective system

  • Surface encumbrances protected/supported

  • Ladder within 25' of all employees

  • Utilities protected/supported

  • Spoil piles minimum of 2' from edge of excavation

  • Overhead power lines minimum distance of 20'

Haz-Mat

  • Lead

  • Asbestos

  • Silica

  • Mercury

Subcontractor Safety

  • PPE

  • Other

Other items found

Positive Insight

  • Comments

  • Safety Representative

  • Foreman / Supervisor

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.