Ahern Safety Assessment

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Record-keeping, Posters

• State/Federal Postings

  Yes

  No

  N/A

• Emergency Telephone #'s

  Yes

  No

  N/A

• Location of nearest Occupational Clinic

  Yes

  No

  N/A

Communication

• Stretching booklet

  Yes

  No

  N/A

• Pre-task Planning

  Yes

  No

  N/A

• Jobsite Pre Plan On Site / JHA

  Yes

  No

  N/A

• Tool Box Talk topic this week?

  Yes

  No

  N/A

PPE

• Hardhat, Safety Glasses, Work Gloves, Proper Boots

  Safe

  At Risk

  N/A

• FR Clothing

  Safe

  At Risk

  N/A

• Respirator

  Safe

  At Risk

  N/A

• Other PPE (ear plugs, dust mask, TyVek suit, high vis vest...

  Safe

  At Risk

  N/A

• First Aid Kit

  Yes

  No

  N/A

Material Handling

• Rigging equipment free from defect

  Yes

  No

  N/A

• Qualified personnel involved in the rigging process

  Yes

  No

  N/A

• Material stored at appropriate height / distance appropriate to work area

  Yes

  No

  N/A

• Proper lifting techniques, team lifting, mechanical advantage being utilized

  Yes

  No

  N/A

• Load capacities being followed

  Yes

  No

  N/A

Ladders

• Properly Inspected

  Yes

  No

  N/A

• Properly Used

  Safe

  At Risk

  N/A

• Necessary labels legible

  Yes

  No

  N/A

Fall Protection

• Proper fall protection at 6' or greater

  Safe

  At Risk

  N/A

• Fall Protection Equipment Inspected and in good condition

  Yes

  No

  N/A

• Personnel below are protected from falling objects

  Safe

  At Risk

  N/A

• Roof top work

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

• Openings properly barricaded or covered

  Safe

  At Risk

  N/A

Fire Protection & Housekeeping

• Trash picked up and disposed of regularly

  Safe

  At Risk

  N/A

• Aisles and passageways clear

  Safe

  At Risk

  N/A

• Flammable and explosive materials stored and handled safely

  Safe

  At Risk

  N/A

• Required number of fire ext. properly located and inspected

  Safe

  At Risk

  N/A

• All vehicles & other mobile equipment provided with fire protection

  Safe

  At Risk

  N/A

Aerial Lifts

• Daily Inspection

  Yes

  No

  N/A

• Proper Use

  Safe

  At Risk

  N/A

• Fall Protection if required

  Safe

  At Risk

  N/A

Hot Work

• Welding screens provided

  Yes

  No

  N/A

• Proper additional PPE provided

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

• Adequate ventilation or respirator utilized

  Safe

  At Risk

  N/A

Electrical

• Assured Grounding Program up to date

  Safe

  At Risk

  N/A

• All electrical equipment in good condition

  Safe

  At Risk

  N/A

• Proper GFCI

  Safe

  At Risk

  N/A

• Adequate Arc Flash Protection (I.e. Hazard boundary, permit, customer discussion)

  Yes

  No

  N/A

• Arc Flash Equipment and PPE inspected and in good condition

  Yes

  No

  N/A

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

  Safe

  At Risk

  N/A

Confined Space

• Declared Permit or non-permit

  Yes

  No

  N/A

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

  Safe

  At Risk

  N/A

• Atmosphere test results documented

  Yes

  No

  N/A

• Energy sources locked out

  Safe

  At Risk

  N/A

• Adequate ventilation

  Safe

  At Risk

  N/A

Cylinders

• Compressed gas cylinders stored and secured upright

  Safe

  At Risk

  N/A

• Empty gas cylinders marked

  Yes

  No

  N/A

• Cylinders capped

  Yes

  No

  N/A

Haz Com

• 1-800 Number visible

  Yes

  No

  N/A

• Employees know about the subject

  Yes

  No

  N/A

• Aware of GHS Update

  Yes

  No

  N/A

Excavations

• Was one-call system contacted

  Yes

  No

  N/A

• Protective system

  Safe

  At Risk

  N/A

• Surface encumbrances protected/supported

  Safe

  At Risk

  N/A

• Ladder within 25' of all employees

  Safe

  At Risk

  N/A

• Utilities protected/supported

  Safe

  At Risk

  N/A

• Spoil piles minimum of 2' from edge of excavation

  Safe

  At Risk

  N/A

• Overhead power lines minimum distance of 20'

  Safe

  At Risk

  N/A

Haz-Mat

• Lead

  Safe

  At Risk

  N/A

• Asbestos

  Safe

  At Risk

  N/A

• Silica

  Safe

  At Risk

  N/A

• Mercury

  Safe

  At Risk

  N/A

Subcontractor Safety

• PPE

  Safe

  At Risk

  N/A

• Other

  Yes

  No

  N/A

Other items found

• Yes

  No

  N/A

• Yes

  No

  N/A

Positive Insight

• Comments

  Yes

  No

  N/A

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