AMS SAFETY AUDIT

• Audit Title

• Conducted on

  Date

• Client / Site

• Prepared by

• Location
  Address

Jobsite Information

• OSHA and DOL posters displayed?

  Yes

  No

  N/A

• OSHA 300 Logs displayed from February 1 thru April 30 ?

  Yes

  No

  N/A

• Emergency phone numbers displayed?

  Yes

  No

  N/A

• Emergency action plan in place and all employees know it?

  Yes

  No

  N/A

• First aid available and up to date?

  Yes

  No

  N/A

Housekeeping

• Passageways and walkways clear?

  Yes

  No

  N/A

• Are all types of materials stock piled and neat?

  Yes

  No

  N/A

• Is the jobsite clear of slips, trips, and falls?

  Yes

  No

  N/A

• Jobsite clean and trash in containers?

  Yes

  No

  N/A

• Toilet facilities adequate and clean?

  Yes

  No

  N/A

• Sanitary supply of drinking water and cups?

  Yes

  No

  N/A

Fire Protection

• Flammables in safety cans with flash arresters and labeled?<br>

  Yes

  No

  N/A

• Fire extinguishers immediately available and inspection tag current?

  Yes

  No

  N/A

• Are Flammable or No Smoking signs posted at storage or fueling location?

  Yes

  No

  N/A

Welding and Cutting

• Gauges, valves, torches and lines in good condition?

  Yes

  No

  N/A

• Cylinders upright, secured and protected from damage?

  Yes

  No

  N/A

• Fire extinguisher near welding or cutting area?

  Yes

  No

  N/A

• Stored oxygen and acetylene capped, separated 20ft.?

  Yes

  No

  N/A

• Adequate ventilation provided?

  Yes

  No

  N/A

Jobsite Safety

• Is there a confined space on site we will be working in?

  Yes

  No

  N/A

• Floor openings covered or guard railed and marked?

  Yes

  No

  N/A

• Vertical rebar capped or covered?

  Yes

  No

  N/A

• Hollow pan treads filled with solid material?

  Yes

  No

  N/A

• Proper guard rails, toe boards at open sided floors, openings, and shafts?

  Yes

  No

  N/A

• Harness and lanyards used when guard rails are absent?

  Yes

  No

  N/A

• Anchor points capable of supporting 5000 lbs.?

  Yes

  No

  N/A

• Subcontractors wearing hard hats, safety glasses 100% of the time?

  Yes

  No

  N/A

• Rate this job site for safety.

  Yes

  No

  N/A

• Select from range

Electrical

• GFCI's in use or positive ground been tested?

  Yes

  No

  N/A

• Temporary distribution boxes covered and marked?

  Yes

  No

  N/A

• Lockout procedures being used?

  Yes

  No

  N/A

• Are extension cords and power tools being inspected daily for cuts and ground pins?

  Yes

  No

  N/A

• If equipment is live, are the proper safeguards and PPE in place for arc flash?

  Yes

  No

  N/A

• Is temporary lighting protected?

  Yes

  No

  N/A

Tools

• All guards in place and used?

  Yes

  No

  N/A

• Lock out tag out procedures in place and being used for defective tools?

  Yes

  No

  N/A

• Proper PPE being used?

  Yes

  No

  N/A

• Cut resistant gloves being worn?

  Yes

  No

  N/A

• Handles in place and free of splinters, fractures and breaks?

  Yes

  No

  N/A

• Proper ladder being used for the task?

  Yes

  No

  N/A

• Three points of contact when ascending and descending ladders?

  Yes

  No

  N/A

• Step ladder fully open and braces locked in place?

  Yes

  No

  N/A

Equipment

• Seat belts in use if equipped?

  Yes

  No

  N/A

• All equipment inspected and documented daily?

  Yes

  No

  N/A

• All operators are certified and have cards on site including crane operators, aerial work platforms, all types of forklifts etc.?

  Yes

  No

  N/A

• Do cranes have current inspections and paperwork?

  Yes

  No

  N/A

• Operators wearing hard hats?

  Yes

  No

  N/A

• Horns and backup alarms functioning?

  Yes

  No

  N/A

• Swing radius of the crane has been cleared and guarded?

  Yes

  No

  N/A

• Certified signalman has been designated for the lift?

  Yes

  No

  N/A

Trenching and Excavation

• Trench side shored, layered back or boxed

  Yes

  No

  N/A

• Ladder in trench every 25 ft.?

  Yes

  No

  N/A

• Materials stock piled at least 2ft. from the edge?

  Yes

  No

  N/A

• Proper ventilation in the pipe?

  Yes

  No

  N/A

• Barricades and warning signs in place?

  Yes

  No

  N/A

• Designated competent person?

  Yes

  No

  N/A

• Utilities contacted and marked before any excavation begins?

  Yes

  No

  N/A

• Tested air quality in pits, shafts, funnels or other confined space before entering?

  Yes

  No

  N/A

Site conclusion

• Did you observe any unsafe acts or practices on this site?

Signatures

• By on site representative

  Sign

• By auditor

  Sign