Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Select date

  • Add location

COMMUNICATION

  • T5 / Risk Assessment done?<br>

  • Tool Box Talkes being done and up to date?

TRAFFIC CONTROL

  • Traffic Control Inspections being done daily and documented?

  • Is the traffic control plan properly implemented? <br>

  • Are employees unnecessarily exposed to traffic?<br>

  • Are flaggers properly trained, attired, equipped, and using proper technique?<br>

  • Backer Spotter being used and wearing spotter vest with emegency whistle?

  • Is equipment parked so as not to present a hazard to through traffic or job traffic? <br>

  • Is equipment and materials stored outside clear zone?<br>

  • Internal traffic cntrol plan in place?<br>

  • A copy of the most current TMUTCD and stater project specific traffic control standards are immediately available for review?

  • Add media

EQUIPMENT & PEDESTRAIN SEGREGATION

  • Breakdown roller clear zone 15 to 20' in effect?

  • All equipment operators following requirements that no equipment is to approach closer than 10 feet to any worker with whom they do not have direct eye contact.

  • No employees riding equipment, unless aprroved seat is provided?

  • Add media

GENERAL HEALTH AND SAFETY

  • Is adequate potable water provided with single service cups in a clean, closed container that is clearly marked?<br><br><br>

  • Are adequate number and types of portable toilets provided where needed?<br>

  • Is the job site kept free of excess debris, lumber with protruding nails, and other scrap that may present a hazard?<br>

MEDICAL AND FIRST AID

  • Are an adequate number of properly stocked first aid kits present on site & readily available?<br>

  • Is at least one employee present who is trained in first aid / CPR / bloodborne pathogens?<br>

PERSONAL PROTECTIVE EQUIPMENT

  • Are employees / subcontractor personnel wearing hard hats, traffic vests, safety glasses and safety boots?<br>

  • Distributor operators have chemical resistant gloves, hard hat with faceshield and long sleeves to protect against hot material?<br>

  • Dust masks are immediately available while any individual is saw cutting concrete or asphalt?

  • Personal Protective Equipment in good working condition?

  • Superviors / Foreman have extra PPE?<br>

Mobile Equipment

  • Are daily inspections conducted on machinery at the site? (fluid levels, brakes, warning devices, etc)<br>

  • Equipment Number

  • Add media

  • Is equipment kept clean to a point of not being an operational hazard?<br>

  • Are all glass panels in equipment free of cracks or breaks?<br>

  • Are seat belts present and in use on all equipment with ROPS?<br>

  • Do all drivers / operators use 3 point contact when climbing on or off vehicles and equipment?<br>

  • Do all pieces of mobile equipment have a slow moving vehicle sign, strobe light and reflective tape?<br>

  • All equipment have back up alarms that can be heard over construction and traffic noise?<br>

  • Does the finish roller have the safety siren / intursion alarm?<br>

  • Equipment being serviced or repaired have proper lockout tagout and blocking procedures?<br>

FIRE PROTECTION AND PREVENTATION

  • Are flammable liquids present only in approved and properly labeled safety cans?<br>

  • Asphalt paver screed free of trash?

  • Are fire extinguishers present in sufficient number & size, properly serviced, and inspected on a periodic basis?<br>

  • Are other fire hazards apparent?<br>

  • Add media

HAND AND POWER TOOLS

  • Are tools free of obvious physical damage with all required guards in place and in good condition?<br>

  • Add media

Fall Protection

  • Are employees and subcontractors working above 6 feet pertoected with adequate fall prtoection?

  • Add media

OVERHEAD AND UNDERGROUND UTILITES

  • Are all overhead power lines identifed and marked / signed "Overhead Power Lines"?

  • Is no work conducted within 10 ft of transmission lines rated greater or equal to 600 V without required precautionary measures taken?<br>

  • Has the one call center (811) been notified?

  • Pot Holeing or Best Practices used for verfication of utilities?

  • Add media

Trench and Excavation

  • Are excavations or trenches deeper than 5 feet on the job site proplery sloped, benched or shored?

  • Have underground utilities been located?

  • Is there a means of exiting any trench 4 feet or more within 25 lateral feet of any employee?

  • Is the pile kept at least 2 feet from edge of anmy excavation?

  • Competent person performed inspection of excavation?

  • Add media

ENVIRONMENTAL

  • No diesel being used on project, biodegradable products being used?<br>

  • Is required sediment control in place and maintained as required by the job plans are standard practices?<br>

  • Are spill response materials present and readily available?<br>

  • Are appropriate housekeeping practices in place to insure responsible environmental performance?<br>

  • Add media

COMPANY VEHICLES

  • All crew drivers trained in company safe driving program (Smith System)?

  • Vehicle clean appropriate housekeeping?<br>

  • Tires in good condtion, tread depth?

  • Mirrors in good working condition?

  • Physical Condition, any body damage?

  • Physical Condition, any body damage?

OTHER SAFETY RELATED IITEMS NOTICED

  • Was unsafe behavior observed during this audit? If yes, please exlian below how it was corrected.

  • Other

SUBCONTRACTORS

  • Are employees unnecessarily exposed to traffic? <br>

  • Wearing proper personal protective equipment?

  • Following CRH FFE's?

  • Add media

  • Overall Safety

  • Add signature

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