Information

  • Job Name, and #

  • General Contractor

  • Conducted on

  • Prepared by

  • Personnel

  • Audit completed by?

Job Scope and High Potential Risks

  • Job Scope

  • High Potential Fatal Risk Hazards

  • Notes Regarding High Potential Risks

  • General notes regarding audit results

Aerial Lifts

  • Operators trained?

  • Workers properly tied off?

  • Load limits not exceede?

  • Climbing on rails?

  • Lift stationary when lifted?

  • Controls clearly marked?

  • Manual on board?

  • Midrail chain on?

  • Outriggers used as needed?

  • Operated on level surface?

  • Platform clear of debris?

  • Fall protection worn?

  • Good compliance, no safety violations?

Behaviours

  • Eyes on path, looks in direction of travel?

  • Looks back when stepping backwards?

  • Pushes instead of pulls when possible?

  • Avoids overhead work if possible?

  • Lifts with legs not with back when possible?

  • Does not more than can be lifted safely?

  • Keeps load close to body when lifting?

  • Uses lift assist device for heavy loads?

  • Avoids lifting heavy loads?

  • Does not subject coworkers to injury?

  • Works at safe pace, not rushed?

Confined Space

  • Pre-access hazard assessment done?

  • Atmospheric testing done?

  • Ermit completed and signed?

  • Workers trained and documented?

  • Attendant on duty?

  • Tendant in constant communication?

  • Azardois energy sources locked out?

  • Ventilation provided as required?

  • Appropriate retrieval equipment used?

  • Proper PPE worn?

  • Barricades provided at entrance as needed?

  • Signage placed at entrance as required?

  • Emergency response plan in place?

  • Good compliance, no safety violations?

Lifting, Working Around Cranes

  • Workers kept clear of suspended loads?

  • Ground conditions adequate to support crane?

  • Power line safety requirements met?

  • Barricade tape, radius guard around crane?

  • Rigging equipment seems visually okay?

  • Adequate communication between operator and signaller?

  • Workers trained on using hoisting equipment?

  • Slings in good shape?

  • Slings rated for load?

  • Shackle in good shape?

  • Shackle rated for load?

  • Barricade and signage up around loading area and far enough back?

  • Adequate communication between operator and signaller?

  • Good compliance, no safety violations?

Demolition

  • Structures shored?

  • Utilities shut off?

  • Broken glass removed?

  • Wall openings protected?

  • Ebris landing area barricaded off?

  • Warning signs for falling debris and material posted each level?

  • Floor openings properly guarded?

  • Stairs, passageways ladders in clean and safe condition?

  • Safsty monitor used when fall protection not used?

  • Safety monitor performs only monitoring duty?

  • Warning lines for roofing and non-roofing activities?

  • Warning line, barricades on unprotected roof line?

  • Hoisting area properly guarded?

  • Workers trained in fall protection?

  • Good compliance, no safety violations?

Fire Safety

  • Extinguishers in good shape, fully charged?

  • Extinguishers have annual inspection?

  • Extinguishers within easy access?

  • Minimum one extinguisher per floor?

  • Flammables stored in appropriate areas, contaimers?

  • Smoking prohibited where fire hazard exists?

  • Scrap piles no closer than 10 feet to buildi g?

  • Flammable liquids protected from ignition sources?

  • ammsbles not stxored near emergency pathways?

  • Extinguisher near gas powered equipment?

  • Good compliance, no safety violations?

Fuelling Operations

  • Dispensing unit protected against vehicle damage?

  • No smoking signs in area?

  • Motor shut off during fuelling?

  • Fire extinguisher available?

  • Fuelling area free of combustibles?

  • Tanks secured during off hours?

  • Dispensing nozzle automztic close, not leaking?

  • Fuel tanks propery labelled?

  • Spill control means provided?

  • Good compliance, no safety violations?

WHMIS

  • MSDS sheets readily available?

  • Azardous chemicals properly labelled?

  • Worker training completed?

  • Good compliance, no safety violations

Health

  • Noise exposure hazards?

  • Asbestos exposure hazards?

  • CO exposure hazards?

  • Lead exposure hazards?

  • Silica exposure hazards?

  • Welding fumes exposure hazards?

  • Extreme heat exposure hazards?

  • Extreme cold exposure hazards?

  • Good compliance , no safety violations?

Housekeeping

  • Worksite reasonably organized, good housekeeping?

  • Combustible scrap removed art regular intervals?

  • Job trailer clean and reasonably organized?

  • Material staging area deasonably organized?

  • Garbage disposed of regularly?

  • Se scrap, materials secured against wi d?

  • No protruding nails in lumber?

  • Containers only used for oily, flammabld waste covered?

  • Good compliance, no safety violations

Ladders, Stairs

  • Ladders no visible defects?

  • Side rsils extend 3 feet above surface?

  • Set up at 4 to 1 ratio?

  • Set up on stable surface?

  • Side rails secured as needed to prevent side slip?

  • Ase of ladder secured if need be?

  • Ladder used for intended purpose?

  • Spreaders fully engaged on step ladders?

  • Top 2 steps not used as a step

  • Area at top and bottom of ladder kept clear?

  • At least one hand free to grasp ladder?

  • Good compliance, no safety violations?

Mechanical

  • Equipment in good shape, no obvious defects?

  • Wheels chocked?

  • Horns, revers alarms, strobes, whips working?

  • Windshields in good shape?

  • Operators competent, familiar with equipment?

  • Good compliance, no safety violations?

First Aid Equipment

  • First aid equipment easily accessible?

  • First aid supplies refilled, maintained?

  • Proper number abd type of first aiders on site?

  • Emergency numbers posted?

  • Location of nearest medical facility posted?

  • Eyewash facility available and maintained?

  • Good compliance, no safety violations?

PPE

  • PPE available as required?

  • PPE maintained as required?

  • Eye protection used as required?

  • Hard hats worn as required?

  • Hand protection worn when required?

  • Safety footwear worn?

  • Respirators used as required?

  • Earing protection used as required?

  • High visibility clothing worn as required?

  • Face shield worn as required?

  • PFD worn when working around water?

  • Good compliance, no safety violations?

Signage

  • Safety posters displayed, 3 rifhts of an employee?

  • Emergency numbers, contzcts posted?

  • Danger, caution signs posted as needed?

  • Warning signs around perimeter of worksite?

  • Good compliance, no safety violations?

Safety Training

  • Toolbox talks done regularly and documented?

  • Hazard asessments done regularly, documented and signed?

  • Job specific safety training provided and documented?

  • Safety orientation provided?

  • Good compliance, no safety violations?

Sanitation

  • Adequate zupply of potable water?

  • No common drinking cups?

  • On potable outlets clearly marked?

  • Adequate toilets provided, clean and sanitary?

  • Washing facilities provided and sanitary?

  • Food, beverage areas away from hazardous materials?

  • Good compliance, no safety vilolations?

Scaffolding

  • Platforms fully planked?

  • call protection abpve 10 feet?

  • Legs, frame bear mud base plates, mud sills?

  • Scaffolds inspected, tzgged, free of visivle defects?

  • Footings rigid, level, no visible settling?

  • Ladder provided?

  • Only scaffold grade lumber used?

  • Platform clean and free of excessive debris?

  • Whe. Platforms overlap, overlap is more than 12 inches?

  • Atform supports plumb to prevent swaying?

  • Toeboards used?

  • Akeshift devices not used to gain extra height?

  • Scaffold does not move horizontally when occupied?

  • Midrails xand toprails in place and at proper heights?

  • Workers trained on use of scaffolds?

  • Workers trained to assemble, disassemble scaffolding?

  • Good compliance, no safety violations?

Power and Hand Tools

  • Ools in safe, operating condition?

  • Tools properly hoisted, lowered?

  • Guards in place?

  • Handles free of cracks, splinters?

  • Grinders, chop saws, sawzalls guards, safetys in place

  • Raised loads blocked?

  • Air hoses, compressors working properly?

  • Od comlliance, no safety violations?

Trenching, Excavations

  • Competent person performs daily inspections?

  • Emloyees protected from cave in?

  • Sloping, benching adequzte for soil type?

  • Spoil pile at least 2 feet back from edge?

  • No more than 25 feet to egress?

  • Utilities identified and located prior to start?

  • Surfzce encumbrznces removed or supported?

  • Water runoof co trolled to prevent accumulation?

  • Access prohibited when water ru off is uncontrolled?

  • Rench barricaded at unsecured worksite after hours?

  • Workers exposed to traffic wearing high viz vest?

  • Backfilling accurs as work proceeds?

  • Stability of adjacent structures ensured?

  • Good compliance, no safety violations?

Trucks

  • Trucks in good shape generally?

  • Inside free of garbafe, reasonably organized?

  • Parked out of the way?

  • Parked to minimize backing up?

  • Strobe, whiplight working?

  • Vehicle log done?

  • Tires turned when parked on an incline?

  • Cargo secure?

  • Truck box reasonably clean and organized

  • Good compliance, no safety violations

Miscellaneous

  • Stretching before work?

  • Steps tsken to address icy, slippery surfaces?

  • Steps tzken to address loose material, tarps in hi ghh wind conditions?

  • Job trailer secure against wind, burglars? Trailer lock on?

  • Construction area properly illuminated?

  • Security fence in place?

  • Egular inspections of jobsite?

  • Defectice equipment tagged and removed from job site?

  • No apparent insafe conditions observed?

  • No apparent unsafe behaviours observed?

  • Photos

Electrical

  • Energized circuits locked out?

  • Tags filled out properly?

  • Everyone working on circuit has lock and tag on?

  • Energized electrical dealt with properly? Good reason for working on live?

  • Arc flash gear worn?

  • Good compliance, no safety violations?

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.