Information
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Job Name, and #
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General Contractor
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Conducted on
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Prepared by
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Personnel
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Audit completed by?
Job Scope and High Potential Risks
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Job Scope
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High Potential Fatal Risk Hazards
- Working At Heights
- Interaction With Electrical/Mechanical
- Objects Dropping From Height
- Confined Space
- Interaction With Heavy Equipment
- Explosive Energy
- Ground Disturbance
- Hazardous Material
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Notes Regarding High Potential Risks
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General notes regarding audit results
Aerial Lifts
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Operators trained?
- Yes
- No
- N/A
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Workers properly tied off?
- Yes
- No
- N/A
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Load limits not exceede?
- Yes
- No
- N/A
-
Climbing on rails?
- Yes
- No
- N/A
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Lift stationary when lifted?
- Yes
- No
- N/A
-
Controls clearly marked?
- Yes
- No
- N/A
-
Manual on board?
- Yes
- No
- N/A
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Midrail chain on?
- Yes
- No
- N/A
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Outriggers used as needed?
- Yes
- No
- N/A
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Operated on level surface?
- Yes
- No
- N/A
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Platform clear of debris?
- Yes
- No
- N/A
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Fall protection worn?
- Yes
- No
- N/A
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Good compliance, no safety violations?
Behaviours
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Eyes on path, looks in direction of travel?
- Yes
- No
- N/A
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Looks back when stepping backwards?
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Pushes instead of pulls when possible?
- Yes
- No
- N/A
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Avoids overhead work if possible?
- Yes
- No
- N/A
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Lifts with legs not with back when possible?
- Yes
- No
- N/A
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Does not more than can be lifted safely?
- Yes
- No
- N/A
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Keeps load close to body when lifting?
- Yes
- No
- N/A
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Uses lift assist device for heavy loads?
- Yes
- No
- N/A
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Avoids lifting heavy loads?
- Yes
- No
- N/A
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Does not subject coworkers to injury?
- Yes
- No
- N/A
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Works at safe pace, not rushed?
- Yes
- No
- N/A
Confined Space
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Pre-access hazard assessment done?
- Yes
- No
- N/A
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Atmospheric testing done?
- Yes
- No
- N/A
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Ermit completed and signed?
- Yes
- No
- N/A
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Workers trained and documented?
- Yes
- No
- N/A
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Attendant on duty?
- Yes
- No
- N/A
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Tendant in constant communication?
- Yes
- No
- N/A
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Azardois energy sources locked out?
- Yes
- No
- N/A
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Ventilation provided as required?
- Yes
- No
- N/A
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Appropriate retrieval equipment used?
- Yes
- No
- N/A
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Proper PPE worn?
- Yes
- No
- N/A
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Barricades provided at entrance as needed?
- Yes
- No
- N/A
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Signage placed at entrance as required?
- Yes
- No
- N/A
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Emergency response plan in place?
- Yes
- No
- N/A
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Good compliance, no safety violations?
Lifting, Working Around Cranes
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Workers kept clear of suspended loads?
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Ground conditions adequate to support crane?
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Power line safety requirements met?
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Barricade tape, radius guard around crane?
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Rigging equipment seems visually okay?
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Adequate communication between operator and signaller?
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Workers trained on using hoisting equipment?
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Slings in good shape?
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Slings rated for load?
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Shackle in good shape?
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Shackle rated for load?
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Barricade and signage up around loading area and far enough back?
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Adequate communication between operator and signaller?
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Good compliance, no safety violations?
Demolition
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Structures shored?
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Utilities shut off?
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Broken glass removed?
- Yes
- No
- N/A
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Wall openings protected?
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Ebris landing area barricaded off?
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Warning signs for falling debris and material posted each level?
- Yes
- No
- N/A
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Floor openings properly guarded?
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Stairs, passageways ladders in clean and safe condition?
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Safsty monitor used when fall protection not used?
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Safety monitor performs only monitoring duty?
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Warning lines for roofing and non-roofing activities?
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Warning line, barricades on unprotected roof line?
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Hoisting area properly guarded?
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Workers trained in fall protection?
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Good compliance, no safety violations?
Fire Safety
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Extinguishers in good shape, fully charged?
- Yes
- No
- N/A
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Extinguishers have annual inspection?
- Yes
- No
- N/A
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Extinguishers within easy access?
- Yes
- No
- N/A
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Minimum one extinguisher per floor?
- Yes
- No
- N/A
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Flammables stored in appropriate areas, contaimers?
- Yes
- No
- N/A
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Smoking prohibited where fire hazard exists?
- Yes
- No
- N/A
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Scrap piles no closer than 10 feet to buildi g?
- Yes
- No
- N/A
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Flammable liquids protected from ignition sources?
- Yes
- No
- N/A
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ammsbles not stxored near emergency pathways?
- Yes
- No
- N/A
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Extinguisher near gas powered equipment?
- Yes
- No
- N/A
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Good compliance, no safety violations?
Fuelling Operations
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Dispensing unit protected against vehicle damage?
- Yes
- No
- N/A
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No smoking signs in area?
- Yes
- No
- N/A
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Motor shut off during fuelling?
- Yes
- No
- N/A
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Fire extinguisher available?
- Yes
- No
- N/A
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Fuelling area free of combustibles?
- Yes
- No
- N/A
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Tanks secured during off hours?
- Yes
- No
- N/A
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Dispensing nozzle automztic close, not leaking?
- Yes
- No
- N/A
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Fuel tanks propery labelled?
- Yes
- No
- N/A
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Spill control means provided?
- Yes
- No
- N/A
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Good compliance, no safety violations?
WHMIS
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MSDS sheets readily available?
- Yes
- No
- N/A
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Azardous chemicals properly labelled?
- Yes
- No
- N/A
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Worker training completed?
- Yes
- No
- N/A
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Good compliance, no safety violations
Health
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Noise exposure hazards?
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Asbestos exposure hazards?
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CO exposure hazards?
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Lead exposure hazards?
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Silica exposure hazards?
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Welding fumes exposure hazards?
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Extreme heat exposure hazards?
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Extreme cold exposure hazards?
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Good compliance , no safety violations?
Housekeeping
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Worksite reasonably organized, good housekeeping?
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Combustible scrap removed art regular intervals?
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Job trailer clean and reasonably organized?
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Material staging area deasonably organized?
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Garbage disposed of regularly?
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Se scrap, materials secured against wi d?
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No protruding nails in lumber?
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Containers only used for oily, flammabld waste covered?
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Good compliance, no safety violations
Ladders, Stairs
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Ladders no visible defects?
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Side rsils extend 3 feet above surface?
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Set up at 4 to 1 ratio?
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Set up on stable surface?
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Side rails secured as needed to prevent side slip?
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Ase of ladder secured if need be?
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Ladder used for intended purpose?
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Spreaders fully engaged on step ladders?
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Top 2 steps not used as a step
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Area at top and bottom of ladder kept clear?
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At least one hand free to grasp ladder?
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Good compliance, no safety violations?
Mechanical
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Equipment in good shape, no obvious defects?
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Wheels chocked?
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Horns, revers alarms, strobes, whips working?
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Windshields in good shape?
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Operators competent, familiar with equipment?
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Good compliance, no safety violations?
First Aid Equipment
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First aid equipment easily accessible?
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First aid supplies refilled, maintained?
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Proper number abd type of first aiders on site?
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Emergency numbers posted?
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Location of nearest medical facility posted?
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Eyewash facility available and maintained?
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Good compliance, no safety violations?
PPE
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PPE available as required?
- Yes
- No
- N/A
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PPE maintained as required?
- Yes
- No
- N/A
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Eye protection used as required?
- Yes
- No
- N/A
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Hard hats worn as required?
- Yes
- No
- N/A
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Hand protection worn when required?
- Yes
- No
- N/A
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Safety footwear worn?
- Yes
- No
- N/A
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Respirators used as required?
- Yes
- No
- N/A
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Earing protection used as required?
- Yes
- No
- N/A
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High visibility clothing worn as required?
- Yes
- No
- N/A
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Face shield worn as required?
- Yes
- No
- N/A
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PFD worn when working around water?
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Good compliance, no safety violations?
Signage
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Safety posters displayed, 3 rifhts of an employee?
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Emergency numbers, contzcts posted?
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Danger, caution signs posted as needed?
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Warning signs around perimeter of worksite?
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Good compliance, no safety violations?
Safety Training
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Toolbox talks done regularly and documented?
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Hazard asessments done regularly, documented and signed?
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Job specific safety training provided and documented?
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Safety orientation provided?
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Good compliance, no safety violations?
Sanitation
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Adequate zupply of potable water?
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No common drinking cups?
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On potable outlets clearly marked?
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Adequate toilets provided, clean and sanitary?
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Washing facilities provided and sanitary?
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Food, beverage areas away from hazardous materials?
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Good compliance, no safety vilolations?
Scaffolding
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Platforms fully planked?
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call protection abpve 10 feet?
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Legs, frame bear mud base plates, mud sills?
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Scaffolds inspected, tzgged, free of visivle defects?
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Footings rigid, level, no visible settling?
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Ladder provided?
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Only scaffold grade lumber used?
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Platform clean and free of excessive debris?
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Whe. Platforms overlap, overlap is more than 12 inches?
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Atform supports plumb to prevent swaying?
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Toeboards used?
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Akeshift devices not used to gain extra height?
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Scaffold does not move horizontally when occupied?
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Midrails xand toprails in place and at proper heights?
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Workers trained on use of scaffolds?
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Workers trained to assemble, disassemble scaffolding?
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Good compliance, no safety violations?
Power and Hand Tools
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Ools in safe, operating condition?
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Tools properly hoisted, lowered?
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Guards in place?
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Handles free of cracks, splinters?
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Grinders, chop saws, sawzalls guards, safetys in place
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Raised loads blocked?
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Air hoses, compressors working properly?
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Od comlliance, no safety violations?
Trenching, Excavations
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Competent person performs daily inspections?
- Yes
- No
- N/A
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Emloyees protected from cave in?
- Yes
- No
- N/A
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Sloping, benching adequzte for soil type?
- Yes
- No
- N/A
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Spoil pile at least 2 feet back from edge?
- Yes
- No
- N/A
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No more than 25 feet to egress?
- Yes
- No
- N/A
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Utilities identified and located prior to start?
- Yes
- No
- N/A
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Surfzce encumbrznces removed or supported?
- Yes
- No
- N/A
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Water runoof co trolled to prevent accumulation?
- Yes
- No
- N/A
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Access prohibited when water ru off is uncontrolled?
- Yes
- No
- N/A
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Rench barricaded at unsecured worksite after hours?
- Yes
- No
- N/A
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Workers exposed to traffic wearing high viz vest?
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Backfilling accurs as work proceeds?
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Stability of adjacent structures ensured?
-
Good compliance, no safety violations?
Trucks
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Trucks in good shape generally?
- Yes
- No
- N/A
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Inside free of garbafe, reasonably organized?
- Yes
- No
- N/A
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Parked out of the way?
- Yes
- No
- N/A
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Parked to minimize backing up?
- Yes
- No
- N/A
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Strobe, whiplight working?
- Yes
- No
- N/A
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Vehicle log done?
- Yes
- No
- N/A
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Tires turned when parked on an incline?
- Yes
- No
- N/A
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Cargo secure?
- Yes
- No
- N/A
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Truck box reasonably clean and organized
- Yes
- No
- N/A
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Good compliance, no safety violations
Miscellaneous
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Stretching before work?
- Yes
- No
- N/A
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Steps tsken to address icy, slippery surfaces?
- Yes
- No
- N/A
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Steps tzken to address loose material, tarps in hi ghh wind conditions?
- Yes
- No
- N/A
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Job trailer secure against wind, burglars? Trailer lock on?
- Yes
- No
- N/A
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Construction area properly illuminated?
- Yes
- No
- N/A
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Security fence in place?
- Yes
- No
- N/A
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Egular inspections of jobsite?
- Yes
- No
- N/A
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Defectice equipment tagged and removed from job site?
- Yes
- No
- N/A
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No apparent insafe conditions observed?
- Yes
- No
- N/A
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No apparent unsafe behaviours observed?
- Yes
- No
- N/A
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Photos
Electrical
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Energized circuits locked out?
- Yes
- No
- N/A
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Tags filled out properly?
- Yes
- No
- N/A
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Everyone working on circuit has lock and tag on?
- Yes
- No
- N/A
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Energized electrical dealt with properly? Good reason for working on live?
- Yes
- No
- N/A
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Arc flash gear worn?
- Yes
- No
- N/A
-
- Yes
- No
- N/A
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Good compliance, no safety violations?