APG Safety

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General Job Site Conditions

• Job-site Housekeeping

  Safe

  At Risk

  N/A

• Lay-down Yard

  Satisfactory

  Un-Satisfactory

• Condition of material trailers

  Satisfactory

  Un-Satisfactory

• Roads and Parking Area

  Safe

  At Risk

  N/A

• Heavy Equipment Fueling Area

  Safe

  At Risk

  N/A

Safety Materials

• Safety Manual present

  Yes

  No

  N/A

• Hazcom Manual up to date

  Yes

  No

  N/A

• Pre-Task Planning

  Satisfactory

  Un-Satisfactory

• OSHA, Labor, Hazcom and First-aid postings

  Yes

  No

  N/A

Personal Protection Equipment

• Safety Glasses<br>

  Yes

  No

  N/A

• Hard Hat

  Yes

  No

  N/A

• High Visibility Gear

  Yes

  No

  N/A

• Proper Clothing

  Yes

  No

  N/A

• Hearing Protection

  Safe

  At Risk

  N/A

• Work Boots

  Yes

  No

  N/A

• Arc Flash Gear

  Yes

  No

  N/A

Ladders

• Ladder Condition

  Safe

  At Risk

  N/A

• Ladders in use

  Yes

  No

  N/A

• Ladder Safety

  Safe

  At Risk

  N/A

Lifts in-use

• Scissor Lifts

  Yes

  No

  N/A

• Fork Lifts

  Yes

  No

  N/A

• Rough Terrain Fork Lifts

  Yes

  No

  N/A

• Ariel Lifts

  Yes

  No

  N/A

• Have employees been trained

  Yes

  No

  N/A

Excavator , Trenching , Front End Loading Equipment in-use

• Are Backhoes in operation

  Yes

  No

  N/A

• Are Trenchers in operation

  Yes

  No

  N/A

• Are Front End Loaders in operation

  Yes

  No

  N/A

• Have employees been trained

  Yes

  No

  N/A

Excavations

• Are Excavations in progress

  Yes

  No

  N/A

• Depth of Excavation

  Safe

  At Risk

  N/A

• Is proper slopping/benching in place

  Yes

  No

  N/A

• Are Protective systems in-use.(trench box or shoring)

  Yes

  No

  N/A

• Are confined spaces present

  Yes

  No

  N/A

• Have means of egress been established

  Yes

  No

  N/A

Tools

• Proper storage

  Satisfactory

  Un-Satisfactory

• Proper use

  Satisfactory

  Un-Satisfactory

• Is proper training taking place

  Yes

  No

  N/A

• Are proper guards and accessories in-use

  Yes

  No

  N/A

Temporary Power

• Is temp power in use

  Yes

  No

  N/A

• Are PODS , GFCI protected

  Yes

  No

  N/A

• Is Temp Service in good condition (main disconnects and distribution panels)

  Yes

  No

  N/A

• Are extension cords in good condition

  Yes

  No

  N/A

• Are temp lights in good condition

  Yes

  No

  N/A

Lock out / Tag out

• Is LOTO in use

  Yes

  No

  N/A

• Is there a LOTO plan in place

  Yes

  No

  N/A

Hot Work

• Has pre-task been completed

  Yes

  No

  N/A

• Is there an Arc Flash Hazard present

  Yes

  No

  N/A

• Is proper PPE in use

  Yes

  No

  N/A

• Have proper boundaries been established

  Yes

  No

  N/A

Fall Protection

• Are employees at risk

  Safe

  At Risk

  N/A

• Are PFAS in-use (Personal Fall Arrest Systems)

  Yes

  No

  N/A

• Are guard rails in-use

  Yes

  No

  N/A

• Are safety nets in-use

  Yes

  No

  N/A

Scaffolding

• Is scaffolding in-use

  Yes

  No

  N/A

• Has scaffolding been inspected

  Yes

  No

  N/A

• Condition of scaffolding

  Safe

  At Risk

  N/A

• Does scaffolding have proper tag indicating "Safe to Use"

  Yes

  No

  N/A

• Received permission to use another contractors scaffolding

  Yes

  No

  N/A

Cranes in-use

• Is Operator certified

  Yes

  No

  N/A

• Has load to be lifted been verified

  Yes

  No

  N/A

• Has crane lift capacity been verified

  Yes

  No

  N/A

• Has rigging been inspected for use

  Yes

  No

  N/A

• Have safety perimeters been set

  Yes

  No

  N/A

• Has pre-task planning been completed

  Yes

  No

  N/A

• Weather conditions

  Safe

  At Risk

  N/A

General Safety

• Are fire extinguishers available and up to date

  Yes

  No

  N/A

• Are first-aid supplies available and up to date

  Yes

  No

  N/A

• Are hazardous materials properly stored ( gas, oils, and mineral spirits)

  Safe

  At Risk

  N/A