Apollo

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1.Housekeeping

• 1.1 garbage picked up?

  Safe

  At Risk

  N/A

• 1.2 Garbage cans empty?

  Safe

  At Risk

  N/A

• 1.3 Hoses, cords, tools picked up and organized?

  Safe

  At Risk

  N/A

• 1.4 All work areas free of accumulated debris?

  Safe

  At Risk

  N/A

2. Electrical

• 2.1 Cord sets, receptacles and portable and stationary equipment shall be grounded in accordance with the requirements identified in 4.1

  Yes

  No

  N/A

• 2.2 Lock and Tag

  Safe

  At Risk

  N/A

• 2.3 GFCI

  Safe

  At Risk

  N/A

• 2.4 Cord - Tool condition

  Safe

  At Risk

  N/A

3. PPE

• PPE requirements met

  Yes

  No

  N/A

4. Fall protection

• Guard rails, fall arrest, restraint, equipment properly stored.

  Yes

  No

  N/A

5. Walking / Working surfaces

• Tripping hazards, slippery floors, floor holes ETC

  Yes

  No

  N/A

6. Tools and Equipment

• Good condition, guards in place, properly stored, used, ETC

  Yes

  No

  N/A

7. Sanitation

• Clean water/disposable cups, hand washing facilities, toilets, eyewash ETC

  Yes

  No

  N/A

8. First aid

• First aid (first aid kits easy access/locate, supervisors training current, ETC

  Yes

  No

  N/A

9. Cranes, hoisting, & rigging

• Rigging in good condition, labeled & properly stored, ETC

  Yes

  No

  N/A

10. Hazardous material

• Properly stored, clearly labeled, MSDS, ETC

  Yes

  No

  N/A

11. Hot work

• Flammable/combustibles protected, fire extinguisher, PPE, ventilation ETC

  Yes

  No

  N/A

12. Scaffolding

• Fully assembled, fully planked, guard rails, access ladder, tagged, ETC

  Yes

  No

  N/A

13. Barricades and warning signs

• Confined spaces, flammable storage, fueling areas, ETC

  Yes

  No

  N/A

14. Excavation/Trenches

• Daily inspection, protective measures utilized(sloping, shoring, shielding), barricaded, competent person designated, ETC

  Yes

  No

  N/A

15. Inspection items

• 15.1 Fire extinguisher

  Safe

  At Risk

  N/A

• 15.2 First Aid kit

  Safe

  At Risk

  N/A

• Apollo on site Foreman

  Sign

• Apollo Safety

  Sign