Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

1.Housekeeping

  • 1.1 Walkways, corridors, stairs clear of debris?

  • 1.2 Material stacked and stored properly?

  • 1.3. Trash taken out?

  • 1.4 Slips, trips, fall hazards?(comply, eye.)

  • 1.5. Emergency egress maintained?

  • 1.6 Other

2. Ladders

  • 2.1. Ladders properly used?

  • 2.2. Ladders properly stored and secure?

  • 2.3. Extension ladders at a 4:1 pitch?

  • 2.4. Extension ladder extended 3' above landing?

  • Other?

3. Electrical.

  • 3.1 GFCI in place

  • 3.2. Quarterly cord inspection done if required?.

  • 3.3. Cords elevated to 7' overhead?

  • 3.4. Cords in good condition?

  • 3.5. Is temporary lighting adequate?

  • 3.6. Other?

4. Barricading

  • 4.1. Barricade tape managed?

  • 4.2. Signage posted on all 4 sides?

  • 4.3. Signage up to date and complete?

  • 4.4. Right type of barricade for work?

5. Aerial lifts (mewp's)

  • 5.1. Is the operator trained?

  • 5.2. Are daily inspections documented?

  • 5.3. Is the green tank permit posted on lift?

  • 5.4. Fall protection in use (Aerial lifts only)?

  • 5.5 Is gate or chain secured?

  • 5.6. Area below lift protected?

  • 5.7. Other?

6. LOTO (CoHE) Lock out tag out

  • 6.1. Competent person present?

  • 6.2. Is the employees trained?

  • 6.3. Are locked keys different?

  • 6.4. Energized electrical work?

  • 6.5. Is tag used and filled out completely?

  • 6.6. Zero energy confirmed?

  • 6.7. Other?

7. Scaffolding

  • 7.1. Guard rails installed correctly?

  • 7.2. Bracing and pins in place?

  • 7.3. Is the scaffold fully planked?

  • 7.4. Is the scalpel inspected daily And tagged?

  • 7.5. Are planks in good condition?

8. Fall protection

  • 81 6' Fall exposure?

  • 8.2 Are workers trained and documented?

  • 8.3. Is the equipment inspected?

  • 8.4. Is the anchor point engineered?

  • 8.5. Are Floor and wall openings protected?

  • 8.6. Fall distance identified?

9. Welding and cutting.

  • 9.1. Proper PPE for welding task?

  • 9.2. Is work area ventilated?

  • 9.3. Are welding screens being used?

  • 9.4. Is that work area free of combustibles?

  • 9.5. Is the area below properly controlled?

  • 9.6. Are the cylinders stored properly?

  • 9.7. Welding leads and hoses in good condition?

  • 9.8. Other?

10. Fire prevention.

  • 10.1. Hot work permit posted?

  • 10.2. Is the firewatch present?

  • 10.3. Are the combustible materials removed?

  • 10.4. Are the bottles upright, capped and secured?

  • 10.5. Fire extinguishers present?

  • 10.6. Are welding leads in good condition?

  • 10.7. Other?

11. PPE

  • 11.1. Hard hats used?

  • 11.2. Face protection?

  • 11.3. Eye protection?

  • 11.4. Hand protection?

  • 11.5. High vis vest or equivalent?

  • 11.6. Hearing protection?

  • 11.7. Proper footwear?

  • 11.8. Other?

12. Excavation and trenching

  • 12.1. Competent person present?

  • 12.2. Protective systems <20' used?

  • 12.3. Are the utilities marked?

  • 12.4. Are the utilities protected and supported?

  • 12.5. Trench box certification?

  • 12.6. Excavation permits and daily inspections?

  • 12.7. Is there access every 25 feet?

  • 12.8. Is the trench sloped and shored properly?

  • 12.9. 4' depth safe distance?

  • 12.10. 6' fall protection?

  • 12.11. Are spoils 2' from edge?

  • 12.12. Are there any atmospheric hazards?

  • 12.13. Public protection barricades?

  • 12.14. Other?

13. Inspection items

  • Apollo on site Foreman

  • Apollo Safety

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