Title Page

  • Audit Title

  • Conducted on

  • Client:

  • Location
  • Superintendent:

  • A&B Job #:

  • Work Being Done at Time of Inspection:

  • Inspected By:

General Site Conditions & Housekeeping

  • Roads & Parking areas have proper signs, speed limits posted.

  • Applicable warning signage, barricades/flagging in place/appropriate for location/work being done

  • Muster area identified/known to all on site

  • All access/egress and passageways to work areas are clear

  • Emergency Response Plan completed and available

  • Toolbox & Hazard Assessment completed, signed by all and available for review

  • Correct/adequate first-aid equipment available for location/work performed

  • Safety Manual, procedures & MSDS' available on-site

  • All hoses, cables and cords are organized and do not obstruct access/egress and high traffic areas or pose as a trip hazard

  • Burning hoses are coiled at the end of each shift

  • Unused cables/hoses/extension cords are coiled and stored out of the way

  • All waste containers are labeled with the waste description

  • Oil, Grease or other liquid spills are cleaned up immediately

  • All debris, waste and scrap materials etc. have been removed from the work area

  • Clean up is performed on a regular basis or as required

  • Fire fighting equipment is unobstructed & appropriate for location/work

  • Work materials and equipment must be stored neatly and in a safe manner

  • Equipment backup alarms working

  • Diesel engines equipped with positive air shutoff (vehicles & equipment)

  • Comments:

  • Upload Pertinent Photos for General Sits Conditions & Housekeeping

Barricades & Signage

  • Barricades installed so as to prevent workers from risk of falling into an opening, excavation or hole

  • No gaps between the barricades exposing workers to a fall

  • Barricading is set back at least two feet where a risk of falling may occur

  • If ribbon is used, is it set back at least 2 meters or 6.5 feet from the edge

  • Area adequately flagged (not too large of an area and not too small of an area)

  • Area is flagged so that workers could not inadvertently enter the area without knowing it may be restricted (must be at every single access point to the area)

  • Is appropriate signage in place to warn of possible dangers

  • Is appropriate traffic control signage in place at any road crossings

  • Once job is complete all of the flagging has been removed and disposed of

  • Comments:

  • Upload Pertinent Photos for Barricades & Signage

Combustible/Flammable Materials

  • WHMIS label is legible

  • Grounded or bonded for liquid transfer

  • ABC Fire Extinguisher in close proximity

  • Stored in approved cabinet or in a well ventilated area

  • Stored away from heat or spark sources

  • Container is in good condition

  • Containers have a proper lid/cover on them

  • Comments:

  • Upload Pertinent Photos for Combustible/Flammable Materials

Compressed Gas Cylinders

  • Stored properly (upright, capped, secured properly)

  • If stored in an enclosed space, space is properly ventilated

  • Stored away from heat sources, corrosive chemicals, grease and oil

  • Stored away from electrical sources where they can become part of the circuit

  • Full and empty cylinders are separated and marked

  • Comments:

  • Upload Pertinent Photos for Compressed Gas Cylinders

Compressed Air

  • Whip checks installed at all compressed air hose connections

  • Air hose connections properly connected

  • Compressed air for cleaning is set at less than 30 psi

  • Depressurized when not in use

  • Hearing protection worn around air compressor

  • Comments:

  • Upload Pertinent Photos for Compressed Air

Lifting Devices & Rigging

  • Log book filled out each shift

  • Hook has a safety latch on it

  • Hoisting line is in a vertical position over the center of gravity of the load

  • Personnel and rigger clear of the load being lifted

  • Tag line is used where required

  • Slings in good condition

  • Load properly rigged and balanced

  • Comments:

  • Upload Pertinent Photos for Lifting Devices & Rigging

Electrical

  • Overhead power lines identified, guarding in place and safe limits of approach maintained

  • Are plug prongs in good condition - not loose, bent, missing

  • Is cable in good condition - no cuts/flattening/etc.

  • Cables elevated out of water

  • Cables strung out on the outer edge of access/egress areas or hung overhead

  • Cable connections are compatible (do not connect a 3 prong plug to a 2 prong plug)

  • Cable voltage capacity is equal (i.e. do not connect 120 volt cable to 240 volt cable)

  • Comments:

  • Upload Pertinent Photos for Electrical

Excavations

  • Barricades or flagging are installed at least 2 feet from the edge

  • Excavation has been de-watered

  • Workers protected from cave-ins, sliding, or rolling materials

  • Shoring installed or sloping anywhere from 30 to 45 degrees depending on the soil stability

  • Spoil pile is at least 1 meter from the edge of the excavation

  • Spoil pile is sloped at an angle not more than 45 degrees from the horizontal

  • A means of egress (i.e. ladder, stairs) must be within 8 meters (25 feet) from the worker

  • Comments:

  • Upload Pertinent Photos for Excavations

Fall Protection

  • Site Specific Fall Protection Plan is completed

  • Rescue Plan in place for the work being performed

  • Anchor point able to withstand 5000 lbs. for Fall Arrest

  • Anchor point able to withstand 800 lbs. for Travel Restraint

  • Anchor point is installed and used as per manufacturer's specifications

  • Control Zone established

  • Swing Fall Hazard <22 degrees

  • Vertical Lifeline/rope grab used properly

  • Horizontal Lifeline is Engineered and Inspected by a qualified person prior to use

  • Safety Strap is used and/or installed as per Manufacturer's Instructions

  • Fall Protection System Inspected before it is used each work shift

  • Lanyard is equipped with a shock absorber

  • All fall protection equipment and components are CSA Approved

  • Toolbox talk was conducted with workers assigned to work in elevated areas

  • Comments:

  • Upload Pertinent Photos for Fall Protection

Fire Prevention

  • Employees smoking only in designated outdoor areas

  • Flammable liquid dispensing systems grounded and bonded

  • Approved safety cans available for storage of flammable liquids

  • Fully charged ABC Fire Extinguisher in close proximity and inspected monthly

  • Are flammables and combustibles properly stored / labeled as per regulatory requirements

  • Hot Work permit requirements fulfilled

  • Fire Watch is in the immediate area

  • Fire Lanes are clear access/egress

  • Comments:

  • Upload Pertinent Photos for Fire Prevention

Hand & Power Tools

  • Defective hand and power tools tagged and taken out of service

  • Eye & face protection available and used when operating power tools

  • Guards and safety devices in place on power tools

  • Electrical cords and connections in good condition

  • Power tools inspected before each use

  • Correct tools being used for the job

  • Comments:

  • Upload Pertinent Photos for Hand & Power Tools

Ladders

  • The bottom of the ladder is on a firm level surface

  • The upper part of the ladder rests on a surface that is able to support the load

  • The angle of the ladder is at a 4:1 ratio

  • The upper part of the ladder extends at least 3 feet above its point of contact

  • The bottom of the ladder is secured to prevent it from kicking out

  • The top of the ladder is secured to prevent it from being able to move in any

  • The ladders does not have any loose, broken or missing rungs, split side rails, painted wood or other defects

  • Straight or extension ladders are held at the bottom by a helper until they are securely tied at the top

  • A hand line is used to raise or lower tools

  • A Non-conductive ladder is used when working on or near electrical equipment

  • The ladder is not placed in front of windows or doors that open towards it

  • The ladder is not placed over items that may cause impalement or other serious injury

  • The ladder is not close to an edge or surface that could result in a fall beyond the base of the ladder

  • Comments:

  • Upload Pertinent Photos for Ladders

Personal Protective Equipment

  • Safety Headwear (Hard Hats) CSA approved

  • Fire Retardant Clothing / Coveralls CSA approved

  • Safety Eyewear CSA approved

  • Safety Footwear CSA approved & is appropriate for task with minimum 6" boot

  • Gloves are appropriate for task

  • Comments:

  • Upload Pertinent Photos for Personal Protective Equipment

Scaffolding

  • Scaffold tag is the correct color

  • Scaffold tag has been filled out correctly

  • Scaffold has been inspected within the past 21 days, if not a Red Tag is installed

  • No loose or stored equipment/tools/materials on the scaffold

  • Toe boards installed

  • Ladder is properly secured

  • Backing on Ladders over 10 feet in height

  • No openings on the scaffold deck

  • Area flagged/illuminated if in a vehicle thoroughfare

  • Comments:

  • Upload Pertinent Photos for Scaffolding

Additional Comments

  • Additional Comments:

Action Items & Action Required

  • Action Items & Action Required:

Signatures

  • Supervisor:

  • Site Safety:

  • Inspector:

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.