Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Select date
Administration
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Job site signage
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First aid kit
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Prejob safety checklist
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Safety Indoctrination program
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Weekly safety meetings
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Date of last meeting
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Health and Safety Program
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MSDS
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JHA program
PPE
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Worker PPE
Worker
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Worker information:
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Appropriate clothing
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Eye/face protection
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Hearing protection
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Respiratory protection
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Hard hat
Special Programs
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Confined spaces
Worker exposed to confined spaces
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Is there a confined space program in place
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Are appropriate measures being taken for safety?
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Excavation
Worker exposed to excavation
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Is there an excavation program in place
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Are appropriate measures being taken for safety?
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Fall protection
Worker exposed to falls
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Are appropriate measures being taken for safety?
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Hot work permit
Worker performing hot work
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Has a hot work permit been issued?
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Is work being performed in accordance to issued permit?
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Lockout / tag out
Worker exposed to electric
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Is there a lockout tagout program in place?
Fire protection
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Is a fire plan in place?
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Fire extinguishers
Fire extinguisher
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Current on inspection?
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Charged?
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Appropriately placed and highlighted?
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Is fuel being stored on site?
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Is fuel in appropriate location?
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Is fuel in an appropriate container?
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Is there an MSDS sheet and safety plan for fuel?
Electrical
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GFCI program in place?
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Are extension cords run in a safe manner?
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Extension Cord
Extension cord
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Is cord in good condition?
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Cut cord if unsafe to use!!!!
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Appropriate size?
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Plugged into GFCI?
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Temporary panels
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Temporary lighting
Scaffolding / Lifts
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Mobil Scaffolds
Scaffold
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Add media
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Proper use
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In good condition
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Guardrail in use if over 6'
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Outriggers being used if needed?
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Wheels locked when in use?<br>
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Notes:
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Fixed scaffolding
Scaffold
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Add media
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Proper use
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In good condition
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Appropriate access / egress
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Decking
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Foundation
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Guardrail in use if over 6'
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Constructed by competent personnel ?
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Inspected on a regular basis?
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Date of last inspection?
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Notes:
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Scissor lift / boom lift
Lift
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Add media
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Proper use
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In good condition
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Chain or guardrail being used
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Notes:
Housekeeping
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Stairways / exits clear?
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Floors clean and neat?
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Toilets in good condition?
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Materials properly stored / stacked ?
Tools / equipment
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Tool / equipment
Tool
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Description:
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Add media
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Condition?
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Use?
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Welder / torch
Equipment
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Description:
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Add media
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Condition?
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Use?
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Fire extinguisher at location?
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Are tanks secured and stored properly?