Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Select date

Administration

  • Job site signage

  • First aid kit

  • Prejob safety checklist

  • Safety Indoctrination program

  • Weekly safety meetings

  • Date of last meeting

  • Health and Safety Program

  • MSDS

  • JHA program

PPE

  • Worker PPE

  • Worker
  • Worker information:

  • Appropriate clothing

  • Eye/face protection

  • Hearing protection

  • Respiratory protection

  • Hard hat

Special Programs

  • Confined spaces

  • Worker exposed to confined spaces
  • Is there a confined space program in place

  • Are appropriate measures being taken for safety?

  • Excavation

  • Worker exposed to excavation
  • Is there an excavation program in place

  • Are appropriate measures being taken for safety?

  • Fall protection

  • Worker exposed to falls
  • Are appropriate measures being taken for safety?

  • Hot work permit

  • Worker performing hot work
  • Has a hot work permit been issued?

  • Is work being performed in accordance to issued permit?

  • Lockout / tag out

  • Worker exposed to electric
  • Is there a lockout tagout program in place?

Fire protection

  • Is a fire plan in place?

  • Fire extinguishers

  • Fire extinguisher
  • Current on inspection?

  • Charged?

  • Appropriately placed and highlighted?

  • Is fuel being stored on site?

  • Is fuel in appropriate location?

  • Is fuel in an appropriate container?

  • Is there an MSDS sheet and safety plan for fuel?

Electrical

  • GFCI program in place?

  • Are extension cords run in a safe manner?

  • Extension Cord

  • Extension cord
  • Is cord in good condition?

  • Cut cord if unsafe to use!!!!

  • Appropriate size?

  • Plugged into GFCI?

  • Temporary panels

  • Temporary lighting

Scaffolding / Lifts

  • Mobil Scaffolds

  • Scaffold
  • Add media

  • Proper use

  • In good condition

  • Guardrail in use if over 6'

  • Outriggers being used if needed?

  • Wheels locked when in use?<br>

  • Notes:

  • Fixed scaffolding

  • Scaffold
  • Add media

  • Proper use

  • In good condition

  • Appropriate access / egress

  • Decking

  • Foundation

  • Guardrail in use if over 6'

  • Constructed by competent personnel ?

  • Inspected on a regular basis?

  • Date of last inspection?

  • Notes:

  • Scissor lift / boom lift

  • Lift
  • Add media

  • Proper use

  • In good condition

  • Chain or guardrail being used

  • Notes:

Housekeeping

  • Stairways / exits clear?

  • Floors clean and neat?

  • Toilets in good condition?

  • Materials properly stored / stacked ?

Tools / equipment

  • Tool / equipment

  • Tool
  • Description:

  • Add media

  • Condition?

  • Use?

  • Welder / torch

  • Equipment
  • Description:

  • Add media

  • Condition?

  • Use?

  • Fire extinguisher at location?

  • Are tanks secured and stored properly?

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.