Barnard Quick Safety Audit - duplicate

• Job #

• Title

• Prepared by

• Conducted on

  Date

• Crew Foreman

• Site Name

• Location
  Address

• Activity Being Performed

  Select Backfill Bending Coating Excavation Potholing Tie-in Welding Other

  • Backfill
  • Bending
  • Coating
  • Excavation
  • Potholing
  • Tie-in
  • Welding
  • Other

• What activity is going on

PPE

• All PPE acceptable

  Yes

  No

  N/A

SANITATION

• Adequate Housekeeping

  Yes

  No

  N/A

LADDERS

• Proper Ladder Usage

  Yes

  No

  N/A

Materials Handling

• Acceptable Rigging

  Yes

  No

  N/A

Excavations / Shoring

• Are there Excavations

  Yes

  No

• Competent Person Inspected<br>

  Yes

  No

  N/A

• Name of Competent Person

• Spoil Pile 2' Clearance<br>

  Yes

  No

  N/A

• Shoring / Slopping Per Tab Data<br>

  Yes

  No

  N/A

• Approved Access and Egress<br>

  Yes

  No

  N/A

• Air Monitoring in place<br>

  Yes

  No

  N/A

• Air Monitor Calibrated and Bumped

  Yes

  No

  N/A

Site Documentation

• JHA

  Yes

  No

  N/A

• Tabulated Data<br><br>

  Yes

  No

  N/A

• Excavation Inspection Report<br>

  Yes

  No

  N/A

• Excavation Safety Manual

  Yes

  No

  N/A

• Traffic Control Plans<br>

  Yes

  No

  N/A