Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Select date

  • Project name & number

General

  • All-In-One OSHA Poster / Safety Bulletin Board

  • Hospital & Clinic information posted

  • First Aid kit

  • OSHA 300 A (posted Feb.1-Apr. 28)

  • Bayley SSSP & SSSP for all Subs

  • Electronic

  • Hard copy (Binder)

  • SS Orientation (Video & Packet)

  • Crisis Manual (Site-specific pages)

  • Safety Data Sheets (Binder, Inventory)

  • SWPPS / CECLE

  • Applicable Permits

  • Bldg.

  • Demolition / Abatement

  • AHERA Bldg. Inspection Report

  • Letter of Good Faith (Bldg. contains no Asbestos)

  • Project Security (Fencing)

  • Site Sanitation (toilets / hand wash)

  • Clean lunch room / garbage cans

  • Emergency Response kits

  • Trucking Haul route

  • Fire Prevention

  • Hydrant & Hoses

  • Fuel Storage Cabinet

  • Fire Extinguishers (2ab every 3000 sq.ft.)

  • Existing system

  • Fire Extinguisher within 25ft. of storage

Trenching & Excavation

  • Engineering Soils Report

  • 811 Call before you dig utility locates

  • Select date

  • Designated Competent Person

  • Bayley

  • Sub-tier Contractor

  • Name of CP

  • Soil Classification

  • Daily Inspection for changing conditions

  • Benching (Type A or B soil only)

  • Sloping (Type C soil)

  • Spoil pile (min. of 2ft. from trench)

  • Ladder or steps within 25ft. (all directions)

  • Bridge / Ramp / Walkway (18in. wide / secured)

Heavy Equipment

  • Check one or more boxes if this work is present on your project.
    All heavy equipment operators are required to complete a visual walk around inspection as well as a controls function test to ensure the machine is in sound safe condition for use.

  • Only qualified personnel are allowed to operate / Certain equipment requires a certification

  • All machines must have an operators manual

  • If machine has a Roll-Over Protection System<br>Then the operator must wear the seatbelt

  • Excavators

  • Loaders

  • Dump Trucks

  • Back hoes

  • Cranes

  • Drill Rigs

  • Aerial Boom lifts

  • Requires certification

  • Scissor lifts

  • Requires certification

  • Skid Steer (Bob cat)

  • Fork lift

  • Requires certification

  • Concrete Pump Truck

  • All work activities require a Job - Hazard - Analysis or Pre-task Work Plan

Heavy Equipment Inspection & Hazards

  • Injuries - Struck by moving equipment / Caught between 2 objects

  • Controlled access zones / Signage / Barriers / Deliniation

  • High Visibility Vest / Shirt (ANZI Class II)

  • Spotter(s)

  • Pedestrian "Foot" traffic - Access & Egress walking path

  • Overhead obstructions

  • Existing structures

  • Utility lines

  • Flagging for visibility

  • De-energize / Relocate

  • Weather conditions

  • Ground conditions

  • Crane work requires special conditions

  • NCCCO Crane Operators Certification<br>Rigger ,certification

  • Crane pick plan

  • Pre-shift safety meeting

  • Designated lift director / Rigging & Signalman /

Concrete & Formwork

  • JHA for all work activities, signed by all who perform the work

  • Does the JHA address all of the associated hazards with work activities

  • Are there fall hazards<br>* Ladders<br>*Scaffold<br>*Aerial Boom lift<br>*Elevated slabs<br>*Roof work

  • Do we have a written Fall Protection Work Plan for elevations greater than 10 ft.?<br>Did all of the employees sign the work plan?

  • Power tools

  • Ever used by worker?

  • Double insulated or grounded

  • Inspected?

  • Electrical cords

  • Inspected prior to use?

  • Hung or protected from damage?

  • Plugged into a Ground Fault Circuit Interrupter?

  • Material handling

  • JHA? Signed?

  • Can material be moved by forklift, hand-truck or pallet jack?

  • Is the material stacked, racked or blocked to prevent a struck by or pinch point injury?

  • Over 50 lbs. - use two persons

  • Keep hands / fingers out of pinch points

  • Clean & Clear path of travel - access & egress?

  • Bridge or walkway planking over trenches?<br>*Must be at least 18 in. and secured

  • Form work

  • JHA? Signed?

  • Saw horses for cutting (no cutting from your foot)?

  • Dumpster for debris?<br>*Keep our work stations clean & clear to prevent slip & trip hazards

  • PPE<br>* Hearing protection<br>*Safety Glasses or Goggles?<br>*Gloves (if deemed necessary by Sup. - Forman)

  • Access & Egress<br>*Ladder or steps (elevations 19 in. or greater)<br>*Clear path of travel

  • Nails? Bent over or removed?

  • Ladders? Appropriately used? Correct Ladder choice?

  • Training needed?

  • Electrical cords?

  • Inspected & protected?

  • GFCI protected?

  • Concrete work

  • JHA? Signed?

  • Workers aware of struck by hose hazards?

  • PPE?<br>*Gloves<br>*Eye wash<br>*Neutralizer or Barrier cream (Burns)<br>Safety Glasses or Goggles

  • Concrete Pump Truck?

  • Outriggers on solid ground? Pads? Steel plates?

  • Eco pan / Plastic?

  • Crew informed on the hazard of a plug in the hose line?

Fall Hazard Exposure

  • Check one or more boxes if these activities are present on your project

  • You must fill out a Fall Protection Work Plan if fall exposure is greater than 10 ft.
    This applies to our Sub-contractors as well!

  • Do workers have Fall Prevention Training (FPWP)?

  • Has the FPWP been reviewed and signed by the workers performing this work?

  • JHA? Signed by workers?

  • Scaffolding

  • Who is the Competent Person inspecting the scaffold daily?

  • Do we have Engineered scaffolding specs?

  • Do workers have scaffold awareness training?

  • JHA? Signed by workers?

  • Is there warning signage (Red or Green tags)

  • Set up on Mud sills, concrete, asphalt, etc...?

  • Frames stood plumb?

  • Fall protection railings?

  • Falling object protection?

  • Controlled access zone below? Delineation? Physical Barriers?

  • Ladder access & egress?

  • 10 ft. or more from Overhead power lines?

  • Guyed or tied to the structure (4 x the base to height ratio)?

  • Planks kept clean and clear of construction material / debris?

  • Ladders

  • Inspected prior to use? Is the ladder free of physical defects?

  • Has the safety stickers / decals?

  • Appropriate ladder for the task?

  • Extended 36 in. above the elevated deck?

  • Secured at the top & bottom?

  • Clean & Clear (access & egress) of debris at the top & bottom?

  • Roof work

  • Roof work has a fall exposure greater than 10 ft. FPWP must be filled out and signed by the workers.

  • Warning line must be 15 ft. from the perimeter edge unless engaged in roofing activities.
    Roofing activities - 6 ft. from perimeter edge.
    Warning line must be taunt & flagged every 6 ft.
    100% Tie off signage beyond this point (unless using a Safety Monitor system)

  • JHA? Signed by workers?

  • Anchor points present?

  • Proper warning line set-up?

  • Skylights present?

  • Protection Handrail / Cover / Engineered for fall thru hazard?

  • Parapet wall present?

  • Floor openings present?

  • Fall Restraint can be achieved by one of the following means:

  • Cover - Plywood or Steel plate

  • Plywood covers must be able to withstand 4 x the intended load
    Secured in place to prevent accidental displacements
    Marked to be highly visible or HOLE

  • Wood or Cable railing

  • Wood - top-rail (200 lbs. of force, smooth, 42 in. in height); mid-rail (halfway between top-rail and walking surface, 150 lbs. of force); Falling object protection.

  • Cable rail - same as above for forces imposed on the cable.
    Cable must be flagged every six ft. and cannot sag more than 3 in. (+/-)

  • Warning line

  • Cannot be made of tape (caution or danger)
    Must have signage & flagged
    Must be set at least 6 ft. from the opening (farther is better)

  • Elevated Decks / Floors

  • An elevated deck or slab includes any surface above ground level.

  • Leading edge work?

  • Required controlled access zones (above and below) working surface in addition to the area directly below.

  • Hand-railing or cable railing (Guidelines listed above or in our SSSP)

  • Is there any fall protection system in place around the perimeter of the upper level?

  • Structural Steel Erection

  • This is a high risk work activity and you must ensure the trades are using appropriate Fall Protection System or Personal Fall Arrest PPE!

  • Crane work?

  • Hot work?

  • Fire Suppression for refueling or welding operations

  • Hot work permit - Fire watch - Fire extinquishers

  • Gas cylinders stored properly / secured with 20 ft. of separation between O2 and compressed gas?

  • Fall Protection Systems?

  • Leading edge work?

  • Boom or Scissor lift activities?

  • Ladders?

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.