Behaviors and Conditions Assessment

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Select date

  Date

Documentation

• Personnel Certifications (OSHA, Tower Certs, Operator)?

  Yes

  No

  N/A

• Is a Pre-Work Hazard Assessment Survey/JSA Documented?

  Yes

  No

  N/A

• Was a Pre-Work/Tailgate Meeting Conducted?

  Yes

  No

  N/A

• Are Hazards Communicated to Employees and Subcontractors?

  Yes

  No

  N/A

• Are Daily Harness Inspections Completed?

  Yes

  No

  N/A

• Is a Rescue Plan Documented and Communicated to Employees?

  Yes

  No

  N/A

• Is Daily Excavation Inspection Form Completed?

  Yes

  No

  N/A

Personal Protective Equipment

• Are Employees Wearing Hard Hats?

  Yes

  No

  N/A

• Are Employees Wearing Safety Glasses/Face Shields?

  Yes

  No

  N/A

• Are Employees Wearing Gloves When Required?

  Yes

  No

  N/A

• Are Employees Dressed in Appropriate Work Clothing?

  Yes

  No

  N/A

• Are Employees Wearing Proper Foot Protection?

  Yes

  No

  N/A

• Is Hearing Protection Being Used When Required?

  Yes

  No

  N/A

Fall Protection

• Are Open Holes or Trenches Clearly Marked and Guarded?

  Yes

  No

  N/A

• Does Safety Harness Have Y-Lanyards?

  Yes

  No

  N/A

• Are Guard Rails in Place where Applicable?

  Yes

  No

  N/A

• Is Warning Line System in Place?

  Yes

  No

  N/A

• Are Employees Employing 100% Fall Protection Above 6 Feet?

  Yes

  No

  N/A

Rescue

• Is Rescue Kit on Site?

  Yes

  No

  N/A

• Are There Two or More Tower Rescue Trained Personnel on Location?

  Yes

  No

  N/A

• Are There First Aid/CPR Certified Personnel on Location?

  Yes

  No

  N/A

• Is a First Aid Kit Available?

  Yes

  No

  N/A

Ladders / Scaffolds

• Are Approved Fiberglass or Wood Ladders Being Used?

  Yes

  No

  N/A

• Are Ladders Being Used Properly?

  Yes

  No

  N/A

• Have All Ladders Been Inspected Prior to Use?

  Yes

  No

  N/A

• If Fixed Scaffolds are Used, Is There a Competent Person on Site?

  Yes

  No

  N/A

• Are Scaffolds Tagged Properly?

  Yes

  No

  N/A

Electrical

• Are Employees Familiar With Lockout/Tagout Procedures?

  Yes

  No

  N/A

• Are Employees Using Proper Lockout/Tagout Methods?

  Yes

  No

  N/A

• Are Electrical Panels Covered When Not in Use?

  Yes

  No

  N/A

• Are GFCI (Ground Fault Circuit Interrupters) Utilized?

  Yes

  No

  N/A

• Are Extension and Other Electrical Cords in Serviceable Condition?

  Yes

  No

  N/A

• Are Electrical Tools Maintained and Used in a Safe Manner?

  Yes

  No

  N/A

Concrete Construction

• Forms Properly Installed and Braced?

  Yes

  No

  N/A

• Protection From Cement Dust and Concrete Contact?

  Yes

  No

  N/A

• Is Waste Concrete Placement Approved?

  Yes

  No

  N/A

RFR Safety

• RFR Warning Signs Identified?

  Yes

  No

  N/A

• Are RFR Monitors Being Utilized?

  Yes

  No

  N/A

Cranes, Hoists & Rigging

• Does the Crane Have Inspection Documentation?

  Yes

  No

  N/A

• Is the Operator and Accompanied Crew Certified and Trained?

  Yes

  No

  N/A

• Is Proper Cribbing for Mobile Cranes in Place?

  Yes

  No

  N/A

• Are Proper Rigging Techniques Being Utilized? (Safety Factor)

  Yes

  No

  N/A

• Is Rigging Properly Labeled?

  Yes

  No

  N/A

• Are Components of the Rigging System in Good Condition?

  Yes

  No

  N/A

• Is Proper Documentation Completed & Onsite? (Personnel Hoisting)

  Yes

  No

  N/A

• Are Load and Hand Signals Charts Posted?

  Yes

  No

  N/A

Fire Prevention/Protection

• Are Fire Extinguishers in Place? Min. (10 lbs. ABC During Hot Work)

  Yes

  No

  N/A

• Are Chemicals, Flammable and Combustible Liquids Properly Labeled?

  Yes

  No

  N/A

• Are Fire Blankets Present and Properly Placed?

  Yes

  No

  N/A

• Are Chemicals, Flammable and Combustible Liquids Stored Properly?

  Yes

  No

  N/A

Housekeeping

• Is the Work Site Clean and Free of Trip Hazards?

  Yes

  No

  N/A

• Are Materials, Including Cable Spools Stored Properly?

  Yes

  No

  N/A

• Is Trash Stored in Containers/Common Area?

  Yes

  No

  N/A

Excavation / Trenching

• If Excavating Over 4 Foot, is There a Competent Person on Site?

  Yes

  No

  N/A

• Are Areas Barricaded as Required?

  Yes

  No

  N/A

• Is Excavation Sloped, Shored, or Shielded?

  Yes

  No

  N/A

• Is Ladder in Excavation Over 4 Feet?

  Yes

  No

  N/A

Environmental

• Is Adequate Erosion Control in Place?

  Yes

  No

  N/A

• Are Environmentally Sensitive Areas Clearly Identified?

  Yes

  No

  N/A

DOT / FMCSR

• Do Driver's Have Current Medical Cards When Required?

  Yes

  No

  N/A

• Are Driver's Record of Duty Status (Logs) Current?

  Yes

  No

  N/A

• Are Daily Vehicle Inspection Records (DVIR) Current?

  Yes

  No

  N/A

Hand & Power Tools

• Power Tools Properly Grounded and in Good Working Condition?

  Yes

  No

  N/A

• Tool Lanyards are Being Used While Working at Heights?

  Yes

  No

  N/A

• Workers are Using Proper PPE with Tools?

  Yes

  No

  N/A

Additional Items

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Signature of Auditor

  Sign

• Signature of Site Supervisor

  Sign

• Additional Comments