Bergelectric Site Audit

• Client / Site

• Conducted on

  Date

• Prepared by

• Section / Floor

• Foreman / Leadman

1. Working at Heights

• 1.1. Fall arrest/protection system used properly (including aerial lifts)?

  Yes

  No

  N/A

• 1.2. Protection from openings/edges/holes?

  Yes

  No

  N/A

• 1.3. Guardrail systems correct?

  Yes

  No

  N/A

• 1.4. Personnel has been trained in Fall Protection?

  Yes

  No

  N/A

• 1.5. Rescue plan in place?

  Yes

  No

  N/A

2. Scaffolds

• 2.1. Scaffolds inspected and used properly?

  Yes

  No

  N/A

• 2.2. Daily inspection documented/posted?

  Yes

  No

  N/A

• 2.3. Scissor lift (mobile scaffold) inspected before use?

  Yes

  No

  N/A

• 2.4. Operators manual, informational decals available/legible?

  Yes

  No

  N/A

• 2.5. Operator has been Aerial/Scissor lift trained?

  Yes

  No

  N/A

3. Material Handling / Lay-down Yard

• 3.1. Personnel are exposed to overhead (suspended/elevated) loads?

  Yes

  No

  N/A

• 3.2. Performed daily inspections on forklifts?

  Yes

  No

  N/A

• 3.3. Operators manual, lifting charts, informational decals available/legible?

  Yes

  No

  N/A

• 3.4. Adequate housekeeping in lay-down yard (slip, trip, fall hazards, etc.)

  Yes

  No

  N/A

4. Ladders

• 4.1. Appropriate and undamaged ladders?

  Yes

  No

  N/A

• 4.2. Correct positioning/set-up of ladders?

  Yes

  No

  N/A

• 4.3. Ladder suitable for job?

  Yes

  No

  N/A

5. Trenching/Excavation and Confined Space/PRCS

• 5.1. Underground utilities located/marked?

  Yes

  No

  N/A

• 5.2. Supported utilities/foundation?

  Yes

  No

  N/A

• 5.3. Excavation inspection prior to entry?

  Yes

  No

  N/A

• 5.4. Protective system (selection, installation)?

  Yes

  No

  N/A

• 5.5. Appropriate access/egress (vertical/horizontal)?

  Yes

  No

  N/A

• 5.6. Traffic control (vehicle/pedestrian)?

  Yes

  No

  N/A

• 5.7. Compliance with confined space entry permit?

  Yes

  No

  N/A

6. Tools / Rigging

• 6.1. Hand/Power tools are operational, functional, safe and applicable guards?

  Yes

  No

  N/A

• 6.2. Rigging is inspected, tagged and appropriate use?

  Yes

  No

  N/A

• 6.3. Hand/Power tools are being used correctly / safely?

  Yes

  No

  N/A

• 6.4. Using appropriate tools to hold material while cutting (tri-vise).

  Yes

  No

  N/A

7. Personal Protective Equipment (PPE)

• 7.1. Personnel wearing appropriate PPE?

  Yes

  No

  N/A

• 7.2. Appropriate specialized PPE being used?

  Yes

  No

  N/A

8. Work Environment

• 8.1. Sufficient lighting?

  Yes

  No

  N/A

• 8.2. Adequate housekeeping (slip, trip, fall hazards, etc.)

  Yes

  No

  N/A

• 8.3. Adequate noise/ vibration control?

  Yes

  No

  N/A

• 8.4. Exits marked and unobstructed?

  Yes

  No

  N/A

• 8.5. Impalement hazards protected?

  Yes

  No

  N/A

• 8.6. Proper handling, use and storage of chemicals?

  Yes

  No

  N/A

• 8.7. Fire extinguishers inspected, unobstructed and available (travel distance)?

  Yes

  No

  N/A

• 8.8. Potable water and cups?

  Yes

  No

  N/A

• 8.9. Sanitary facilities adequate and clean?

  Yes

  No

  N/A

• 8.10. Adequate traffic control plan (MUTCD)?

  Yes

  No

  N/A

• 8.11. Walking/working surfaces and stairs in compliance?

  Yes

  No

  N/A

9. Electrical Hazards

• 9.1. Safe electrical conductor?

  Yes

  No

  N/A

• 9.2. All outlets/tools GFCI?

  Yes

  No

  N/A

• 9.3. Temporary lights elevated & lamps caged?

  Yes

  No

  N/A

• 9.4. Energized work plan/permit used?

  Yes

  No

  N/A

• 9.5. All openings in cabinets or boxes covered?

  Yes

  No

  N/A

• 9.6. Panels covered, locked and labeled?

  Yes

  No

  N/A

• 9.7. Conductors secured properly?

  Yes

  No

  N/A

• 9.8. Temporary splices covered?

  Yes

  No

  N/A

• 9.9. Appropriate ARC-Flash PPE?

  Yes

  No

  N/A

10. Environmental Hazards

• 10.1. Clear and/or controlled rodents, insects, snakes, wild/domestic animals?

  Yes

  No

  N/A

• 10.2. Adequate dust suppression control?

  Yes

  No

  N/A

• 10.3. Adequate systems to prevent contaminants entering stormwater drains?

  Yes

  No

  N/A

11. Administrative Procedures

• 11.1. Job Hazard Analysis has been completed prior to task being performed ?

  Yes

  No

  N/A

• 11.2. Obtain applicable permits (Entry, Hot, EEWP, etc)?

  Yes

  No

  N/A

• 11.3. Site Emergency Action Plan?

  Yes

  No

  N/A

• 11.4. Toolbox Talks?

  Yes

  No

  N/A

• 11.5. Competent, qualified, licensed personnel (1st Aid/CPR, aerial/scissor lift, confined space, powder actuated tools, mobile equipment, crane/rigging)!

  Yes

  No

  N/A

• 11.6. Corporate Safety Manual?

  Yes

  No

  N/A

• 11.7. Safety Data Sheets readily available, on site?

  Yes

  No

  N/A

• 11.8. State/Federal Postings?

  Yes

  No

  N/A

• 11.9. First Aid Kit/Eyewash?

  Yes

  No

  N/A

Corrective Actions

• Enter any corrective actions that will be undertaken

Sign Off

• Auditor's signature

  Sign