Bergelectric Tesla Site Audit

• Client / Site

• Prepared by

• Date

• Section / Floor

• Foreman / Leadman

• Job Number

1. Working at Heights

• 1.1. Fall arrest/protection system used properly (including in 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

• 1.6. Proper connecting device used (duel lanyards, retractable, restricting, etc.)

  Yes

  No

  N/A

• 1.7. Proper anchor point used?

  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

• 2.6. Is area bellow Scissor lift / Arial lift caution taped off?

  Yes

  No

  N/A

3. Material Handling / Lay-down Yard

• 3.1. Are personnel safe from exposed 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

• 4.4. Ladder information stickers present and legible?

  Yes

  No

  N/A

• Ladder Number

• Missing stickers

• 4.5. Was ladder inspected prior to use?

  Yes

  No

  N/A

5. Trenching/Excavation and Confined Space

• 5.1. Underground utilities located/marked?

  Yes

  No

  N/A

• 5.2. Excavation inspection prior to entry?

  Yes

  No

  N/A

• 5.3. Protective system (i.e. trench box, etc.)?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 5.5. Traffic control (vehicle/pedestrian)?

  Yes

  No

  N/A

• 5.6. Compliance with confined space entry permit?

  Yes

  No

  N/A

• 5.7. Ladder is located within 25 ft. of workers while in an excavation?

  Yes

  No

  N/A

• 5.8. Air quality in confined space was monitored prior to entry and is continuous monitored while personnel is in the confined space?

  Yes

  No

  N/A

• 5.9. Air monitor is calibrated and within the exportation date?

  Yes

  No

  N/A

• 5.10. Adequate Barricade With Proper Identification.

  Yes

  No

  N/A

• 5.11. Crew member have been trained in confined space?

  Yes

  No

  N/A

6. Tools / Rigging

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

  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?

  Safe

  At Risk

  N/A

• 8.4. Exits marked and unobstructed?

  Yes

  No

  N/A

• 8.5. Impalement hazards protected?

  Yes

  No

  N/A

• Picture Of Impalement Hazard

  Media

• Location of Impalement hazard.

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

  Yes

  No

  N/A
8.7. Fire Extinguisher

• Is Fire extinguisher unobstructed?

  Yes

  No

  N/A

• Picture of obstructed fire extinguisher.

  Media

• Location of fire extinguisher?

• Is The Fire Extinguisher in date?

  Yes

  No

  N/A

• When Did The Fire Extinguisher Expire?

  Date

• Location of Fire Extinguisher.

• Is The Fire Extinguisher The Proper Size?

  Yes

  No

  N/A

• 8.8. Potable water sufficient for 2 gal. per worker for an 8hr period?

  Yes

  No

  N/A

• 8.8. Sanitary facilities adequate and clean?

  Yes

  No

  N/A

• When Was The Last Cleaning?

  Date

• What is the number and location of facility?

• 8.12. Adequate traffic control plan (MUTCD)?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 8.14. Floor Holes Covered?

  Yes

  No

  N/A

9. Electrical Hazards

• 9.1. MOP has been developed for energizing any piece of equipment?

  Yes

  No

  N/A

• 9.2. All outlets/tools are GFCI protected?

  Yes

  No

  N/A

• 9.3. Temporary lights elevated & lamps caged?

  Yes

  No

  N/A

• 9.4. Energized work authorization form used?

  Yes

  No

  N/A

• 9.5. All openings in cabinets or boxes covered?

  Yes

  No

  N/A

• 9.6. Energized 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

• 9.10. Employee working near/on energized systems has been Arch Fault trained?

  Yes

  No

  N/A

• 9.11. Temp Power: Properly Identified

  Yes

  No

  N/A

• 9.12. Temp Power: Barricaded w/ Correct Signage

  Yes

  No

  N/A

• 9.13. Temp Power: Surface Cables Are Buried or Protected.

  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. Spill kits available?

  Yes

  No

  N/A

• 10.4. Air Quality?

  Safe

  At Risk

  N/A

• CH4 %

• O2 %

• CO ppm

• H2S ppm

• Location of hazard

• Action performed to mitigate hazard.

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. Weekly Toolbox Talks Perfomed?

  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 (SDS) 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

• Location of needed kits.

• 11.10. Emergency numbers posted?

  Yes

  No

  N/A

• 11.11. Site reviews conducted weekly by safety dept./ supervisors / construction managers?

  Yes

  No

  N/A

12. Lockout / Tagout

• 12.1. Was the LOTO record sheet completely filled out?

  Yes

  No

  N/A

• 12.2. If a Lock-Box was used, is it labeled?

  Yes

  No

  N/A

• 12.3. Is the isolation adequate for the work being performed?

  Yes

  No

  N/A

• 12.4. Is the person(s) performing the LOTO on the authorized employee list?

  Yes

  No

  N/A

• 12.5. Were all affected personnel notified of the equipment to be isolated and the expected duration?

  Yes

  No

  N/A

• 12.6. Were all sources of energy properly isolated, locked and tagged?

  Yes

  No

  N/A

• 12.7. Were approved locks and tags used?

  Yes

  No

  N/A

• 12.8. Was the placement of all applied locks and tags documented on the LOTO log sheet?

  Yes

  No

  N/A

13. Forklifts

• 13.1. Daily inspection performed

  Yes

  No

  N/A

• 13.2. Seat belt is being worn during operation.

  Yes

  No

  N/A

• 13.3. When traveling, forks are close to the ground as possible.

  Yes

  No

  N/A

• 13.4. When traveling, only the driver is on the truck at all times.

  Yes

  No

  N/A

• 13.5. Is operator traveling at safe speeds in the forklift?

  Yes

  No

  N/A

• 13.6. Unattended forklift: Forks are fully lowered, tilted slightly so tips touch the ground.

  Yes

  No

  N/A

• 13.7. Unattended forklift: Controls are in neutral.

  Yes

  No

  N/A

• 13.8. Unattended forklift: Power/ engine is shut off.

  Yes

  No

  N/A

• 13.9. Unattended forklift: Parking brake is applied.

  Yes

  No

  N/A

• 13.10. Operator(s) certified to use the forklift?

  Yes

  No

  N/A

14. Powder Actuated Tools

• 14.1. Are users of powder actuated tools certified to use them?

  Yes

  No

  N/A

• 14.2. Are warning signs displayed where powder actuated tools are used?

  Yes

  No

  N/A

• 14.3. Task area barricaded to prevent unauthorized persons from entering?

  Yes

  No

  N/A

• 14.4. Misfired charges secured and discarded as per requirement?

  Yes

  No

  N/A

• 14.5. Powder actuated tools left unattended?

  Yes

  No

  N/A

Additional Comments

• Enter any corrective actions that will be undertaken.

• Were positive actions or use of correct ergonomics witnessed?

  Yes

  No

  N/A

• Description of what was witnessed.

• Pictures of what was witnessed

  Media

Sign Off

• Auditor's signature

  Sign