Title Page
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Document No.
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Job Name
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Client / Site
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Conducted on
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Prepared by
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Location
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Crew Leader
All of the following questions will be answered in one of three ways: "YES" (green) 2 points - met or exceeded expectations for this specific audit question. "Improve" (yellow) 1 point - Generally met expectations but some improvements are needed. "NO" (red) -2 points - Failed to meet expectations or a serious violation was identified. If an audit question does not apply to the job sites activities, NA "not applicable" will be selected - no points.
Descriptive photo
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1.0. First Impression
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1.1. Company vehicles parked in safe location?<br>
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1.2. Company vehicles reasonably clean and organized?
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1.3. Are materials on ground reasonably organized?
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2.0. Ladder
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2.1. Do ladders appear to be in good condition?
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2.2. Is the ladder set up and positioned correctly?
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2.3. Is the area near the ladder free from slip/trip hazards?
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2.4. Are employees maintaining 3 points of contact while using ladder?
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2.5. Is the ladder secured to prevent movement?
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2.6. Is a step, ramp or ladder in place at break in elevation of 19", or more?
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3.0. Fall Protection
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3.1. Does it appear fall protection was planned for?
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3.2. Is adequate fall protection equipment on site?
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3.3. Are employees protected from falling 6', or more?
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3.4. Are warning lines being maintained at the correct height and distance from edge?
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3.5. If applicable; Does the safety monitor appear trained and aware of their responsibilities?
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3.6. Is the area within 6' of the roof edge free of slip/trip hazards?
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3.7. Does it appear a Competent Person is on site?
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4.0. Housekeeping
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4.1. Is the work area reasonably clean and organized?
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4.2. Is the surrounding area free of debris that has been thrown, or blown, off the roof?
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4.3. Are pedestrians and building occupants protected from construction activity?
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5.0. Electrical
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5.1. Electrical cords in good condition?
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5.2. Is GFI protection being used with all electrical cords?
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5.3. Are employees protected from energized parts?
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6.0. Chemicals / Fuels
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6.1. Are containers labeled?
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6.2. Flammables stored in safety can with self-closing lid?
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6.3. Is compressed gas upright and secure?
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6.4. Are safety data sheets (SDS) on site or readily available?
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7.0. Fire Prevention/Protection
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7.1. Are fire extinguishers fully charged and immediately available?
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7.2. Is an up to date annual inspection tag affixed to the extinguisher?
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7.3. Are torches in good condition and being operated safely?
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8.0. Equipment
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8.1. Forklift operators certified?
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8.2. Does equipment appear to be reasonably maintained?
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8.3. Did operator conduct an inspection of the forklift and surrounding work area?
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8.4. Was the equipment being operated in a safe manner?
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9.0. Personal Protective Equipment (PPE)
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9.1. Are hard hats being worn when required?
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9.2. Is adequate eye protection being worn?
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9.3. Are nitrile gloves being worn when working with solvents?
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9.4. Are leather work boots being worn?
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9.5. Is hearing protection readily available?
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9.6. Are employees dressed in appropriate work clothes?
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10.0. Emergency Response
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10.1. Is an adequately stocked first-aid kit readily available?
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10.2. Is the foremen aware of where the nearest medical facility is?
11.0. OTHER hazards/concerns
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11.1. Other hazards or concerns
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