Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

General

  • Emergency Action Plan/Phone numbers posted

  • HazCom manual/SDS available

  • Safety Orientation being done and up to date

  • JSA's being done daily

  • Weekly safety inspection checklist being done

  • Weekly safety meeting held/documented

  • Federal, State, and EOE postings are visible and updated

  • First aid kit available<br>

Personal Protective Equipment

  • Hard Hats worn by all personnel in work areas

  • Eye and face protection worn as required

  • Hand protection worn as required

  • Harness and lanyard worn for fall protection

  • Respiratory protection worn as required

  • Hi-Vis worn as required

Electrical

  • Hot Work policy is complied with for any planned Hot Work

  • Lockout/Tagout kit is onsite

  • Lockout/Tagout procedure is in place and monitored

  • GFCI's are tested and documented<br>

  • Extension cords and portable GFCI's inspected before use

  • Temporary power installation meets requirements

  • Temporary lighting meets requirements

  • Electrical Panels labeled

  • Live Junction boxes covered

  • Live Electrical outlets/switches covered

  • Dead fronts installed on panels

Housekeeping

  • Walkways and stairs kept clear of material and debris

  • Cords and hoses placed to minimize trip hazards

  • Spills cleaned up immediately

  • Work areas clean and orderly

  • Site trailers/Conex box clean and orderly

  • Gang box clean and orderly

  • Trash, scrap and debris disposed of

Fire Protection

  • Fire extinguishers well marked and accessible

  • Fire extinguishers inspected monthly

  • Flammables stored in approved containers

  • Fuel containers labeled

  • Oily rags disposed of in an approved container

  • Heaters kept 20' away from combustible materials

Material Handling and Storage

  • Are employees trained to operate Forklifts

  • Are Forklifts in good operating condition

  • Materials stored neatly in stacks and piles

  • Aisle space maintained around stored materials

  • Storage areas kept clear

Tools

  • Power tools have guards in place

  • Power tools either grounded or double insulated

  • Power tool cords and plugs in good condition

  • Damaged tools taken out of service

  • Impact tools with mushroomed heads dressed as needed

Welding and Cutting

  • Gas cylinders stored upright and secured

  • Oxygen cylinders segregated from fuel gas cylinders

  • Full cylinders segregated from empty cylinders

  • Caps secured on all cylinders not in use

  • Welding leads in good condition

  • Welding screens erected in high flash areas

  • Welding blankets used to protect materials/equipment

  • Fire watch posted as needed

  • Permits issued as required

  • Fire extinguisher in hot work areas

Ladders

  • Straight ladders secured at top landing

  • Straight ladders extend 3' above top landing

  • Straight ladders have feet or blocked at bottom

  • Straight ladders set up on a 4 to 1 ratio

  • Top two steps of stepladders not being used

  • Stepladders not being used as straight ladder

Scaffolds and Aerial lifts

  • Scaffold parts and hardware used as required

  • Scaffold hardware and parts in good condition

  • Scaffolds fully planked and free of debris

  • Scaffolds have guardrails, midrails, and toe boards

  • Scaffolds been inspected and tagged

  • Scaffolds have ladder or equivalent safe access

  • Wheels locked on rolling scaffolds

  • Aerial lifts in good operating condition

  • Employees received operator training on Aerial lifts

  • Aerial lifts being used correctly

Handrails and Hole Covers

  • Perimeters and drop-offs protected by rails or cables

  • Railings sturdy and have midrails

  • Railings replaced after temporary removal

  • Floor holes protected by railings or hole covers

  • Hole covers secured to prevent movement

  • Hole covers marked to prevent accidental removal

  • Hole covers replaced after temporary removal

Excavation and Trenching

  • Trenches inspected daily by a competent person

  • Trenches inspected as conditions change

  • Trenches 5' or deeper shored, sloped, or boxed

  • Excavated spoils at least 2' from edges

  • Ladder, steps or ramps within 25' of all workers

  • Heavy equipment kept away from trench edges

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.