Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

WORK ZONE

  • IS WORK ZONE SET UP PROPERLY?

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  • IS SIGNS AT PROPER DISTANCES?

  • IS THERE A SUFFICIENT AMOUNT OF CONES AROUND VEHICLES AND EQUIPMENT?

  • IS THE SIGNS AND STANDS IN GOOD CONDITION AND SUITABLE FOR THE TYPE OF WORK ZONE?

  • DO THEY HAVE THE PROPER FLAGGING EQUIPMENT, STOP AND SLOW PADDLES, TWO WAY RADIOS?

  • IS THE FLAGMEN THE PROPER DISTANCE APART FOR SAFE CONTROL OF TRAFFIC?

  • ARE THEY PROPERLY TRAINED, OR CERTIFIED TO FLAG?

  • CAN THEY SHOW PROOF OF TRAINING, AND IS IT UP TO DATE?

  • IS THE PUBLIC PROTECTED FROM OPEN HOLES OR MOVING EQUIPMENT?

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EXCAVATION SAFETY

  • IS THERE A COMPETENT PERSON ON SIGHT?

  • CAN THE COMPETENT PERSON SHOW PROOF BY CARD OR CERTIFICATE?

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  • HAS A ONE CALL BEEN MADE AND UTILITIES BEEN MARKED?

  • IS THERE A TICKET # AVAILABLE ON SITE?

  • IS THE SPOIL PILE KEPT BACK 2 FEET FROM THE EXCAVATION?

  • IS THE HOLE MORE THAN 4 FEET IN DEPTH?

  • IF YES, IS THERE PROPER MEANS OF EXIT AND ENTRY?

  • IF A LADDER IS BEING USED, DOES IT EXTEND 3 FEET ABOVE THE TRENCH AND IS IT TIED OFF?

  • IF RAMPS ARE DUG IN, ARE THEY SUITABLE FOR ENTRY AND EXIT?

  • HAS THE TRENCH BEEN SLOPED, BENCHED OR SHORED IF OVER 5 FEET IN DEPTH?

  • IS IT DONE ACCORDING TO OSHA REGULATIONS?

PERSONAL PROTECTIVE EQUIPMENT

  • HARD HATS BEING WORN?

  • ARE THEY IN GOOD CONDITION AND NOT EXPIRED?

  • SAFETY GLASSES BEING WORN?

  • SIDE SHIELDS BEING USED?

  • FACE SHIELDS BEING USED WHEN REQUIRED?

  • EAR PLUGS BEING USED WHEN REQUIRED?

  • PROPER GLOVES BEING USED FOR THE TASK BEING PERFORMED?

  • PROPER VEST BEING WORN? AND IN GOOD CONDITION?

  • STEEL TOE OR SAFETY TOE WORK BOOTS BEING WORN?

  • ARE ALL OXYGEN MONITORS BEING WORN IN THE PROPER LOCATIONS WITHIN BREATHING ZONE?

  • ARE THE MONITORS WORKING PROPERLY

  • IS FR CLOTHING BEING WORN WHEN REQUIRED?

TRUCKS AND EQUIPMENT

  • TRUCKS, TRAILERS, AND AIR COMPRESSOR'S WHEELS DOUBLE CHOCKED?

  • BUCKETS ON EQUIPMENT GROUNDED, NOT RAISED OFF OF GROUND?

  • KEYS REMOVED FROM ALL TRUCKS AND EQUIPMENT WHEN NOT OCCUPIED?

  • ALL LIGHTS WORKING PROPERLY?

  • ANY LEAKS, OIL, ANTIFREEZE, HYDRAULIC ?<br>

  • BACKUP ALARMS WORKING?

  • OPERATORS OF EQUIPMENT AND TRUCKS WEARING SEAT BELTS WHEN OPERATING?

  • EQUIPMENT CHECKS BEING PERFORMED DAILY?

  • HOUSE KEEPING IN TOOL TRAILER OR TOOL HOUSE BEING KEPT?

TOOLS

  • HAND AND SMALL TOOLS IN GOOD CONDITION?

  • TOOL CHECKS BEING PERFORMED DAILY/

  • HAVE THE RIGHT TOOLS TO DO JOB CORRECTLY?

  • ARE SLINGS AND CHAINS IN GOOD CONDITION?

  • ARE THEY APPROPRIATE FOR WHAT IS BEING LIFTED, PULLED OR TIED DOWN?

  • DOES THE LIFTING HOOKS HAVE SAFETY LATCHES?

EMPLOYEE TRAINING AND QUALIFICATIONS

  • ARE THE ONES PERFORMING TASKS TRAINED AND QUALIFIED TO DO SO?

  • ARE THEY CARRYING A VALID O.Q, OR QUALIFICATION CARD TO PROVE SO?

  • IF NOT, IS THERE SOMEONE THERE WHO IS QUALIFIED TO WATCH AND VERIFY TASK IS BEING DONE CORRECTLY?

  • IS THERE ENOUGH QUALIFIED PEOPLE ON THE JOB?

EQUIPMENT WITH REQUIRED CALIBRATION OR INPSECTION

  • HAVE ALL FIRE EXTINGUISHERS BEEN INSPECTED WITHIN THE LAST 30 DAYS AND INITIALED ON BACK OF TAG?

  • IS THE TAG AVAILABLE AND IDENTIFIED PER EXTINGUISHER /

  • HAS ALL GAS SNIFFERS AND TRACKERS BEEN CALIBRATED WITHIN THE CUSTOMERS REQUIRED TIME LINE (3 MONTHS) ?

  • ALL OTHER CALIBRATION REQUIRED EQUIPMENT?

EMERGENCY RESPONSE AND FIRST AID

  • IS THERE A ENOUGH PEOPLE QUALIFIED IN FIRST AID ON SITE?

  • ARE THE FIRST AID KITS PROPERLY STOCKED AND UP TO DATE, WITH INSPECTION LABEL PRESENT?

  • ARE THERE EYE WASH STATIONS STOCKED AND UP TO DATE ON SITE?

HAZARD COMMUNICATION

  • IS COPIES OF MSDS, OR SDS SHEETS AVAILABLE WHETHER ELECTRONIC OR PAPER FORM?

  • ARE ALL EMPLOYEES AWARE THIS INFORMATION'S LOCATION ON SITE?

HAZARDOUS,FLAMMABLE MATERIAL STORAGE AND CONTAINMENT

  • ARE ALL GAS CANS AND FUEL STORAGE TANKS PROPERLY LABELED?

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  • ARE ALL LEAK-SEEK BOTTLES PROPERLY LABELED?

REQUIRED DAILY AND WEEKLY PAPERWORK

  • HAS JSA BEEN FILLED OUT?

  • WAS JSA COMMUNICATED TO THE CREW?

  • DOES THE JSA COVER APPROPRIATE HAZARDS FOR TASK BEING PERFORMED?

HYGIENE & EMPLOYEE HEALTH

  • IS RESTROOMS AVAILABLE?

  • IS THERE WATER AVAILABLE FOR EMPLOYEE'S

  • ARE THEY DRINKING ENOUGH WATER TO PREVENT HEAT STRESS ILLNESS?

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