Central States Roofing

• Site conducted

  Select

• Audit Title

• Conducted on

  Date

• Prepared by

• Personnel

• Location
  Address

Access / Egress to the Roof

• Portable Ladders (if not checked than N/A)

• Ladders are secured at the top - no Bungee Cords

  Yes

  No

  N/A

• Ladder is secured at the bottom

  Yes

  No

  N/A

• Ladder is set up at 4 to 1 rule

  Yes

  No

  N/A

• Ladder is extended 3 feet (3 rungs) above the top edge

  Yes

  No

  N/A

• Ladders are inspected Bi-Annually

  Yes

  No

  N/A

• Ladder rungs are kept fee from mud, snow, and other slippery substances

  Yes

  No

  N/A

• Ladder is not set up near energized electrical lines

  Yes

  No

  N/A

• Fixed Ladders & Roof Hatches (if not checked than N/A)

• Roof Hatch is in good shape, no visible damage

  Yes

  No

  N/A

• Fixed Ladder in good repair, no visible damage

  Yes

  No

  N/A

• Stairs (if not checked than N/A)

• Stairways with 4 or more risers, or rising more than 30 inches in height (whichever is less) have stair rails provided on each unprotected edge

  Yes

  No

  N/A

• Handrails are provided between 30 inches and 37 inches

  Yes

  No

  N/A

• All railings are free from projection hazards such as nails, surfaced to prevent injuries or snagging of clothing

  Yes

  No

  N/A

• Metal pan stairs are filled with with suitable material or barricaded to prevent access

  Yes

  No

  N/A

• Other

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Fall Protection

• Warning Line Systems (if not checked than N/A)

• Warning lines kept minimum of 6' from edge of roof, or minimum of 10' from edge of roofs with mechanical equipment in use

  Yes

  No

  N/A

• Well maintained, a minimum of 34" off the working surface, a maximum of 39"

  Yes

  No

  N/A

• Stanchions utilized are designed to resist, without tipping over, a force of at least 16 lbs applied horizontally 30" above the walking / working surface

  Yes

  No

  N/A

• Employees adhering with requirement and remaining inside warning lines unless using a different fall protection system

  Yes

  No

  N/A

• Guardrails System (if not checked than N/A)

• Top rail 39-45 inches above the walking working surface. Cable deflects 3" or less and does not sag below 39" with 200lbs of force applied. Midrails installed midway between top rail and walking / working surface

  Yes

  No

  N/A

• Guardrail system properly installed capable of withstanding 200lbs of force

  Yes

  No

  N/A

• Standard toe boards installed if exposure below exists

  Yes

  No

  N/A

• Guardrails surfaced to prevent injury. No protruding nails

  Yes

  No

  N/A

• Safety Monitoring System (if not checked than N/A)

• Safety monitor in audible & visual distance, on same working level and performing monitoring duties only

  Yes

  No

  N/A

• Safety monitor educated to recognize fall hazards and aware of items that he/she should be looking for

  Yes

  No

  N/A

• Employees ensuring a safety monitor is present prior to going outside warning lines or working on an unprotected roof

  Yes

  No

  N/A

• Monitor used in conjunction with warning line, except for on roofs that are <50' in length or width

  Yes

  No

  N/A

• Personal Fall Arrest Systems (if not checked than N/A)

• Fall Cart (Raptor) on the roof

  Yes

  No

  N/A

• Anchorage points of suitable strength to support fall or restraint (5,000lbs arrest, 3,000lbs restraint)

  Yes

  No

  N/A

• Equipment inspected prior to use

  Yes

  No

  N/A

• Harness & lanyards worn and adjusted properly. Lifelines installed properly, slack removed, pendulum effect and free fall distance considered and controlled

  Yes

  No

  N/A

• Skylight and Hole protection (if not checked than N/A)

• Skylight / holes protected by guardrail, cover, net, or personal fall arrest system is used

  Yes

  No

  N/A

• Hole covers capable of withstanding twice the intended load. "Hole" or "Cover" painted atop the cover

  Yes

  No

  N/A

• Hoist area fall protection (if not checked than N/A)

• Guardrails or PFAS utilized in hoisting areas (areas where material / debris / equipment is being brought up to or removed from roof)

  Yes

  No

  N/A

• Employees using PFAS in hoist areas set them up for fall restraint

  Yes

  No

  N/A

• Other Fall Protection

• Add media

  Media

• undefined

Electrical Safety

• GFCI utilized at all times

  Yes

  No

  N/A

• Cords and tools in good condition. Damaged cords / tools tagged out of service or rendered inoperable

  Yes

  No

  N/A

• Other

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  Media

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Fire Prevention

• Extinguishers in place, charged, tagged and in work area. Clear of obstruction. No more than 100' from employees, no more than 50' from flammables

  Yes

  No

  N/A

• No smoking on the Roof or near flammables

  Yes

  No

  N/A

• Proper flammable safety cans in use

  Yes

  No

  N/A

• Other

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  Media

• undefined

General Safety

• First aid kits available on the jobsite

  Yes

  No

  N/A

• Drinking water on the jobsite

  Yes

  No

  N/A

• Portable Toilet on the jobsite

  Yes

  No

  N/A

• SDS available onsite for all chemicals, chemicals properly labelled

  Yes

  No

  N/A

• Weekly tool box talks conducted

  Yes

  No

  N/A

• General housekeeping efforts kept up

  Yes

  No

  N/A

• All materials and debris secured daily. Public protected from falling / flying objects

  Yes

  No

  N/A

• Other

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  Media

• undefined

Hand and Power Tools

• All hand and power tools in good repair. Damaged equipment tagged out of service or rendered inoperable

  Yes

  No

  N/A

• All power tools have proper machine guards in place

  Yes

  No

  N/A

• Hand tools used for the task they are designed for. No prying items with a utility knife

  Yes

  No

  N/A

• Utility knife blades kept sharp, cuts made away from body. Retracted or fully sheathed when not in use

  Yes

  No

  N/A

• Other

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  Media

• undefined

Material Handling

• Proper lifting techniques observed. Team lifts or mechanical equipment used when lifting heavy objects

  Yes

  No

  N/A

• Material handling equipment in good condition

  Yes

  No

  N/A

• Debris removed of promptly and safely. Chute provided when over 20'.

  Yes

  No

  N/A

• Crane Safety (if not checked than N/A)

• Operators licensed / certified

  Yes

  No

  N/A

• Rigging in good condition. Capacities legible. Inspected prior to use with no visible damage.

  Yes

  No

  N/A

• Qualified rigger / signal person used

  Yes

  No

  N/A

• Outriggers fully deployed, pads/cribbing used on soft surfaces

  Yes

  No

  N/A

• Daily inspection of crane performed. Must be documented at least once per month and available on crane

  Yes

  No

  N/A

• Work zone established. Elevated visual aids in place to ensure crane maintains minimum approach distance from overhead power lines

  Yes

  No

  N/A

• Forklift Safety (if not checked than N/A)

• Operator certified. License available and current (not more than 3 years old)

  Yes

  No

  N/A

• Daily inspection completed. All critical safety elements in good repair (back up alarm, windows & mirrors, boom angle indicator, load chart available, tires in good repair, etc)

  Yes

  No

  N/A

• Seatbelt worn at all times

  Yes

  No

  N/A

• Safe speeds maintained

  Yes

  No

  N/A

• Other

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  Media

• undefined

Personal Protective Equipment

• Eye protection worn when hazard exits and per policy

  Yes

  No

  N/A

• Hard hats worn when hazard exits and per policy

  Yes

  No

  N/A

• Proper gloves worn when handling tear off debris, when handling sharp metal, and when handling chemicals requiring glove usage

  Yes

  No

  N/A

• Proper work attire worn (boots, pants, sleeved shirts, long sleeve shirts if handling hot asphalt)

  Yes

  No

  N/A

• Other

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  Media

• undefined

Scaffolding & Arial Lifts

• Supported Scaffolding (if not checked than N/A)

• Competent person onsite - daily inspections conducted

  Yes

  No

  N/A

• All components in good condition, properly assembled

  Yes

  No

  N/A

• Safe access onto scaffold available

  Yes

  No

  N/A

• Guardrails and toeboards on all open sides of work area

  Yes

  No

  N/A

• Work platform fully decked with proper overhang / cleating of planks

  Yes

  No

  N/A

• All employees using have user training

  Yes

  No

  N/A

• Scaffold kept a safe distance (10' minimum) from overhead powerlines unless lines have been de-energized or other acceptable safeguards implemented

  Yes

  No

  N/A

• Falling object protection adequate if exposure below exists. Toe boards in place, or netting used if material stacked higher than toe boards

  Yes

  No

  N/A

• Aerial Lifts (if not checked than N/A)

• All employees using have received user training

  Yes

  No

  N/A

• Inspections performed prior to operating. No dropoffs, depressions, holes, etc. surrounding the equipment that can be driven into

  Yes

  No

  N/A

• Guardrails in proper working condition. Safety chains latched closed on scissor lifts. Swing gates shut on boom lifts

  Yes

  No

  N/A

• Proper fall protection in place when working from boom lift. Retractable lanyard or other restraining device used. Harness worn properly

  Yes

  No

  N/A

• Equipment kept a safe distance from overhead powerlines (minimum of 10' unless power lines are de-energized or other acceptable safeguard is implemented)

  Yes

  No

  N/A

• Other

• Add media

  Media

• undefined

Sign Off

• On site representative

  Sign

• Auditor's signature

  Sign