Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Select date

  • Add location

Company Name

General Requirements

  • Do employees know the location of the MSDS sheets

  • Are all containers labeled properly?

Excavations

  • Is the competent person on site when work is being done?

  • Are excavations inspected daily

  • Has a dig permit been filled out prior to the start of work and signed by a Mortenson team member?

  • Are spoils piles back at least 2' from the edge of the excavation?

  • Are protective systems in place? (Trench boxes,shoring or sloping)

  • Is a fall protection system in place on the trench box?

  • Is there adequate access/ egress to the trench?

  • Add media

Confined Space

  • Has a confined space permit been filled out for the day?

  • Is a tri-pod in place?

  • Is an air monitor being used?

  • Are they ventilating the hole?

  • Is the attendant identifiable?

  • Is the entrant wearing a harness properly?

  • Add media

Fire Prevention

  • Has a Hot Work Permit been filled out for the day and signed by a Mortenson team member?

  • Have all flammables/combustibles been removed from the area?

  • Is a 10# fire extinguisher present?

  • Is a fire watch present?

  • Add media

Fall Protection

  • Is the anchorage point cable of supporting 5,000 lbs?

  • Has the employee been properly trained in how to wear a harness?

  • Has your harness been inspected prior to each use?

  • Add media

Utilities

  • Have all utilities been located

Spills and Leaks

  • Do employees know the procedure for containment of spills/leaks.

  • Is a spill kit on site?

  • Add media

Equipment Inspections

  • Inspections done daily

  • Written log available

  • Add media

PPE

  • Hard hat being worn

  • High visibility vest

  • Gloves

  • Safety glasses

  • Hard soled shoes (boots)

  • All other necessary PPE being worn

Storm Water

  • BMPs in place/maintenance

  • Current site plan with BMPs shown?

  • Rain gauge/inspection frequency

  • Add media

Traffic Control

  • Traffic pattern for haul roads in place?

  • Traffic control/ road closure plan in place?

  • Flaggers being used are in place and are CDOT certified?

  • Traffic control devices set up per plan and checked daily

  • Add media

Concrete Work

  • All vertical steel has caps on it

  • Respirators being worn while doing saw cutting?

  • Correct PPE being worn (gloves,rubber boots)

  • Face shield being used while saw cutting

  • Add media

Pre Shift Start up

  • Pre task completed

  • IWP reviewed daily

General observations/other

  • Add media

  • Add signature

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.