Communications Site Safety Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Initial Site Conditions

• Are weather conditions acceptable for the SOW tasks?

  Yes

  No

  N/A

• Are there any site security issues?

  Yes

  No

  N/A

• Are there any initial safety concerns?

  Yes

  No

  N/A

• Select date

  Date

Type of Structure

• Type of Structure

  Select Rooftop Monopole SST Guyed Water Tower Rooftop Other

  • Rooftop
  • Monopole
  • SST
  • Guyed
  • Water Tower
  • Rooftop
  • Other

• Height of Structure?

• Height of SOW Work?

Documentation, Emergency, and Rescue

• List all employees names:

• Are there any subcontractors working ons site?

  Yes

  No

  N/A

• Is there a Pre-Construction JSA or DHA completed and signed?

  Yes

  No

  N/A

• List names of all subcontractors and SOW role:

• Is there a SOW and plans available onsite?

  Yes

  No

  N/A

• Is a Site Hazard sign posted at the entrance to the site?​

  Yes

  No

  N/A

• Is there Emergency Contact Information for Police, Fire, EMS ?

  Yes

  No

  N/A

• Is there nearest Hospital location and address information?

  Yes

  No

  N/A

• Is there a map and directions to the site and hospital?

  Yes

  No

  N/A

• Is there a Site Specific Rescue Plan?

  Yes

  No

  N/A

• Is the First Aid Kit immediately available?

  Yes

  No

  N/A

• Is there a Trauma Kit immediately available?

  Yes

  No

  N/A

• Is there a Fire Extinguisher immediately available?

  Yes

  No

  N/A

General Site Conditions

• Is Drinking water available?

  Yes

  No

  N/A

• Are hazardous areas barricaded?

  Yes

  No

  N/A

• Is the worksite free of excessive trash?

  Yes

  No

  N/A

• Are there any un-authorized persons on-site?

  Yes

  No

  N/A

• Are there any Hazardous materials on-site?

  Yes

  No

  N/A

• Are the SOW Materials orderly?

  Yes

  No

  N/A

• Are there excessive trip hazards onsite?

  Yes

  No

  N/A

• Are there security concerns at or surrounding the site?

  Yes

  No

  N/A

• Are there plant, insect, or animal hazards?

  Yes

  No

  N/A

General PPE

• Are all employee wearing hardhats?

  Yes

  No

  N/A

• Are all employees wearing proper footwear?

  Yes

  No

  N/A

• Are all employees wearing safety glasses?

  Yes

  No

  N/A

• Are employees wearing gloves?

  Yes

  No

  N/A

• Are employees dressed properly for the SOW tasks?

  Yes

  No

  N/A

• Are employees wearing hearing protection?

  Yes

  No

  N/A

Fall Protection

• Are there a minimum of 2 Competent Climber Rescuers onsite?

  Yes

  No

  N/A

• Is there a documented rescue plan?

  Yes

  No

  N/A

• Is the rescue kit immediately available for use?

  Yes

  No

  N/A

• Is there a rescue rope?

  Yes

  No

  N/A

• What type of descent device is included with the rescue kit?

  Petzl ID

  Fisk Descender

  Other

• Does the rescue kit meet the current ANSI 359 Standard?

  Yes

  No

  N/A

• Does the rescue kit have all components to effect a rope rescue?

  Yes

  No

  N/A

Personal Fall Protection PPE

• How many Tower Climbers are on site?

  Select 1 2 3 4 5 6

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

• Name of Climber 1

• Does Climber have Climber Certificate?

  Yes

  No

  N/A

• List Company and Date of Certificate, and Certificate number:

• Does the climbers harness and fall protection PPE appear to be acceptable for the SOW tasks?

  Yes

  No

  N/A

• Name of Climber 2

• Does Climber have Climber Certificate?

  Yes

  No

  N/A

• List Company and Date of Certificate, and Certificate number:

• Does the climbers harness and fall protection PPE appear to be acceptable for the SOW tasks?

  Yes

  No

  N/A

• Name of Climber 3

• Does Climber have Climber Certificate?

  Yes

  No

  N/A

• List Company and Date of Certificate, and Certificate number:

• Does the climbers harness and fall protection PPE appear to be acceptable for the SOW tasks?

  Yes

  No

  N/A

• Name of Climber 4

• Does Climber have Climber Certificate?

  Yes

  No

  N/A

• List Company and Date of Certificate, and Certificate number:

• Does the climbers harness and fall protection PPE appear to be acceptable for the SOW tasks?

  Yes

  No

  N/A

• Name of Climber 5

• Does Climber have Climber Certificate?

  Yes

  No

  N/A

• List Company and Date of Certificate, and Certificate number:

• Does the climbers harness and fall protection PPE appear to be acceptable for the SOW tasks?

  Yes

  No

  N/A

• Name of Climber 6

• Does Climber have Climber Certificate?

  Yes

  No

  N/A

• List Company and Date of Certificate, and Certificate number:

• Does the climbers harness and fall protection PPE appear to be acceptable for the SOW tasks?

  Yes

  No

  N/A

• Are all active climbers using 100% tie off practices for both positioning and protection?

  Yes

  No

  N/A

• List deficiencies and individuals:

RF Hazards

• Does the crew have a minimum of 1 RF monitor onsite?

  Yes

  No

  N/A

• Does the work location involve an RF Concern?

  Yes

  No

  N/A

• Has the crew requested a turn down or turn off of equipment that could pose an RF hazard?

  Yes

  No

  N/A

• Name of company required to turn down or turn off equipment?

Electrical Hazards

• Are there any SOW tasks that require electrical work?

  Yes

  No

  N/A

• List Tasks

  Select Installing new breakers Installing new outlets Removing or installing new power cables Installing new cords Installing conduit Installing Lighting

  • Installing new breakers
  • Installing new outlets
  • Removing or installing new power cables
  • Installing new cords
  • Installing conduit
  • Installing Lighting

• Is a licensed electrician performing the electrical work?

  Yes

  No

  N/A

• Are there any electrical safety concerns?

  Yes

  No

  N/A

• Does the electrical work appear to be performed in a safe manner?

  Yes

  No

  N/A

• Are LOTO procedures being utilized for worker safety?

  Yes

  No

  N/A

• Are GFCI outlets being used?

  Yes

  No

  N/A

• Are extension cords in acceptable condition?

  Yes

  No

  N/A

• Are the extension cords the proper gauge for the equipment, or tool being used?

  Yes

  No

  N/A

• Are power tools being used in acceptable electrical condition?

  Yes

  No

  N/A

• If not list deficiencies:

• Is there a generator in use on the site?

  Portable

  Backup Site

• Are there shielded electrical service lines in the compound area, or work area?

  Yes

  No

  N/A

• Are there unshielded primary lines near the compound or work area?

  Yes

  No

  N/A

• What distance from the compound are the unshielded primary lines?

• Is the crew using safe work practices around electrical lines and poles?

  Yes

  No

  N/A

• Do the electrical lines require additional protective covers from the power company?

  Yes

  No

  N/A

• Have the electrical lines been temporarily shut down to accomplish the SOW tasks?

  Yes

  No

  N/A

• Does the Tower or Monopole appear to be properly grounded?

  Yes

  No

  N/A

• Is there any boom equipment or manlifts in use near power lines

  Yes

  No

  N/A

• Is the operator using best practice electrical clearance procedures?

  Yes

  No

  N/A

Cranes

• Is there a crane onsite?

  Yes

  No

  N/A

• Is there a rigging plan with documented picks?

  Yes

  No

  N/A

• Is there a qualified signal person directing for crane operations?

  Yes

  No

  N/A

• Is the swing area barricaded?

  Yes

  No

  N/A

• Is there private channel radio communication between all directing employees?

  Yes

  No

  N/A

• What is the tonnage of the crane?

• What is the tallest pick height for the SOW?

• Will there be any personnel hoisting?

  Yes

  No

  N/A

• Has there been a documented test pick before personnel are to be hoisted?

  Yes

  No

  N/A

• Are there any rigging concerns?

Capstan (Rope) Hoist

• Is there a capstan hoist in use for the SOW task?

  Yes

  No

  N/A

• Does the load rope appear to be acceptable?

  Yes

  No

  N/A

• Is the crew using good rigging practices?

  Yes

  No

  N/A

• Is the foot switch in acceptable working order?

  Yes

  No

  N/A

• Are the loads being hoisted within the load rating of the rope and hoist capacity?

  Yes

  No

  N/A

• Does the capstan have any rough leading edges or nicks?

  Yes

  No

  N/A

Rigging

• Are fabric slings, chains, and/or cable slings in acceptable condition?

  Yes

  No

  N/A

• Are shackles clearly marked with rating and manufacturers name?

  Yes

  No

  N/A

• Are acceptable rigging practices being used (i.e. sling angle, protection, etc.) ?

  Yes

  No

  N/A

Trenching and Excavation

• Is there trenching or excavation as part of this SOW?

  Yes

  No

  N/A

• Has dig alert visited and marked the excavation safety area?

  Yes

  No

  N/A

• What depth is the trench or excavation?

• Is there a documented plan for depths more than 5'?

  Yes

  No

  N/A

• Has a documented soil test been completed for the type of soil and classification?

  Yes

  No

  N/A

• Are there any utilities, or underground hazards in the excavation area?

  Yes

  No

  N/A

• Is the excavation properly sloped and/or benched?

  Yes

  No

  N/A

• Are the spoils placed a minimum of 2' from the edge of the excavation?

  Yes

  No

  N/A

• Is there a clear egress by step or ladder within 10' of the employee work area?

  Yes

  No

  N/A

• Is the perimeter of the excavation marked or barricaded for safety?

  Yes

  No

  N/A

Ladders

• Are there any ladders in use on the site?

  Yes

  No

  N/A

• What height is the ladder

• What type of ladder?

  Step

  Extension

  A Frame

  Foldable

• What type of Construction?

  Wood

  Metal

  Fiberglass

• Is the ladder the proper OSHA rating 1A-300#?

  Yes

  No

  N/A

• Is the ladder on a stable footing?

  Yes

  No

  N/A

• Is the ladder being used in the safest manner?

  Yes

  No

  N/A

Heavy Equipment

• Is there any heavy equipment being used onsite?

  Yes

  No

  N/A

• What type?

  Forklift

  Boom Truck

  Aerial Lift

  Other

• Are there any visible damages to the equipment?

  Yes

  No

  N/A

• Is there a fire extingusher with the equipment?

  Yes

  No

  N/A

• Does the equipment have working lights?

  Yes

  No

  N/A

• Does the equipment have an operational backup alarm?

  Yes

  No

  N/A

• Are there any hydraulic or fluid leaks?

  Yes

  No

  N/A

• Is the rollover protection, interlocks, and safety belts functional?

  Yes

  No

  N/A

• Are employees operating the equipment in a safe manner?

  Yes

  No

  N/A

Vehicle Condition

• Is there a current vehicle tag? Both Front and Back if required by jurisdiction?

  Yes

  No

  N/A

• Tag Number?

• Is there a current registration and windshield sticker if required by jurisdiction?

  Yes

  No

  N/A

• Is there a current insurance certificate?

  Yes

  No

  N/A

• Is there a current company safety manual in the vehicle?

  Yes

  No

  N/A

• Is there a company MSDS binder in the vehicle?

  Yes

  No

  N/A

• Is there any exterior vehicle damage?

  Yes

  No

  N/A

• If yes, describe:

• Are the tires in good condition?

  Yes

  No

  N/A

• Is there a spare?

  Yes

  No

  N/A

• Is there a set of jumper cables?

  Yes

  No

  N/A

• Is there a truck jack and lug wrench?

  Yes

  No

  N/A

• Is there a set of reflective triangles or traffic cones (minimum of 3)?

  Yes

  No

  N/A

• Are the lights in good working order?

  Yes

  No

  N/A

• Does the crew have any operating issues with the vehicle?

  Yes

  No

  N/A

• Is the exterior of the vehicle clean?

  Yes

  No

  N/A

• Is the interior of the vehicle clean?

  Yes

  No

  N/A

Trailer Condition

• Is there a trailer on site with this crew?

  Yes

  No

  N/A

• Is there a current tag on the trailer?

  Yes

  No

  N/A

• Is there any structural damage to the trailer?

  Yes

  No

  N/A

• Are there any lug nuts missing?

  Yes

  No

  N/A

• Are the tires in good condition?

  Yes

  No

  N/A

• Are the lights working correctly?

  Yes

  No

  N/A

• Are any lenses damaged?

  Yes

  No

  N/A

• Are the safety chains in good condition?

  Yes

  No

  N/A

• Is the lighting plug in good condition?

  Yes

  No

  N/A

• Is the brake controller operational?

  Yes

  No

  N/A

• Are binder straps in good condition?

  Yes

  No

  N/A

Observations

• List any other observations:

Deficiencies resolved during the Visit

• List items that were resolved during this visit:

Employee Warnings Issued?

• Were any verbal employee warnings issued?

  Yes

  No

  N/A

• If so, list all:

• Will verbal warnings be followed up with written warnings?

  Yes

  No

  N/A

• If so, list employees:

Other comments regarding safety or non safety issues

• List any other comments:

Visit Time

• Enter time spent on this visit:

Validate Site Visit

• Auditors Signature

  Sign