Information

  • Audit Title

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Housekeeping and Sanitation

  • Rubbish containers

  • Toilets (1per 20 employees) Hand wash station

  • Adequate supply of water and cups/rubbish containers

Personal Protective Equipment

  • Eye protection, ear protection, vests hardhats

  • Harnesses, lanyards and foot protection

Power tools and cords

  • Tools in good working condition

  • Damaged extension cords and plugs

  • Welding leads in good repair/stinger insulated

  • Lock/Out, Tag/Out practice in use

  • Chaps worn when using chainsaw

  • Whip checks on high pressure hoses

  • GFCI protection in place

Ladders

  • In good condition/Tied off as necessary

  • No work on the top three steps

  • Secured and three feet above landing

Heavy Equipment ( Daily Inspection)

  • Fire extinguishers, brakes, horn, backup alarm

  • Mirrors, windows, signals/Log books filled out

Control Traffic

  • Flag person wearing proper PPE

  • Slow/Stop paddles

  • Signs, cones, lights and barricades

Excavations

  • Shoring and/or shields

  • Slope or benched

  • Spoils two feet from edge of excavation

  • Access in excavations 4+' deep and every 25' laterally

  • Employee/Public protection

Pile Driving/Steel Erection

  • 100% tied off

  • Daily, quarterly, crane logs filled out and cents in cab

  • Maintenance logs filled out and current

  • Inspect rigging/chokers, slings, bridles, hooks

Crane/Hoisting (Daily Inspection)

  • Current certification in cab

  • Maintenance log filled out and current

  • Rigging and load charts in cab

  • Fire extinguisher in cab/Inspection current

  • First-kit in good supply

  • Proper warning signs on crane

  • No operation within limits of High Voltage Lines

  • Tag lines used on all picks

  • Swing radius protection

  • Boom angle indicator operational

  • Anti- two block devices operational

  • Rigging inspection

Rebar Protection

  • Job built

  • Caps

Confined Space

  • Tested before entry and as needed thereafter

  • Positive air flow

  • PPE

  • Rescue plan

  • Permits

Scaffolds and Aerial Lifts

  • Level, guard rails base plates and fully planked

  • Tie off as required

  • No working or standing on guardrail

  • Toe boards as needed

  • Overhead protection

Flammable Gases and Liquids

  • Oxygen/acetylene bottles separated by 20'

  • Capped and secured

  • All gases/liquids ID and stored properly

  • Fire extinguishers within 25'-75' of storage

  • Flashback arrestors in use

  • #5 shade lens for cutting torch operations

Safety Supplies and Gear

  • Emergency stretcher and rigging

  • Emergency blanket

  • First- aid kits in good supply

Paperwork

  • Injury and Illness Prevention Plan

  • MSDS available / JHA files

  • Evacuation Plan

  • Site Specific Safety Plan

Containment

  • Permits/secured

  • Regular pick-up

  • Fire extinguishers within 25'-75'

Unsafe Pracices

  • Individual

  • Company

  • Location

Corrective Actions

  • Enter any corrective actions that will be undertaken

Sign Off

  • On site representative

  • Auditor's 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.