TMNA Safety Audit

• Contractor:

• Department:

• Conducted on

  Date
• Location
  Address

1. Section C - Major

• Reviewed by workers, signed (TCSR)

  Yes

  No

  N/A

• Follows Work: Applicable

  Yes

  No

  N/A

• Updated: being followed

  Yes

  No

  N/A

• Hot Work Requirements Met: issued

  Yes

  No

  N/A

• 100% tie off in use

  Yes

  No

  N/A

• Leading Edges: Identified, protected

  Yes

  No

  N/A

• Floor openings: permit issued, followed

  Yes

  No

  N/A

• Excavation over 5ft; sloped, benched, shored

  Yes

  No

  N/A

• Energy Sources: Identified, isolated, locked out

  Yes

  No

  N/A

• Crane Operator Certified: Card checked

  Yes

  No

  N/A

• Confined space air quality tested

  Yes

  No

  N/A

• Choose the appropriate answer

• ARE ALL ABOVE ITEMS IN "YES"?

  Yes

  No

  N/A

2. Section C1 - JSA

• Posted, easy access

  Yes

  No

  N/A

• Required documents on control board

  Yes

  No

  N/A

3. Section D - Environment / Site Conditions

• First Aid Kit: Stocked, Eye Wash, Accessible

  Yes

  No

  N/A

• Sanitation: Toilets clean, stocked (portables)

  Yes

  No

  N/A

• Noise: Below 85dba, protection used

  Yes

  No

  N/A

• Lighting: General, Task

  Yes

  No

  N/A

• Ventilation: Heat, Odors

  Yes

  No

  N/A

• Dust Control

  Yes

  No

  N/A

4. Section E - Personal Protective Equipment

• Stand: Hard hat, glasses, high vis clothing, boots

  Yes

  No

  N/A

• Other: Correct for area, task, department

  Yes

  No

  N/A

5. Section F - Fire Protection

• Extinguishers: Sized for task, inspected

  Yes

  No

  N/A

• Flammable Liquids: Controlled, stored properly

  Yes

  No

  N/A

6. Section G - Signs, Barricades

• Proper Barricades: Placement

  Yes

  No

  N/A

• Signs: Correct, posted, phone number, red, yellow

  Yes

  No

  N/A

7. Section H - Materials / Handling / Storage / SS

• Mat, Tools, Equipment: Stored properly, neatly stacked

  Yes

  No

  N/A

• Trip Hazards: Cords neatly run, areas clean

  Yes

  No

  N/A

• Liquids on floor: spill kit available

  Yes

  No

  N/A

• Rigging for mat handling correct, stored properly

  Yes

  No

  N/A

8. Section I - Tools: Hand and Power

• Condition: Handles on, cord not cut

  Yes

  No

  N/A

• Guarding: Used, adjusted correctly

  Yes

  No

  N/A

• Proper Usage: Correct tool for the job

  Yes

  No

  N/A

• Identification on gang boxes, tools, equipment

  Yes

  No

  N/A

9. Section J - Welding, Cutting, and Grinding

• Proper PPE: Non-flammable clothing

  Yes

  No

  N/A

• Shields, Barriers: Equipment, area protected

  Yes

  No

  N/A

• Gas Equipment: Proper storage, flash arrestors used

  Yes

  No

  N/A

10. Section K - Electrical

• GFCI Protection: tested

  Yes

  No

  N/A

• Extension Cords: Condition, Protected, Inspected

  Yes

  No

  N/A

11. Section L - Scaffolds

• No missing planking, bracing, guardrails

  Yes

  No

  N/A

• Inspected: Tagged, hazards noted

  Yes

  No

  N/A

• Falling Object Protection: Toe boards

  Yes

  No

  N/A

• Rolling Scaffolds: Wheels locked

  Yes

  No

  N/A

• Basket: Floor cleaned, materials loaded properly

  Yes

  No

  N/A

12. Section M - Fall Protection

• PFRS: Inspected, good condition, worn properly

  Yes

  No

  N/A

• Proper Anchorage: Clamps, Straps, Lines

  Yes

  No

  N/A

• Workers tied off in scissor lifts

  Yes

  No

  N/A

• Warning Lines: Used, proper distance

  Yes

  No

  N/A

• Roof work: Permitted, weather conditions

  Yes

  No

  N/A

13. Section O - Motor Vehicles / Mechanized Equipment

• Daily inspections, equipment identified

  Yes

  No

  N/A

• Safety Devices: Seat belts, lights, alarm

  Yes

  No

  N/A

• Operators: Certified, authorized, licensed

  Yes

  No

  N/A

• Forklift operated correctly

  Yes

  No

  N/A

14. Section P - Excavations

• Over 4 ft: Ladder access, every 25 ft.

  Yes

  No

  N/A

• Spoils: Back 3 ft.

  Yes

  No

  N/A

• Water Intrusion: Rain, seepage

  Yes

  No

  N/A

• Excavation Protected: Equipment, workers

  Yes

  No

  N/A

15. Section Q - Concrete and Masonry Construction

• Rebar / rods capped, protected

  Yes

  No

  N/A

• Masonry walls supported, limited access zone

  Yes

  No

  N/A

16. Section R - Steel Erection, Equipment Placement

• Area protected from overhead lifts

  Yes

  No

  N/A

• Site specific erection plan in place

  Yes

  No

  N/A

• Area will support equipment and load

  Yes

  No

  N/A

17. Section T - Demolition

• Engineer survey by Competent Person made

  Yes

  No

  N/A

• All Serv: Shut off, capped, disc, removed

  Yes

  No

  N/A

18. Section V - Power Transmission / Distribution / LO

• Sign In/Out Sheet: Used and correct

  Yes

  No

  N/A

• Group LO: Key box used / key inside

  Yes

  No

  N/A

• Locks: Labeled, contain required information

  Yes

  No

  N/A

• Arc Flash: Proper PPE, workers trained

  Yes

  No

  N/A

19. Section X - Ladders

• Secured: Used properly, right type for work

  Yes

  No

  N/A

• Non-Conductive: No metal side rails

  Yes

  No

  N/A

• Good Condition: rungs, rails, bracing

  Yes

  No

  N/A

20. Section Z - Toxic / Hazardous Substances

• Chemicals: Identified, labeled

  Yes

  No

  N/A

• Stored Properly: Correct containment

  Yes

  No

  N/A

• SDS Sheets: Available, correct

  Yes

  No

  N/A

• Proper PPE being used

  Yes

  No

  N/A

21. Section CC - Cranes and Derricks

• Crane Inspection: Certifications current

  Yes

  No

  N/A

• Rigging: Condition, inspected, rating tag

  Yes

  No

  N/A

• Rigger Qualified: Checked

  Yes

  No

  N/A

• Signal Person: Qualified, checked

  Yes

  No

  N/A

22. Section A1 - Confined Space

• Permit / Checklist Posted

  Yes

  No

  N/A

• Workers Trained / Rescue notified

  Yes

  No

  N/A

Completion

• Auditor

  Sign

• Audited Company

  Sign