• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Environmental Safety

  • OSHA or general safety standards violations

  • Permits not posted or maintained

  • Contractors found without proper ID

  • 5 day notification for shutdown request not sent to ESEM

Life Safety

  • Interim life safety measure requirements met

  • Fire extinguisher/heat detector logs submitted to ESEM monthly

  • Design items for 80% punch list complete

  • Construction items for 80% punch list complete

  • Evidence of smoking

  • General life safety issues


  • Contractors attend Epi/Safety meeting for planning

  • Epi guidelines met (e.g., negative air machines on, manometers in place and logged, etc.)

  • Corridor dust and tacky mat managed

  • Barriers maintained or notification submitted to ESEM for barrier change

  • Contractors working outside of barriers

  • General epidemiology issues

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