Information
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Audit Title
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Client / Site
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Week Of
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Date of Report
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Prepared by
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Prepared for
Project Safety Update
Safety Statistics:
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Project man-hours to date
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Lost Time Rate (LT)
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Days Away / Restricted Time (DART) Rate
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Total Recordable Incident (TRIR) Rate
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Number of days worked without a recordable accident
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Number of days worked without a DART
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Number of employees through site specific safety orientation
ESP Follow Up
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Incentive Program Update
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Safety Suggestions Received
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Safety Committee Update
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General Project Safety Update
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Picture
Safety observations and corrections
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Safety Observations
Observed Hazards & Corrections
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Observed Hazard
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Corrective Action
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Contractor Responsible
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Signature