Corporate Safety Services

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1. General

• 1.1 Did company representative accompany inspector?

  Yes

  No

  N/A

• 1.2 Are all Safety/HazCom/Emergency Programs on site?

  Yes

  No

  N/A

• 1.3 Are OSHA posters/emergency numbers posted?

  Yes

  No

  N/A

• 1.4 Are confined space hazards identified & addressed?

  Yes

  No

  N/A

• 1.5 Are safety meetings held/documented?

  Yes

  No

  N/A

• 1.6 Are first aid kits available & properly stocked?

  Yes

  No

  N/A

• 1.7 Are fire extinguishers available/charged/inspected?

  Yes

  No

  N/A

• 1.8 Are all rebar/pipe & other impalement hazards capped/protected?

  Yes

  No

  N/A

• 1.9 Are gas cylinders properly used & stored?

  Yes

  No

  N/A

• 1.10 Is material storage proper?

  Yes

  No

  N/A

• 1.11 Is housekeeping and sanitation proper & enforced?

  Yes

  No

  N/A

• 1.12 Are flammable materials in approved containers & properly labeled?

  Yes

  No

  N/A

• 1.13 Are all hand/power tools properly used/maintained/stored?

  Yes

  No

  N/A

• 1.14 Are all operations performed at least 10 feet from overhead power lines?

  Yes

  No

  N/A

• 1.15 Are competent flagmen properly dressed, trained & posted?

  Yes

  No

  N/A

• 1.16 Are barricades/traffic control through & around site proper?

  Yes

  No

  N/A

• 1.17 Are access/egress locations with a change in elevation >19 inches provided with stairs, ladders or ramp?

  Yes

  No

  N/A

2. Equipment

• 2.1 Are parts/equipment free from damage?

  Yes

  No

  N/A

• 2.2 Are all guards in place & working properly?

  Yes

  No

  N/A

• 2.3 Is all equipment properly maintained & inspected?

  Yes

  No

  N/A

• 2.4 Do backup alarms work?

  Yes

  No

  N/A

• 2.5 Are equipment operators properly trained?

  Yes

  No

  N/A

• 2.6 Are seatbelts operative & used?

  Yes

  No

  N/A

• 2.7 Are aerial/scissors lifts properly used?

  Yes

  No

  N/A

• 2.8 Are forks on the ground when parked?

  Yes

  No

  N/A

• 2.9 Is the forklift operator in the seat with a raised load?

  Yes

  No

  N/A

3. Personal Protective Equipment

• 3.1 Is all PPE provided by the employer?

  Yes

  No

  N/A

• 3.2 Is respiratory protection proper?

  Yes

  No

  N/A

• 3.3 Is hearing protection used & proper?

  Yes

  No

  N/A

• 3.4 Is proper foot protection worn?

  Yes

  No

  N/A

• 3.5 Is proper head protection worn?

  Yes

  No

  N/A

• 3.6 Is proper eye protection worn?

  Yes

  No

  N/A

• 3.7 Is hand protection/clothing proper?

  Yes

  No

  N/A

• 3.8 Is PPE hazard assessment complete & on file?

  Yes

  No

  N/A

• 3.9 Is Appendix D on file for voluntary respirator use?

  Yes

  No

  N/A

4. Electrical

• 4.1 Are GFCI's or AEG Program in use?

  Yes

  No

  N/A

• 4.2 Is temporary lighting used & proper?

  Yes

  No

  N/A

• 4.3 Are Lockout/Tagout procedures in place & used?

  Yes

  No

  N/A

• 4.4 Are temporary cords properly used & maintained?

  Yes

  No

  N/A

• 4.5 Do all boxes/panels have covers & are all circuits labeled?

  Yes

  No

  N/A

• 4.6 Are arc flash hazards identified & addressed?

  Yes

  No

  N/A

• 4.7 Are generators over 5kv properly grounded?

  Yes

  No

  N/A

5. Fall Protection

• 5.1 Are fall protection plans required & in place?

  Yes

  No

  N/A

• 5.2 Is fall protection provided at heights over 6 feet?

  Yes

  No

  N/A

• 5.3 Is fall protection equipment inspected & maintained?

  Yes

  No

  N/A

• 5.4 Are stairways properly protected & used?

  Yes

  No

  N/A

• 5.5 Are ladders properly used & maintained?

  Yes

  No

  N/A

• 5.6 Are all floors holes properly covered or protected?

  Yes

  No

  N/A

• 5.7 Is the roofer's warning line system/roof monitor system proper?

  Yes

  No

  N/A

6. Steel Erection/Cranes

• 6.1 Is site access/layout/storage area proper?

  Yes

  No

  N/A

• 6.2 Has GC provided all written documents for erection process to begin?

  Yes

  No

  N/A

• 6.3 Is a Steel Erection Plan required & in place?

  Yes

  No

  N/A

• 6.4 Is crane setup proper?

  Yes

  No

  N/A

• 6.5 Is crane properly maintained/copy of annual inspection available?

  Yes

  No

  N/A

• 6.6 Is rigging hardware inspected daily?

  Yes

  No

  N/A

• 6.7 Are loads properly rigged/carried?

  Yes

  No

  N/A

• 6.8 Are areas under swinging loads properly barricaded & enforced?

  Yes

  No

  N/A

• 6.9 Are rigger & signalperson trained/qualified?

  Yes

  No

  N/A

• 6.10 Are steel erection procedures proper?

  Yes

  No

  N/A

• 6.11 Are 2-bolt connections/4 bolt column anchor requirements followed?

  Yes

  No

  N/A

• 6.12 Are connector requirements in compliance?

  Yes

  No

  N/A

• 6.13 Does Controlled Decking Zone meet standards.

  Yes

  No

  N/A

• 6.14 Are employees using fall protection above 15 feet?

  Yes

  No

  N/A

• 6.15 Are oxygen & acetylene bottles properly used & stored?

  Yes

  No

  N/A

• 6.16 Is a Hot Work Permit completed & posted when required?

  Yes

  No

  N/A

• 6.17 Is perimeter safety cable properly installed & used?

  Yes

  No

  N/A

7. Masonry/Scaffolding

• 7.1 Is scaffold competent person on site?

  Yes

  No

  N/A

• 7.2 Are all scaffold users properly trained?

  Yes

  No

  N/A

• 7.3 Are scaffold erection/disassembly procedures proper?

  Yes

  No

  N/A

• 7.4 Is fall protection provided for erectors/dismantlers?

  Yes

  No

  N/A

• 7.5 Are baseplates/mud sills stable & proper?

  Yes

  No

  N/A

• 7.6 Are all scaffold frames pinned together?

  Yes

  No

  N/A

• 7.7 Is scaffold tied to structure using stiffbacks?

  Yes

  No

  N/A

• 7.8 Are scaffold frames/planks/parts free of damage & defects?

  Yes

  No

  N/A

• 7.9 Are walk/work planks properly installed & set?

  Yes

  No

  N/A

• 7.10 Are guardrails properly installed & used?

  Yes

  No

  N/A

• 7.11 Are toe boards/warning line properly installed & used?

  Yes

  No

  N/A

• 7.12 Is scaffold access proper?

  Yes

  No

  N/A

• 7.13 Are masonry walls properly braced?

  Yes

  No

  N/A

• 7.14 Is the Limited Access Zone set & enforced?

  Yes

  No

  N/A

• 7.15 Are mixer operations proper?

  Yes

  No

  N/A

• 7.16 Is wet-cutting or respiratory protection in place?

  Yes

  No

  N/A

8. Trenching/Excavating

• 8.1 Is the trench competent person on site?

  Yes

  No

  N/A

• 8.2 Is the trench/excavation inspected daily?

  Yes

  No

  N/A

• 8.3 Has a proper soils analysis been conducted?

  Yes

  No

  N/A

• 8.4 What is the soil type?

  Type A

  Type B

  Type C

  Stable rock

• 8.5 Is employee protection proper for soil type & depth?

  Yes

  No

  N/A

• 8.6 What type of employee protection is in place?

  Sloping

  Benching

  Trenchbox

  Shoring

  None

• 8.7 Is safe access/egress provided?

  Yes

  No

  N/A

• 8.8 Are water removal procedures proper?

  Yes

  No

  N/A

• 8.9 Has the trench been evaluated as a confined space?

  Yes

  No

  N/A

9. Summary

• The overall rating for this audit is?

  Outstanding-no deficiencies

  Satisfactory-minor issues

  Unsatisfactory-major issues

• Comments

• Supervisor signature

  Sign