CRS Safety Audit 3

• Document No.

• CRS -Safety Audit

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Vehicle Safety

• Seatbelt worn?

  Safe

  At Risk

  N/A

• Vehicle kept neat and orderly?

  Safe

  At Risk

  N/A

• Vehicle in good condition?

  Safe

  At Risk

  N/A

Ladder Safety

• 3-Point (ascending & descending )

  Safe

  At Risk

  N/A

• Appropriate ladder used for the job/task at hand?

  Safe

  At Risk

  N/A

• Eyes on hand/task?

  Safe

  At Risk

  N/A

• Belt buckle remains between uprights?

  Safe

  At Risk

  N/A

• Extension ladders: <br>- hooks over wire when appropriate?<br>- correct angle?<br>-tied off? <br>- 3' above level when accessing higher level e.g. Roof,<br>- Ladder tied off?

  Safe

  At Risk

  N/A

• Pinch points?

  Safe

  At Risk

  N/A

Body use/Position

• Pushing/Pulling

  Safe

  At Risk

  N/A

• Lifting/Lowering

  Safe

  At Risk

  N/A

• Twisting

  Safe

  At Risk

  N/A

• Over exertion /Cramped

  Safe

  At Risk

  N/A

• Repetitive Motion

  Safe

  At Risk

  N/A

Procedures

• Standard/Adequate?

  Yes

  No

  N/A

• Standard/Followed?

  Yes

  No

  N/A

• Permits?

  Yes

  No

  N/A

• Not known/ not understood?

  Safe

  At Risk

  N/A

• Safety absolutes adhered?

  Yes

  No

  N/A

Tools and Equipments

• Tool selection used

  Safe

  At Risk

  N/A

• Right tool /Equipment

  Yes

  No

  N/A

• Equipment Condition

  Safe

  At Risk

  N/A

• Mobile equipment use /spotter used?

  Safe

  At Risk

  N/A

• Tool/equipment Inspection

  Safe

  At Risk

  N/A

PPE

• Head

  Yes

  No

  N/A

• Eyes and Face

  Safe

  At Risk

  N/A

• Hearing

  Safe

  At Risk

  N/A

• Respiratory

  Safe

  At Risk

  N/A

• Body

  Safe

  At Risk

  N/A

Behaviors Observations

• Safe behaviors observed - Actions taken to encourage safe behavior

  Safe

  At Risk

  N/A

• Unsafe behaviors observed - Actions taken to correct & prevent reoccurrence

  Safe

  At Risk

  N/A

Contractor Safety

• Unsafe Act or Condition Presented by General Contractor?

  Safe

  At Risk

  N/A

• Unsafe Act or Condition Presented by Sub?

  Safe

  At Risk

  N/A

• Unsafe Condition noted at Job-site?

  Safe

  At Risk

  N/A