DACON DASHIELL AUDIT

• Document No.

• To: Department Head

• Job Number

• Client / Location

• Task Description

• Conducted on

  Date

• Prepared by

• Location
  Address

• Supervisor/Foreman

Paperwork

• Emergency Plan In Place

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Safety Manual (On Site)

  YES

  Immediately Corrected

  Correction Needed

  N/a

• JSTA (Job Safety Task Analysis In Place/Signed by all)

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Job Briefing/Tailboard

  YES

  Immediately Corrected

  Correction Needed

  N/a

Personal Protective Equipment

• Hard Hats

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Eye Protection (All Levels)

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Welding Helmet

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Respiratory Protection

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Proper Work Clothing

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Proper Foot Wear<br>

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Proper Hand Protection

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Hearing Protection

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Other

  YES

  Immediately Corrected

  Correction Needed

  N/a

Lockout/Tag Out

• Required For The Task

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Properly Installed/Effective Isolation

  YES

  Immediately Corrected

  Correction Needed

  N/a

Energized Electrical Work

• Is Line/Equip. De-Energized/Grounded

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Energized Work Permit Required

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Gloves/Sleeves-Dielectrically Tested

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Used As Required @ > or = 50 Volts

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Rubber Blankets Or Dielectric Cover

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Exposed Energized Parts Covered

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Rubber Goods Properly Stored

  YES

  Immediately Corrected

  Correction Needed

  N/a

Haz/Flammable Material

• Proper Storage

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Properly Labeled

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Plan/SDS Available

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Used Properly & Safely

  YES

  Immediately Corrected

  Correction Needed

  N/a

Welding

• Proper Welding/Cutting Equipment

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Fire Extinguisher Available

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Gas Cylinders Properly Stored

  YES

  Immediately Corrected

  Correction Needed

  N/a

Fall Protection

• Harness & Lanyard (Inspected/In Use)

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Proper Tie Off Used

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Other Fall Protection Components

  YES

  Immediately Corrected

  Correction Needed

  N/a

Ladders/Scaffolds

• In Safe Working Condition

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Used Properly (Tied Off)

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Inspected/Tagged/Color Coded

  YES

  Immediately Corrected

  Correction Needed

  N/a

Worksite Conditions

• Barricades/Hole Covers

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Housekeeping Adequate

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Fire Extinguishers Inspected

  YES

  Immediately Corrected

  Correction Needed

  N/a

Temporary Power

• Temp. Panels (Adequate)

  YES

  Immediately Corrected

  Correction Needed

  N/a

• GFCI's (Installed & Tested)

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Cords Inspected/Color Coded

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Temp. Lighting (Adequate)

  YES

  Immediately Corrected

  Correction Needed

  N/a

Excavations

• Competent Person Available

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Checklist (In Use/Correct)

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Shored or Sloped Properly

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Access Ladders Within 25'

  YES

  Immediately Corrected

  Correction Needed

  N/a

Confined Spaces

• Permit Required/Posted

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Rescue Available

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Monitor/Blower In Use

  YES

  Immediately Corrected

  Correction Needed

  N/a

Hoisting/Rigging & Cranes

• Equipment Inspected

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Critical Lift Checklist Used

  YES

  Immediately Corrected

  Correction Needed

  N/a

Tools (Observed)

• Safe Working Condition

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Proper Storage

  YES

  Immediately Corrected

  Correction Needed

  N/a

Protective Grounds

• Inspected/Test Date Current

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Installed Properly (Equal Potential In Use)

  YES

  Immediately Corrected

  Correction Needed

  N/a

Vehicles/Eqiupment

• Inspected (In Safe Condition)

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Operator Authorized/Qualified

  YES

  Immediately Corrected

  Correction Needed

  N/a

Miscellaneous (Job Site)

• First Aid/BBP Kit Avail.

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Eyewash Available

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Is Drinking Water Fresh

  YES

  Immediately Corrected

  Correction Needed

  N/a

• Supervisor/Foreman

  Sign

• Auditor

  Sign