Daily Job Task Audit

• Job Task:

• Supervisor
  Address

• Conducted on

  Date

• Prepared by

• Location
  Address

• Contractors/ Sub-Contractors Involved

JHA

• Is the JHA/JSA readily available?

  Yes

  No

  N/A

• Is the JHA/JSA pre-task section completely filled out?

  Yes

  No

  N/A

• Critical jobs steps identified?

  Yes

  No

  N/A

• How many workers are signed onto the JHA/JSA?

PPE

• Basic site PPE being used by all employees?

  Yes

  No

  N/A

• Task specific PPE being used? (Ear Plugs, Ear Muffs, Cut Sleeves, Leather Gloves, Face Shield, FR Clothing, Rubber Insulated Gloves)

  Yes

  No

  N/A

Equipment (UTV, Heavy Equipment, Generators,

• All equipment inspected prior to use and documented?

  Yes

  No

  N/A

• Equipment clean and free of debris?

  Yes

  No

  N/A

• Spotters being used if needed? (spotters are required in congested areas or where a operators view is limited/restricted)

  Yes

  No

  N/A

Tools and Electrical Cords

• Correct tools being used to complete job task?

  Yes

  No

  N/A

• Tools inspected prior to use for any defects?

  Yes

  No

  N/A

• Have electrical cords been inspected for damage and taken out of service if needed?

  Yes

  No

  N/A

Excavation/ Trench

• Working in or around a open trench/excavation?

  Yes

  No

  N/A

• Depth of trench/ excavation?

• Trench inspection completed?

  Yes

  No

  N/A

• Egress and Aggress every 25'?

  Yes

  No

  N/A

Fall Protection

• Employees working at or over 4’ above the ground or next lower level?

  Yes

  No

  N/A

• If needed has fall protection been inspected for damage prior to use? (Safety Harness, Safety Lanyard, Anchor Points)

  Yes

  No

  N/A

• Correct ladder selected, inspected and, used? (A-frame, extension ladder, trench ladder, step ladder)

Housekeeping and Restrooms

• Restroom clean?

  Yes

  No

  N/A

• Hand wash station and trash can with restroom?

  Yes

  No

  N/A

• Are restrooms within 1/4 mile or a 5 minute walk?

  Yes

  No

  N/A

• Is the Restroom to worker ratio correct? (15 people : 1 restroom * if a female is on the crew a female restroom is REQUIRED and doesn't count for the overall ratio)

  Yes

  No

  N/A

Unsafe Acts or Conditions

• Please list all unsafe acts and conditions found in work area

Picture of crew working (**NO FACES IN PHOTOS UNLESS GIVEN PRIOR CONSENT BY PERSONNEL**)

• Please take a picture of crew working safely or unsafely

  Media