D&L Incorporated

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General Safety Audit

• This job site audit is to review general safety and includes ONLY the following points.

• JSA completed and signed?

  Yes

  No

  N/A

• JSA reviewed with all employees before beginning work?

  Yes

  No

  N/A

• Proper PPE identified and being used appropriately?

  Yes

  No

  N/A

• Emergency action plan?

  Yes

  No

  N/A

• Aerial or Scissor Lift being used correctly with Fall Protection being worn?

  Yes

  No

  N/A

• Welding and cutting?

  Yes

  No

  N/A

• Posting requirements ( signs, barricades, marking tape ) in place?

  Yes

  No

  N/A

• All required permits are acquired? ( Hot Work, Crane Interference, Confined Space )

  Yes

  No

  N/A

• Proper use of crane spotters, fire watch, and ground guides?

  Yes

  No

  N/A

• Ladder use?

  Yes

  No

  N/A

• Scaffolding?

  Yes

  No

  N/A

• Fall protection is in place? Correct use of harness, SRL, life line, etc...

  Yes

  No

  N/A

• LOTO - Procedures identified, reviewed, and followed?

  Yes

  No

  N/A

• General Housekeeping - Work site clean and free of waste and materials?

  Yes

  No

  N/A

• Electrical safety - GFCI being used?

  Yes

  No

  N/A

• Tools used correctly and all appropriate guards in place?

  Yes

  No

  N/A

• Findings and Corrective Actions:

• Auditor Signature

  Sign

• Supervisor Signature

  Sign