Digco Gas Construction "Safety Dept." Audit

• Document No.

• Job Foreman

• Client:

• Conducted on

  Date

• Prepared by

• Location
  Address

Vehicle

• Is the crew at location?

  Yes

  No

  N/A

• Is there a Bore Rig onsite?

  Yes

  No

  N/A

• Bore Rig Truck Number

  Yes

  No

  N/A

• Bore Rig within Compliance of Safety while in use...... Grounded, etc?

  Yes

  No

  N/A

• Are the any damaged cables, fiber optic, pipelines or property damage in association with bore rig.

  Yes

  No

  N/A

• Does Bore Rig have any unsafe issues that need attention?

  Yes

  No

  N/A

• All welders on this within compliance of safety... Welding leads, cylinders, grinders, etc?

  Yes

  No

  N/A

• Digco Crew truck #

  Yes

  No

  N/A

• D.V.I.R. LOG completed?

  Yes

  No

  N/A

• Windshield Wipers

  Yes

  No

  N/A

• Horn working?

  Yes

  No

  N/A

• Are tire pressures/tread good? Trucks, trailers, equipment, etc?

  Yes

  No

  N/A

• Mirrors not broken?

  Yes

  No

  N/A

• Seat Belts ok & Worn?

  Yes

  No

  N/A

• Parking Brake working?

  Yes

  No

  N/A

• Are the truck/trailer Inspection tags updated within D.O.T. Compliance?

  Yes

  No

  N/A

• All lights working on trucks and trailers?

  Yes

  No

  N/A

• Seat belts being worn while riding or driving company vehicles?

  Yes

  No

  N/A

Trenching, Excavation, Shoring

• Competent Person at jobsite for trench inspection?

  Yes

  No

  N/A

• Trenches/Excavations - shored, sloped and spoil pile fenced correctly?

  Yes

  No

  N/A

• Means of access and egress? (Ladder, etc)

  Yes

  No

  N/A

• Underground facilities marked correctly?

  Yes

  No

  N/A

• CGI/O2 meter onsite? (Calibrated)

  Yes

  No

  N/A

• Locate request copies on jobsite, filled out and completed properly

  Yes

  No

  N/A

• All spoil piles back > 3" or better and inside fencing properly if needed?

  Yes

  No

  N/A

Tools /Equipment

• Are there any Heavy Equipment hazards present?

  Safe

  At Risk

  N/A

• Safety guards in place on all Hand and Power Tools? (Drills, Grinders, etc)

  Yes

  No

  N/A

• Operators trained properly on all heavy equipment?

  Yes

  No

  N/A

• Seat Belts being worn while operating all heavy equipment?

  Yes

  No

  N/A

• Does the Housekeeping look good on trucks and trailers?

  Yes

  No

  N/A

• Yes

  No

  N/A

• Proper metal cans being used safely for Gasoline/Diesel fuels?

  Yes

  No

  N/A

• Fire Extingushers available, inspected, tagged and employees trained to use?

  Yes

  No

  N/A

Health and Safety

• Certified First Aid/CPR person available on jobsite?

  Yes

  No

  N/A

• Drinking water and cups available and mounted properly on trucks?

  Yes

  No

  N/A

• Any Enviromental Hazards released I safely to the atmosphere?

  Yes

  No

  N/A

Personal Protective Equipment

• Hard Hat being worn while working?

  Yes

  No

  N/A

• Safety Glasses being worn while working?

  Yes

  No

  N/A

• Safety Vest/High Vis-Shirt being worn while working in and around jobsite?

  Yes

  No

  N/A

• First Aid kit fully stocked and usable?

  Yes

  No

  N/A

• Was employee wearing proper hearing protection if needed?

  Yes

  No

  N/A

• Was employee wearing proper foot protection when needed?

  Yes

  No

  N/A

• Was employee wearing proper hand protection if needed while working?

  Yes

  No

  N/A

General

• Job Briefing completed each morning before work starts?

  Yes

  No

  N/A

• JHA briefing completed properly and filled out?

  Yes

  No

  N/A

• Competent person at jobsite?

  Yes

  No

  N/A

• Traffic Control/Signs out in both directions for employee and public safety?

  Yes

  No

  N/A

• AED monthly inspection completed and signed?

  Yes

  No

  N/A

• Housekeeping in and around jobsite?

  Yes

  No

  N/A

• Does this Crew have a monthly eligibility for 95% completion drawing?

  Yes

  No

  N/A

• Comments

  Yes

  No

  N/A

Signatures

• Add signature

  Sign

• Add signature

  Sign