Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Project #

Location

Vehicle/Equipment #

Date

Vehicle

  • Drivers Log (if required)

  • D.V.I.R Log

  • Windshield Wipers

  • Horn

  • Tires

  • Mirrors

  • Seat Belts OK & Worn

  • Parking Brake

  • Lights

  • Body Components

  • Seat Belts Worn

Trenching, Excavation, Shoring

  • Competent Person Trench Inspection

  • Trenches > 4' Shored or Benched

  • Means of Access and Egress

  • Spoil Piles Back 3'

  • Underground Facilities Marked

  • CGI On Site

  • Locate Request Copies on Jobsite

Tools/Equipment

  • Safety Guards in Place

  • Operators Trained

  • Seat Belts Used (while operating equipment)

  • Housekeeping

  • Safety Cans Used For Gasoline

  • Fire Extinguishers Available, Inspected, Tagged, and Employees Trained to Use

Health & Enviromental

  • Certified First Aid/CPR Person

  • Drinking Water & Cups Available

Personal Protective Equipment

  • Hard Hat

  • Safety Glasses

  • Safety Vest

  • First Aid Kit Stocked

General

  • Job Briefing Completed

  • Competent Person at Site

  • Traffic Control/Signs

  • AED I inspection

  • Housekeeping

  • Add media

  • Add signature

  • Add signature

  • Add media

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.