Information

  • Audit Number

  • Project Name

  • Project Number

  • Conducted on

  • Prepared by

  • Location

SUPERINTENDENTS NAME

PERSONAL PROTECTIVE EQUIPMENT

  • Hard Hats (with bills forward)

  • Safety Glasses Appropriate for Conditions (tinted or clear)

  • Reflective Vests (when required) and/or High Visibility Shirts

  • Hard Toed Work Boots

  • Gloves (if required)

  • Hearing Protection (if required)

  • Face Shields (if required)

HOUSEKEEPING

  • General Site Storage and Housekeeping

  • Trash Cans in Work Area

  • Storage / Conex

  • Safe Walkways or Passages

TEMPORARY BARRICADES

  • Proper tape used (red for danger and yellow for caution if required)

  • All sides of work area barricaded and labeled (if required)

LADDERS AND ELEVATED WORK

  • Extension ladders tied off

  • Extension ladders extended 3' above leading edge

  • Damaged ladders tagged Out-of-Service

  • Step ladders fully open and locked

  • Employees 100% tied off when working over 6'

  • Fall protection in place at the leading edge greater than 6' (i.e. handrails and warning lines)

FALL PROTECTION

  • Harness and lanyards used correctly

  • Harness and lanyards inspected prior to use

  • Employees anchored off correctly

MOBILE EQUIPMENT

  • Operating at a safe speed (both travel and swing)

  • Operating at a safe distance from ground personnel

  • Inspected and documented prior to each shift

  • Seatbelts used

  • Operators trained

  • Backup alarms working

  • Spotters used when needed

  • Equipment maintained without leaks

  • Safety guards and covers in place

HOISTING AND RIGGING EQUIPMENT

  • Annual crane inspection placard in place

  • Daily crane inspection performed and documented

  • Operators manual in cab

  • Swing radius protection in place

  • Workers staying clear of suspended loads

  • Rigging inspected prior to each use

  • Proper rigging and techniques used

  • Rigging properly stored

  • Qualified rigger/signal person being used

  • Knowledge of crane signals

  • Proper use of tag lines

EXCAVATION

  • Daily excavations inspected and documented by a competent person

  • Means of entering/exiting for excavations deeper than 4' when is use

  • Excavations deeper than 4' posted as Confined Space

  • Daily air quality checked for excavations deeper than 4’ when is use

  • Cave-In protection for excavations deeper that 5' when is use

  • Excavation protected from unauthorized personnel (handrails/barricades)

  • Equipment staged at a safe distance from the edge

  • Spoils and materials at least 2' from leading edge

COMPRESSES GAS CYLINDERS

  • Stored upright and succored

  • Oxygen and acetylene stored at least 20 feet apart when not in use

  • Hard caps in place when not in use and/or during transport

CONCRETE OPERATIONS

  • Concrete pump and hoses in good condition and used properly

  • Slick lines and hoses properly clamped with safety wire and whip checks

  • Concrete washed from skin in a timely manner

  • Employees involved where concrete dust is present, have been trained in Silica Awareness

CONFINED SPACE

  • Are confined spaces identified and posted

  • Permit required spaces controlled by permit and attendant (when in use)

  • All confined spaces inspected and documented

  • All confined spaces air quality checked and documented (when in use)

  • Are open spaces, such as manholes protected from pedestrians and vehicular traffic

PREWORK

  • Weekly Toolbox Talks are performed and documented

  • Daily JHA's communicated to all employees and documented

  • SDS for all chemicals on the project are available upon request

  • Supervisors are aware of local first-aid and hospital facilities

  • All required jobsite work permits (i.e. hot work permits, excavation permits) obtained

  • Underground locates are in place and current

  • Employee training records are available for work being performed

REPRIMANDS OR WARNINGS

  • We're any safety violations issued?

  • We're any verbals warnings or directives given?

  • Was any Stop Work order issued?

COMMENTS

  • Add media

AUDIT PERFORMED BY:

  • Add signature

AUDITORS TITLE

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.