DSM06 Fall Protection and Rigging Audit

• Document No.

• Audit Title

• Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Guard Rails [FP]

• Top Rail @ 42"

  Safe

  At Risk

  N/A

• Mid Rail @ 21"

  Safe

  At Risk

  N/A

• Max 3" deflection

  Safe

  At Risk

  N/A

• Will withstand 200 lbs of force

  Safe

  At Risk

  N/A

• Toe boards

  Safe

  At Risk

  N/A

• Wire rope flagged

  Safe

  At Risk

  N/A

Vertical Lifelines [FP]

• Free from Knots

  Safe

  At Risk

  N/A

• Independently secured to anchor

  Safe

  At Risk

  N/A

• Anchor to support 5000 pounds

  Safe

  At Risk

  N/A

• line and rope grab inspected daily

  Safe

  At Risk

  N/A

• Has rating been verified

  Safe

  At Risk

  N/A

• One worker per lifeline

  Safe

  At Risk

  N/A

• Abrasion protection for Lifeline

  Safe

  At Risk

  N/A

Tie off [FP]

• Mandatory tie off at 6' or above

  Safe

  At Risk

  N/A

• No one ties off to handrails

  Safe

  At Risk

  N/A

• Equipment approved and inspected

  Safe

  At Risk

  N/A

• "D" ring between shoulder blades

  Safe

  At Risk

  N/A

• Leg straps intact

  Safe

  At Risk

  N/A

• Free fall no greater than 6'

  Safe

  At Risk

  N/A

• Lanyard inspected

  Safe

  At Risk

  N/A

• Rescue plan in place

  Safe

  At Risk

  N/A

Self retractable lanyard [FP]

• Inspected daily

  Safe

  At Risk

  N/A

Holes/ openings [FP]

• Cover secured

  Safe

  At Risk

  N/A

• Will support 2x intended load

  Safe

  At Risk

  N/A

• Minimum 3/4" plywood or guard rail

  Safe

  At Risk

  N/A

• Are covers color coded or marked

  Safe

  At Risk

  N/A

• Handrail at opening more than 2 x 2

  Safe

  At Risk

  N/A

• Barricade use for sister lifts

  Safe

  At Risk

  N/A

Ladders [FP]

• Baselevel and free from debris

  Safe

  At Risk

  N/A

• No one stands on top 2 steps

  Safe

  At Risk

  N/A

• Ladder/stair/ramp elev break 19"

  Safe

  At Risk

  N/A

• Inspected by a competent person

  Safe

  At Risk

  N/A

• Non-conductive

  Safe

  At Risk

  N/A

• Slip resistant

  Safe

  At Risk

  N/A

• Job made ladders built properly

  Safe

  At Risk

  N/A

• Proper climbing angle

  Safe

  At Risk

  N/A

• Work facing ladder

  Safe

  At Risk

  N/A

Scaffolding [FP]

• Supervision of competent person

  Safe

  At Risk

  N/A

• Sill plates

  Safe

  At Risk

  N/A

• Cross bracing in place/Secure

  Safe

  At Risk

  N/A

• Guard rails in place

  Safe

  At Risk

  N/A

• Fully decked/scaffold grade plank

  Safe

  At Risk

  N/A

• Proper access

  Safe

  At Risk

  N/A

• Toeboard's on all open sides

  Safe

  At Risk

  N/A

• Not overloaded

  Safe

  At Risk

  N/A

• Canopy for public liability

  Yes

  No

  N/A

• Inspected and tagged daily

  Safe

  At Risk

  N/A

• Scaffold user training conducted

  Safe

  At Risk

  N/A

• Scaffold release on file

  Safe

  At Risk

  N/A

Concrete Work [FP]

• Impalement hazards covered

  Safe

  At Risk

  N/A

Steel Erection, Welding, Bolting, Metal Decking [FP]

• Head Clarence for multiple lift

  Safe

  At Risk

  N/A

• Tag lines in use

  Safe

  At Risk

  N/A

Steel

• Perimeter protection installed

  Safe

  At Risk

  N/A

• Leading-edge delineated 15' back

  Safe

  At Risk

  N/A

Rigging/ Hoisting Equipment [S]

• Nylon straps/ slings

  Safe

  At Risk

  N/A

• Nylon lanyard

  Safe

  At Risk

  N/A

• Fall harness

  Safe

  At Risk

  N/A

• Chain fall

  Safe

  At Risk

  N/A

• Chain/ shackles

  Safe

  At Risk

  N/A

• wire rope

  Safe

  At Risk

  N/A

• Spreader bars block/ tackle shackles and other rigging

  Safe

  At Risk

  N/A

• Duct lift inspected

  Safe

  At Risk

  N/A

• Pneumatic/ hydraulic lifting devices inspected/ safe

  Safe

  At Risk

  N/A

• Safety latches on on all hooks

  Safe

  At Risk

  N/A

• Roustabout inspected

  Safe

  At Risk

  N/A

• Loads are properly rigged and balanced

  Safe

  At Risk

  N/A

• Winches/ tuggers secured to the floor and guarded

  Safe

  At Risk

  N/A

• Loads rigged from forks only using stinger attachments

  Safe

  At Risk

  N/A