Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

DTA & JHA Review

  • Daily Toolbox Talk / Job Hazard Analysis completed Properly?

  • Daily Equipment Inspection Checklist completed?

  • Safety Manual & MSDS on site?

  • Job specific paperwork available (AHA and/or SSJHA)?

  • Federal, Ethics and EEO Statement Posted?

  • Emergency numbers and facilities identified?

  • Proper First Aid Kit on site?

  • Fresh drinking water available on site?

Personal Protective Equipment (PPE)

  • Employee(s) dressed properly for work (shirts w/ 4" sleeves, long pants, and safety-toe work boots)?

  • Safety Glasses?

  • Hardhats

  • Gloves?

  • High Visibility Clothing and/or Reflective Vest?

  • All suppliers and sub contractors involved with HJ Foundation are in compliance w/ PPE requirements?

Heavy Equipment

  • Qualified Operator(s)?

  • Machine Type:

  • Operator's Manual in Equipment?

  • E-Stop(s) Operational?

  • Swing Alarm Operational?

  • Back-Up Alarm Operational?

  • Mirrors and Windows in good condition?

  • Tracks Clean?

  • Mechanical deficiencies reported on daily equipment inspection checklist?

Work Area Set-Up

  • Shade Tent set-up?

  • Iron Work Area Ground Leveled?

  • Iron Work Area Safe? (No Overhead Hazards, Ground Obstacles, Obstructions)

  • Brief Description

Steel Materials Delivery

  • Using 2 Spotters to direct delivery truck and prevent unauthorized personnel entrance of delivery area?

  • Rigging Properly Tagged and Inspected?

  • Shackles?

  • Nylon Straps?

  • Chains?

Steel Cage Assembly

  • Proper Lifting Techniques Being Used?

  • Type of Lifting:

  • Iron Rack Stands Being Used?

  • Dywidag Nuts OR Couplers Installed At Ends Of Iron Rack Cross Bars?

  • Are Cages Stacked LESS Than 5 Feet?

Weather

  • Weather Application Installed on Superintendent/Foreman Phone?

  • Shelter Available for safe hiding from inclement weather? Grounded Conex, Mobile Office, or Personal Vehicle?

Company Vehicle

  • Company Truck is reasonably clean?

  • Company Truck is well organized?

  • Back-Up Alarm OR Camera Operational?

  • Which Device:

  • Mirrors, Seat Belts, & Windows in good condition?

  • Mechanical deficiencies reported?

Signatures

  • Superintendent

  • Inspector

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.