Information
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
1.0 - Working at Heights
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1.1 - Fall risks of 6 feet or more? (including voids, pits, and trenches)
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1.2 - Lack of edge protection?
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1.3 - Unsafe or incomplete edge protection?
2.0 - Tools and Equipment
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2.1 - Unsafe or damaged tools or equipment? (including missing or damaged guards)
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2.2 - Incorrect tools or equipment for job? (e.g. grinding discs for cutting)
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2.3 - Unsafe or incompatible attachments used with tools or equipment?
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2.4 - Unlicensed operators?
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2.5 - Lack of safe work instructions?
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2.6 - Lack of training in safe operation, clean-up and maintenance?
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2.7 - Lack of LOTO procedures for cleaning, servicing and maintenance?
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2.8 - Lack of daily inspection?
3.0 - Scaffolds
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3.1 - Unlicensed persons erecting scaffold above 12 feet?
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3.2 - Unsafe or incomplete scaffold?
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3.3 - Lack of daily scaffold inspection?
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3.4 - Incompatible scaffold components?
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3.5 - Safe Work Load (SWL) exceeded? (tools, stored materials, number of persons)
4.0 - Lifting Equipment
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4.1 - Unsafe lifting practices?
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4.2 - Loads lifted over persons, close proximity to obstacles incl. overhead power lines?
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4.3 - Lack of maintenance, testing and inspection?
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4.4 - Lack of Safety Work Load information displayed?
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4.5 - Lack of daily inspection protocol?
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4.6 - Unsafe or damaged lifting equipment, including ropes, slings, chains, hooks?
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4.7 - Lifting equipment unlabeled or missing manufactures tag?
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4.8 - Unlicensed operators?
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4.9 - Lack of LOTO procedures for cleaning, servicing and maintenance?
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4.10 - Safe Word Load of lifting equipment exceeded?
5.0 - Harness and Equipment
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5.1 - Unsafe or damaged harness or equipment?
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5.2 - Incompatible hooks/equipment?
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5.3 - Unlabeled or damaged?
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5.4 - Unsafe or uncertified anchor points?
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5.5 - Lack of inspection protocol for equipment?
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5.6 - Lack of or inadequate formal training for operators?
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5.7 - Lack of or improper use of fall prevention body harness?
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5.8 - Lack of proper prevention devices? (Retractable or Double legged 6 foot lanyards?
6.0 - Ladders
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6.1 - Unsafe or damaged ladders?
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6.2 - Unsafe positioning of ladders?
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6.3 - Ladder not properly secured?
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6.4 - Ladder unsuitable for job? (e.g. metal ladder used for electrical work)
7.0 - Hazardous Manual Tasks
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7.1 - Lack of identification hazardous manual tasks?
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7.2 - Lack of assessment of hazardous manual tasks?
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7.3 - Inadequate risk controls? (examples: no job rotation, lighter loads, trolleys, lifting equipment, etc)
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7.4 - Lack of training in risk controls and safe lifting/ team lifting techniques?
8.0 - Hazardous Chemical (including fuel and oil)
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8.1 - Unsafe storage location? (e.g. flammables near ignition sources, spills could enter stormwater drains, etc)
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8.2 - Incompatible chemicals stored near each other?
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8.3 - Inadequate spill containment equipment?
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8.4 - Safety Data Sheets not accessible on site?
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8.5 - Lack of emergency procedures for injury/spills/fire etc?
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8.6 - Excessive quantities stored on site or in vehicles?
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8.7 - Insufficient ventilation?
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8.8 - Insufficient, or incorrect, PPE?
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8.9 - Unsuitable storage containers? (unlabeled or stored in food containers)
9.0 - Emergency Response
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9.1 - Lack of, or no emergency plans for site?
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9.2 - Emergency procedures not displayed at site?
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9.3 - Lack of training and rehearsal of emergency plans?
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9.4 - Lack of, or inadequate first aid kits aid equipment for site?
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9.5 - Insufficient access to formally trained First Aiders for all shifts?
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9.6 - Unsuitable or inadequate communication equipment?
10.0 - Traffic Management
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10.1 - Lack of, or inadequate, Traffic Management Plan (TMP) in place?
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10.2 - Lack of training in TMP for all persons on site? <br>(contractors and visitors)
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10.3 - Inadequate controls for TMP? (physical barriers, bollards, speed limits, flashing lights, spotters, etc)
11.0 - Personal Protective Equipment (PPE)
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11.1 - Lack of, or inadequate PPE
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11.2 - Lack of system to issue, inspect, replace and monitor PPE?
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11.3 - Lack of training in safe use, clean-up and inspection of PPE?
12.0 - Work Environment
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12.1 - Lack of/or inadequate amenities? (toilets, wash areas, lunch rooms, etc)
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12.2 - Insufficient lighting?
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12.3 - Inadequate housekeeping?
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12.4 - Lack of, or inadequate noise/ vibration control?
13.0 - Electrical Hazards
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13.1 - Unsafe electrical leads? (damaged, out of test date or untested)
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13.2 - Lack of GFCI protection?
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13.3 - Contact with underground assets?
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13.4 - Contact with overhead electrical lines?
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13.5 - Overloading outlets?
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13.6 - Leads placed on ground or on metal structures?
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13.7 - Electrical equipment near water?
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13.8 - Electrical equipment near flammables?
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13.9 - Electrical equipment near chemicals that could cause damage?
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13.10 - Electrical leads that may be damaged from contact with moving machinery parts?
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13.11- Electrical leads on work surfaces?
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13.12 - Lack of Lock-out/tag-out (LOTO) procedures for electrical equipment?
14.0 - Environmental Hazards
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14.1 - Lack of/or inadequate Environmental Management plan (EMP)?
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14.2 - Lack of/or inadequate, dust suppression system?
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14.3 - Lack of/or inadequate systems to prevent contaminants entering stormwater drains?
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14.4 - Lack of current Safety Data Sheet for chemical and materials on site?<br>
15.0 - Administrative Procedures
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15.1 - Lack of/or inadequate Site Safety Plan?
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15.2 - Failure to obtain permits before work began(Work,Hot Work, Excavation, Confined Space, Lifting, etc.)
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15.3 - Lack of, or inadequate, induction for workers, contractors, visitors?
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15.4 - Lack or, or inadequate, supervisory arrangements?
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15.5 - Lack of/or inadequate training, licenses, skills, experience?
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15.6 - Lack of, or inadequate system to review SWMS as needed?
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15.7 - Lack of/or inadequate incident notification procedures?
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15.8 - Lack of, or inadequate, routine inspections, monitoring, audits?
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15.9 - Lack of/or inadequate consultative arrangements?
Corrective Actions
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Enter any corrective actions that will be undertaken
Sign Off
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On site representative
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Auditor's signature
