Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Paper Work and Qualifications

  • 1 JSA Completed/Meaning Full Conversation

  • 2 Proper Permit Completed

  • 3 Meet & Greet Procedures/EAP

  • 4 Gang Truck Inspection/ Rig Cab Inspection

  • 5 Pre-Job Safety Meeting

  • 6 Designated Smoking Area

  • 7 Training Documentation

  • 8 Operators Trained & Certified

  • 9 Drivers License

  • 10 First Aid/CPR certified

Standard Job Safety

  • 11 Minimum PPE Worn

  • 12 H2S Monitor/Gas Monitor

  • 13 First Aid Kits & Inspection

  • 14 Fire Extinguisher & Inspection

  • 15 Adverse Weather Conditions

  • 16 Fall Protection

  • 17 Hearing Protection @ 85 dec.

  • 18 House Keeping

  • 19 Ladder Use and Condition

  • 20 Proper Tools for the Job

  • 21 Tools In Good Condition

Specific Job Task Safety

  • 22 Energy Isolation/ LOTO

  • 23 Traffic Control

  • 24 Guards on Equipment

  • 25 Tongs, Slips, Dies in Good Condition

  • 26 Back Up Slings on Tongs(length, tag, condition)

  • 27 All guard rails & Toe Guards

  • 28 Static/Ground

  • 29 Derrick/Out Rigger

  • 30 BOP Equipment (size, bolts, tests; function/pressure)

  • 31 Work Floor Platform Stairs

  • 32 Equipment Clean and in Order

  • 33 SRL/Harness/Lanyards

  • 34 Proper Lifting Techniques (mechanical means/buddy system, flex the knees

  • 35 Slings Shackles & Rigging

  • 36 Rig Stickers

  • 37 Power LIne Avoidance

  • Auditor Signature

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.