EHS Inspection Form

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

EHS Program

• Required training completed

  Yes

  No

  N/A

• Risk Assessment Completed/FLRA Completed/Reviewed

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

PPE

• Eye Protection (sealed, close-fitting, face shield)

  Yes

  No

  N/A

• Foot Protection (met guards)

  Yes

  No

  N/A

• Hearing Protection (plugs, muff, both)

  Yes

  No

  N/A

• Hand Protection (proper glove for the task)

  Yes

  No

  N/A

• Respiratory Protection (1/2, full, supplied)

  Yes

  No

  N/A

• Fall Protection (harness, SRL, lanyard, 100% tie-off

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

General Facility/Site Conditions/Housekeeping

• Surface / Floor / Wall / Ceilings

  Yes

  No

  N/A

• Exits / Egress Routes Clear / Signage Posted

  Yes

  No

  N/A

• Stairways / Walkways / Ramps / Platforms

  Yes

  No

  N/A

• Driveways / Aisles

  Yes

  No

  N/A

• Warning Signs / Markings / Postings

  Yes

  No

  N/A

• General and Emergency Lighting

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Orderliness & Material / Chemical Storage

• Stacking And Storage

  Yes

  No

  N/A

• Organized / Not Congested / Stable

  Yes

  No

  N/A

• Containers Provided For Debris

  Yes

  No

  N/A

• Spill Containment and Response / Proper Resources

  Yes

  No

  N/A

• Proper Container in Use - Labelled

  Yes

  No

  N/A

• MSDS Available and Reviewed

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Fire Protection

• Fire Extinguishers Provided & Inspected

  Yes

  No

  N/A

• No Smoking - Flammable - Combustible Signs

  Yes

  No

  N/A

• Flammable / Combust Liquid / Material Storage

  Yes

  No

  N/A

• Welding & Cutting (Flash Arrestors)

  Yes

  No

  N/A

• Oxy - Fuel Cylinders Stored 25' Apart

  Yes

  No

  N/A

• Hot Work Permitted / Emergency Controls

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Fall Protection

• Underfoot Walking Working Surface Safe

  Yes

  No

  N/A

• Handrail Systems / Perimeter Guards

  Yes

  No

  N/A

• Scaffolding Properly Installed & Inspected

  Yes

  No

  N/A

• Ladder Condition, Setup, Tie Off & Use

  Yes

  No

  N/A

• Personnel Practicing 100% Tie Off

  Yes

  No

  N/A

• Wall Openings Guarded and Holes Covered

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Confined Space

• Permits Completed and Posted

  Yes

  No

  N/A

• Air Movement Systems in Place

  Yes

  No

  N/A

• Respiratory System Being Used

  Yes

  No

  N/A

• Supplied Air System Inspected and Signed Off

  Yes

  No

  N/A

• Confined Space Watch in Place

  Yes

  No

  N/A

Electrical

• Energy Isolation Program (LOTO)

  Yes

  No

  N/A

• GFCI in place and being used

  Yes

  No

  N/A

• Cords - Tools - Plugs Inspected & Colour-Coded

  Yes

  No

  N/A

• High Voltage Hazards Marked

  Yes

  No

  N/A

• Generators and Welders Grounded

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Equipment - Cranes, Loaders, Forklifts, Aerial Lifts & All Other Machines

• Daily Pre-Use Inspection Completed / Signed

  Yes

  No

  N/A

• Alarms, Horns, and Warning Lights Working

  Yes

  No

  N/A

• Guards in Place / Wheel Chalks

  Yes

  No

  N/A

• Overall Safe Operation Condition

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Tools, Equipment and Rigging

• Hand-Power Tools Free of Defects

  Yes

  No

  N/A

• Air Guns & Hoses Pinned / Check Valves

  Yes

  No

  N/A

• Slings, Chains, Rigging Inspected & Tagged

  Yes

  No

  N/A

• Saw-Horses / Cribbing

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A