Eire Safety Services Inc.

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Hdd

General

• Weekly tool box talk available for review?

  Yes

  No

  N/A

• Weekly safety inspection available for review?

  Yes

  No

  N/A

• Daily JSA forms for each crew available for review?

  Yes

  No

  N/A

• Drinking water and cups available?

  Yes

  No

  N/A

• Adequate temporary lighting in work areas?

  Yes

  No

  N/A

• First aid kit stocked?

  Yes

  No

  N/A

Housekeeping

• Adequate number of toilets available and clean?

  Yes

  No

  N/A

• Projecting nails or screws bent over or removed?

  Yes

  No

  N/A

• Walkways and passages clear to walk?

  Yes

  No

  N/A

• Rebar ends protected by caps or 2x4?

  Yes

  No

  N/A

Personal Protective Equipment

• Employees wearing safety glasses at all times?

  Yes

  No

  N/A

• Employees wearing hard hats?

  Yes

  No

  N/A

• Employees wearing gloves when exposed to cut/chemical hazards?

  Yes

  No

  N/A

• Hearing / Respiratory Protection worn by employees when required?

  Yes

  No

  N/A

Electrical

• GFCI protection in use on all temporary power sources?

  Yes

  No

  N/A

• Electrical panels and devices labeled and secured?

  Yes

  No

  N/A

• Extension cords in good condition?

  Yes

  No

  N/A

Hand and Power Tools

• Power Tools free from damage (switches, cords, and guards)?

  Yes

  No

  N/A

• Hand tools free from damage ( shaft, head, splinters, etc.)?

  Yes

  No

  N/A

• PAT operator have training card available for review.

  Yes

  No

  N/A

Excavations

• Have utilities been located and protected?

  Yes

  No

  N/A

• Adequately sloped or shored if below 5' in depth?

  Yes

  No

  N/A

• Means of egress every 25 feet?

  Yes

  No

  N/A

• Spoil pile and equipment back at least 2 feet from edge?

  Yes

  No

  N/A

• Water being pumped out if present?

  Yes

  No

  N/A

• Documented daily inspection available for review?

  Yes

  No

  N/A

Fall Protection

• Employees using anchor capable of supporting 5,000 lbs?

  Yes

  No

  N/A

• Elevated work levels have guardrails or cables at 21" and 42"?

  Yes

  No

  N/A

• Employees working above 6 feet using fall protection?

  Yes

  No

  N/A

• All holes covered and labeled?

  Yes

  No

  N/A

Fire Protection

• Only NFPA approved containers used for fuel?

  Yes

  No

  N/A

• Flammable materials removed from job site properly?

  Yes

  No

  N/A

• Adequate number of fire extinguishers in place?

  Yes

  No

  N/A

Ladders

• Do extension or job built ladders extend 36 inches above laning?

  Yes

  No

  N/A

• Are spreader bars locked on step ladders?

  Yes

  No

  N/A

Powered Industrial Equipment

• All equipment have ROPS installed?

  Yes

  No

  N/A

• Back up alarm working on on equipment?

  Yes

  No

  N/A

• Operator wearing seatbelt?

  Yes

  No

  N/A

• Operator have training card available (forklift)?

  Yes

  No

  N/A

• Employees wearing fall protection when using aerial lift?

  Yes

  No

  N/A

Cranes

• Does crane have annual inspection available for review?

  Yes

  No

  N/A

• Does operator have training card available for review?

  Yes

  No

  N/A

• Does operator have daily/weekly inspection available for review?

  Yes

  No

  N/A

• Is swing radius of crane barricaded?

  Yes

  No

  N/A

• Are outriggers in use (if equipped and needed)?

  Yes

  No

  N/A

Scaffolding

• Mudsill, base plate, and Screwjack in place?

  Yes

  No

  N/A

• Guardrails, Midrails and Toeboards installed?

  Yes

  No

  N/A

• Ladder access provided for employees on all working levels?

  Yes

  No

  N/A

• Rolling scaffold wheels locked?

  Yes

  No

  N/A

Hot Work

• Fire extinguisher available and inspected?

  Yes

  No

  N/A

• Flashback arresters in place on torch heads?

  Yes

  No

  N/A

• Gas cylinders separated when not in use?

  Yes

  No

  N/A

Review

• Superintendent signature

  Sign

• Safety Director signature

  Sign