Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Hdd

General

  • Weekly tool box talk available for review?

  • Weekly safety inspection available for review?

  • Daily JSA forms for each crew available for review?

  • Drinking water and cups available?

  • Adequate temporary lighting in work areas?

  • First aid kit stocked?

Housekeeping

  • Adequate number of toilets available and clean?

  • Projecting nails or screws bent over or removed?

  • Walkways and passages clear to walk?

  • Rebar ends protected by caps or 2x4?

Personal Protective Equipment

  • Employees wearing safety glasses at all times?

  • Employees wearing hard hats?

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

  • Hearing / Respiratory Protection worn by employees when required?

Electrical

  • GFCI protection in use on all temporary power sources?

  • Electrical panels and devices labeled and secured?

  • Extension cords in good condition?

Hand and Power Tools

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

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

  • PAT operator have training card available for review.

Excavations

  • Have utilities been located and protected?

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

  • Means of egress every 25 feet?

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

  • Water being pumped out if present?

  • Documented daily inspection available for review?

Fall Protection

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

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

  • Employees working above 6 feet using fall protection?

  • All holes covered and labeled?

Fire Protection

  • Only NFPA approved containers used for fuel?

  • Flammable materials removed from job site properly?

  • Adequate number of fire extinguishers in place?

Ladders

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

  • Are spreader bars locked on step ladders?

Powered Industrial Equipment

  • All equipment have ROPS installed?

  • Back up alarm working on on equipment?

  • Operator wearing seatbelt?

  • Operator have training card available (forklift)?

  • Employees wearing fall protection when using aerial lift?

Cranes

  • Does crane have annual inspection available for review?

  • Does operator have training card available for review?

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

  • Is swing radius of crane barricaded?

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

Scaffolding

  • Mudsill, base plate, and Screwjack in place?

  • Guardrails, Midrails and Toeboards installed?

  • Ladder access provided for employees on all working levels?

  • Rolling scaffold wheels locked?

Hot Work

  • Fire extinguisher available and inspected?

  • Flashback arresters in place on torch heads?

  • Gas cylinders separated when not in use?

Review

  • Superintendent signature

  • Safety Director 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.