ELDECO

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Conducted On

• Select date

  Date

Personal Protective Equipment

• Head Protection

  Safe

  At Risk

  N/A

• Eye and Face Protection

  Safe

  At Risk

  N/A

• Hand Protection

  Safe

  At Risk

  N/A

• Foot Protection

  Safe

  At Risk

  N/A

• Hi-Vis Clothing

  Safe

  At Risk

  N/A

• Hearing Protection

  Safe

  At Risk

  N/A

Body Position

• Help for Heavy Items

  Safe

  At Risk

  N/A

• Hand Position/ Pinch Points

  Safe

  At Risk

  N/A

• Overhead Hazards

  Safe

  At Risk

  N/A

• Line of Fire

  Safe

  At Risk

  N/A

• Body Mechanics

  Safe

  At Risk

  N/A

Housekeeping

• Trash and Debris

  Safe

  At Risk

  N/A

• Cords off the Floor or Overhead

  Safe

  At Risk

  N/A

• Walkways kept clear

  Safe

  At Risk

  N/A

• Correct Barricades

  Safe

  At Risk

  N/A

Tool Use

• Correct Tool

  Safe

  At Risk

  N/A

• Used Correctly

  Safe

  At Risk

  N/A

• Guards in Place

  Safe

  At Risk

  N/A

• GFCI Used

  Safe

  At Risk

  N/A

• In Good Condition

  Safe

  At Risk

  N/A

• Properly inspected

  Safe

  At Risk

  N/A

Job Planning

• STA complete for task

  Safe

  At Risk

  N/A

• Hazards Defined

  Safe

  At Risk

  N/A

• Safe Plan Defined

  Safe

  At Risk

  N/A

• All team members signed

  Safe

  At Risk

  N/A

• Familiar with Hazards

  Safe

  At Risk

  N/A

Lifting Equipment

• In good condition

  Safe

  At Risk

  N/A

• Properly Trained

  Safe

  At Risk

  N/A

• Properly Used

  Safe

  At Risk

  N/A

Fall Protection

• Slip and trip hazards

  Safe

  At Risk

  N/A

• Holes Covered

  Safe

  At Risk

  N/A

• Ladder Used Correctly

  Safe

  At Risk

  N/A

• Fall Protection Equipment Sufficient

  Safe

  At Risk

  N/A

• Anchorage capable of supporting 5000lbs

  Safe

  At Risk

  N/A

• In good condition and properly inspected

  Safe

  At Risk

  N/A

• Stored properly

  Safe

  At Risk

  N/A

Electrical

• Proper locks and tags in place

  Safe

  At Risk

  N/A

• Proper permit for energized work

  Safe

  At Risk

  N/A

• Properly Trained

  Safe

  At Risk

  N/A

• Temporary Power Properly Installed

  Safe

  At Risk

  N/A

• Proper Documentation in place for temporary power

  Safe

  At Risk

  N/A

Hazardous Substances

• Properly Labeled

  Safe

  At Risk

  N/A

• Stored Properly

  Safe

  At Risk

  N/A

• Proper Fire Protection

  Safe

  At Risk

  N/A

• Proper Documentation

  Safe

  At Risk

  N/A

Additional Comments

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  Media