Electri-Tech Services

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Housekeeping

• Are Stairways and walkways clear?

  Yes

  No

  N/A

• Is material storage neat?

  Yes

  No

  N/A

• If applicable, do you have caution signs around the area you are working?

  Yes

  No

  N/A

• Debris & garbage cleared?

  Yes

  No

  N/A

• Are extension cords free of walkways, and are not causing tripping hazards?

  Yes

  No

  N/A

Building Emergency Procedures

• Are exits clearly marked?

  Yes

  No

  N/A

• Are they obstructed or blocked?

  Yes

  No

  N/A

Worker Training

• Do you have your training cards on you?

  Yes

  No

  N/A

• Are the training cards up to date?

  Yes

  No

  N/A

PPE

• Are employees wearing a hard hat?

  Yes

  No

  N/A

• Are employees wearing appropriate safety footwear?

  Yes

  No

  N/A

• Are employees wearing safety glasses?

  Yes

  No

  N/A

• Are employees wearing the right glove for the job?

  Yes

  No

  N/A

• Are employees wearing a Hi-Vis vest?

  Yes

  No

  N/A

First Aid Kits / D.P. Postings

• Is there a first aid kit on site?

  Yes

  No

  N/A

• Are there any expired items in the kit?

  Yes

  No

  N/A

Lock Out Tag Out

• Are you working on live electrical equipment?

  Yes

  No

  N/A

• Is the equipment being worked on locked out?

  Yes

  No

  N/A

• Is your tag attached to the lock with your contact information visible?

  Yes

  No

  N/A

Arc Flash

• Are you wearing the appropriate arc flash gear for the job being performed?

  Yes

  No

  N/A

• Is Arc Flash gear up to date and in good condition?

  Yes

  No

  N/A

Fall Protection

• Is Fall Protection properly worn?

  Yes

  No

  N/A

• Is harness in good working condition?

  Yes

  No

  N/A

• Is fall protection being used at heights of 6' and greater?

  Yes

  No

  N/A

• Has the fall protection been inspected?

  Yes

  No

  N/A

Ladders

• Proper size and type?

  Yes

  No

  N/A

• Ladder on level ground and free of debris?

  Yes

  No

  N/A

• Equipped with non-slip bases?

  Yes

  No

  N/A

• Proper angle if working on extension ladders?

  Yes

  No

  N/A

Scaffold

• Scaffold in good condition?

  Yes

  No

  N/A

• Guard rails in place?

  Yes

  No

  N/A

• Scaffold is level and plumb?

  Yes

  No

  N/A

• Secured in place to prevent movement?

  Yes

  No

  N/A

Lift

• Has the employee been trained to operate a lift and have a training card on their person?

  Yes

  No

  N/A

• Has a daily lift inspection checklist been filled out?

  Yes

  No

  N/A

• Is the area safe to be operating a lift? (uneven surfaces, leading edges, debris)

  Yes

  No

  N/A

Hand and Power Tools

• Have they been inspected?

  Yes

  No

  N/A

• Is the right tool for the job being used?

  Yes

  No

  N/A

• Is the tool being used properly?

  Yes

  No

  N/A

• Are the guards in place?

  Yes

  No

  N/A

• If a Port-a-band is being used is a tripod in place?

  Yes

  No

  N/A

Extension cords

• Are cords in good condition?

  Yes

  No

  N/A

• Any damage to cord ends? (No ground pin, broken ends)

  Yes

  No

  N/A

Confined Spaces

• Proper Access?

  Yes

  No

  N/A

• Air testing completed before entry?

  Yes

  No

  N/A

• Safety harness, lifeline in place?

  Yes

  No

  N/A

• Man watch/ hole watch?

  Yes

  No

  N/A

• Do you have an entry permit?

  Yes

  No

  N/A

• Do you personal air monitoring with you in the confined space?

  Yes

  No

  N/A

Fire Protection

• Does this job require a hot work permit?

  Yes

  No

  N/A

• Is there a fire extinguisher nearby?

  Yes

  No

  N/A

• Has the monthly inspection been conducted and documented?

  Yes

  No

  N/A

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