Electrical Consultants, Inc.

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Select date

  Date

PPE

• Hard Hat

  Safe

  At Risk

  N/A

• Safety Glasses

  Safe

  At Risk

  N/A

• Safety Toed Boots

  Safe

  At Risk

  N/A

• Hearing Protection

  Safe

  At Risk

  N/A

• FR Clothing

  Safe

  At Risk

  N/A

• Gloves

  Safe

  At Risk

  N/A

Manual Lifting

• Correct body position

  Yes

  No

  N/A

• Help for heavy items

  Yes

  No

  N/A

• Hand placement

  Yes

  No

  N/A

• Weight known

  Yes

  No

  N/A

• Use of Equipment

  Yes

  No

  N/A

Line of Fire

• Hand / Body Position

  Yes

  No

  N/A

• Overhead Hazards

  Yes

  No

  N/A

• Rotating Equipment

  Yes

  No

  N/A

• Pinch / Shard Edges Identified and Protected

  Yes

  No

  N/A

Housekeeping

• Trash / Debris

  Yes

  No

  N/A

• Cord / Lead Control

  Yes

  No

  N/A

• Protruding Items

  Yes

  No

  N/A

• Correct Barricades

  Yes

  No

  N/A

Fall Protection

• Trip Hazard

  Yes

  No

  N/A

• Daily Inspection

  Yes

  No

  N/A

• Fall Arrest Equipment Used

  Yes

  No

  N/A

• Protected at 6 feet / 4 Feet California

  Yes

  No

  N/A

• Correct Ladder Use

  Yes

  No

  N/A

Tool Use

• Correct Tool

  Yes

  No

  N/A

• Used Correctly

  Yes

  No

  N/A

• Material Secured

  Yes

  No

  N/A

• Guards in Place

  Yes

  No

  N/A

• GFCI Used

  Yes

  No

  N/A

Equipment / Vehicle Use

• Seat Belt Use

  Yes

  No

  N/A

• Inspection

  Yes

  No

  N/A

• Equipment Used Properly

  Yes

  No

  N/A

• Backing

  Yes

  No

  N/A

Adjacent Work

• Equipment Start Up

  Yes

  No

  N/A

• Vehicle Traffic

  Yes

  No

  N/A

• Work Scope Known

  Yes

  No

  N/A

• Excavations

  Yes

  No

  N/A

• Crane / Hoist Use

  Yes

  No

  N/A

Procedures

• Lockout / Tagout

  Yes

  No

  N/A

• Confined Space

  Yes

  No

  N/A

• Other Procedure

  Safe

  At Risk

  N/A

Other

• Yes

  No

  N/A

• Yes

  No

  N/A

Job Hazard Analysis

• Hazards Identified

  Safe

  At Risk

  N/A

• Daily Tailboard Meeting Complete

  Yes

  No

  N/A

• PPE Last Hazard Control

  Yes

  No

  N/A