Elliot Job Safety Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Task

• Add media

  Media

Job Breifing

• Is it documented

  Yes

  No

  N/A

• Adequate Job Briefing Conducted before job?<br>

  Yes

  No

  N/A

Work Area Protection

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  Media

• Appropriate Work Signs?

  Yes

  No

  N/A

• Flag Person Required?

  Yes

  No

  N/A

• Flag Person Used?

  Yes

  No

  N/A

• Flag Person Properly Equipped?

  Yes

  No

  N/A

• Traffic Cones in Place?

  Yes

  No

  N/A

• Traffic Control Manual?

  Yes

  No

  N/A

PPE Being Used

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  Media

• Hardhat

  Yes

  No

  N/A

• Safety Glasses

  Yes

  No

  N/A

• Safety Toed Work Boots

  Yes

  No

  N/A

• Properly Rated Rubber Gloves

  Yes

  No

  N/A

• Properly Rated Rubber Sleeves

  Yes

  No

  N/A

• Arc Rated Clothing

  Yes

  No

  N/A

• Fall Protection

  Yes

  No

  N/A

• Work Gloves

  Yes

  No

  N/A

• Additional Eye/Face Protection

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

Rubber Goods Tested

• Gloves

  Yes

  No

  N/A

• Sleeves

  Yes

  No

  N/A

• Line Hoses

  Yes

  No

  N/A

• Blankets

  Yes

  No

  N/A

Vehicles / Equipment

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  Media

• Seat Belts

  Yes

  No

  N/A

• Auger Roll-Up

  Yes

  No

  N/A

• Have Grounds

  Yes

  No

  N/A

• Properly Grounded

  Yes

  No

  N/A

• Chocked

  Yes

  No

  N/A

• Safe Working Order

  Yes

  No

  N/A

• Housekeeping Satifactory

  Yes

  No

  N/A

• Fire Ext. / First Aid Kits

  Yes

  No

  N/A

• Safety Latch on Hook

  Yes

  No

  N/A

• Driver Log - Up to Date

  Yes

  No

  N/A

• FMCSR Book in Truck

  Yes

  No

  N/A

• Owner's Manual Present

  Yes

  No

  N/A

• Pre-Trip/Post-Trip Inspection

  Yes

  No

  N/A

• CDL License / Class / Med Card

  Yes

  No

  N/A

Energized Lines

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  Media

• Are Necessary Lines and Equipment Covered?

  Yes

  No

  N/A

• Approach Distance Followed

  Yes

  No

  N/A

De-Energized Lines

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  Media

• Tested (Voltage Detector)

  Yes

  No

  N/A

• Grounded

  Yes

  No

  N/A

• Grounded with Live Line Tool

  Yes

  No

  N/A

• Grounded in Proper Order

  Yes

  No

  N/A

• Tags Installed

  Yes

  No

  N/A

General

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  Media

• Work Procedures Satisfactory

  Yes

  No

  N/A

• Housekeeping of Job Site

  Yes

  No

  N/A

Training

• CPR / First Aid Trained

  Yes

  No

  N/A

• Workers Qualified for Task Assignment

  Yes

  No

  N/A

BEYOND COMPLIANCE

• Team Work

  Yes

  No

  N/A

• Effective Communication

  Yes

  No

  N/A

• Leadership

  Yes

  No

  N/A

• Actively Caring

  Yes

  No

  N/A

• Attitude/Behavior

  Yes

  No

  N/A

• Commitment

  Yes

  No

  N/A

SIGN

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  Sign