Encore Electric Executive Audit - Caught in Hazards

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Caught in Hazards

• Are guards in place on tools and equipment?

  Yes

  No

  N/A

• Add media

  Media

• Do pathways have clear access and egress?

  Yes

  No

  N/A

• Add media

  Media

• Will confined spaces be entered? (If the answer is yes complete confined space permit in heath and safety manual.)

  Yes

  No

  N/A

• Add media

  Media

• Will there be excavation work on site?

  Yes

  No

  N/A

• Add media

  Media

Signatures

• Person performing the Audit

  Sign

• Site Supervisor

  Sign