Envirotrol - Field Level Job Site Audit

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Personal Protective Equipment

• Arc Flash Protection Required

  Yes

  No

• Cut Resistant Gloves Required

  Yes

  No

• Eye / Face Protection Required

  Yes

  No

• Face Mask Required

  Yes

  No

• Fall Protection Required

  Yes

  No

• Hard Hat Required

  Yes

  No

• Hearing Protection Required

  Yes

  No

Body Positioning

• Proper Body Mechanics when Lifting, Reaching, Pulling, Pushing or Carrying Risks

  Yes

  No

• Please describe the hazard

• Attach picture here

  Media

• Proper Footing Conditions

  Yes

  No

• Please describe hazard and attach picture if able

• Attach picture here

  Media

• Safe Ladder Work Environment

  Yes

  No

• Please describe hazard and attach picture if able

• Attach picture here

  Media

• Pinch Points, Sharp Edges, Hot Surfaces Risks (If Hazards Exist)

  Yes

  No

• Please describe hazard and attach picture if able

• Attach picture here

  Media

Work Environment

• Clear Path to Emergency Equipment (Fire Extinguisher, First Aid Kit, etc.)

  Yes

  No

• Please describe the lack of access in regards to where your work area is located

• Need for Warning Cones, Barriers, Barricades, etc

  Yes

  No

• Please attach a picture of the unsafe condition

  Media

• Adequate Working Space - (Tight, Open, etc.)

  Yes

  No

• Please attach picture of the work area

  Media

• Congested Work Area - (More than one trade in the area?)

  Yes

  No

• Please attach a picture of the work area

  Media

• Materials are Properly Staged / Stored

  Yes

  No

• Please attach a picture of the unsafe condition

  Media

• Adequate Lighting

  Yes

  No

• Work Area Clean and Free from Slip or Trip Hazards at the time of inspection

  Yes

  No

• Please attach a picture of the unsafe condition

  Media

• Electrical Cords Protected (Ran Overhead, or taped to the floor?)

  Yes

  No

• Please attach a picture of the unsafe condition

  Media

• Weather Conditions safe for work

  Yes

  No

• Please describe the weather conditions and how it impacts your planned work

Tools / Equipment Use

• Proper Tools / Equipment On Hand for task

  Yes

  No

• What tools or equipment are you missing in order to safely completely this task?

• Lock Out / Tag Out Required

  Yes

  No

• * Are extension cords in proper working order? (Ground Prong, Cord Condition, etc.)

  Yes

  No

Inspector's Signature

• Please sign below

  Sign