Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Paper Work and Qualifications

  • 1 JSA Completed/Meaning Full Conversation

  • 2 Proper Permit Completed

  • 3 Meet & Greet Procedures/EAP

  • 4 Pre-Job Safety Meeting

  • 5 Designated Smoking Area

  • 6 Training Documentation

  • 7 Operators Trained & Certified

  • 8 Drivers License

  • 9 First Aid/CPR certified

Standard Job Safety

  • 10 Minimum PPE Worn

  • 11 H2S Monitor/Gas Monitor

  • 12 First Aid Kits & Inspection

  • 13 Fire Extinguisher & Inspection

  • 14 Heat Illness Prevention

  • 15 Fall Protection

  • 16 Hearing Protection @ 85 dec.

  • 17 House Keeping

  • 18 Proper Tools for the Job

  • 19 Tools In Good Condition

Specific Job Task Safety

  • 20 Energy Isolation/ LOTO

  • 21 Traffic Control

  • 22 Proper Lifting Techniques (mechanical means/buddy system, flex the knees

  • 23 Power LIne Avoidance

Equipment Clean and in Order

  • 24 Guards on Equipment

  • 25 In Cab Inspection

  • 26 Truck Bed/Tool Box

  • Audited Signature

  • Auditor signature

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