FMB Jobsite Safety Audit

• Site conducted

  Select

• Jobsite Number/Name

• Conducted on

  Date

• Prepared by

• SITE CONDITIONS

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• Yes

  No

  N/A

• OSHA/EAP/CSP/HIPP POSTED?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• SAFETY MEETINGS - JHA'S - PRE-TASK COMPLETED & REVIEWED?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• FIRST AID KITS ACCESSIBLE? STOCKED?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• FIRE EXTINGUISHERS SIGNED OFF - CURRENT CERTIFICATIONS?

  Select Yes No N/A

  • Yes
  • No
  • N/A

PPE - EYE/HEAD/FACE/HEARING/HAND/FOOT PROTECTION

• WEARING REQUIRED PPE FOR TASK?

  Select Yes No N/A

  • Yes
  • No
  • N/A

TOOLS

• TOOLS - EMPLOYEES USING HAND & POWER TOOLS PROPERLY

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• TOOLS - STORED PROPERLY

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

SIGNS & BARRICADES

• TESTING - PLUMBING (WET/DRY) SIGNAGE COMPLETED & IN PLACE?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• PLUMBING (WET/DRY) TEST AREA SAFED OFF?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• TESTING - HVAC SIGNAGE COMPLETED & IN PLACE?

  Select Yes No N/A

  • Yes
  • No
  • N/A

EQUIPMENT

• FMB FORKLIFT USE? CHECKLISTS SIGNED OFF?

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• FMB SCISSOR/BOOM LIFT USE? CHECKLISTS SIGNED OFF?

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• FMB HI-JACKS INSPECTED? USED/STORED PROPERLY?

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• CRANE ACTIVITY

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• OTHER TRADES HEAVY EQUIPMENT

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

ELECTRICAL

• GFCI

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• FMB CORDS/PLUGS/CAPS IN GOOD CONDITION

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• FMB LOTO

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• OTHER TRADE LOTO

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• FMB GANG BOXES HAVE GROMMETS IN PLACE

  Select Yes No N/A

  • Yes
  • No
  • N/A

TRENCHES/EXCAVATIONS

• FMB ACCESS - EGRESS -CONFINED SPACE - CAVE-IN - FALL PROTECTION - BARRICADES

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• FMB DAILY TRENCH INSPECTION CHECKLIST COMPLETED

  Select Yes No N/A

  • Yes
  • No
  • N/A

• OTHER TRADE TRENCHING IN PROGRESS

  Select Yes No N/A

  • Yes
  • No
  • N/A

CONFINED SPACE

• CONFINED SPACE PERMIT ENTRY CHECKLISTS COMPLETED

  Select Yes No N/A

  • Yes
  • No
  • N/A

• PROPER PPE IN PLACE

  Select Yes No N/A

  • Yes
  • No
  • N/A

FALL PROTECTION

• GUARDRAILS - FLOOR OPENINGS - LEADING EDGE

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• PFAS REQUIRED?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• FALL PLAN-RESCUE PLAN IN PLACE

  Select Yes No N/A

  • Yes
  • No
  • N/A

WALKING/WORKING SURFACES

• FMB taking proper steps to minimize exposure to silica

  Select Yes No N/A

  • Yes
  • No
  • N/A

• SLIP - TRIP - FALL HAZARDS?

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• RAMPS - STAIRWAYS - ACCESS

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• OPEN HOLES - COVERED - SECURED - MARKED

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

LADDERS

• SET-UP & USED PROPERLY

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• LABELS INTACT & LEGIBLE

  Select Yes No N/A

  • Yes
  • No
  • N/A

• LADDER CONDITION

  Select Good Poor N/A

  • Good
  • Poor
  • N/A

SCAFFOLDS

• SAFE TO USE?

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

HOUSEKEEPING/SANITATION

• PROPER DISPOSAL OF WASTE

  Select Yes No N/A

  • Yes
  • No
  • N/A

• PORTABLE TOILETS - DRINKING WATER ADEQUATE?

  Select Yes No N/A

  • Yes
  • No
  • N/A

MATERIAL STORAGE

• MATERIALS STORED PROPERLY?

  Select Yes No N/A

  • Yes
  • No
  • N/A

HOT WORK

• PERMIT - COMPLETED & CURRENT?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• COMPRESSED GAS USED & STORED PROPERLY?

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

• OTHER FLAMMABLES USED & STORED PROPERLY? SIGNAGE AND FIRE EXTINGUISHER IN PLACE?

  Select Safe At Risk N/A

  • Safe
  • At Risk
  • N/A

TRAINING

• TRAINING CONDUCTED?

  Select Yes No N/A

  • Yes
  • No
  • N/A

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