Information

  • Audit Title/Job Name

  • Job No.

  • Conducted on

  • Prepared by

  • Location
  • Superintendent

  • Project Manager

  • Inspected With

1. Personal Protective Equipment

  • 1.1 Safety glasses and/or goggles available & used

  • 1.2 High visibility vests/class II vests where required

  • 1.3 Face shield available for bulk liquid tasks or grinding

  • 1.4 Hand protection used/worn as required

  • 1.5 Foot protection worn where required

  • 1.6. Hard hats worn as required

2. Tools

  • 2.1 Portable circular saws equipped with protective guards<br>

  • 2.3 Pneumatic power tools have hoses secured

  • 2.4 Hand grinders have guards in place

  • 2.5 Table saws are properly guarded

  • 2.6 Electric power tools are double insulated or grounded

  • 2.7 Compressed gas cylinders not in use have caps in place

  • 2.8 Compressed gas cylinders stored secured & upright

3. Electrical

  • 3.1 Energized breaker panels have covers & breakers are labeled

  • 3.2 Cords are protected from damage such as vehicles

  • 3.3 Electrical panel knockouts are in place

  • Lockout tagout procedures are being followed

  • Light bulbs for illumination protected from breakage and have bulbs provided

4. Fire Protection

  • 4.1 Flammable liquids are in metal safety cans

  • 4.2 Burn permits are completed and at the location of hot work operations

  • 4.3 Fire extinguisher readily available, accessible & inspected

  • 4.4 Fire extinguishers inspected monthly/annually as needed

  • 4.5 Flammable liquids storage containers labeled properly

  • 4.6 Combustible material and waste is removed from the building on a regular basis

5. Cranes and Forklifts

  • 5.1 Mobile crane setup properly

  • 5.2 Overhead hazards/power lines indentified

  • 5.3 Tag lines are used during hoisting

  • 5.4 Rigging is inspected for ware and damage

  • 5.5 Forklift and Crane inspections completed

  • 5.6 Forklift, Crane, Rigger and signal person training current

6. General Safety Issues

  • 6.1 Required postings are posted on bulletin board

  • 6.2. Subcontractor safety plans and MSDS are on site

  • 6.3. General housekeeping is neat and orderly - cord management - off to one side of walkway or off the floor<br>

  • 6.4 Exit and pathways are free from material and debris

  • 6.5 Exits are clearly marked

  • 6.6. Public hazards evaluated

7. Fall Protection

  • 7.1 Wall openings & floor holes are guarded or covered

  • 7.2 Guardrails (top rails at 42" +/- 3" and mid rail halfway between) and toe boards in place

  • 7.3 Cable guardrails are taught with minimal deflection

  • 7.4 Warning lines are set back from edge at least 15'

  • 7.5 Fall body harness & lanyard used when employees are exposed a fall hazard

  • 7.6 100% fall protection in place above 4'

  • 7.7 Rebar protection in place for protruding rebar and form stakes

8. Excavations

  • 8.1 Protection from cave-ins for >4' deep

  • 8.2 Ladders in place every 25' and extended 3' above ground

  • 8.3 Trench boxes are less than 2' off the trench floor

  • 8.4 Standing water has been removed from the trench

  • 8.5 Fall protection around the trench is in place

  • 8.6 Soil spoils are greater than 2' from the excavation

  • 8.7 Trench is inspected daily and as needed

9. Scaffold / Aerial lifts

  • 9.1 Work platforms are fully planked

  • 9.2 Ladders are provided on scaffolds

  • 9.3 Guardrails and toe boards which meet requirements are in place when over 6'

  • 9.4 Base plates are in place

  • 9.5 Scaffolds are set up on firm footing

  • 9.6. Tied to structure at 4:1 base ratio and at the following 26'

  • 9.7 Scaffolds are plumb and square

  • Aerial lifts used properly

  • Aerial lift operator trained

10. Ladders, Stairs, and Ramps

  • 10.1 Ladders are safe and inspected as appropriate

  • 10.2 Extension & straight ladders extend 3' beyond landing

  • 10.3 Step ladders are only used in the open position

  • 10.4 Stair rail are provided when change in elevation is greater that 30" or there are 4 risers or more

  • 10.5 Stair or ladder is provided for access points > 19" high

  • 10.6 Ramps used for access are at least 18" wide

  • Audit conclusions and items still needing attention

  • Add media

  • FORMA Superintendent

  • FORMA Safety Representative

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.