Information
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Audit Title/Job Name
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Job No.
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Conducted on
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Prepared by
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Location
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Superintendent
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Project Manager
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Inspected With
1. Personal Protective Equipment
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1.1 Safety glasses and/or goggles available & used as required
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1.2 High visibility vests/class II vests where required
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1.3 Face shield available for bulk liquid tasks or grinding
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1.4 Hand protection used/worn as required
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1.5 Proper footwear worn as required?
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1.6. Hard hats worn as required
2. Tools
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2.1 Circular/skill saws properly guarded<br>
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2.2 Hand grinders have guards in place
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2.3 Table saws are properly guarded (hood, spreader, anti-kickback)
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2.4 Compressed gas cylinders not in use have caps in place
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2.5 Compressed gas cylinders stored secured & upright
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2.6 Does Pneumatic equipment have a safety device on the muzzle?
3. Electrical
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3.1 Energized breaker panels have covers & breakers are labeled
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3.2 Electrical panel knockouts are in place
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3.3. Lockout tag/out procedures are being followed
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3.4 Light bulbs for illumination protected from breakage and have bulbs provided
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3.5 Electric power tools are double insulated or grounded
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3.6 Is strain relief provided on flexible cords and cables
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3.7 Do extension cords have ground pins
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3.8 Cords are protected from damage such as vehicles
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3.9 Are extension cords free from splices or damage to insulation
4. Fire Protection
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4.1 Flammable liquids are in metal safety cans
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4.2 Burn permits are completed and at the location of hot work operations
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4.3 Fire extinguisher readily available, accessible & inspected
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4.4 Fire extinguishers inspected monthly/annually as needed
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4.5 Flammable liquids storage containers labeled properly
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4.6 Combustible material and waste is removed from the building on a regular basis
5. Cranes and Forklifts
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5.1 Mobile crane setup properly
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5.2 Overhead hazards/power lines identified
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5.3 Tag lines are used during hoisting
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5.4 Rigging is inspected for wear and damage
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5.5 Forklift and Crane inspections completed
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5.6 Forklift, Crane, Rigger and signal person certification current
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5.7 Is the crane currently certified for the state of washington
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5.8 Has a qualified lift director been designated
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5.9 Are all parts of the crane, load line or load prevented from getting within 20 FT of power lines
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5.10 Load lift plan filled out and signed
6. Program Requirements, First Aid, and Housekeeping
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6.1 Required postings are posted on bulletin board
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6.2. Subcontractor safety plans and MSDS are on site
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6.3. General housekeeping is neat and orderly
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6.4 Are safety meetings held weekly
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6.5 Are safety meetings tailored to the operations, documented and attendance taken
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6.6 Are weekly safety audits conducted weekly, documented and available for inspection
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6.7 Is there a first aid certified person/persons available onsite at all times and is their certification current and listed on the first aid roster
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6.8 Are Superintendents, Foreman, crew leaders first aid trained
7. Fall Protection
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7.1 Wall openings & floor holes are guarded or covered
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7.2 Guardrails (top rails at 42" +/- 3" and mid rail halfway between) and toe boards in place
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7.3 Cable guardrails are taught with minimal deflection
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7.4 Are employees protected from impalement hazards (rebar, stakes, etc)
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7.5 Are employees protected from falls while constructing leading edge
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7.6 Are floor openings and/or skylight openings guarded
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7.7 Are employees using fall protection while working on low pitch roof (4:12 or less)
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7.8 Are employees protected from falls when working on steep pitch roofs (greater than 4:12) (included roofing work)
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7.9 Are employees using personal fall restraint or positioning device systems while working on hazardous slopes
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7.10 Is there a written fall protection plan that addresses fall hazards of 10 ft or more? is it available on site?
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7.11 Are there unprotected walking working surfaces (an area larger than 45" in all directions
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7.12 Are employees protected from falls while placing or tying reinforcing steel on a vertical surface
8. Trenches and Excavations
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8.1 Were utilities that would be expected to be encountered during excavation work located prior to opening and excavation
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8.2 Protection from cave-ins for >4' deep
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8.3 Ladders in place every 25' and extended 3' above ground
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8.4 Trench boxes are less than 2' off the trench floor
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8.5 Standing water has been removed from the trench
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8.6 Fall protection around the trench is in place
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8.7 Soil spoils are greater than 2' from the excavation
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8.8 Trench is inspected daily and as needed by a competent person
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8.9 Was soil classified by a competent person
9. Scaffold / Aerial lifts
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9.1 Is scaffolding erected, moved, dismantled, or altered by a competent person who is supervising experienced and trained employees selected by the competent person
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9.2 Has the scaffolding been inspected each day before use and signed off by a competent person
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9.3 Work platforms are fully decked and planked
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9.4 is safe access provided on scaffolds
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9.5 Guardrails and toe boards which meet requirements are in place when over 6'
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9.6 Are guardrails or personal fall arrest systems used to protect employees from falls greater than 10ft to a lower level
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9.7 Are guardrails installed in accordance with the standard along open-sides and ends
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9.8 Are scaffolds are set up on firm, level foundation capable of supporting the load
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9.9 Tied to structure at 4:1 base ratio and at the following 26'
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9.10 Scaffolds are plumb and square
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9.11 Are wheels on mobile scaffolds locked
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9.12 Aerial lifts used properly and inspected daily
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9.13 Aerial lift operator has proof of training
10. Ladders, Stairs, and Ramps
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10.1 Are ladders in good repair
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10.2 Are defective ladders tagged out of service and/or removed
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10.3 Extension & straight ladders extend 3' beyond landing
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10.4 Are ladders used for the purpose they were designed for
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10.5 Is the weight on the ladder within the capacity of the ladder rating
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10.6 Is the ladder set up at a 4:1 angle
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10.7 Are workers carrying tools, materials, equipment in a manner that allows the use of both hands
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10.8 If the ladder doesn't extend at least 3 FT for persons accessing an upper level, is the top and bottom secure and have other grasping devices been provided?
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10.9 Is the ladder secured at the top and bottom for the person working from the ladder
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10.10 When there is a break in elevation of 19 inches or more, is there a stairway, ramp or ladder provided
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10.11 Stair rail provided when change in elevation is greater than 30' or there are 4 risers or more
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10.12 Ramps used for access are at least 18" wide
11.0 Chemicals/Hazard Communication Globally Harmonized System (GHS)
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11.1 Is there a written hazard communication program and is it implemented
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11.2 Is there a chemical inventory on-site
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11.3 Is there an MSDS (material safety data sheet) or SDS (safety data sheet) for each hazardous product
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11.4 Are employees provided hazard communication training
12.0 Dump Trucks
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12.1 Do dump trucks used on site with an obstructed rear view have an operable automatic reverse alarm
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12.2 Is the alarm audible above the surrounding noise level and no less than 15 FT from the rear of the vehicle
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12.3 If the workers are in the backing zone or could reasonably be expected to enter the area, is there a spotter/observer or a back up video camera for the driver
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Audit conclusions and items still needing attention, Items marked N/A are either not applicable or have not been observed on this audit
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Add media
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FORMA Safety Representative
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FORMA Superintendent
