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 as required

  • 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 Proper footwear worn as required?

  • 1.6. Hard hats worn as required

2. Tools

  • 2.1 Circular/skill saws properly guarded<br>

  • 2.2 Hand grinders have guards in place

  • 2.3 Table saws are properly guarded (hood, spreader, anti-kickback)

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

  • 2.5 Compressed gas cylinders stored secured & upright

  • 2.6 Does Pneumatic equipment have a safety device on the muzzle?

3. Electrical

  • 3.1 Energized breaker panels have covers & breakers are labeled

  • 3.2 Electrical panel knockouts are in place

  • 3.3. Lockout tag/out procedures are being followed

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

  • 3.5 Electric power tools are double insulated or grounded

  • 3.6 Is strain relief provided on flexible cords and cables

  • 3.7 Do extension cords have ground pins

  • 3.8 Cords are protected from damage such as vehicles

  • 3.9 Are extension cords free from splices or damage to insulation

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 identified

  • 5.3 Tag lines are used during hoisting

  • 5.4 Rigging is inspected for wear and damage

  • 5.5 Forklift and Crane inspections completed

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

  • 5.7 Is the crane currently certified for the state of washington

  • 5.8 Has a qualified lift director been designated

  • 5.9 Are all parts of the crane, load line or load prevented from getting within 20 FT of power lines

  • 5.10 Load lift plan filled out and signed

6. Program Requirements, First Aid, and Housekeeping

  • 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

  • 6.4 Are safety meetings held weekly

  • 6.5 Are safety meetings tailored to the operations, documented and attendance taken

  • 6.6 Are weekly safety audits conducted weekly, documented and available for inspection

  • 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

  • 6.8 Are Superintendents, Foreman, crew leaders first aid trained

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 Are employees protected from impalement hazards (rebar, stakes, etc)

  • 7.5 Are employees protected from falls while constructing leading edge

  • 7.6 Are floor openings and/or skylight openings guarded

  • 7.7 Are employees using fall protection while working on low pitch roof (4:12 or less)

  • 7.8 Are employees protected from falls when working on steep pitch roofs (greater than 4:12) (included roofing work)

  • 7.9 Are employees using personal fall restraint or positioning device systems while working on hazardous slopes

  • 7.10 Is there a written fall protection plan that addresses fall hazards of 10 ft or more? is it available on site?

  • 7.11 Are there unprotected walking working surfaces (an area larger than 45" in all directions

  • 7.12 Are employees protected from falls while placing or tying reinforcing steel on a vertical surface

8. Trenches and Excavations

  • 8.1 Were utilities that would be expected to be encountered during excavation work located prior to opening and excavation

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

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

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

  • 8.5 Standing water has been removed from the trench

  • 8.6 Fall protection around the trench is in place

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

  • 8.8 Trench is inspected daily and as needed by a competent person

  • 8.9 Was soil classified by a competent person

9. Scaffold / Aerial lifts

  • 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

  • 9.2 Has the scaffolding been inspected each day before use and signed off by a competent person

  • 9.3 Work platforms are fully decked and planked

  • 9.4 is safe access provided on scaffolds

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

  • 9.6 Are guardrails or personal fall arrest systems used to protect employees from falls greater than 10ft to a lower level

  • 9.7 Are guardrails installed in accordance with the standard along open-sides and ends

  • 9.8 Are scaffolds are set up on firm, level foundation capable of supporting the load

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

  • 9.10 Scaffolds are plumb and square

  • 9.11 Are wheels on mobile scaffolds locked

  • 9.12 Aerial lifts used properly and inspected daily

  • 9.13 Aerial lift operator has proof of training

10. Ladders, Stairs, and Ramps

  • 10.1 Are ladders in good repair

  • 10.2 Are defective ladders tagged out of service and/or removed

  • 10.3 Extension & straight ladders extend 3' beyond landing

  • 10.4 Are ladders used for the purpose they were designed for

  • 10.5 Is the weight on the ladder within the capacity of the ladder rating

  • 10.6 Is the ladder set up at a 4:1 angle

  • 10.7 Are workers carrying tools, materials, equipment in a manner that allows the use of both hands

  • 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?

  • 10.9 Is the ladder secured at the top and bottom for the person working from the ladder

  • 10.10 When there is a break in elevation of 19 inches or more, is there a stairway, ramp or ladder provided

  • 10.11 Stair rail provided when change in elevation is greater than 30' or there are 4 risers or more

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

11.0 Chemicals/Hazard Communication Globally Harmonized System (GHS)

  • 11.1 Is there a written hazard communication program and is it implemented

  • 11.2 Is there a chemical inventory on-site

  • 11.3 Is there an MSDS (material safety data sheet) or SDS (safety data sheet) for each hazardous product

  • 11.4 Are employees provided hazard communication training

12.0 Dump Trucks

  • 12.1 Do dump trucks used on site with an obstructed rear view have an operable automatic reverse alarm

  • 12.2 Is the alarm audible above the surrounding noise level and no less than 15 FT from the rear of the vehicle

  • 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

  • Audit conclusions and items still needing attention, Items marked N/A are either not applicable or have not been observed on this audit

  • Add media

  • FORMA Safety Representative

  • FORMA Superintendent

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