FRANSEN PITTMAN CONSTRUCTION, INC.

• Audit No.:

• Audit Date:

  Date

• Date of Last Audit:

  Date

• Project Name:

• Client Name:

• Audit Conducted by:

• Subcontractors on Site:

• Note: Use of this form is not intended to be all encompassing, but is to be used to assist those responsible for implementation of safety procedures, practices , and general compliance with OSHA standards. This form will be used on a weekly basis and all items noted for correction are to be monitored until noted as corrected on this form. A copy of this form is to remain onsite in the field office. Copy to main office and to Subcontractors as deemed necessary or appropriate.

Job Trailer / Bulletin Board (This section is only required during project start-up or job trailer relocation):

• First aid kit(s) on site and properly stocked?

  Yes

  No

  N/A

• First aid and/or CPR certified personnel posted on the first aid kit?

  Yes

  No

  N/A

• Emergency meeting/muster area posted?

  Yes

  No

  N/A

• Are the rails installed on the job site trailer stairs?

  Yes

  No

  N/A

• Are defective tool tags available?

  Yes

  No

  N/A

• Is there a current OSHA manual on site or access to the OSHA website www.osha.gov?

  Yes

  No

  N/A

• Are all emergency phone numbers for the job site posted?

  Yes

  No

  N/A

• Has the latest OSHA 300A log been posted? Please post log Feb. 1st thru April 31st.

  Yes

  No

  N/A

• Are the latest Federal and State all-in-one posters posted?

  Yes

  No

  N/A

• Are the Fransen Pittman "Work Rules" posted?

  Yes

  No

  N/A

• Has the designated medical provider poster, maps, and DMP letter been posted?

  Yes

  No

  N/A

• Has the Hazard Communication library been located?

  Yes

  No

  N/A

• Has the Crane Signal poster been posted?

  Yes

  No

  N/A

Site Documentation:

• Have all outstanding deficiencies for the previous audit been corrected?

  Yes

  No

  N/A

• Has the weekly Fransen Pittman safety meeting been conducted and filed?

  Yes

  No

  N/A

• Has the weekly Subcontractor safety meetings been conducted and filed?

  Yes

  No

  N/A

• Have all of the Hazard Communications programs been placed in the library and are the MSDS/SDS current?

  Yes

  No

  N/A

• Per the Hazard Communications program are all containers on site properly labeled?

  Yes

  No

  N/A

• Are all Health and Safety programs on site?

  Yes

  No

  N/A

Housekeeping:

• Does the project have adequate trash containers and dumpsters?

  Yes

  No

  N/A

• Are proper toilet facilities available and clean?

  Yes

  No

  N/A

• Are aisles and stairs clear of obstacles, adequately lite, and handrails and toe-boards in place?

  Yes

  No

  N/A

• Are work areas clean and organized?

  Yes

  No

  N/A

• Are fall hazards like holes, stairwells, and openings properly protected?

  Yes

  No

  N/A

• Is drinking water and cups available?

  Yes

  No

  N/A

• Are trash chutes properly enclosed and protected?

  Yes

  No

  N/A

• Are all powder actuated tool loads stored and disposed of properly (in a bucket of water)?

  Yes

  No

  N/A

• Are all safety signs (Caution, Danger) posted where needed?

  Yes

  No

  N/A

• Is the public protected from all hazards?

  Yes

  No

  N/A

Fire Prevention and Protection:

• Are fire extinguishers properly located with signs posted?

  Yes

  No

  N/A

• Are all fire extinguishers charged, in good condition, and being inspected monthly?

  Yes

  No

  N/A

• Are fire extinguishers and no smoking signs posted at all fuel or gas storage locations?

  Yes

  No

  N/A

• Are all fuel and gas storage locations properly isolated?

  Yes

  No

  N/A

• Are all flammable and combustible liquids in approved containers?

  Yes

  No

  N/A

• Are all oxygen, acetylene, and other fuels stored a minimum of 20' apart and secured in the upright position with caps in place?

  Yes

  No

  N/A

• Are all gas cylinders in torch carts chained in place?

  Yes

  No

  N/A

• Are all flammables stored away from stairwells and exits?

  Yes

  No

  N/A

Personal Protective Equipment (PPE):

• Is the location of the PPE supplies clearly identified and fully stocked?

  Yes

  No

  N/A

• Are workers wearing their hard hats?

  Yes

  No

  N/A

• Are workers wearing adequate foot protect?

  Yes

  No

  N/A

• Are workers wearing appropriate clothing (shirts with proper sleeves, pants, cold weather clothes...)?

  Yes

  No

  N/A

• Are workers wearing their ear plugs (if required)?

  Yes

  No

  N/A

• Are workers wearing their safety glasses (if required)?

  Yes

  No

  N/A

• Are workers wearing their safety vests (if required)?

  Yes

  No

  N/A

• Are workers wearing their safety goggles (if required)?

  Yes

  No

  N/A

• Are workers wearing respiratory protection (if required)?

  Yes

  No

  N/A

• Are workers wearing their face shields (if required)?

  Yes

  No

  N/A

Tools:

• Are all personal hand tools in good working order?

  Yes

  No

  N/A

• Is all welding and cutting equipment in good working order?

  Yes

  No

  N/A

• Are all power tools in good working condition and equipped with any manufacturer required guards?

  Yes

  No

  N/A

• Are all workers using powder actuated tools certified, properly storing the PAT, and displaying proper warning signage?

  Yes

  No

  N/A

• Are all workers using lasers properly trained and displaying proper warning signage?

  Yes

  No

  N/A

Fall Protection:

• Has the project designated a competent person for the use and periodic inspection of the fall protection?

  Yes

  No

  N/A

• Are all necessary guardrails and hole covers in place and adequate?

  Yes

  No

  N/A

• Are all necessary fall protection/arrest systems in place and adequate?

  Yes

  No

  N/A

• Is the fall protection equipment being inspected before each and every use by the user?

  Yes

  No

  N/A

• Is the fall protection equipment being kept clean and properly stored?

  Yes

  No

  N/A

• Have all workers using a fall arrest system been properly trained?

  Yes

  No

  N/A

Electrical:

• Is all temporary power on the project GFCI protected?

  Yes

  No

  N/A

• Are the GFCIs on site being tested monthly?

  Yes

  No

  N/A

• Are all of the temp power panels on site properly protected from moisture?

  Yes

  No

  N/A

• Are all the extension cords and power tool cords free of nicks and cuts as well as have their ground prongs intact?

  Yes

  No

  N/A

• Are all cords on site being inspected before each use?

  Yes

  No

  N/A

• Do all of the power tools have the correct plug type (grounded tool with a ground prong and double insulated tools without)?

  Yes

  No

  N/A

• Are all areas of the project well lite and the temp lighting installed, protected, and maintained properly?

  Yes

  No

  N/A

Ladders:

• Are all ladders on the project used for access properly secured and extended 3' above the working surface?

  Yes

  No

  N/A

• Are all workers using the ladders correctly and for there intended purpose?

  Yes

  No

  N/A

• Are all ladders in good condition and being inspected before every use?

  Yes

  No

  N/A

• Are all extension ladders being placed using the 4:1 ratio rule?

  Yes

  No

  N/A

• Are all ladders being placed on a firm and reliable surface?

  Yes

  No

  N/A

Scaffold:

• Is all scaffold being erected, moved, modified, or dismantled by a competent person (no riding the scaffold while moving)?

  Yes

  No

  N/A

• Is the scaffolding being properly inspected and/or tagged, before and after every use?

  Yes

  No

  N/A

• Is the scaffold properly supported at it's base (solid footing, sill plates, metal or adjustable screw baseplates, or locking wheels)?

  Yes

  No

  N/A

• Are all braces in place and sections fully pinned?

  Yes

  No

  N/A

• Is the working surface fully planked and are toe boards in place?

  Yes

  No

  N/A

• Is fall protection (guard rails or fall arrest system) in place for all scaffold at or above 6'?

  Yes

  No

  N/A

• Are all workers working around or below the scaffold properly protected from falling objects?

  Yes

  No

  N/A

Trenching and Excavations:

• Have all proposed "dig" areas been properly evaluated for underground utilities?

  Yes

  No

  N/A

• Are all trenches being inspected daily by a competent person?

  Yes

  No

  N/A

• Are any trenches being evaluated as a confined space by a competent person, and if so, are they being properly monitored?

  Yes

  No

  N/A

• Are all workers working in or around the trench/excavation properly trained?

  Yes

  No

  N/A

• Is a proper ladder or ramp being used to access all trenches 4' or deeper?

  Yes

  No

  N/A

• Is proper shoring and/or benching being used in trenches 5' or deeper?

  Yes

  No

  N/A

• Is fall protection in place or being used around all trenches 6' or greater in depth?

  Yes

  No

  N/A

• Are all spoil piles and other materials being stored a minimum 2' away from the edge of all trenches.

  Yes

  No

  N/A

• Are all workers working around any trench/excavation being protected from any turning, swinging, spinning, or moving equipment?

  Yes

  No

  N/A

Heavy Equipment:

• Are all forklift operators trained and certified?

  Yes

  No

  N/A

• Are all skid-steer operators trained and certified?

  Yes

  No

  N/A

• Are all equipment operators using seat belts?

  Yes

  No

  N/A

• Are all arial lifts being used properly, operators trained and certified, and in the case of a boom lift are operators using fall protection?

  Yes

  No

  N/A

• Are spotters being used for any operation involving equipment where the operator, other workers, or the public are at risk?

  Yes

  No

  N/A

• Are flaggers or traffic control devices being used when the normal flow or operation of traffic is being disrupted?

  Yes

  No

  N/A

• Is all rigging/lifting equipment in good condition and being stored properly?

  Yes

  No

  N/A

• Are all temporary power generators well located and properly ventilated?

  Yes

  No

  N/A

Safety Audit Completion and Summary:

• Were the workers actively pre-tasking or using the "4 What's"?<br> - What am I doing today?<br> - What materials and tools do I need?<br> - What are the hazards I am going to encounter?<br> - What am I doing to eliminate those hazards?

  Yes

  No

  N/A

• Were there any near misses to report this week?

• Were there any accidents to report this week?

• Was the site free of safety violations? If no, what were the violations?

  Yes

  No

  N/A

• What were the corrective actions taken to eliminate those violations?

• Closing Comments?

Safety Audit Sign-off:

• Signature:

  Sign