General Workplace Inspection

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1.0 Job Pre-Planning

• 1.1 Safe work permit signed and completed correctly?

  Yes

  No

  N/A

• 1.2 Daily JSA completed for task?

  Yes

  No

  N/A

• 1.3 Lockout required for job?<br>

  Yes

  No

  N/A

2.0 Fall Protection

• 2.1 Workers protected from fall if above 6 feet?<br>

  Yes

  No

  N/A

• 2.2 Personal fall arrest system required?

  Yes

  No

  N/A

• 2.3 Fall protection equipment in good condition?

  Yes

  No

  N/A

• 2.4 Fall protection equipment being used properly?

  Yes

  No

  N/A

3.0 Walking/Working Surfaces

• 3.1 Floor surfaces even and uncluttered?

  Yes

  No

  N/A

• 3.2 Entry and walkways kept clear?

  Yes

  No

  N/A

• 3.3 Walkways adequately and clearly marked?

  Yes

  No

  N/A

• 3.4 Intersections kept clear of boxes etc?

  Yes

  No

  N/A

• 3.5 Stair and risers kept clear?

  Yes

  No

  N/A

• 3.6 Are fall preventive measures in place and used where gaps occur in railings?

  Yes

  No

  N/A

• 3.7 Are footpaths in good condition?

  Yes

  No

  N/A

4.0 Personal Protective Equipment

• 4.1 Hand protection being used?

  Yes

  No

  N/A

• 4.2 Eye protection being used?

  Yes

  No

  N/A

• 4.3 Head protection being used?

  Yes

  No

  N/A

• 4.4 Hearing protection being used?

  Yes

  No

  N/A

• 4.5 All Personal Protective Equipment included?

  Yes

  No

  N/A

5.0 Aerial Lifts

• 5.1 Daily lift inspection completed?

  Yes

  No

  N/A

• 5.2 Lift positioned safely?

  Yes

  No

  N/A

• 5.3 User following manufactures procedures?

  Yes

  No

  N/A

6.0 Tools and Equipment

• 6.1 Tools in working properly?

  Yes

  No

  N/A

• 6.2 GFCI protected?

  Yes

  No

  N/A

• 6.3 Guards in place?

  Yes

  No

  N/A

• 6.4 Cords and hoses in good condition?

  Yes

  No

  N/A

7.0 Excavations

• 7.1 Barricades in place?

  Yes

  No

  N/A

• 7.2 Access and Egress in place?

  Yes

  No

  N/A

• 7.3 Excavation permit required?

  Yes

  No

  N/A

• 7.4 Spoil piles away from excavation?

  Yes

  No

  N/A

• 7.5 Competent person on site for excavation?

  Yes

  No

  N/A

• 7.6 Atmospheric air monitoring required?

  Yes

  No

  N/A

• 7.7 Excavation sloped and or benched properly?

  Yes

  No

  N/A

8.0 Cranes and Rigging

• 8.1 Lift permit completed?

  Yes

  No

  N/A

• 8.2 Qualified rigger and signal person being used?

  Yes

  No

  N/A

• 8.3 All rigging material inspected and rated for intended loads?

  Yes

  No

  N/A

• 8.4 Barricades and signs in place?

  Yes

  No

  N/A

• 8.5 Area representative been notified of lift?

  Yes

  No

  N/A

9.0 Fire Protection

• 9.1 Fire permit obtained?

  Yes

  No

  N/A

• 9.2 Fire Extinguisher charge, inspected, and in area?

  Yes

  No

  N/A

• 9.3 Fire watch required?

  Yes

  No

  N/A

• 9.4 Area clear of flammables and combustibles?

  Yes

  No

  N/A

10.0 Ladders

• 10.1 Are ladders in good condition?

  Yes

  No

  N/A

• 10.2 Used according to instructions?

  Yes

  No

  N/A

11.0 Field Notes/Comments

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

Sign Off

• On site representative

  Sign

• Auditor's signature

  Sign