Geo Pacific Services Site Audit

• Company Audited

• Site (Job#)

• Conducted on

  Date

• Prepared by

• City

• Weather

  Select Clear Sky Cloudy Raining Windy Hazy Snow / Hail OTHER

  • Clear Sky
  • Cloudy
  • Raining
  • Windy
  • Hazy
  • Snow / Hail
  • OTHER

• Site Foreman / Supervisor

• Any abnormal Situations on or near the site

Site Audit

• JSA In Place and Reviewed?

  Good

  Fair

  Poor

  N/A

• Are required Job site inspections conducted?

  Safe

  At Risk

  N/A

• If needed are COVID-19 protocols being observed?

  Safe

  At Risk

  N/A

• Other Site documentation

  Good

  Fair

  Poor

  N/A

• Has USA been notified?

  Safe

  At Risk

  N/A

• Have mark-outs been performed?

  Safe

  At Risk

  N/A

• Are Sanitation Facilities in acceptable condition?

  Good

  Fair

  Poor

  N/A

• Fire Equipment in place, clearly marked for type of fire?

  Safe

  At Risk

  N/A

• Is site perimeter fenced off appropriately with required site public signage posted?

  Good

  Fair

  Poor

  N/A

• Noise produced by work activities is within acceptable parameters and is not excessive?

  Good

  Fair

  Poor

  N/A

• Are walking surfaces even and uncluttered?

  Good

  Fair

  Poor

  N/A

• Is site generally orderly, with rubbish or waste materials disposed of correctly?

  Good

  Fair

  Poor

  N/A

• Is all mandatory PPE being worn?

  Safe

  At Risk

  N/A

• Is the public protected or shielded from work hazards?

  Good

  Fair

  Poor

  N/A

• Is additional PPE used where required?

  Safe

  At Risk

  N/A

• If needed, are dust mitigation procedures in place

  Good

  Fair

  Poor

  N/A

• Any other discrepancies noted?

  Safe

  At Risk

  N/A

• Is work being performed in a safe manner?

  Good

  Fair

  Poor

  N/A

• Ladders Serviceable?

  Good

  Fair

  Poor

  N/A

• Ladders properly setup?

  Good

  Fair

  Poor

  N/A

• Excavations protected?

  Good

  Fair

  Poor

  N/A

• Excavation has 2' clear area each side?

  Safe

  At Risk

  N/A

• Material handling safely performed?

  Good

  Fair

  Poor

  N/A

• Are floor, wall and roof openings protected

  Good

  Fair

  Poor

  N/A

• Is Fall protection properly used?

  Good

  Fair

  Poor

  N/A

• Are electrical hand tools utilizing a GFCI?

  Safe

  At Risk

  N/A

• Are there any impalement hazards?

  Safe

  At Risk

  N/A

• Is equipment being greased daily?

  Good

  Fair

  Poor

  N/A

General Comments

• Overall Perception of Site

• Any further comments or recommendations arising from this inspection?

• Add any additional relevant photos

  Media

Sign Off

• Signature

  Sign