Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Foreman
Project Information
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Job #/Project Name
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General Contractor
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Conducted on
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Prepared By
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Location
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Foreman
1. Working at Heights
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1.1 Fall risks (6ft. or more, including voids, pits, and trenches)
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1.2 Lack of edge protection?
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1.3 Unsafe or incomplete edge protection?
2. Equipment (Chop saws, drills,mixers,pumps,etc.)
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2.1 Unsafe or damaged equipment (including missing or damaged guards)
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2.2 Incorrect equipment for job? (ex. grinding discs for cutting)
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2.3 Unsafe or incompatible attachments used with equipment?
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2.4 Unlicensed operators?
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2.5 Lack of safe work instructions?
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2.6 Lack of LOTO procedures for cleaning, servicing and maintenance?
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2.8 Lack of inspection regime?
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3. Scaffolds
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3.7 Unsafe or damaged scaffolds (including brakes that will not lock)
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3.1 Uncertified persons erecting scaffold above 6 ft.?
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3.2 Unsafe or incomplete scaffold?
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3.3 Lack of inspection protocol for scaffold?
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3.4 Incompatible scaffold components? unlabeled or do not meet SAIA standards?
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3.5 Safe Work Load (SWL) exceeded? (tools,stored materials, number of persons)
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3.6 All wheels locked on rolling scaffolds while in use?
4. Lifting Equipment (scissor, boom, fork)
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4.5 Unsafe or damaged lifting equipment, including ropes, slings, chains, hooks?
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4.6 Lifting equipment unlabeled, does not meet manufacturers recommended standards?
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4.7 Lack of LOTO procedures for cleaning, servicing and maintenance?
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4.8 Lack of SWL information displayed?
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4.9 SWL of any lifting equipment exceeded?
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4.10 Lack of maintenance?
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4.1 Unsafe act?
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4.2 Lack of daily inspections protocol?
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4.3 Unlicensed operators?
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4.4 Loads lifted over persons, close proximity to obstacles incl. overhead power lines?
5. Fall Protection
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5.3 Unlabeled or does not meet manufacturers standards?
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5.4 Unsafe or uncertified anchor points?
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5.5 Lack of inspection protocol for equipment?
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5.6 Inadequate training for PFAS?
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5.1 Unsafe or damaged harness or equipment?
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5.2 Incompatible hooks/equipment?
6. Ladders
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6.1 Unsafe or damaged ladders?
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6.2 Unsafe positioning of ladders?
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6.3 Ladder not properly secured?
7. Manual Tasks (hazardous)
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7.2 Lack of assessment of hazardous manual tasks?
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7.3 Inadequate risk controls? (ex. no job rotation, lighter loads, trolleys, lifting equipment, etc.)
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7.4 Lack of training in risk controls and safe lifting/team lifting techniques?
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7.1 Lack of identification hazardous manual tasks?
8. Hazardous Chemical (including fuel and oil)
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8.5 Lack of emergency procedures for injury/spills/fire/etc.
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8.6 Excessive quantities stored on site or in vehicles?
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8.7 Insufficient Ventilation?
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8.8 Insufficient, or incorrect, PPE?
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8.9 Unsuitable/missing/damaged fire protection (fire extinguisher)
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8.1 Unsafe storage location? (ex. flammables near ignition sources, spills could enter storm water drains, etc)
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8.2 Incompatible chemicals stored near each other?
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8.3 Inadequate spill containment equipment?
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8.4 Safety data sheets not accessible on site?
9. Emergency Response
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9.1 Lack of, or no emergency plans for site?
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9.2 Emergency procedures not displayed at site?
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9.3 Lack of training and rehearsal of emergency plans?
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9.4 Lack of, or inadequate first aid kits and equipment for the site?
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9.5 Insufficient access to formally trained first aiders for all shifts?
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9.6 Unsuitable or inadequate communication equipment?
10. Traffic Management
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10.1 Lack of, or inadequate, Traffic Management Plan (TMP) in place?
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10.2 Lack of training in TMP for all persons on site? (contractors and visitors)
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10.3 Inadequate controls for TMP? (physical barriers, bollards, speed limits, flashing lights, spotters, etc)
Personal Protective Equipment (PPE)
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11.1 Lack of, or inadequate PPE (including sun protection)
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11.2 Lack of system to issue, inspect, replace and monitor PPE?
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11.3 Lack of training in safe use, clean-up and inspection of PPE?
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11.4 Respiratory protection/equipment?
12. Work Environment
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12.1 Inadequate housekeeping?
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12.2 Potentially Hazardous condition?
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12.3 Lack of/or inadequate amenities? (Toilets, wash areas, lunch rooms, etc)
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12.4 Insufficient lighting?
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12.5 Danger area/unsafe act/horseplay?
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12.6 Lack of, or inadequate noise/vibration control?
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12.7 Striking against-struck by/ergonomics
13. Electrical Hazards
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13.1 Unsafe electrical leads? (damaged, out of test date or untested)
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13.2 Lack of GFCI protection?
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13.3 Contact with overhead electrical lines?
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13.4 Overloading outlets?
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13.5 Electrical equipment near water?
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13.6 Electrical equipment near flammables?
14. Environmental Hazards
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14.1 Lack of/or inadequate Environmental Management Plan (EMP)?
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14.2 SWPPP
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14.3 PACM/PLCM- ACM/LCM (Asbestos/Lead)
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14.4 Lack of/or inadequate, dust suppression system?
15. Administrative Procedures
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15.5 Lack or/or inadequate Job Hazard Analysis (JHA) for high-risk work?
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15.6 OSHA posters/permits/workers comp. postings?
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15.1 Lack of/or inadequate Site Safety Plan?
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15.2 Lack of/or inadequate system to review SWP/IIPP as needed?
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15.3 Lack of/or inadequate routine inspections, monitoring, audits?
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15.4 Lack or/or inadequate training, licenses, skills, experience?
16. Fire Protection
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16.1 Fire extinguisher within proper distance of spark emitting/hot work operation?
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16.2 Fire extinguisher to code and inspected?
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16.3 Combustible gasses/flammable stored properly?
17. Confined Space
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17.2 All permitted confined space controls in place?
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17.1 Confined space personnel trained and certified?
18. Excavations
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18.1 Covers/shoring/access/sloping/etc.?
19. Misc.
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Safe?
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19.1 Unsafe?
Comments & Corrective Actions
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Enter any corrective actions that will be undertaken
Sign Off
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Foreman Signature
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Auditor's Signature Kirk Williamson, Giampolini & Co. Director of Safety
