Information
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Audit Title
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Client / Site
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Location
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Personnel
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Conducted on
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Prepared by
1. Personal Protective Equipment (PPE)
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1.1 Lack of, or inadequate PPE (including sun protection)
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1.2 Lack of system to issue, inspect, replace and monitor PPE? (Inspection forms, Equipment sign-out sheet)
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1.3 Lack of training in safe use, clean-up and inspection of PPE?
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1.4 Respiratory protection/equipment?
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 Incompatible scaffold components? unlabeled or do not meet SAIA standards?
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2.4 Unsafe or incompatible attachments used with equipment?
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2.5 Unlicensed operators?
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2.6 Lack of safe work instructions?
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2.7 Lack of LOTO procedures for cleaning, servicing and maintenance?
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2.8 Lack of inspection regime?
3. Job Site Specific
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3A. Scaffolds on the job? (Rolling, non-rolling)
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3A.1 Unsafe or damaged scaffolds (including brakes that will not lock)
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3A.2 Uncertified persons erecting scaffold above 6 ft.?
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3A.3 Unsafe or incomplete scaffold?
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3A.4 Safe Work Load (SWL) exceeded? (tools,stored materials, number of persons)
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3A.5 Lack of inspection protocol for scaffold?
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3A.6 All wheels locked on rolling scaffolds while in use?
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3B. Are we working at a Height greater than 6ft? (shafts, voids, edge)
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3B.1 Fall risks (6ft. or more, including voids, pits, and trenches)
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3B.2 Lack of edge protection?
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3B.3 Unsafe or incomplete edge protection?
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3C. Are we using Ladders?
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3C.1 Unsafe or damaged ladders?
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3C.2 Unsafe positioning of ladders?
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3C.3 Ladder not properly secured?
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3D. Is Fall Protection required for any site work?
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3D.1 Unlabeled or does not meet manufacturers standards?
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3D.2 Unsafe or uncertified anchor points?
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3D.3 Lack of inspection protocol for equipment?
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3D.4 Inadequate training for PFAS?
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3D.5 Unsafe or damaged harness or equipment?
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3D.6 Incompatible hooks/equipment?
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3E. do we have Lifting Equipment on site? (scissor, boom, fork)
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3E.1 Unsafe or damaged lifting equipment, including ropes, slings, chains, hooks?
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3E.2 Lifting equipment unlabeled, does not meet manufacturers recommended standards?
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3E.3 Lack of LOTO procedures for cleaning, servicing and maintenance?
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3E.4 Lack of SWL information displayed?
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3E.5 SWL of any lifting equipment exceeded?
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3E.6 Lack of maintenance?
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3E.7 Unsafe act?
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3E.8 Lack of daily inspections protocol?
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3E.9 Unlicensed operators?
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3E.10 Loads lifted over persons, close proximity to obstacles incl. overhead power lines?
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3F. Are we working in a confined Space?
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17.1 Confined space personnel trained and certified?
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17.2 All permitted confined space controls in place?
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3G. Are there Hazardous Chemicals on site? (including fuel, oil)
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3G.1 Lack of emergency procedures for injury/spills/fire/etc.
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3G.2 Excessive quantities stored on site or in vehicles?
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3G.3 Insufficient Ventilation?
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3G.4 Insufficient, or incorrect, PPE?
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3G.5 Unsuitable/missing/damaged fire protection (fire extinguisher)
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3G.6 Unsafe storage location? (ex. flammables near ignition sources, spills could enter storm water drains, etc)
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3G.7 Incompatible chemicals stored near each other?
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3G.8 Inadequate spill containment equipment?
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3G.9 Safety data sheets not accessible on site?
4. Manual Tasks (hazardous)
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4.1 Lack of assessment of hazardous manual tasks?
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4.2 Inadequate risk controls? (ex. no job rotation, lighter loads, trolleys, lifting equipment, etc.)
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4.3 Lack of training in risk controls and safe lifting/team lifting techniques?
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4.4 Lack of identification hazardous manual tasks?
5. Electrical Hazards
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5.1 Unsafe electrical leads? (damaged, out of test date or untested)
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5.2 Lack of GFCI protection?
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5.3 Contact with overhead electrical lines?
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5.4 Overloading outlets?
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5.5 Electrical equipment near water?
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5.6 Electrical equipment near flammables?
6. Work Environment
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6.1 Inadequate housekeeping?
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6.2 Potentially Hazardous condition?
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6.3 Lack of/or inadequate amenities? (Toilets, wash areas, lunch rooms, etc)
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6.4 Insufficient lighting?
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6.5 Danger area/unsafe act/horseplay?
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6.6 Lack of, or inadequate noise/vibration control?
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6.7 Striking against-struck by/ergonomics
7. Emergency Response
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7.1 Lack of, or no emergency plans for site?
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7.2 Emergency procedures not displayed at site?
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7.3 Lack of training and rehearsal of emergency plans?
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7.4 Lack of, or inadequate first aid kits and equipment for the site?
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7.5 Insufficient access to formally trained first aiders for all shifts?
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7.6 Unsuitable or inadequate communication equipment?
8. Administrative Procedures
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8.1 Lack or/or inadequate Job Hazard Analysis (JHA) for high-risk work?
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8.2 Lack of/or inadequate Site Safety Plan?
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8.3 Lack of/or inadequate system to review SWP/IIPP as needed?
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8.4 Lack of/or inadequate routine inspections, monitoring, audits?
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8.5 Lack or/or inadequate training, licenses, skills, experience?
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8.6 OSHA posters/permits/workers comp. postings?
9. Fire Protection
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9.1 Fire extinguisher within proper distance of spark emitting/hot work operation?
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9.2 Fire extinguisher to code and inspected?
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9.3 Combustible gasses/flammable stored properly?
10. General Contractor
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10. Did you evaluate the General Contractor? (check if yes)
10.1. Environmental Hazards
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10.1.1 Lack of/or inadequate Environmental Management Plan (EMP)?
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10.1.2 SWPPP
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10.1.3 PACM/PLCM- ACM/LCM (Asbestos/Lead)
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10.1.4 Lack of/or inadequate, dust suppression system?
10.2. Excavations
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10.2.1 Covers/shoring/access/sloping/etc.?
10.3 Traffic Management
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10.3.1 Lack of, or inadequate, Traffic Management Plan (TMP) in place?
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10.3.2 Lack of training in TMP for all persons on site? (contractors and visitors)
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10.3.3 Inadequate controls for TMP? (physical barriers, bollards, speed limits, flashing lights, spotters, etc)
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
Area Walked
Area Walked for Safety Audit
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Zone 1
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Train Platform Level
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Grid Lines
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Lower Concourse Level
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Grid Lines
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Ground Level
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Grid Lines
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Second Level
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Grid Lines
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Bus Deck Level
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Grid Lines
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Roof Park Level
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Grid Lines
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Zone 2
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Train Platform Level
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Grid Lines
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Lower Concourse Level
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Grid Lines
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Ground Level
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Grid Lines
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Second Level
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Grid Lines
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Bus Deck
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Grid Lines
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Roof Park Level
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Grid Lines
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Zone 3
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Train Platform Level
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Grid Lines
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Lower Concourse Level
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Grid Lines
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Ground Level
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Grid Lines
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Second Level
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Grid Lines
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Bus Deck Level
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Grid Lines
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Roof Park Level
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Grid Lines
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Zone 4
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Train Platform Level
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Grid Lines
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Lower Concourse Level
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Grid Lines
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Ground Level
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Grid Lines
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Second Level
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Grid Lines
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Bus Deck Level
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Grid Lines
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Roof Park Level
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Grid Lines
