Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Administrative

  • OSHA 300 log posted and up to date?

  • MSDS sheets up to date and available to employees?

  • OSHA and DOL posters up to date and posted?

  • Emergency phone numbers, evacuation plan and muster points posted?

  • SWPPP inspections up to date?

  • Tool box safety talks log up to date?

  • First aid kits available in the office?

  • First responders available?

  • Site safety signage is in place (speed, stop, slow, muster points, visitor sign in, safety rules, etc)?

STA Completion

  • Pre-task planning forms in use and properly filled out (STA, JHA, etc)

  • Hazards properly identified on STA?

  • Tasks being performed are on the STA?

  • Emergency notification section filled out completely on STA?<br> -phone number<br> -nearest plant phone<br> -emergency contact <br> -eye wash station/ first-aid location

  • Supervisor's briefing crews on task for that day?

  • Crew members signing in on STA?

  • Crew members signing out on STA?

Site Condition

  • Ground around work areas?

  • Wet

  • Muddy

  • Slick

  • Standing water

  • Dry

  • Dusty

  • Trash containers available, in proper location and not overflowing?

  • Spill containers available and in proper location?

  • Proper amount of sanitary facilities available and well maintained/cleaned?

  • Hand wash stations available and well maintained/cleaned?

  • Drinking water available and properly maintained?

  • Eye wash stations available and ready for use?

  • Eye wash stations unobstructed?

  • Cords, leads, hose, rope etc picked up so they do not pose a tripping hazard?

  • Walkways clear of debris and excess material?

  • Barricades installed and properly maintained?

  • Wooden barricades

  • Orange snow fence

  • Red danger tape

  • Yellow caution tape

  • Wire rope

  • Nails removed or bent over?

  • Proper storage of flammable material?

  • Fuel and other liquids properly stored in berm, diked, or double wall containers?

  • Fuel storage area properly barricaded?

  • Smoking areas posted and adhered to?

  • Fire extinguishers available, full, inspected and in proper locations?

  • Combustibles removed from hot work areas?

  • Sufficient lighting to perform task?

  • All tools, ladders, cords, leads etc are the proper quarterly color code?

  • White

  • Green

  • Red

  • Orange

  • Overall general site condition?

PPE

  • Hard hats worn properly and in good repair?

  • Proper safety glass worn for proper lighting?<br> -indoors clear/smoke<br> -outdoors dark/clear/smoke

  • Goggles or face shields used when required?

  • Employees wearing proper attire?

  • Respiratory protection used properly when needed?

  • Hearing protection used where required?

  • High visibility vest worn when required?

  • Fire retardant clothing worn where required?

  • Steel toed boots or foot protection used?

  • Gloves being worn when handling material or tools?

Fall Protection

  • Fall arrest equipment inspected prior to each use?

  • Harness

  • Lanyards

  • SRL

  • Fall arrest equipment used properly?

  • Maintaining 100% tie off?

  • Tools secured from falling?

  • Unused fall protection and ladders properly stored when not in use?

  • Employees below protected from falling objects?

  • Holes are covered and labeled?

  • Excess material, trip hazards, removed from work area?

  • Step ladders opened and not used as straight ladders?

  • Extension ladders extend 3 ft beyond landing?

  • Extension ladders secured from displacement? Tied off?

  • Ladders used properly?

  • Ladders and fall protection quarterly inspections current?

  • White

  • Green

  • Red

  • Orange

Equipment Usage

  • Employees operating equipment have proper training for specific equipment?

  • Pre-use inspection forms being used on all equipment?

  • Aerial lifts used properly, employees are tied off and not standing on rails to perform work?

  • Scissor lifts used properly, employees are tied off and not standing on rails to perform work?

  • Warning devices in place on vehicles (back up alarms, strobes, signage etc)?

  • Seat belts worn at all times?

  • Operators checking surroundings at all times?

  • Operators using spotters when backing or in tight spots?

Tools

  • Proper tools used for the job?

  • Proper use of tools by employees ?

  • Tools in good repair?

  • GFCI's used on all 110V power tools?

  • Guards properly used and functional?

  • Handles and guards are installed on all tools?

  • Cords in acceptable condition for use and have ground?

  • Unused tools returned to gang box?

Welding

  • Hot work permits filled out properly and used?

  • Fire watch utilized?

  • Fire extinguisher within 25' of any hot work and accessible?

  • Compressed gasses properly secured and separated when stored?

  • Proper separating distances between fuels and oxygen?

  • Welding shields and fire blankets used?

  • Ventilation adequate during welding?

  • Sparks, slag and flames controlled?

  • Leads and hoses protected and not causing a hazard?

Scaffolding

  • Scaffolding properly labeled?

  • Green

  • Yellow

  • Red

  • Scaffold inspections up to date?

  • Scaffold properly anchored?

  • Access ladders appropriate and affixed?

  • Railings, mid rails and toe-boards in place?

  • Workers are not standing on railings to complete work?

  • Working surfaces fully planked?

  • Working surfaces clean of debris?

  • Employees below protected from falling objects?

Cranes and Rigging

  • Crane annual inspection up to date?

  • Certified crane operators operating cranes?

  • Daily crane inspection and pre-operational checks complete?

  • Lift plan in place and approved for all lifts?

  • Rigging inspected prior to each use?

  • Rigging in good repair?

  • Safety latches in place?

  • Softness used?

  • Rigging has proper quarterly inspections complete and proper color code?

  • White

  • Green

  • Red

  • Orange

  • Lift area barricaded or spotter in place during all lifts?

  • One person directing operator at all times?

  • Riggers keeping employees clear of overhead loads?

  • Operators and riggers using horns/whistles during lifts?

  • Riggers maintaining eye contact with crane operator?

Pressure Testing

  • Test perimeter sufficiently barricaded and controlled?

  • LOTO in place as required?

  • Safety in place to ensure system is not over pressurized?

  • Testing plan in place and approved?

  • System and equipment tested in accordance with plan?

  • Energy within system properly controlled?

  • Pressurizing equipment shut down during breaks unless testing personnel is not breaking?

Energy Control (LOTO)

  • Personnel working on equipment requiring LOTO are properly trained?

  • LOTO form completed?

  • LOTO equipment in good repair, organized and available?

  • Locks installed properly and all locks tagged?

  • Energy within system properly controlled?

  • Employees removed locks upon end of shift?

  • LOTO logging system and records in place and organized?

Excavations

  • Dig permits used properly prior to excavations?

  • DigSafe or OneCall complete prior to excavations? Note: not all utilities can be located<br>In this manner. Private utilities located using drawings or proper locating service.

  • Holes deeper then 4' are benched or sloped in accordance with dig permit?

  • All holes, trenches and pits properly barricaded?

  • Access/Egress within 25' of each employee. Minimum 2 exits from excavation.

  • Spoil piles more then a minimum of 2' from excavation?

  • Employees working in trench can see operator at all times?

Confined Space

  • Employees working in confined space are trained?

  • Hole watch and standby entry person are confined space trained?

  • Confined space paperwork is complete, work is authorized and paperwork is present at the work location?

  • Emergency equipment in place for standby person?

  • Confined space are identified and signs posted?

  • Attendant is trained in gas monitor operation?

  • Gas monitor is calibrated and certified?

  • Entry person wearing harnesses?

  • Safety Manager

  • Superintendent

  • Project Manager

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.