Hausmann Safety Inspection Report

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

OSHA Posters

• Are all required OSHA posters present?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Emergency Procedures Update

• Emergency Action Plan Posted?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

911 Posters

• Emergency Services Maps Posted?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Sub-Contractor SDS - On Hand

• SDS/MSDS Information Available?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Sub-Contractor Safety Programs - On Hand

• Sub-Contractor weekly safety talks available? JHA's up to date for site specific task?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Hausmann Safety Meeting Held

• Weekly Safety Meetings being held (i.e Toolbox Talks)?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Head Protection

• Hardhats on all personnel?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Eye Protection

• Eye protection worn at all times?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Hearing Protection

• Tasks that require hearing protection?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Foot Wear

• Acceptable Foot Wear worn?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Housekeeping

• Housekeeping acceptable?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Fall Protection

• Tasks that present fall hazard protected?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Guardrails

• Areas that present exposure to falls protected?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Floor Openings Protected

• Floor Openings properly marked and protected?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

G.F.C.I / Extension Cords

• Extension cords suitable? G.F.C.I being used?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Electrical Equipment

• Electrical Equipment protected properly?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Power Lines & Utilities

• Power Lines & Utilities marked, identified, locked and protected?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Excavations / Competent Person

• Excavation meet Hausmann excavation plan requirements?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Slope

• Slope acceptable?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Spoil Pile

• Spoil Piles acceptable?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Access to Excavation

• Access to excavations meet Hausmann requirements?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Scaffolding / Guardrail

• Scaffolding / Guardrail systems meet Hausmann requirements?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Scaffolding / Access

• Scaffold access acceptable?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Scaffolding/ Competent Person

• Scaffolding systems meet requirements?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Flammable Liquids

• Combustible materials meet protection requirements?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Compressed Gas Cylinders

• Compressed gas cylinders meet requirements?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Fire Extinguishers

• Fire extinguishers present, serviced, and operable?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Welding Equipment / Hot Work

• Hot Work meets Hausmann requirements?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Crane / Hoist Operations

• Crane / Hoist operations meet Hausmann requirements?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Crane Operators / Certified

• Crane operators certified?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Rigging Inspections

• Rigging inspections completed?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Equipment Operations

• Equipment operations, certifications, inspections meet Hausmann requirements?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Equipment Warning Devices

• Equipment warning devices meet requirements?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Roll-Over Protection

• Roll Over Protection Systems functional?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

High Visibility Vests

• High visibility vests present?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Traffic Controls / Signage

• Traffic Control / Signage meet requirements?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Forklift Operators Certified

• Forklift operators certified?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Chemicals / Labeling

• Hazardous materials accounted for and properly labeled?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Monitor Air Quality

• Areas that present atmospheric concern properly monitored?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Hand Tools

• Hand tools serviceable with proper guards installed?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Ladders / Stairways

• Ladders serviceable? Stairways clear from obstruction?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

Rebar Protection

• Rebar protection present?

  Yes

  No

  N/A

• Corrective Action (Initial & Date):

• Select date

  Date

• Inspected by Kenny Thompson

  Sign

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