Information
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Audit Title
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Document No.
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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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Personnel
Daily Paperwork & General Safety
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Daily JHA/Toolbox Talk completed (CORRECTLY)
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Daily Crane & Equipment Inspection completed
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Copy of the Safety Policy & MSDS on site.
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Job specific paperwork available (AHA and/or SSJHA)
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Federal, Ethics and EEO Statement Posted
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No Cuts Locate number(s) available
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Emergency numbers and facilities identified
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Proper First Aid Kit on site
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Fresh drinking water available on site
Personal Protective Equipment (PPE)
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Employee(s) dressed properly for work (shirts w/ 4" sleeves, long pants and sturdy work boots (safety-toe if reuired)
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Hardhats
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Safety Glasses
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Gloves (if required)
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High Visibility Clothing and/or Reflective Vest
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Hearing Protection
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Type:
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Face Sheild
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Activity:
- Burning - #3 or #5
- Chipping
- Grinding
- Saw Cutting
- Welding Hood
- Multiple
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Buoyant Work Vest (if near water i.e. tremie work)
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Respiratory Protection (if required, fit test needed)
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Type:
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All suppliers and sub contractors involved with HJ Foundation are in compliance w/ PPE requirements
Fall Protection
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Competent Person(s)
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Hazard(s)
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Proper System/Equipment used
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Type:
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Full Body Harness and lanyards in good working condition
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(SRL) Self Retracting Lifeline tested
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Proper Anchorage/Tie-Off
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Rebar Caps in use
Crane(s)
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Certified Operator(s)
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Set up:
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Inspection Certificate up to date
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Expires:
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Operator's Manual in crane
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Lift Plan and Weight Sheet in crane
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Anti 2-Block(s) Operational
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Line(s) installed on
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E-Stop(s) Operational
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Swing Radius
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Swing Alarm Operational
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Boom Angle Indicator Operational
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Type:
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Fire Extinguisher (5lb ABC)
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Warning and/or Operational Decals
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Steps and/or Ladder
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Mirrors & Windows in good condition
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Mechanical deficiencies reported
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Catwalks (clear of debris)
Drill Rig//Low Headroom Rig
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Qualified Operator(s)
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Operator's Manual in drill rig
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Anti 2-Block Operational
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E-Stop(s) Operational
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Swing Alarm Operational
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Back Up Alarm Operational
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Fire Extinguisher (5lb ABC)
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Warning and/or Operational Decals
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Steps and/or Ladder
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Mirrors & Windows in good condition
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Mechanical deficiencies reported
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Catwalks (clear of debris)
Rigging
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Certified Rigger(s)/Signal Person(s)
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Nylon Straps
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Wire Rope Slings
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Chains
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Spreaders
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Type:
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Blocks, Hooks & Latches
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Shackles
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Other
Material Handling
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Proper Lifting
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Hands free of Pinch Points
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Mechanical Assist or 2-Man Lift when too heavy
Heavy Equipment
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Qualified Operator(s)
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Machine Type:
- Aerial Lift
- Backhoe
- Dozer/End Loder
- Excavator
- Forklift
- Skid Steer
- Multiple
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Operator's Manual in machine
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E-Stop(s) Operational
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Back-Up Alarm Operational
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Mirrors and Windows in good condition
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Tracks Clean
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Mechanical deficiencies reported
Grout Pump (Operator & Surrounding Area)
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Operator wearing Hearing Protection
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Operator Position (Caught-In-Between, etc)
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E-Stop(s) Operational
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Clamps properly secured
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1st Grout Hose properly secured
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Gray Cover on 1st Grout Hose
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Machine kept clean
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Mechanical deficiencies reported
Confined Spaces/Excavations
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Competent Person(s)
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Permit Required
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Air Monitoring completed
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Decibel Monitoring completed
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Access/Egress
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Type:
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Proper Excavation Protection
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Type:
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Soil Type (if known)
- Solid Rock
- Stable Rock
- A
- B
- C
- Multiple
Cutting & Welding
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Hot Work Permit Pulled
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Fire Watch
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Area clear of combustibles
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Compressed Gas Cylinders properly stored
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Storage Type:
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Striker used for ignition
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Hoses in good condition
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Leads in good condition
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Gauges in good condition
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Caps on Compressed Gas Cylinders if Gauges are removed
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Chop Saw Disc in good condition
Fire Safety
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Fire Extinguisher(s) are charged and in good condition
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Fire Extinguisher(s) have up-to-date tag(s)
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All Equipment has an accessible Fire Extinguisher
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20lb Fire Extinguisher 25' to 75' from Fuel Containment
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Combustibles properly stored
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Fuel Containers labeled
Electrical
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GFCI working properly
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Power Tools in good working condition
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Extension Cords free from defects
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Overhead Power Lines (proper distance indicated and observed)
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Under Ground Utilities (properly identified and marked)
Company Vehicle/Conex Box
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Truck/Conex is reasonably clean
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Truck/Conex is well organized
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Back-Up Alarm Operational
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Mirrors, Seat Belts & Windows in good condition
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Mechanical deficiencies reported
Other
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Guards provided for rotating parts
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Grout Hoses have Whip-Checks
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Laser Sign visible
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Tag Lines in use when unloading or flying materials
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Sheet Shackles in good condition
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Housekeeping (trash & debris) controlled
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Other Essential Findings
Signatures
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Superintendent
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Inspector