Title Page
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Site conducted
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Project Location
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Project Name
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Job Number
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Conducted on
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Prepared by
Housekeeping
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Project work areas are clean and free of trash or debris
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Walkways and passageways clear of tripping hazards.
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Material or equipment properly stored?
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Scrap metal/wood free of protruding nails or other puncture hazards
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Warning signs posted, work areas barricaded as required.
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Drinking water containers labeled properly
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Other
Personal Protective Equipment (PPE)
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Hard hats
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Proper footwear
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Ear protection
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Eye protection
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Hand protection
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Safety Vests
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Other
Fall Protection
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Guardrails in place.
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Safety harness/lanyards worn in a proper manner
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Floor openings guarded
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Proper fall protection used
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Fall protection equipment maintained and has current inspection
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Other
Motor Vehicles and Equipment
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Daily inspections of lifts
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Fire extinguisher in place and fully charged
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Equipment in good condition
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Spotters present
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Other
Excavations
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Support systems in place for adjacent structures.
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Ladders provided
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Competent person on site
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Underground utilities located and marked
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Soil bank and equipment sufficient distance from excavation
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Sharing adequate for soil type and depth
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Access and egress provided ever 25ft.
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Other
Welding And Cutting
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Qualified personnel performing task
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Screens, shields, goggles, gloves
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Gas cylinders secured in upright position
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Fire extinguisher available
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Electrical equipment properly grounded
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Valve protection caps in place when not in use
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Fire watch present
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Other
Electrical
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GFCIs in use
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Terminal boxes equipped with required covers
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Extension cords are 3-wire with ground pin
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Electrical tool are 3-wire with ground pin
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Extension cords inspected with monthly color code
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Other
Scaffolding
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Supervised properly by a competent person
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Daily inspection performed and available for review
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Scaffolding tied to structure
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Ladder access provided
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Fall protection in use while working from elevated scaffolding
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Base plates used
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Other
Stairways and Ladders
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Inspected and in good condition
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Properly secured
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3 point contact method used
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Extension ladder used on 4 to 1 pitch
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Employees not exceeding max rung height
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Guardrails provided for stairways
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Other
Fire Protection
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Approved gas cans in use.
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No smoking in undesignated areas
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Proper number of extinguishers provided and charged
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Combustibles >10’ from structures
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Other
First Aid and Emergency
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First aid kits fully stocked
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Employees aware of emergency procedures
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Employees aware of evacuation procedures and meeting points
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Other
Administration
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Pre-construction meetings (tailgate) (Tool Box topic)
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Emergency phone numbers posted
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SDS on site
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SPAs completed
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SORs completed
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Other
Comments
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Worker Training and Performance
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Employees following all safety practices
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Employees need retraining
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Supervisors informed of audit results
Signatures
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Supervisor
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Supervisor
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Inspected by