Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Compliance Verification NOTE: Reported nonconformances and incomplete items in the Follow-Up section

  • Compliance with safety policies and procedures

  • Compliance with material inspection and tests

  • Compliance with initial job ready requirements

Heightened awareness check points based on Spec

  • Proper material type

  • Proper material thickness

  • Proper material fasteners

  • If jacketing is required

  • Jacketing installed properly

Field Management Quality and Completion Scores

  • Quality of Work

  • ON-Time

  • Safety of Site

  • Quality Score: 5= 100% NO Problems 4= 1 minor problem 3= Hotspot or 2-3 minor problems 2= 6+ or major problems 1= Excessive problems

    ON-Time Score : 5= On Time 4= Late 3= Late by 1 day 2= Late by 2 days 1= Late by more than 2 days

    Safety Score: 5= 100% NO Problems 4= 1 minor problem 3= Hotspot or 2-3 minor problems 2= 4+ or major problems 1= Injury

  • Print and Sign

  • Cell#/ID#

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.