Information
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Document No.
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Audit Title
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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
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Job #:
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Job Name/Location:
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Job Site Forman:
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Select date
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No Problem = yes
Problem = no, include an explanation
Personal Protective Equipment
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Hard Hats
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Eye Protection
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Ear Protection
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Respirators
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Proper Clothing
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Footwear
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Safety Harnesses/Lanyards
Housekeeping
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Exits and Stairs Clear
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Piling and Stacking
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Debris Removal
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Nails Bent or Removed
Ladders/Stairs
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Ladder Condition
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Ladder Tied Off
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Ladder 3' Above Landing
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Stairs
Railings/Covers
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Perimeter
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Floor Openings
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Stairs/Ramps
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Walkways
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Elevator Door/Shaft Openings
Scaffolds
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Railings
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Tied to Buildings
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Planks and Platforms
Electrical
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Lighting
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Grounding
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Cords, Plugs, and Recepticles
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Lockout/Tagout
Fire Protection
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Extinguishers
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Flammable Materials Storage
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Welding/Cutting Equipment
Tools
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Condition
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Guarded
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Power Cords
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Temporary Power Boxes
Site/Public Protection
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Excavations/Trenches
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Earthmoving Equipment
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Forklifts/Cranes
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Fences
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Lighting
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Barricades
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Signs
First Aid
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Trained Personell
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Kits/Supplies
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Sanitation/Water
Programs/Information
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Daily Visual Inspections
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Orientation: New Employees
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Hazardous Substances
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Weekly Safety Meetings
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Posting Requirements/ Signs
Equipment Inspection
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Bobcat/Forklift/Gradall
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Scissors Lift
Other
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List Item, Status
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Sign and Print
