IX Comprehensive Field Safety Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Fall Protection

• Add media

  Media

• Fall protection present at 6' or above?

  Yes

  No

  N/A

• Fall protection plan present?

  Yes

  No

  N/A

• Guardrails at 42"/21" +/- 3"?

  Yes

  No

  N/A

• Have users been trained and documented in fall protection?

  Yes

  No

  N/A

• Has fall protection equipment been inspected prior to use?<br> Safety harness<br> SRL<br> Anchor points

  Safe

  At Risk

  N/A

• Is impalement protection in place?

  Yes

  No

  N/A

• Are floor and wall openings protected, covered, and marked?<br> Are covers adequate, secured, and labelled?

  Yes

  No

  N/A

• Is protection present for changes in elevation?

  Yes

  No

  N/A

Ladders/Stairs

• Add media

  Media

• Is ladder free of defects?

  Safe

  At Risk

  N/A

• Is ladder being used properly?

  Safe

  At Risk

  N/A

• Is ladder secured?

  Safe

  At Risk

  N/A

• Is extension ladder used on 4:1 pitch

  Safe

  At Risk

  N/A

• Does ladder extend 3' or more above landing?

  Yes

  No

  N/A

• Is ladder a safe work distance from hazard?

  Safe

  At Risk

  N/A

• Have slip/trip exposures on ladder been eliminated?

  Yes

  No

  N/A

• Are access/egress areas free of debris/materials?

  Safe

  At Risk

  N/A

Excavations

• Add media

  Media

• One-Call system used?

  Yes

  No

  N/A

• Surface traffic exposure?

  Safe

  At Risk

  N/A

• Is there a competent person present?

  Yes

  No

  N/A

• Are daily inspections documented?

  Yes

  No

  N/A

• Are excavations > 20' engineered?

  Yes

  No

  N/A

• Water entering excavation?

  Safe

  At Risk

  N/A

• Is excavation >5' deep properly sloped, benched, or shored?

  Safe

  At Risk

  N/A

• Is a ladder present in excavation over 4' deep and within 25' of workers?

  Safe

  At Risk

  N/A

• Spoils > 2' from edge?

  Yes

  No

  N/A

• Surface encumbrances present within 2' of edge?

  Safe

  At Risk

  N/A

• Perimeter properly protected?

  Safe

  At Risk

  N/A

Confined Space

• Add media

  Media

• Are atmospheric conditions being monitored?

  Safe

  At Risk

  N/A

• Is Permit required?

  Yes

  No

  N/A

• Area secured/ signage posted?

  Yes

  No

  N/A

• Are rescue plans, emergency numbers, maps readily available?

  Yes

  No

  N/A

• Is training documentation readily available?

  Yes

  No

  N/A

• Are regular periodic inspections, including monitoring, taking place?

  Yes

  No

  N/A

• Is ventilation adequate?

  Yes

  No

  N/A

• Are electrical and/or fire hazards present?

  Safe

  At Risk

  N/A

• Attendant/Entrant communication sufficient?

  Yes

  No

  N/A

• Is harness and extraction equipment inspected and in proper working condition?

  Yes

  No

  N/A

• Is respiratory equipment in proper working condition?

  Safe

  At Risk

  N/A

• Is entry supervisor/ monitor present and properly trained?

  Safe

  At Risk

  N/A

Motorized Equipment

• Add media

  Media

• Is operator working safely?

  Safe

  At Risk

  N/A

• Is machine operating at least 20' away from overhead power lines?

  Safe

  At Risk

  N/A

• Is proper operator protection in place (ROPS, cage, screen, etc.)?

  Yes

  No

  N/A

• Are seat belts being used?

  Yes

  No

  N/A

• Does backup alarm function properly?

  Safe

  At Risk

  N/A

• Is fire extinguisher present with current inspection?

  Safe

  At Risk

  N/A

• Is flag man present?

  Yes

  No

  N/A

• Is glass free of obstructions?

  Safe

  At Risk

  N/A

• Does horn function properly?

  Safe

  At Risk

  N/A

• Are operator training documents current and available?

  Yes

  No

  N/A

• Is daily equipment inspection form completed?

  Yes

  No

  N/A

Electrical

• Add media

  Media

• Is electrical equipment properly grounded?

  Safe

  At Risk

  N/A

• Are GFCI's being utilized?

  Yes

  No

  N/A

• Are appropriate cords being used and in good condition?<br>- 3-wire type cords<br>- no exposed wires, cuts in rubber <br>- ground pin in place

  Safe

  At Risk

  N/A

• Are cords protected from traffic?

  Yes

  No

  N/A

• Are energized parts and equipment protected?

  Safe

  At Risk

  N/A

• Are LOTO procedures in use?

  Safe

  At Risk

  N/A

• Is signage present warning of electrocution hazards? (Where applicable)

  Yes

  No

  N/A

Hand and Power Tools

• Add media

  Media

• Proper tool for the job?

  Yes

  No

  N/A

• Tool in good condition? Guards in place? Info label on tool?

  Safe

  At Risk

  N/A

• Cord in good condition? Ground prong in place? GFCI's in use?

  Safe

  At Risk

  N/A

• Auto shut-off/ safety switches operational?

  Safe

  At Risk

  N/A

• Anti-whip attached to pressurized lines?

  Safe

  At Risk

  N/A

• Strain relief functioning properly?

  Safe

  At Risk

  N/A

• Proper PPE? (face shield, chaps, gloves, etc.)

  Safe

  At Risk

  N/A

Manual Material Handling

• Add media

  Media

• Proper lifting technique? (Lifting in "power zone," no twisting, no over-reaching)

  Safe

  At Risk

  N/A

• No manual lift over 50 lbs

  Safe

  At Risk

  N/A

• Lifts over 50 lbs get aid or assistance

  Yes

  No

  N/A

• Use of mechanical aid? (if applicable)

  Yes

  No

  N/A

• Clear and planned path?

  Yes

  No

  N/A

PPE

• Add media

  Media

• Hard hats

  Yes

  No

  N/A

• Safety glasses (goggles where applicable)

  Yes

  No

  N/A

• Face shields

  Yes

  No

  N/A

• Hearing protection

  Yes

  No

  N/A

• Respiratory protection

  Yes

  No

  N/A

• Appropriate clothing for the task (hi-vis, chaps, fire retardant, etc.)

  Yes

  No

  N/A

• Gloves

  Yes

  No

  N/A

• Work boots

  Yes

  No

  N/A

• Visitor PPE available?

  Yes

  No

  N/A

Fire Protection

• Add media

  Media

• Extinguishers charged and inspections current?

  Yes

  No

  N/A

• Extinguishers at least 25' from fuel station, not more than 75'?

  Safe

  At Risk

  N/A

• Temporary fuel station properly protected (signs, barricades, ground pin, locks, etc)?

  Safe

  At Risk

  N/A

• Flammables stored properly (vented, labelled, containers 25' away from other unlike flammables)?

  Safe

  At Risk

  N/A

• Flammables stored away from structures?

  Yes

  No

  N/A

• Clear access for emergency vehicles, hydrants?

  Yes

  No

  N/A

Housekeeping

• Add media

  Media

• First Aid equipment onsite and accessible?

  Yes

  No

  N/A

• Is trailer access/egress hazard free?

  Safe

  At Risk

  N/A

• Are sanitary facilities available, adequate, and clean?

  Yes

  No

  N/A

• Is an adequate supply of drinking water available?

  Yes

  No

  N/A

• Are slip, trip, and fall hazards present in or around work areas?

  Safe

  At Risk

  N/A

• Is material storage adequate and utilized properly?

  Yes

  No

  N/A

• Is trash collected in protected containers?

  Yes

  No

  N/A

Medical/Emergency

• Is there an individual certified in first aid/CPR onsite?

  Yes

  No

  N/A

• Is there a first aid kit available onsite?

  Yes

  No

  N/A

• Are emergency numbers posted?

  Yes

  No

  N/A

• Are project emergency/crisis management plans available/posted?

  Safe

  At Risk

  N/A

• Are safety team numbers available/posted?

  Yes

  No

  N/A

• Is a map to medical facility available/posted?

  Yes

  No

  N/A

• Is eyewash available?

  Safe

  At Risk

  N/A

HAZCOM

• Are employees trained?

  Yes

  No

  N/A

• Site specific SDS (MSDS) available?

  Yes

  No

  N/A

• Copy of program readily available?

  Yes

  No

  N/A

• Containers properly labelled and inventory listed?

  Yes

  No

  N/A

Environmental

• Are airborne contaminants properly controlled/eliminated?

  Safe

  At Risk

  N/A

• Is HazMat storage, use, and disposal adequate/appropriate?

  Safe

  At Risk

  N/A

• Is spill containment adequate/appropriate?

  Safe

  At Risk

  N/A

• Is concrete cut wet and/or vacuumed?

  Safe

  At Risk

  N/A

• Is nuisance dust controlled/ eliminated?

  Safe

  At Risk

  N/A

• Is SWPPP plan available?

  Yes

  No

  N/A

Site/Public Protection

• Add media

  Media

• Are excavations properly protected?

  Safe

  At Risk

  N/A

• Is falling object/overhead protection in place?

  Safe

  At Risk

  N/A

• Are perimeter fences installed?

  Safe

  At Risk

  N/A

• Are barricades installed properly?

  Safe

  At Risk

  N/A

• Is adequate lighting available?

  Safe

  At Risk

  N/A

• Is public protection signage necessary/present?

  Safe

  At Risk

  N/A

• Is traffic control plan in place?

  Yes

  No

  N/A

• Is street closure properly identified?

  Yes

  No

  N/A

• Is a company rep. present?

  Yes

  No

  N/A

• Is security system in place?

  Yes

  No

  N/A

Administration

• Documentation of corrective actions taken since last audit?

  Yes

  No

  N/A

• OSHA Posters posted/OSHA 300 log available?

  Yes

  No

  N/A

• State/Fed. posters posted in English/Spanish?

  Yes

  No

  N/A

• Safety manual readily available?

  Yes

  No

  N/A

• Trench box tabulated data readily available?

  Yes

  No

  N/A

• Orientations conducted/completed?

  Yes

  No

  N/A

• Has a JHA been submitted for each trade?

  Yes

  No

  N/A

• Are frequent/regular safety inspections taking place?

  Yes

  No

  N/A

• Are subs OSHA 30 certified?

  Yes

  No

  N/A

• Is SDS (MSDS) manual readily available?

  Yes

  No

  N/A

• Are Toolbox talks being conducted and recorded weekly?

  Yes

  No

  N/A

• Are Pre-con meetings documented?

  Yes

  No

  N/A

• Is visitor sign in form available and up to date?

  Yes

  No

  N/A

Welding/Cutting

• Fire extinguisher present; properly charged, inspected?

  Yes

  No

  N/A

• Are flash arresters present on torches?

  Yes

  No

  N/A

• Is flash protection available?

  Safe

  At Risk

  N/A

• Are gauges working and adjusted properly?

  Safe

  At Risk

  N/A

• Is burn permit in use and properly filled out?

  Safe

  At Risk

  N/A

• Are bottles upright, capped, and properly secured?

  Safe

  At Risk

  N/A

• Are torch hoses in good condition?

  Safe

  At Risk

  N/A

• Is proper PPE in use (FR clothing, gloves, burning shield, safety glasses)?

  Safe

  At Risk

  N/A

• Is welding machine properly ventilated?

  Safe

  At Risk

  N/A

• Are welding leads in good condition?

  Safe

  At Risk

  N/A

• Are unused cylinders stored properly?

  Safe

  At Risk

  N/A

Aerial Lifts

• Are operator training records readily available including fall protection training?

  Yes

  No

  N/A

• Are PFAS (Personal Fall Arrest Systems) in use during operation?

  Yes

  No

  N/A

• Is gate or chain secured?

  Safe

  At Risk

  N/A

• Is lift operating on stable surface?

  Yes

  No

  N/A

• Is operating surface free of holes, sudden changes in elevation?

  Safe

  At Risk

  N/A

• Are safe work distances addressed and maintained?

  Safe

  At Risk

  N/A

• Is anything present in basket to increase workers height (box, bucket, stool, etc)?

  Safe

  At Risk

  N/A

• Is equipment loaded properly (not to exceed manufacturers weight limit including operator, tools, and equipment)?

  Safe

  At Risk

  N/A

Cranes and Hoisting Equipment

• Annual inspection current?

  Yes

  No

  N/A

• Are operator, signaler/rigger training records readily accessible?

  Yes

  No

  N/A

• Is crane properly supported and level?

  Safe

  At Risk

  N/A

• Are safe work distances from power lines being adhered to?

  Safe

  At Risk

  N/A

• Fire extinguisher present; properly charged, inspected?

  Yes

  No

  N/A

• Is a lift plan on file, readily accessible?

  Yes

  No

  N/A

• Is the proper load chart posted?

  Safe

  At Risk

  N/A

• Are outriggers properly extended, supported, cribbed?

  Safe

  At Risk

  N/A

• Are loads properly rigged by trained, certified rigger?

  Safe

  At Risk

  N/A

• Does operator appear competent, comfortable?

  Safe

  At Risk

  N/A

• Has the weight of the load been field verified?

  Safe

  At Risk

  N/A

• Has rigging been properly rated and inspected?

  Safe

  At Risk

  N/A

• Are safety latches present and being used?

  Safe

  At Risk

  N/A

• Has swing radius been properly barricaded?

  Safe

  At Risk

  N/A

• Are tag lines being used properly?

  Safe

  At Risk

  N/A

• Are effective means of communication in use?

  Safe

  At Risk

  N/A

• Is anti-two block device in place and working properly?

  Safe

  At Risk

  N/A

• Is boom angle indicator in place and working properly?

  Safe

  At Risk

  N/A

• Is operator's manual present in crane?

  Yes

  No

  N/A

• Are daily inspections performed and current?

  Yes

  No

  N/A

Scaffolds

• Is a competent person present?

  Yes

  No

  N/A

• Are scaffolds inspected daily and documented?

  Yes

  No

  N/A

• Are scaffold user training records readily available?

  Yes

  No

  N/A

• Are all appropriate guard rails in place?

  Safe

  At Risk

  N/A

• Are all wheels locked?

  Safe

  At Risk

  N/A

• Are compatible components used?

  Safe

  At Risk

  N/A

• Are outriggers necessary and installed properly?

  Safe

  At Risk

  N/A

• Are bracing and pins placed properly?

  Safe

  At Risk

  N/A

• Is scaffold properly secured to structure?

  Safe

  At Risk

  N/A

• Is proper access to platforms present?

  Safe

  At Risk

  N/A

• Is proper height to base ratio maintained?

  Safe

  At Risk

  N/A

• Are materials being loaded properly?

  Safe

  At Risk

  N/A

• Have safe work distances been addressed and maintained?

  Safe

  At Risk

  N/A

• Are sills, plates, and jacks properly installed?

  Safe

  At Risk

  N/A

• Is work surface in safe condition?

  Safe

  At Risk

  N/A

Conclusion

• I agree to address and abate the above issues prior to

  Date

• Add signature

  Sign