Jacobson & Company Site Safety Audit

• Audit Title

• Client / Site

• Conducted on

  Date
• Location
  Address

• Prepared by

Working at Heights

• Fall risks of 6' or more? (including shafts, leading edges, working at heights)

  Safe

  At Risk

  N/A

• Lack of edge protection?

  Safe

  At Risk

  N/A

• Unsafe or incomplete edge protection?

  Safe

  At Risk

  N/A

• Correct use of Garlock (pins, toe-kicks, pads, etc.)

  Yes

  No

  N/A

Scaffolds/Lifts

• Unsafe or incomplete scaffold/lift?

  Safe

  At Risk

  N/A

• Safe Work Load? (tools, stored materials, number of persons)

  Safe

  At Risk

  N/A

• Safe access to platform

  Yes

  No

  N/A

• Properly secured & planked

  Yes

  No

  N/A

• Guardrails at regulation height; modified for tight work spaces

  Yes

  No

  N/A

• Green scaffold tag signed & dated

  Yes

  No

  N/A

• For work in stairwell - castors replaced with plates?

  Yes

  No

  N/A

Harness and Equipment

• Incompatible hooks/equipment?

  Safe

  At Risk

  N/A

• Safe & certified anchor points

  Safe

  At Risk

  N/A

• Condition of harnesses

  Safe

  At Risk

  N/A

Tools

• General condition of tools

  Safe

  At Risk

  N/A

• Working GFCI

  Yes

  No

  N/A

• Saw guards working/in use

  Yes

  No

  N/A

• Extension cords; minimizing & organizing

  Safe

  At Risk

  N/A

• Proper guards & cords

  Yes

  No

  N/A

• Any damaged or broken equipment?

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• Head protection

  Yes

  No

  N/A

• Proper foot protection

  Yes

  No

  N/A

• Eye protection

  Yes

  No

  N/A

• Gloves <br>

  Yes

  No

  N/A

• Hearing protection

  Yes

  No

  N/A

• Hi-Visibility vest

  Yes

  No

  N/A

• Respirators for Tapers

  Yes

  No

  N/A

Ladders

• Unsafe or damaged ladders?

  Safe

  At Risk

  N/A

• Unsafe positioning of ladders?

  Safe

  At Risk

  N/A

• Ladder not properly secured?

  Safe

  At Risk

  N/A

• Ladder suitable for job? (e.g. metal ladder used for electrical work)

  Yes

  No

  N/A

Site conditions

• Is the job site clear of debris and other hazards?

  Safe

  At Risk

  N/A

• Other trades using Jacobson equipment

  Yes

  No

  N/A

• "Laser in Use" signs visible

  Yes

  No

  N/A

• Are there any air quality issues that need to be addressed, ex. fumes, excessive dust, irritants?

  No

  Yes

• Cutting stations set up & off floor

  Yes

  No

  N/A

• Adequate lighting

  Yes

  No

  N/A

• Heat Stress Hazard

  No

  Yes

• Cold Stress Hazards

  Safe

  At Risk

  N/A

Administrative Procedures

• Jacobson & Company "PIECE" poster on site and displayed

  Yes

  No

  N/A

• All new hires thru Jacobson orientation

  Yes

  No

  N/A

• Jacobson Worker Orientation forms completed

  Yes

  No

  N/A

• "PIECE" stickers on hardhats

  Yes

  No

  N/A

• MSDS, HASP, & Blue Book on site

  Yes

  No

  N/A

• PTPs conducted; returned to Elizabeth office or picture sent via email

  Yes

  No

  N/A

• Crews made aware of safety raffle program

  Yes

  No

  N/A

• Foremen made aware of EMC for medical treatment with informational sheet on site

  Yes

  No

  N/A

• Subcontractors following Jacobson/Client HASP

  Yes

  No

  N/A

Turner Construction Jobs

• PTPs conducted using white boards

  Yes

  No

  N/A

• Stretch and Flex

  Yes

  No

  N/A

• No cords on the ground

  Yes

  No

  N/A

• Lifting Techniques TBT conducted

  Yes

  No

  N/A

• Pallet Jack TBT conducted

  Yes

  No

  N/A

• Use of "safe space" cones

  Yes

  No

  N/A

• Face-shield and safety glasses donned for overhead work

  Yes

  No

  N/A

• 1st Aid & CPR trained personnel on site

  Yes

  No

  N/A

• Project specific safety checklist completed by all on 1st day

  Yes

  No

  N/A

Corrective Actions

• Enter any corrective actions that will be undertaken

Sign Off

• On site representative

  Sign

• Auditor's signature

  Sign