Information

  • Document No.

  • Audit Title

  • Project Name:

  • Conducted on

  • Person(s) conducting audit

  • Title

  • Name of Superintendent onsite

CONDITIONS AND PROTECTION

  • RECORDKEEPING

  • 1. OSHA 300 Log (up-to-date/posted 2/1 thru 4/31)

  • Date Corrected

  • Corrected By

  • 2. Required OSHA/State Posting displayed

  • Date Corrected

  • Corrected By

  • 3. Emergency action plan available (up-to-date)

  • Date Corrected

  • Corrected By

  • 4. Emergency information posted (medical clinic map)

  • Date Corrected

  • Corrected By

  • 5. JMI written Safety Policy/Procedure Manual

  • Date Corrected

  • Corrected By

  • 6. Project Health and Safety Plan

  • Date Corrected

  • Corrected By

  • 7. Weekly safety meetings conducted & documented

  • Date Corrected

  • Corrected By

  • 8. Hazardous substance inventory available (up-to-date)

  • Date Corrected

  • Corrected By

  • 9. SDS information available (up-to-date)

  • Date Corrected

  • Corrected By

  • 10. Activity hazard analysis available (up-to-date)

  • Date Corrected

  • Corrected By

  • 11. Traffic control plan & documentation

  • Date Corrected

  • Corrected By

  • 12. Personnel training records

  • Date Corrected

  • Corrected By

  • 13. Injury & Illness Prevention Plan (CA only)

  • Date Corrected

  • Corrected By

  • 14. Federal & State OSHA standards on site

  • Date Corrected

  • Corrected By

  • FIRST AID

  • 1. First aid kit(s) centrally located/adequately stocked

  • Date Corrected

  • Corrected By

  • 2. First aid kit(s) checked and inspection documented

  • Date Corrected

  • Corrected By

  • 3. Personnel trained in first aid/CPR available

  • Date Corrected

  • Corrected By

  • FIRE

  • 1. Fire extinguisher charged, inspected, well located & visible

  • Date Corrected

  • Corrected By

  • 2. Flammable waste removed daily/properly contained

  • 3. No Smoking signs posted where appropriate

  • Date Corrected

  • Corrected By

  • 4. Compressed gas cylinders secured and upright position. Oxygen & Acetylene bottles properly stored/separated

  • Date Corrected

  • Corrected By

  • HOUSEKEEPING

  • 1. General appearance neat/orderly

  • Date Corrected

  • Corrected By

  • 2. Aisles & walkways clear & maintained

  • Date Corrected

  • Corrected By

  • 3. Trash containers adequate and available

  • Date Corrected

  • Corrected By

  • 4. No projecting nails/screw or unprotected rebar

  • Date Corrected

  • Corrected By

  • 5. Slip, Trip, & Fall hazards eliminated

  • Date Corrected

  • Corrected By

  • PERSONAL PROTECTIVE EQUIPMENT

  • 1. Hard hats, safety glasses & safety vest worn by all project personnel

  • Date Corrected

  • Corrected By

  • 2. Proper eye/face protection when cutting, grinding, welding, drilling, or operations with flying debris

  • Date Corrected

  • Corrected By

  • 3. Full body harness and tie offs worn and inspected

  • Date Corrected

  • Corrected By

  • 4. Hearing protection utilized where required

  • Date Corrected

  • Corrected By

  • 5. Gloves utilized when needed

  • Date Corrected

  • Corrected By

  • 6. Respirators properly used, stored and maintained.

  • Date Corrected

  • Corrected By

  • 7. Respirator cartridges and filters appropriate for use

  • Date Corrected

  • Corrected By

  • 8. Eyewash station available and centrally located

  • Date Corrected

  • Corrected By

  • 9. Abrasive blasting hood maintained and available

  • Date Corrected

  • Corrected By

  • 10. Chemical protective clothing available

  • Date Corrected

  • Corrected By

  • WALKING AND WORKING SURFACES

  • 1. Wall openings & open sides of floor levels properly guarded

  • Date Corrected

  • Corrected By

  • 2. Floor openings properly covered, identified or guarded

  • Date Corrected

  • Corrected By

  • 3. Handrails provided on all stairwells

  • Date Corrected

  • Corrected By

  • LADDERS

  • 1. All ladders inspected as required and rails, rungs and hardware in good condition

  • Date Corrected

  • Corrected By

  • 2. Extension ladders secured at top and bottom and extend 3 feet above landing

  • Date Corrected

  • Corrected By

  • 3. Employee utilizing safe practices not standing on top two steps

  • Date Corrected

  • Corrected By

  • 4. Ladders positioned on level, unobstructed surface and secure footing

  • Date Corrected

  • Corrected By

  • 5. Ladders not positioned in walkways, doorway or equipment traffic areas

  • Date Corrected

  • Corrected By

  • ELECTRICAL

  • 1. Adequate lighting provided where needed

  • Date Corrected

  • Corrected By

  • 2. Assured grounding program implemented

  • Date Corrected

  • Corrected By

  • 3. Power tools and extension cords inspected and tagged with current color coding

  • Date Corrected

  • Corrected By

  • 4. Extension cords free of cuts, splices, and bare wires

  • Date Corrected

  • Corrected By

  • 5. Electrical tools and machinery equipped with three wire cords with ground pin or double insulated

  • Date Corrected

  • Corrected By

  • 6. Ground fault circuit interrupters (GFCI) used

  • Date Corrected

  • Corrected By

  • EQUIPMENT AND TOOLS

  • 1. All machinery, equipment guards used and maintained

  • Date Corrected

  • Corrected By

  • 2. Hand tools in good working condition

  • Date Corrected

  • Corrected By

  • 4. Back up alarms are equipped and operational on vehicles and equipment

  • Date Corrected

  • Corrected By

  • 6. Spotter/flagmen utilized when needed

  • Date Corrected

  • Corrected By

  • 8. Pneumatic tools, hoses and compressors pinned or properly secured

  • Date Corrected

  • Corrected By

  • 10. Aerial lifts in proper working conditions

  • Date Corrected

  • Corrected By

  • 11. Only trained operators on aerial lifts and forklifts

  • Date Corrected

  • Corrected By

  • Additional

  • Additional

  • Additional

  • SCAFFOLD/WORK PLATFORM

  • 1. Proper planking provided (minimum two 2"x10" planks)

  • Date Corrected

  • Corrected By

  • 2. Proper bracing and tie-ins

  • Date Corrected

  • Corrected By

  • 3. Guardrail system & toe boards in use

  • Date Corrected

  • Corrected By

  • 4. No riding on rolling scaffold

  • Date Corrected

  • Corrected By

  • 5. Casters to rolling scaffold locked when scaffolds in use

  • Date Corrected

  • Corrected By

  • CONFINED SPACE/TRENCH/EXCAVATION

  • 1. Confined space entry permit is current and utilized when required

  • Date Corrected

  • Corrected By

  • 2. Rescue procedures & services are readily available

  • Date Corrected

  • Corrected By

  • 3. Adequate ventilation is available & utilized

  • Date Corrected

  • Corrected By

  • 4. Walls, banks are properly supported, shored or sloped

  • Date Corrected

  • Corrected By

  • 5. Spoils, materials & equipment are stored at least 2 feet from top opening

  • Date Corrected

  • Corrected By

  • 6. Access & egress is appropriate & provided at least every 25'

  • Date Corrected

  • Corrected By

Action Plans

  • Action taken for deficiencies:

  • Special safety activities this week:

  • Injuries reported and investigated this week:

  • All safety issues have been corrected

  • Select date

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.