Information
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Audit Title
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Document No.
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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
General Information
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List the names of the employees involved in the task
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Description of task being inspected
Work Area
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The area is neat, clean, and free from debris, dirt, or other materials
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Illumination is adequate for the tasks to be performed
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Ventilation is adequate for the task being performed
Personal Protective Equipment (PPE)
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Employees are wearing appropriate PPE
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PPE is in good condition and sized correctly
Job Briefing and Planning
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JSA is properly filled out and signed
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JSA and any other applicable work permits are properly communicated via tailboard meeting
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Employees are following precautions listed on the JSA and any other required work permits
Safety Equipment
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GFI protection in place and extension cords, grounding clusters in good condition
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A fire extinguisher is staged at the worksite where hot work is being performed
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Inspections on safety equipment have been perfromed within the required frequency
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All safety equipment is clearly labelled and accessible
Electrical NFPA 70E
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Electrical hazards identified
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Proper electrical PPE used (shock/arc flash)
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Protective grounds as needed (PPE and grounds tested & inspected)
Tools/Equipment
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Tools are in good condition
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Tools are effectively grounded
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Tools, equipment, and PPE tested and calibrated as needed
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Ladders, scaffolds, lifts, working at height platforms properly inspected and secured
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Fall protection equipment used, appropriate, and inspected
Lockout and Tagout (LOTO)
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LOTO devices are in place
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LOTO form has been completed correctly
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LOTO devices adequately isolate energy from the employee
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LOTO devices are attached correctly and provide a warning and deterant for employees
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Employee is following LOTO procedure
Emergency Preparedness
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Emergency preparedness is in place and evacuation procedures understood
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First aid kit and spill kit is on station or available
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Signature of inspector