Job Site Safety Audit

• MAS JOB #

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

PPE (Personal Protective Equipment)

• Is proper PPE being used?

  Yes

  No

  N/A

• Is special PPE required?

  Yes

  No

  N/A

• What kind?

• Are all truck drivers wearing the proper PPE being.

  Yes

  No

  N/A

Traffic Control

• Is/Was traffic control required?

  Yes

  No

  N/A

• Are all traffic signs, cones, and flaggers in their proper position in regards to the location of work?

  Yes

  No

  N/A

• Are flaggers paying attention to their jobs?

  Yes

  No

  N/A

Job Brief

• Has the Job Brief been given in detail?

  Yes

  No

  N/A

• Have all visitors been briefed?

  Yes

  No

  N/A

• Is the DWT (Daily Work Ticket) or WOP (Work Order Permit) filled out correctly and in detail?

  Yes

  No

  N/A

• Is the JSA (Job Site Safety Analysis) filled out correctly and in detail?

  Yes

  No

  N/A

• Has all equipment been checked before the start of the day's work?

  Yes

  No

  N/A

• Was the Equipment Safety Inspection & Repair Report used?

  Yes

  No

  N/A

• Why?

• Is the Equipment Inspection & Repair Report located with the JSA

  Yes

  No

  N/A

• Is there any weather conditions that present hazards?

  Yes

  No

  N/A

• Explain:

Housekeeping

• Is there any dunnage on the job site?

  Yes

  No

  N/A

• Is the dunnage neatly stacked?

  Yes

  No

  N/A

• Add media

  Media

• Are there any trip hazards due to poor housekeeping?

  Yes

  No

• Add media

  Media

• Is the job site clean and organized?

  Yes

  No

  N/A

• Add media

  Media

Zone Setup & Protection

• Are cones and signs being used in the loading/unloading area?

  Yes

  No

  N/A

• Add media

  Media

• Are there any overhead obstructions?

  Yes

  No

• Is there protection set up to protect employees and equipment from this overhead hazard

  Yes

  No

  N/A

• What kind of protection for these overhead obstructions are in use?

• Add media

  Media

• Are there any underground pipelines that need to be crossed?

  Yes

  No

• Are the underground pipelines protected?

  Yes

  No

  N/A

• Add media

  Media

• Are truck drivers physically located in a safe location while their truck is being loaded/unloaded?

  Yes

  No

  N/A

• Are spotters staying at least 20' away from moving equipment? (Unless needed to guide forks to load or unload or move mats) (Operation Bubble)

  Yes

  No

  N/A

• Are mats being stacked according to company safety standards outlined in EHS&E policy #2 > section #4 > paragraph #4?

  Yes

  No

  N/A

• Add media

  Media

Reporting

• Any "Near Misses" on this job site?

  Yes

  No

• Explain:

• Any accidents on this job site?

  Yes

  No

• Explain:

Special or customer requirements?

• Are all customer required books on site and available?

  Yes

  No

  N/A

• Add media

  Media

Signature of review and acceptance of audit findings

• Foreman:

  Sign

• Project Manager:

  Sign

• Safety Representative

  Sign

• Company Officer

  Sign