Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

JOB INFORMATION

  • Safety Book

  • Tool box safety talks?

  • MSDS Book?

  • Work areas properly signed and barricaded?

  • Water available?

HOUSEKEEPING

  • Work areas neat?

  • Waste containers provided and used?

  • Passageways and walkways clear?

  • Cords and leads off the floor?

FIRE PREVENTION

  • Adequate fire extinguishers, checked and accessible?

  • Hot Work Permit Filed?

  • "No Smoking" posted and enforced near flammables?

ELECTRICAL

  • Extension wires with bare wires or missing ground prongs taken out of service?

  • Ground fault interrupters being used?

  • Terminal boxes equipped with required covers?

HAND, POWER & POWDER ACTUATED TOOLS

  • Hand tools inspected regularly?

  • Guards in place on machines?

  • Correct tool being used for job at hand?

  • Operators of powder actuated tools licensed?

FALL PROTECTION

  • Safety rails and cables secured properly?

  • Safety harnesses worn properly?

  • Employees exposed to fall hazards tied off?

  • Employees below protected from falling objects?

LADDERS

  • Ladders extended at least 36" above landing?

  • Ladders are secure to prevent slipping, sliding or falling?

  • Ladders with split or missing rungs taken out of service?

  • Stepladders used in fully open position?

  • No step at top two rungs of stepladder?

SCAFFOLDING

  • All scaffolding inspected daily?

  • Erected on sound rigid footing?

  • Tied to structure as required?

  • Guardrails, intermediate rails, toe boards and screens in place?

  • Planking is sound and sturdy?

  • Proper access provided?

  • Employees below protected from falling objects?

FLOOR & WALL OPENINGS

  • All floor openings planked over or barricaded?

  • Perimeter protection in place?

  • Deck planks secure?

  • Materials stored away from edge?

TRENCHES, EXCAVATION & SHORING

  • Competent person identified and present?

  • Excavations are shored and sloped back?

  • Materials are stored at least 2' away from trench?

  • Ladders provided every 25' in trench?

  • Equipment is at a safe distance from edge of trench or excavation?

MATERIAL HANDLING

  • Materials properly stored or stacked?

  • Employees using proper lifting techniques?

  • Proper number of workers for each operation?

PERSONAL PROTECTIVE EQUIPMENT

  • Hard hats being worn?

  • Safety glasses being worn?

  • Respirators used when required? Proper respirator documentation available?

  • Hearing protection being worn when required?

  • Traffic vests or high visibility clothing material being worn?

SUBCONTRACTOR'S

  • Westside Mechanical's Subcontractors working Safe?

SIGNATURES

  • Safety Manager

  • Superintendent

  • Rich Bulava

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.