Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Personnel
Previous Jobsite Safety Survey
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Was previous survey reviewed?
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Are there any outstanding items?
Personal Protective Equipment
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Hard Hat<br>
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Safety Glasses
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Gloves
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High-Visibility Vest
Material Handling & Ergonomics
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Morning Stretching Completed
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Spool Handling
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Material Handling Aids
Electrical
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Temporary Splices Properly Executed
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Proper Support for Cables
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Enclosures Entact
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Cord & Cable Condition
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Weather Protection
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GFCI Inspections Current
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Temporary Lighting
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LOTO & Electrical Safe Work Practices
Walking & Working Surfaces
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Housekeeping
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Water-Mud-Snow-Ice Removal
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Building Egress
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Other
Ladder Use
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Stepladders
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Extension Ladders
Boom and Scissors Lift Operations
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Safety Chains Used on Lifts
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Pre-Shift Inspection Performed
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Tied Off When Required
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Annual Inpections Current
Fall Protection
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Guardrails and Warning Lines
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Holes Covered
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Personal Fall Arrest System
Fire Protection
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Fire Extinguishers
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Combustible Loads Managed
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Hot Work Procedures
Employee Health
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Other
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Dust Control
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Sanitation
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Wet Concrete Cutting & Boring
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Proper Clean Up of Slurry
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Fireproofing Clean Up
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Carbon Monoxide
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PACM Survey & Procedures
Scaffolding
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Inspected by Competent Person
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Baseplates & Mudsills
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Guardrails
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Working Level Completely Decked
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Diagonal Brace on Rolling Tower
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Proper Access (Ladders & Stairs)
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Miscellaneous (pins, wind clips, anchorage)
Excavations
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Proper Slope & Shore
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Spoils Pile Set Back 2 Feet
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Egress within 25 Feet
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Ladder Use
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Daily Inspection by Competent Person
Cranes & Rigging
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Crews Under Loads
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Loads Properly Controlled
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Sling Condition & Storage
Employee Safety Contacts
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Name & Comments:
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Name & Comments:
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Name & Comments:
