Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Personnel

Previous Jobsite Safety Survey

  • Was previous survey reviewed?

  • Are there any outstanding items?

Personal Protective Equipment

  • Hard Hat<br>

  • Safety Glasses

  • Gloves

  • High-Visibility Vest

Material Handling & Ergonomics

  • Morning Stretching Completed

  • Spool Handling

  • Material Handling Aids

Electrical

  • LOTO & Electrical Safe Work Practices

  • Live Work Authorization - Review Results

  • Enclosures Entact

  • Temporary Lighting

  • GFCI Inspections Current

  • Proper Support for Cables

  • Temporary Splices Properly Executed

  • Cord & Cable Condition

  • Weather Protection

Walking & Working Surfaces

  • Housekeeping

  • Water-Mud-Snow-Ice Removal

  • Building Egress

  • Other

Ladder Use

  • Stepladders

  • Extension Ladders

Boom and Scissors Lift Operations

  • Safety Chains Used on Lifts

  • Pre-Shift Inspection Performed

  • Tied Off When Required

  • Annual Inpections Current

Fall Protection

  • Guardrails and Warning Lines

  • Holes Covered

  • Personal Fall Arrest System

Fire Protection

  • Fire Extinguishers

  • Combustible Loads Managed

  • Hot Work Procedures

  • Are there live sprinkler heads on this job?

Employee Health

  • Sanitation

  • Dust Control

  • Fireproofing Clean Up

  • Wet Concrete Cutting & Boring

  • Proper Clean Up of Slurry

  • Carbon Monoxide

  • PACM Survey & Procedures

  • Other

Scaffolding

  • Inspected by Competent Person

  • Baseplates & Mudsills

  • Guardrails

  • Working Level Completely Decked

  • Diagonal Brace on Rolling Tower

  • Proper Access (Ladders & Stairs)

  • Miscellaneous (pins, wind clips, anchorage)

Excavations

  • Proper Slope & Shore

  • Spoils Pile Set Back 2 Feet

  • Egress within 25 Feet

  • Ladder Use

  • Daily Inspection by Competent Person

Cranes & Rigging

  • Crews Under Loads

  • Loads Properly Controlled

  • Sling Condition & Storage

Miscellaneous

  • Health & Safety

  • Environmental

  • Other

Short Service Employee - Contacts

  • Name & Comments:

  • Name & Comments:

Employee Safety Contacts

  • Name & Comments:

  • Name & Comments:

  • Name & Comments:

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