Jostin Site Safety Audit

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Is the JSA properly filled out and relevant to today’s task(s)?

  Yes

  No

  N/A

• Is the JSA signed by all crew members?

  Yes

  No

  N/A

• What is the toolbox topic this week? Ask member of crew.

PPE

• Hard hats worn by all personnel in work areas?

  Yes

  No

  N/A

• Eye and face protection worn as required?

  Yes

  No

  N/A

• Hearing protection worn as required?

  Yes

  No

  N/A

• Respiratory protection worn as required?

  Yes

  No

  N/A

• Proper boots worn as required?

  Yes

  No

  N/A

• Coveralls/Tyvek worn as required?

  Yes

  No

  N/A

• PPE in good condition and stored properly?

  Yes

  No

  N/A

Housekeeping

• Walkways and stairs kept clear of material and debris?

  Yes

  No

  N/A

• Cords and hoses strung to avoid trip/fall hazard?

  Yes

  No

  N/A

• Gang boxes clean and orderly?

  Yes

  No

  N/A

• Trash, scrap and debris picked up and disposed of?

  Yes

  No

  N/A

Fire Protection

• Proper class fire extinguishers in work area?

  Yes

  No

  N/A

• Fire extinguishers inspected and signed monthly?

  Yes

  No

  N/A

• Flammables stores and handled in approved containers?

  Yes

  No

  N/A

Tools

• Correct tool used for the job?

  Yes

  No

  N/A

• Tools in good and reliable condition?

  Yes

  No

  N/A

• Power tools unplugged if unattended?

  Yes

  No

  N/A

Ladders

• Straight ladders secured/tied off?

  Yes

  No

  N/A

• Straight ladders extend 3’ above landing?

  Yes

  No

  N/A

• Straight ladders have feet or blocked at bottom?

  Yes

  No

  N/A

• Straight ladders set with 4 to 1 slope?

  Yes

  No

  N/A

• Step ladders locked in place properly?

  Yes

  No

  N/A

Scaffolds and Aerial Lifts

• Scaffold planks kept clean?

  Yes

  No

  N/A

• Scaffolds have guardrails, mid rails and toe boards?

  Yes

  No

  N/A

• Wheels on rolling scaffolds locked during use?

  Yes

  No

  N/A

• Scaffold tags present and signed off by competent person?

  Yes

  No

  N/A

• Only trained employees using aerial lift?

  Yes

  No

  N/A

• Operator and passenger are tied off properly?

  Yes

  No

  N/A

Working at Heights and Open Holes

• Elevated work areas closed in by handrails or other hard barricade?

  Yes

  No

  N/A

• Rails are sturdy, continuous and have mid rails?

  Yes

  No

  N/A

• Floor holes are surrounded by hard barricade or covered with hole cover?

  Yes

  No

  N/A

• Hole covers secured down?

  Yes

  No

  N/A

• Hole covers properly marked?

  Yes

  No

  N/A

Excavation and Trench

• Excavations 5’ or deeper shored, sloped or boxed

  Yes

  No

  N/A

• Workers staying within protected area?

  Yes

  No

  N/A

• Spoil pile is kept at least 2’ back from lip of trench?

  Yes

  No

  N/A

• Barricades placed when trench not occupied?

  Yes

  No

  N/A

• Ladders placed every 25’ for worker entry and exit?

  Yes

  No

  N/A

Communication

• Do foreman/supervisors communicate with their crew when needed?

  Yes

  No

  N/A

• Do foreman/supervisors address safety concerns?

  Yes

  No

  N/A