Information
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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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Location
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Personnel
Job Tasks
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List the tasks to be performed at the time of this audit.
PPE
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Is PPE supplied adequate for the task?<br>- Correct Eye Protection<br>- Correct Work Shoes<br>-Correct Gloves
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Is PPE being worn properly? <br> -Ear plugs completely inserted into ears<br> -Safety glasses being worn?<br> -Gloves being worn when needed?<br> -Are Hi-vis safety vests worn by all employees?<br> -Are the Hi-vis vests properly maintained and in good condition?
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PPE supplies readily available to operators (Interview >= 2 employees.)
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Name of first employee interviewed.
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Name of second employee interviewed.
Material Handling
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Is the staking / storage of material in a safe condition?<br>-Is it out of the way?<br>-Secured?
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Are there proper signs indicating dangerous or hazardous material storage?
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Is the storage of equipment and tools adequate?
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Is correct lifting technique being used?
Tools/Machinery/Equipment
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Are all tools in good working condition?<br> -Held together with tape?<br> -Excessive noise/vibration?<br> -Requires excessive force?<br> -Are Breaker/Cheater bars being used?
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All existing guarding in place?<br> - No Guards missing or removed?
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Hand tools and equipment working properly and not causing regular manual manipulation?<br> -Machinery producing excessive noise/vibration due to disrepair?
Hazard Communication
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Employees know how to find SDS and understand the hazards of the chemicals they work with. (Interview >=2 employees)
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Ventilation adequate for the airborne health hazards?<br> -Employee complaints about "fumes" or "nausea/dizziness"
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Is there excessive dust present in the air or on surfaces?<br> -Is water needed to wet driving paths?
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Chemicals are stored in proper containers and labeled properly?<br> -Labels legible and accurately indicates the chemical that is inside the container?
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Are fuel containers being stored properly?<br> -Are fuel containers stored in the designated area?<br> -Are fuel containers made of the proper material? (No plastic)
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Incidental spills cleaned up immediately?<br> -No evidence of spills being left?<br> -Are spill cleanup supplies available?<br> -Is there any secondary containment?
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Chemicals stored properly?<br> -Flammable materials not in use stored in proper cabinet/safety container?<br> -Incompatible materials stored away from each other?<br> -Are oxygen tanks stored away from fuels, including acetylene?
Walking/Working Surfaces and Fall Protection
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Are there portable stairs or ladders in place to provide safe access on steep slopes or trenches/excavations when employees present?<br> -Are the stairs or ladders maintained and in good condition?
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Are ladders being used correctly?<br>- Secured<br>- Correct angle<br>- 3 ft above<br>- Inspected before use
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Is the work site well kept and free of trash and tripping hazards?<br> -Are materials stored in a neat and orderly fashion?
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Handrails installed where a fall from a height of six feet or greater exists?
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Fall protection equipment available for working at heights greater than 6 feet from the working surface below it where fall prevention is not available?
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Harnesses, lanyards, SRL, and lifelines maintained in good condition and inspected properly?<br> -Inspection labels present and legible?<br> -Webbing free of frayed, cut or broken fibers?<br> -Quick connect buckles working properly?
Emergency Response/Fire Protection
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Are there fire extinguishers near fire hazards?<br> -Near hot work?<br> -Between 10 and 20 ft from fueling areas?
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Fire extinguishers inspected monthly and unblocked?
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Employees aware of Emergency Action Plans? (Interview >=2 employees)
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Name of first employee interviewed
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Name of second employee interviewed
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First Aid stations inspected and unblocked?<br> -Do employees know where the first aid stations are located?
Mobile Equipment
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Equipment inspected daily before use?
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If applicable, are steps in good condition on the equipment?
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Does operator use 3 points of contact when entering or exiting equipment?
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Is the equipment checked for:<br> -Is the window glass broken?<br> -Are Radios working?<br> -All lights functioning?
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Are birms at least axle height on haul roads or buk edges?
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Operators using horns and warning devices where required?<br> -Do the backup alarms work?
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Are fueling areas efficiently laid out with respect to the entry and exit of the work site?
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No passengers on equipment designed for operators only?
Electrical Hazards/Arc Flash
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High voltage signs in place and visible?<br> -Are overhead lines marked?
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Electrical cabinets closed and in good repair?<br> -Do the cabinets close securely?<br> -Knock-outs all in place?<br> -Large dents in the housing/door?
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Is there GFCI protection?
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Are temporary power areas protected from accidental damage?<br> -Are there barricades or other controls to prevent damage?
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Electrical cabinets not blocked?<br> -Nothing within 36 inches of the front of the cabinet?<br> -Clear access/pathway to electrical cabinets?
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If portable generators are used:<br> -Are there GFCI present?<br> -If over 5000W, is it grounded?
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Are all electrical chords in good condition?<br>-No self Repair<br>-No cuts or holes
Hazardous Energy Control (Lockout/Tagout)
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Energy control procedures exist for all equipment in the area and employees know where to find them?
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Employees have locks available?<br> -For maintenance<br> -
Crane/Hoist Safety
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Inspections completed as per requirements?<br> -Operator inspections completed?<br> -PM's completed as per the schedule?
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Are outriggers fully engaged?<br> -Is the ground condition adequate for the weight of the outriggers?
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Is the crane barricaded so that no one can get hit by the counter weight?
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Are employees working under suspended loads?
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Is there a designated signal person?
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Are cranes working within their operating limits?<br> -Capacity not exceeded?<br> -Upper limit switch not used as a stop?
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Is all rigging equipment in good condition?<br>- Chokers / Slings / Chains<br>-Hooks and Safety Latches
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Is all rigging equipment inspected before use?
General Safety and Housekeeping
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Trash, debris, and equipment not left laying around?
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Equipment free of excessive dust, oil and/or soot?
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General tripping hazards due to housekeeping, equipment layout, and/or workstation design?
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Is there proper sanitation on site?
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Are barricades, fences, or bails in good working order and in the correct position?
Environmental Management
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Are there controls that satisfy the Department of Environmental Protection?
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Are there controls for erosion and sediment?
Excavation Safety
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What is the soil type?
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Is the sloping adequate for the soil type? A = 3/4:1; B = 1:1; C = 1.5:1
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Is there trenching?
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Is the trenching less than 5 ft deep or is there sufficient employee protection? (Trench box)
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Is there means of access / egress?<br>-Is it within 25 ft of employees?
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Are employees at the bottom of the excavation properly protected from from the hazard of falling, rolling, or sliding material or equipment?<br>-Equipment, Spoils, and/or rocks at least 2 ft from the top of the excavation?
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Are barricades or stop blocks necessary?
Corrective Action
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Actions
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Item Description
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Control or Mitigation strategy
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Person Responsible for correction
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Time frame for corrective action completion
Signature and Finalization
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I have completed this assessment to the best of my knowledge. This audit is not intended to identify all safety and health hazards, but to identify all visible/known hazards as of the date printed on the completed assessment. assessment.
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Select date
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General Comments
