Title Page

  • Audit Title

  • Prepared by

  • Superintendent

SIGNAGE and COVID19 Controls

  • First Glance Site Appearance

  • COVID19 Prevention

  • Warning Signs

  • Laser Sign if needed

  • Silica Sign if risk present

  • Haz Assessment Thoroughly Completed - Does it reflect ALL risks?

  • Sign In

  • DOL Poster

  • Cal OSHA Safety Poster

  • KDC rules posted

  • MPN and map posted

  • Incident Reporting instructions posted

  • Emergency Evac

  • Fire Extg Inspection

  • If applicable organization and cleanliness of job trailer

Public

  • Pedestrian / Public Protection Plan

  • Any trip hazards for public

Fall Protection/Prevention

  • Potential of 6ft fall or more

  • PFAS Correctly Used & Inspected

  • Scissor lift safety and compliance

  • Boom Lift Safety Compliance

Scaffold Compliance

  • Rolling Scaffold Plan

  • Scaffold Safety Plan

  • Condition of planking, spacing etc

  • Base Plate and Sills

  • Guard Rails

  • Access Ladder

  • Daily Inspection & Signed Green Tag

Trenching Excavation

  • Soil Testing (A , B or C)

  • Comp Person on site

  • Annual Trench Permit from OSHA

  • KDC Plan

  • Access Egress 4ft or >

  • Egress within 25ft of workers

  • Cave In Protection 5ft or >

  • Spoil Piles 2ft Back

  • Fall Protection 6ft or >

  • For speed shoring Tabulated Data Sheets

  • Signage and Trench Protection

Electrical / Tools / Equipment

  • Tool safety

  • Powder Actuated Tool Cert

  • Equipment safety

  • Aerial Lift Cert

  • Forklift Cert

  • Shock/Arc Energized Exposure

  • Temp Power

  • Extension Cords

  • LOTO and Plan

  • GFCI

Ladders

  • Ladder Safety including manufacturing labels

  • Ladder usage and set up

Housekeeping

  • Housekeeping [Interior & Exterior]

  • Water in compliance with HIPP

  • Caught In-Between

  • Struck By

  • Trip and Fall Risks(non-public)

  • Impalement Protection

  • Impalement Warning Signs

KDC Safety Plans Completed

  • Silica Mngt Plan

  • Demo Plan

  • Hot Work Permit

  • Crane Plan

PPE

  • Class II Vests or apparel

  • Hard Hats

  • Safety Glasses

  • Face Protection

  • Foot Protection

  • Hearing Protection

  • Respiratory Protection

  • Hand Protection

Sanitation

  • External Wash Station

  • Clean with supplies

  • Trash Container

SWPPP

  • Strom Drains Protected

  • Track Out

  • Fiber Rolls Installed Correctly

  • Dust Control

  • Erosion Control

  • Trash and Debris

  • SWPPP / ECP Followed

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Notes

  • Notes/Comments/Suggestions

Training or Follow Up

  • Suggested training

  • Staff member to follow up

Signature

  • Safety Inspector & Superintendent

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.