KDC SAFETY AUDIT SERV MAIN 2022

• Job No

• Audit Title

• Client / Site

• Prepared by

• Personnel

• Add location
  Address

SIGNAGE

• Haz Assessment Thoroughly Completed

  Yes

  No

  N/A

• KDC HSE and SDS on phone

  Yes

  No

  N/A

• MPN Location

  Yes

  No

  N/A

• Incident Reporting Instruction Understood

  Yes

  No

  N/A

• Heat Illness SOP if Applicable

  Yes

  No

  N/A

Public

• Duty To Warn, Duty To Protect & Duty To Control

  Yes

  No

  N/A

• Public protection access egress

  Safe

  At Risk

  N/A

Fall Protection/Prevention

• Fall protection if exposed to a free fall six feet or more

  Safe

  At Risk

  N/A

• PFAS Inspected

  Yes

  No

  N/A

• Electrical cords extension cords GFCI

  Safe

  At Risk

  N/A

Ladders

• Ladder Safety including manufacturing labels

  Safe

  At Risk

  N/A

• Brackets

  Yes

  No

  N/A

• Rungs

  Yes

  No

  N/A

• Ladder usage and set up

  Yes

  No

  N/A

• Housekeeping

  Yes

  No

  N/A

• FOCUS FOUR - electrical caught in between struck by fall protection

  Yes

  No

  N/A

• Any trip and fall hazards

  Safe

  At Risk

  N/A

• SWPPP ISSUES?

  Safe

  At Risk

  N/A

Safety Plans - Required Permits

• Fall Protection > 15ft

  Yes

  No

  N/A

• Silica Awareness Plan

  Yes

  No

  N/A

• Hot Work Permit

  Yes

  No

  N/A

• Dust Control

  Safe

  At Risk

  N/A

PPE

• Hard Hats

  Yes

  No

  N/A

• Vests

  Yes

  No

  N/A

• ANZI Z87.1

  Yes

  No

  N/A

• Hand Protection Correct for task

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Respiratory Protection

  Yes

  No

  N/A

• Silica Exposure

  Safe

  At Risk

  N/A

• Silica Exposure Plan Completed

  Yes

  No

  N/A

• Equipment safety

  Yes

  No

  N/A

• Machinery equipment tool certifications

  Yes

  No

  N/A

• Safety Non-Compliance

  Safe

  At Risk

  N/A

• Current registration insurance and claims information

  Yes

  No

  N/A

• Vehicle walk around prior to operation

  Yes

  No

  N/A

• Cleanliness of Van

  Yes

  No

  N/A

• Driving skills

  Yes

  No

  N/A

• 1st aid kit readily accessible

  Yes

  No

  N/A

• Fire extinguisher readily accessible

  Yes

  No

  N/A

• Clean company logo shirt with name ballcap

  Yes

  No

  N/A

• Signature

  Sign