Title Page

  • Audit Title

  • Client / Site

  • Prepared by

  • Personnel

SIGNAGE

  • Haz Assessment Thoroughly Completed

First Impression

  • First Impression - cleanliness and order

  • Sign In

All signs:Warnings, DOL, Cal OSHA, MPN, IR, Map, Emerg Evac, Laser, PAT, KDC Rules

  • See Above all compliant

  • First Aid Kit

  • Fire extinguisher

Public

  • Pedestrian / Public Protection Plan

Fall Protection/Prevention

  • Scissor lift safety and compliance

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

Scaffold Compliance

  • Scaffold Safety

Trenching Excavation

  • Cave In Protection

  • Fall Protection 6ft or >

Electrical / Tools

  • Tool safety

  • Electrical Safety - GFCI, Temp Power, Cords, Open Panels, LOTO

Ladders

  • Ladder Safety including manufacturing labels

  • Ladder usage and set up

Housekeeping

  • Housekeeping [Interior & Exterior]

  • Water in compliance with HIPP

  • Impalement Risks

  • Any trip and fall hazards

Safety Plans - Required Permits

  • Silica Mngt Plan

  • Demo Plan

  • Hot Work Permit

  • Scaffold Plan

  • Rolling Scaffold Plan

  • Pedestrian Protection Plan (Signed)

  • Crane Plan

  • Trenching Plan

  • Fork/Boom Lift Certs

  • Powder Actuated Tool Lic

PPE

  • PPE Compliance - Z87.1, N95, N100, Hardhats, Gloves, Hearing P, Class II Vests

  • SWPPP ISSUES?

  • Sanitation

  • Notes/Commeny

  • Signature

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.