Knife River Intermountain Job Audit

• Audit Title

• Prepared by

• Position

• Client / Site

• Conducted on

  Date
• Location
  Address

• Personnel

PPE

• Hard Hats

  Yes

  No

  N/A

• Safety Glasses and/or Face Shield and/or Goggles

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Respiratory Protection

  Yes

  No

  N/A

• Gloves

  Yes

  No

  N/A

• Safety Toe Boots

  Yes

  No

  N/A

• Chaps

  Yes

  No

  N/A

• Sleeved shirt and long pants

  Yes

  No

  N/A

• High Visibility Shirt/Vest

  Yes

  No

  N/A

• Class 3 Vest

  Yes

  No

  N/A

Mobile Equipment/Trucks

• Equipment Inspected

  Yes

  No

  N/A

• Guarding of Machine Parts

  Yes

  No

  N/A

• Horns, Lights, Backup Alarms, Cameras all Working

  Yes

  No

  N/A

• Seatbelts Inspected and Worn

  Yes

  No

  N/A

• Floorboard Free of Clutter

  Yes

  No

  N/A

• Steps Clear of Debris

  Yes

  No

  N/A

• Fire Extinguishers Mounted and Inspected

  Yes

  No

  N/A

Work Site

• Organized Flow/Traffic Control

  Yes

  No

  N/A

• Standard Railing and Toe Boards Installed

  Yes

  No

  N/A

• Berms or Guards in Place

  Yes

  No

  N/A

• Electrical Hazards

  Yes

  No

  N/A

• Fire Extinguishers Mounted and Inspected

  Yes

  No

  N/A

• Eyewash Stations Inspected and Clear

  Yes

  No

  N/A

• Flammable Liquids and Gases Controlled

  Yes

  No

  N/A

• JSA’s Available

  Yes

  No

  N/A

• SDS’s Available

  Yes

  No

  N/A

Personal Risk Management

• Worker Responding To Hazards

  Yes

  No

  N/A

• Proper Lifting

  Yes

  No

  N/A

• Workers Trained for Task

  Yes

  No

  N/A

• Workers Protected from Falls Above 6ft.

  Yes

  No

  N/A

• Repetitive Motion Hazards

  Yes

  No

  N/A

• Extreme Cold/Heat - Hydration and Breaks

  Yes

  No

  N/A

Trenching Site

• 4’ - 5’ Deep - Egress Ladder within 25ft.

  Yes

  No

  N/A

• 5’ or Deeper - Properly Sloped/Shored/Shielded

  Yes

  No

  N/A

• Standing or Flowing Water Comtrolled

  Yes

  No

  N/A

• Spoil Pile Minimum 2’ Away from Edge

  Yes

  No

  N/A

• Soil Classified

  Yes

  No

  N/A

• Trenching Data Available/Trench Inspection Conducted

  Yes

  No

  N/A

• Utilities Marked

  Yes

  No

  N/A

• Workers Not Exposed To Cave-In or Falling Object

  Yes

  No

  N/A

• Competent Person Near By

  Yes

  No

  N/A

Housekeeping

• Egress Clear

  Yes

  No

  N/A

• Slips, Trips, Fall Hazards

  Yes

  No

  N/A

• Clutter

  Yes

  No

  N/A

• Vegetation Controlled

  Yes

  No

  N/A

• Food Consumed Properly

  Yes

  No

  N/A

Employee Interview

• Safety Statement

  Yes

  No

  N/A

• Toolbox Talk/JSA Conducted and Understood

  Yes

  No

  N/A

• Supervisory Support of Safety

  Yes

  No

  N/A

• Unchecked Hazards (Document Below)

Comments

• Audit Positive Comments

• Audit Corrective Comments

Driver/Operator Observations

• Equipment #

• Seatbelt Worn?

• Free of Distractions (Cell Phone, Radio, etc.)?

• Aware of Surrounding Hazards/Conditions?

• Comments

Driver/Operator Observations

• Equipment #

• Seatbelt Worn?

• Free of Distractions (Cell Phone, Radio, etc.)?

• Aware of Surrounding Hazards/Conditions?

• Comments

Driver/Operator Observations

• Equipment #

• Seatbelt Worn?

• Free of Distractions (Cell Phone, Radio, etc.)?

• Aware of Surrounding Hazards/Conditions?

• Comments

Pictures

• Pictures

  Media