Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

General

  • Job Site Location
  • Site Visit Date and Time

PPE - Personal Protective Equipment

  • All employees are wearing their hard hats?

  • All employees are wearing safety glasses?

  • All employees are wearing work boots? No gym shoes.

  • All employees are using the proper respirator protection when applicable? Full, 1/2, particle mask respirators.

  • All employees bodies are protected when spraying? Tyvek suits, gloves, head sock, etc..

  • Reflective vests are being worn where required and when working with the general public?

  • Hearing protection is utilized when needed?

  • All employees have proper work clothing? Pants, shirts with sleeves? Clean and professional appearance?

Fall Protection

  • Employees working above 6' are utilizing fall protection?

  • Employees working on boom lifts are utilizing a harness and retractable lanyard?

  • Anchor points are capable of supporting 5000 lbs?

  • Warning lines are flagged and placed a minimum of 6' from leading edge?

Step Ladders

  • Employees are not to be standing on or above the last 2 steps.

  • Employees are not to lean step ladders during use.

  • Are spreaders fully opened on step ladder?

  • Employees are not over reaching to one side losing 3 points of contact.

Baker Scaffolding

  • Safety rails and outriggers are installed when using scaffold above 6'.

  • Are wheels locked during use?

  • Scaffold is not being moved with employee on baker scaffold? No "surfing".

Powered Industrial Equipment

  • Forklift, scissor lift, boom lift and lull lift are operated by trained/certified employees?

  • Forklift operator is wearing a seatbelt? Reflective vest is being worn?

  • Forklift back up beeper is operational?

  • Scissor lift chain is connected or door is closed when in use?

  • Employees on scissor lifts are standing in base of lift? No standing on the rails.

  • Terrain was inspected before any lift is used in that area?

Hand and Power Tools

  • Power tools are free from damage? (Switches, cords, guards, etc..)

  • Hand tools are free from damage?

  • Pumps and generators are inspected before use? Fuel is added with equipment not running?

Electrical

  • Extension cords are inspected and in good condition?

  • GFCI'S are being used on all cords and equipment?

  • There are no open electrical panels in our work area?

Housekeeping/Site Conditions

  • Is work site clean and free of debris?

  • Storage yard/area is clean and organized?

  • Spray pumps are cleaned and maintained every shift?

  • Site has adequate lighting?

Hazard Communication/GHS

  • Have all employees had their Hazard Communication/GHS training?

  • Product labels and pictograms have not been removed from manufacturers containers?

  • Any materials transferred to portable containers have been labeled with product name and type.

  • Are SDS sheets available electronically or as hard copies on job site?

First Aid

  • First aid kit is on site and accessible to all employees?

Signature

  • Lankford Management 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.