LAX

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Personal Protection Devices

• Hard hats

  Yes

  No

  N/A

• Eye Protection

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Hand Protection

  Yes

  No

  N/A

• Respiratory Protection

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Electrical

• Temp Lighting

  Yes

  No

  N/A

• Temp Power

  Yes

  No

  N/A

• Extension Cords

  Yes

  No

  N/A

• GFCI's In Use

  Yes

  No

  N/A

• Electrical Panel Cover

  Yes

  No

  N/A

• Lock-out/Tag-out Program

  Yes

  No

  N/A

Fire Protection

• Temp Fire Extinguishers

  Yes

  No

  N/A

• Smoking

  Yes

  No

  N/A

• Gasoline Containers

  Yes

  No

  N/A

• Oxygen/Acetylene Tanks

  Yes

  No

  N/A

• Burn Permit

  Yes

  No

  N/A

• Fire Watch

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Housekeeping/General

• Clean-up

  Yes

  No

  N/A

• First Aid Kits

  Yes

  No

  N/A

• Emergency Info Posted

  Yes

  No

  N/A

• Portable Toilets

  Yes

  No

  N/A

Access/Fall Protection

• Ladders

  Yes

  No

  N/A

• Stairways

  Yes

  No

  N/A

• Guard rails

  Yes

  No

  N/A

• Scaffolding

  Yes

  No

  N/A

• Holes Covered

  Yes

  No

  N/A

• Rebar Protection

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Equipment

• Back-up Alarms

  Yes

  No

  N/A

• Operators Trained

  Yes

  No

  N/A

• Seatbelts

  Yes

  No

  N/A

• Guards In Place

  Yes

  No

  N/A

Excavations

• Dig Alert Notified

  Yes

  No

  N/A

• Proper Slope or Shoring

  Yes

  No

  N/A

• Barricaded

  Yes

  No

  N/A

Additional Comments