LES Guard Rail Audit (Rev 12-2013)

• Name and Address of Project
  Address

• Name of Team Leader

• # of Employees

• Date Audit Performed

  Date

• Prepared by

1.0 Guard Rail

• 1.1 Guard Rail Required

  Safe

  At Risk

  N/A

• 1.2 Top Rail, 42 inches (+ / - 3) above working surface.

  Safe

  At Risk

  N/A

• 1.3 Mid Rail, 21 inches (+ / - 3) above working surface.

  Safe

  At Risk

  N/A

• 1.4 Toe-board for work above 10 ft.

  Yes

  No

  N/A

• 1.5 Guard Rail. (Max 25 Points)

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2.0 Fixed Stairs

• 2.1 Fixed Stairs

  Yes

  No

  N/A

• Fixed Stair Max (20 points)

3.0 Fixed Ladder

• 3.1 Fixed Ladder

  Yes

  No

  N/A

• 3.2 Secured to Wall or Structure

  Yes

  No

  N/A

• 3.3 Safe to Climb

  Yes

  No

  N/A

• 3.4 Fixed Ladder (10 Points Max)

4.0 Extension Ladder

• 4.1 Extension Ladder Used

  Yes

  No

  N/A

• 4.2 Has inspection tag.

  Safe

  At Risk

  N/A

• 4.3 Missing, bent, or broken parts

  Safe

  At Risk

  N/A

• 4.4 Missing fly rope.

  Safe

  At Risk

  N/A

• 4.5 3 ft. above landing or eave.

  Safe

  At Risk

  N/A

• 4.6 Secured at top.

  Safe

  At Risk

  N/A

• 4.7 Secured at bottom.

  Safe

  At Risk

  N/A

• 4.8 Extension Ladder (10 Max Points)

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5.0 PPE

• 5.1 Hearing Protection Required for Loud Noises.

  Safe

  At Risk

  N/A

• 5.2 Hard Hat worn for overhead hazards and work.

  Safe

  At Risk

  N/A

• 5.3 Longs Pants Required for Hot Work

  Safe

  At Risk

  N/A

• 5.4 Long Sleeved Shirt Required for Hot Work

  Safe

  At Risk

  N/A

• 5.5 Respirator Required.

  Safe

  At Risk

  N/A

• 5.6 Safety Glasses

  Safe

  At Risk

  N/A

• 5.7 Worn for tear off.

  Safe

  At Risk

  N/A

• 5.8 Worn for other eye hazards.

  Safe

  At Risk

  N/A

• 5.9 PPE worn correctly.

  Safe

  At Risk

  N/A

• 5.0 Personal Protective Equipment (PPE) (5 Points Max)

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6.0 Electrical

• 6.1 Electrical Used.

  Yes

  No

  N/A

• 6.2 Wires inspected.

  Safe

  At Risk

  N/A

• 6.3 GFCI Used for Temporary Power Sources.

  Safe

  At Risk

  N/A

• 6.4 Work Remains 20 feet Away from Electrical Lines

  Safe

  At Risk

  N/A

• 6.5 Covers Required for Electrical Lines.

  Safe

  At Risk

  N/A

• 6.6 Electrical (5 Points Max)

7.0 Material Hoisting

• 7.1 Trash Chute or Hoisting Used for Elevated Projects (20 feet or more)

  Safe

  At Risk

  N/A

• 7.2 Pallets Not Stacked More than 2 High

  Safe

  At Risk

  N/A

8.0 Cranes

• 8.1 Crane Used.

  Yes

  No

  N/A

• 8.2 Crane Operator Trained.

  Safe

  At Risk

  N/A

• 8.3 Signal Person Trained and Communicates with Operator.

  Safe

  At Risk

  N/A

• 8.4 Sling tag available and serviceable for use.

  Safe

  At Risk

  N/A

• 8.5 Overhead Work Signs Posted near Hoisting Area(s).

  Safe

  At Risk

  N/A

• 8.6 Flagging or Warning Lines Around Crane and Lift Area.

  Safe

  At Risk

  N/A

• 8.7 Taglines Used for Material or Equipment Control.

  Safe

  At Risk

  N/A

• 8.8 Crane Inspection Performed

  Yes

  No

  N/A

• 8.9 Hoisting (5 Points Max)

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9.0 Fire Prevention

• 9.1 Extinguishers within 25 - 50 feet of Work.

  Yes

  No

  N/A

• 9.2 Used / Spent Extinguishers removed from Project or Site.

  Yes

  No

  N/A

• 9.3 Gas Cans Labeled and Stored.

  Yes

  No

  N/A

• 9.4 Screen Located Within Gas Cans.

  Yes

  No

  N/A

• 9.5 Fire Prevention (5 Points Max)

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10.0 Forklift

• 10.1 Forklift Used.

  Yes

  No

  N/A

• 10.2 Forklift Operator Trained.

  Yes

  No

  N/A

• 10.3 Daily Inspection Performed.

  Yes

  No

  N/A

• 10.4 Rigger Trained and Communicates with Operator.

  Yes

  No

  N/A

• 10.5 Signal Person Trained and Communicates with Operator.

  Yes

  No

  N/A

11.0 General Liability

• 11.1 Nails Bent or Removed from Boards.

  Safe

  At Risk

  N/A

• 11.2 Roof Tie-in Performed Daily.

  Safe

  At Risk

  N/A

• 11.3 Plugs Removed from Drains.

  Safe

  At Risk

  N/A

• 11.4 Work logged Daily in a Journal.

  Safe

  At Risk

  N/A

• 11.5 Site or Project Inspected for Previous Damage.

  Safe

  At Risk

  N/A

• 11.6 Caution Signs Posted.

  Safe

  At Risk

  N/A

• 11.7 Drain Holes Covered

  Yes

  No

  N/A

• 11.8 Stairwells or Ladder Access have Guard Rails

  Yes

  No

  N/A

• 11.9 General Liability (5 Points Max)

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12.0 Emergency Readiness

• 12.1 First Aid Kit (with Eye Wash Bottle) On-Site and Available to Employees.

  Yes

  No

  N/A

• 12.2 HAZCOM Manual On-Site and Available to Employees.

  Yes

  No

  N/A

• 12.3 Safety Manual On-Site and Available to Employees.

  Yes

  No

  N/A

• 12.4 Emergency Readiness (5 Points Max)

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13.0 Scaffold.

• 13.1 Scaffold Required

  Yes

  No

  N/A

• 13.2 Scaffold has Hoist for Materials.

  Safe

  At Risk

  N/A

• 13.3 Access Secured at Night.

  Safe

  At Risk

  N/A

• 13.4 Inspected by Competent Person.

  Safe

  At Risk

  N/A

• 13.5 Scaffold has Green Tag for Use.

  Safe

  At Risk

  N/A

• 13.6 Scaffold is level.

  Safe

  At Risk

  N/A

• 13.7 4:1 Ratio and Tied to Building (Push / Pull)

  Safe

  At Risk

  N/A

• 13.8 Walk Boards Bent.

  Safe

  At Risk

  N/A

• 13.9 Scaffold (5 Points Max)

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14.0 Safety Talks

• 14.1 Performed Weekly, Signed & Turned In

  Yes

  No

  N/A

• Safety Talks (5 Points Max)

15.0 Signature

• Add signature

  Sign