Management Safety Audit

• Site conducted

  Select

• Client / Site

• Conducted on

  Date

• Prepared by

• Name(s) of Person(s) Participating in Inspection:

• Location
  Address

• Number of Employees on Site

General

• Supervisor / Foreman at time of this inspection

• Select site weather conditions at time of this inspection (select all that apply)

  Select Clear Sky Cloudy Raining Windy Hazy Snow / Hail OTHER

  • Clear Sky
  • Cloudy
  • Raining
  • Windy
  • Hazy
  • Snow / Hail
  • OTHER

• Describe weather conditions on site today

• Minimum temperature today?

• Maximum temperature today?

• Current activities being undertaken on site (select all that apply)

  Select Asbestos Abatement Abrasive Blasting Cleanup Coatings General Insulation Lead Removal OTHER Scaffolding Siding

  • Asbestos Abatement
  • Abrasive Blasting
  • Cleanup
  • Coatings
  • General
  • Insulation
  • Lead Removal
  • OTHER
  • Scaffolding
  • Siding

• Describe activity being undertaken on site

Safety Audit

Administrative / General Inspection

• Is Administrative/General Inspection to be conducted during this audit?

  Yes

  No

  N/A

• Federal and State Posters are posted and up to date.

  Safe

  At Risk

  N/A

• Daily/Weekly Safety Meetings documented.

  Safe

  At Risk

  N/A

• Supervisor Safety Inspections are being conducted throughout the week.

  Safe

  At Risk

  N/A

• JHA/JSA are completed for each task and reviewed daily.

  Safe

  At Risk

  N/A

• Emergency phone numbers and evacuation procedures posted.

  Safe

  At Risk

  N/A

• BBP and First Aid kit available and adequately stocked for workplace manpower.

  Safe

  At Risk

  N/A

• Monthly/Quarterly Equipment Inspections completed (Color Tape).

  Safe

  At Risk

  N/A

• Scaffold log available and up to date.

  Safe

  At Risk

  N/A

• Work areas properly signed/barricaded.

  Safe

  At Risk

  N/A

• Sign In/Out Log completed and accurate.

  Safe

  At Risk

  N/A

• OSHA 300 Summary Posted (Feb. 1 – Apr.1).

  Safe

  At Risk

  N/A

• Drinking water is available.

  Safe

  At Risk

  N/A

• Sanitary facilities available.

  Safe

  At Risk

  N/A

Housekeeping

• Is housekeeping to be inspected during this audit?

  Yes

  No

  N/A

• General housekeeping is neat and orderly

  Safe

  At Risk

  N/A

• Materials stored away from unprotected edges.

  Safe

  At Risk

  N/A

• Scrap materials have been removed or stacked in an orderly fashion.

  Safe

  At Risk

  N/A

• Scrap materials are not creating a slip/trip/fall hazard (i.e. clear aisles and stairs)

  Safe

  At Risk

  N/A

• Waste is disposed of in appropriate containers.

  Safe

  At Risk

  N/A

• No spills of liquid materials are creating a slip/trip/fall hazard.

  Safe

  At Risk

  N/A

• Work areas have the appropriate amount of lighting.

  Safe

  At Risk

  N/A

Fire Prevention

• Is fire prevention being inspected during this audit?

  Yes

  No

  N/A

• Sufficient fire extinguishers provided, of the correct type.

  Safe

  At Risk

  N/A

• Exits marked/accessible.

  Safe

  At Risk

  N/A

• Flammable and combustible substances are safely stored and labeled in approved safety cans/cabinets.

  Safe

  At Risk

  N/A

• Flammable material containers are properly bonded when transferring liquids.

  Safe

  At Risk

  N/A

• Flammable and combustible materials are stored a safe distance from heat generating equipment.

  Safe

  At Risk

  N/A

Personal Protective Equipment/PPE

• Is Personal Protective Equipment/PPE to be inspected during this audit?

  Yes

  No

  N/A

• Proper equipment available for existing or potential hazards.

  Safe

  At Risk

  N/A

• Safety supplies adequate for job manpower.

  Safe

  At Risk

  N/A

• Employees issued appropriate PPE for assigned tasks.

  Safe

  At Risk

  N/A

• Eye and face protection available and utilized (i.e. safety spoggles, face shield)

  Safe

  At Risk

  N/A

• Hearing protection available, utilized and properly maintained

  Safe

  At Risk

  N/A

• Hand protection available, utilized and properly maintained

  Safe

  At Risk

  N/A

• Hard hats available, utilized and properly maintained

  Safe

  At Risk

  N/A

• Appropriate clothing worn by employees (No synthetic materials).

  Safe

  At Risk

  N/A

• Foot Protection worn as required by all employees (No synthetic materials).

  Safe

  At Risk

  N/A

Respiratory Protection

• Is Respiratory Protection to be inspected during this audit?

  Yes

  No

  N/A

• Respirators available, maintained, and stored properly.

  Safe

  At Risk

  N/A

Abrasive Blasting

• Is Abrasive Blasting to be inspected during this audit?

  Yes

  No

  N/A

• Equipment hoses are not creating a tripping hazard.

  Safe

  At Risk

  N/A

• Hose couplings have lock pins and whipcheck.

  Safe

  At Risk

  N/A

Fall Protection

• Is Fall Protection to be inspected during this audit?

  Yes

  No

  N/A

• Wall and floor openings are covered/guarded and marked appropriately.

  Safe

  At Risk

  N/A

• Adequate fall protection provided and utilized at > 4ft. (100% tie off required on all scaffold)

  Safe

  At Risk

  N/A

• Fall protection equipment inspected quarterly and documented.

  Safe

  At Risk

  N/A

• Appropriate anchorage locations are utilized.

  Safe

  At Risk

  N/A

Hand Tools/Power Tools

• Hand Tools/Power Tools to be inspected during this audit?

  Yes

  No

  N/A

• Tools stored in a secure location and maintained in an orderly fashion.

  Safe

  At Risk

  N/A

• All guards and safety devices in place and operational.

  Safe

  At Risk

  N/A

• Correct tools available and utilized for the job.

  Safe

  At Risk

  N/A

• Inoperable/Unsafe tools are destroyed or tagged and repaired.

  Safe

  At Risk

  N/A

• Operators of PAT’s are trained.

  Safe

  At Risk

  N/A

Electrical Safety

• Electrical Safety to be inspected during this audit?

  Yes

  No

  N/A

• GFCI’s are available/maintained/utilized.

  Safe

  At Risk

  N/A

• Temporary lights are equipped with guards

  Safe

  At Risk

  N/A

• Electrical cords strung so they do not hang on pipes, nails, hooks, etc.

  Safe

  At Risk

  N/A

• Energized panels/device outlets are covered.

  Safe

  At Risk

  N/A

• Damaged electrical cords are removed from use.

  Safe

  At Risk

  N/A

• Locks & tags are identifiable to each employee

  Safe

  At Risk

  N/A

• Group lock boxes available for group LOTO.

  Safe

  At Risk

  N/A

• Sub sheets utilized for group TagOut in PowerGen facilities.

  Safe

  At Risk

  N/A

• Locks and tags are removed by the owner of the lock.

  Safe

  At Risk

  N/A

Company Vehicles/Powered Industrial Trucks

• Are Company Vehicles/Powered Industrial Trucks to be inspected in this audit?

  Yes

  No

  N/A

• Equipment and vehicles are parked so as to prevent the release of stored energy.

  Safe

  At Risk

  N/A

• Equipment and vehicles are maintained in good working order.

  Safe

  At Risk

  N/A

• Seatbelts are available and in use by all operators and passengers.

  Safe

  At Risk

  N/A

• Current licenses maintained for all vehicle drivers on or off road.

  Safe

  At Risk

  N/A

• Equipment and vehicle operators are trained and possess an operators permit.

  Safe

  At Risk

  N/A

• Spotters are used as conditions deem it necessary.

  Safe

  At Risk

  N/A

HAZCOM/Right to Know

• Is HAZCOM/Right to Know to be inspected in this audit?

  Yes

  No

  N/A

• Materials properly stored and labeled.

  Safe

  At Risk

  N/A

• Spill kits available.

  Safe

  At Risk

  N/A

Ladders

• Are ladders to be inspected in this audit?

  Yes

  No

  N/A

• Ladders inspected, in good condition, and properly stored.

  Safe

  At Risk

  N/A

• Ladders are of appropriate duty rating and size for the task.

  Safe

  At Risk

  N/A

• No stepping on top two rungs of stepladder.

  Safe

  At Risk

  N/A

• Ladders extend at least 36” above top of landing.

  Safe

  At Risk

  N/A

• Step ladders fully opened when in use.

  Safe

  At Risk

  N/A

Scaffold

• Are scaffolds to be inspected in this audit?

  Yes

  No

  N/A

• Erection, Dismantling, and Modification properly supervised

  Safe

  At Risk

  N/A

• Scaffolds have secure foundations with mud sills, base plates, and screw jacks.

  Safe

  At Risk

  N/A

• Scaffolds plumb and square with proper cross bracing.

  Safe

  At Risk

  N/A

• Guardrails, midrails, and toe boards in place.

  Safe

  At Risk

  N/A

• All working-level platforms fully planked/decked.

  Safe

  At Risk

  N/A

• All platforms at least 18” wide or protected by guardrail system or PFAS.

  Safe

  At Risk

  N/A

• Platforms properly constructed with scaffold grade lumber/planks.

  Safe

  At Risk

  N/A

• Scaffold levels are being completed as the scaffold is erected.

  Safe

  At Risk

  N/A

• Safe access provided and adequate.

  Safe

  At Risk

  N/A

• SRL’s are provided for ladder access ≥ 10’ above a lower level or where an employee could fall into dangerous equipment.

  Safe

  At Risk

  N/A

• Competent person has inspected scaffold prior to each shift scaffold is in use.

  Safe

  At Risk

  N/A

• Scaffold tag displayed at every point of access.

  Safe

  At Risk

  N/A

Confined Space

• Is confined space to be inspected in this audit?

  Yes

  No

  N/A

• Proper permits executed, posted, and retained.

  Safe

  At Risk

  N/A

• All entrants are wearing a PFAS harness.

  Safe

  At Risk

  N/A

• Continuous air monitoring being performed and documented.

  Safe

  At Risk

  N/A

• Sign In/Out sheet in use.

  Safe

  At Risk

  N/A

• Emergency procedure and phone numbers documented.

  Safe

  At Risk

  N/A

• Attendant in present and performing monitoring from outside.

  Safe

  At Risk

  N/A

Hazardous Material Operations

• Is Hazardous Material Operations to be inspected in this audit?

  Yes

  No

  N/A

• Properly supervised by a Competent Person.

  Safe

  At Risk

  N/A

• All required permits/notifications executed and retained.

  Safe

  At Risk

  N/A

• Waste is adequately wet, properly bagged, labeled, and promptly removed from work area.

  Safe

  At Risk

  N/A

• Waste containers are secured, lined, and labeled.

  Safe

  At Risk

  N/A

• Containments properly constructed.

  Safe

  At Risk

  N/A

• Warnings and barricades in place.

  Safe

  At Risk

  N/A

• Containment security maintained.

  Safe

  At Risk

  N/A

• Appropriate PPE available and in use.

  Safe

  At Risk

  N/A

• Decon areas properly constructed, maintained, sanitary.

  Safe

  At Risk

  N/A

Welding and Cutting

• Is welding and cutting to be inspected in this audit?

  Yes

  No

  N/A

• Properly stored, inspected, and maintained.

  Safe

  At Risk

  N/A

• Proper PPE available and in use.

  Safe

  At Risk

  N/A

• Hot work permits in use.

  Safe

  At Risk

  N/A

• Fire watch is use during and after hot work activities

  Safe

  At Risk

  N/A

• Tools being used properly.

  Safe

  At Risk

  N/A

• Gas cylinders secured and upright.

  Safe

  At Risk

  N/A

Hoists/Rigging

• Are Hoists/Rigging to be inspected in this audit?

  Yes

  No

  N/A

• Hoists used properly.

  Safe

  At Risk

  N/A

• Correct rigging procedures followed (i.e. barricade in place, away from suspended load).

  Safe

  At Risk

  N/A

• Tag line in use to guide loads.

  Safe

  At Risk

  N/A

General Comments

• Any further comments or recommendations arising from this inspection?

• Add any additional relevant photos

  Media

• Have all required corrective actions been added as Actions to this inspection?

  Yes

  No

  N/A

• Please add any corrective actions to the appropriate questions above before completing this report

Sign Off

• Name & Signature of Inspector

  Sign

• Name & Signature of Site Supervisor / Foreman

  Sign