Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by-Cris Casteel, CHST
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Location
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Personnel
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Construction Manager for Site:
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Customer:
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Type of structure:
- Monopole
- Self-Supporter
- Guyed
- Rooftop
- Water Tank
- Other
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Scope of work:
Part 1: Job Site Documentation
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Was a Job Hazard Analysis conducted, form filled out and on site?
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Are applicable safety banner/signs posted?
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Is there a competent person on site?
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Is someone on site certified in First Aid/CPR/BBP?
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Has the emergency data and action plan form been filled out and posted?
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Has a site-specific emergency rescue plan been developed and documented?
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Is there a documented procedure for any overhead electrical hazards?
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Are MSDS's available for the material being used on site?
Part 2: Job Site Conditions (Include Enviromentals)
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Is the work site clean of trash?
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Are materials stored properly and orderly?
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Are measures taken to prevent access by unauthorized personnel to the site?
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Are areas barricaded as required?
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Is drinking water available?
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Are chemical, flammable and combustible liquids stored properly? (I.e., no plastic gas cans)
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Are fire extinguishers of appropriate size and type available, and with current inspection tags?
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Are plant and animal hazards addressed and documented?
Part 3: PPE
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Are employees wearing hard hats?
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Are employees wearing proper work boots?
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Are safety glasses being used?
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Are employees wearing work gloves?
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Are employees dressed in appropriate work clothing?
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Is hearing protection being used?
Part 4: Fall Protection Equipment
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Do employees that are exposed to falls, have documented training?
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Is fall protection equipment being inspected daily and documented?
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Are fall protection tags legible?
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If work being preformed requires fall protection, is it being used 100%?
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Is the proper equipment on site to complete the task?
Part 5: RF
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Are RF monitors being worn by all climbers?
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Are RF monitors inside calibration dates?
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Is there a procedure in place to reduce the RF exposure within statutory limits?
Part 6: Electrical (Include Overhead)
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Are employees familiar with Lock Out/Tag Out procedures?
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Is the tower grounded during construction?
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Are electrical panels covered with not being worked on?
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Are Ground Fault Circuit Interrupters (GFCI) available?
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Are extension cords in good condition? ( i.e., No splices, cuts, exposed wires)
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Has the power company been notified?
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Is GFCI on the generator operational?
Part 7: Cranes
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Are boom trucks or cranes properly cribbed?
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Is annual inspection tag current or inspection report available?
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Is the crane operator qualified? (Certified through training or qualified through experience)
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Are load charts posted and readily available to crane operator?
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Is headache ball properly marked?
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Is end connection properly secured?
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Are daily inspections being conducted and documented?
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Are taglines in good condition?
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Are two-way radios being tested daily, if being used?
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Is a hand signal chart posted and visible to all personnel on site?
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Has personnel lifting plan been filled out and on-site? (if applicable)
Part 8: Hoists
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Are daily inspections being completed with documentation on site?
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Is hoist operator qualified? (Certified through training or qualified through experience)
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Are load charts posted and readily available to hoist operator?
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Is there an operator's manual for the unit on site?
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Are headache ball markings legible?
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Is end connection properly secured?
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Are all hoists secured properly and anchored for the load intended?
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Are hoist controls clearly identified?
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Are hoist controls easily accessible to the operator?
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Is the hour meter operational and functioning properly?
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Are two-way radios being tested daily, if being used?
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Are all exposed moving parts properly guarded?
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Is a hand signal chart posted and visible to all personnel on site?
Part 9: Personnel Lifting
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Is the hoist approved for lifting personnel?
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Has a pre-lift meeting been held, documented and made available on site?
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In the pre-lift plan, was the trial lift completed and documented?
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If a personnel platform is on-site, does it have an identification plate with the proper data in place? (Proper data includes: weight of the platform, maximum intended load, and employee capacity)
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If a gin pole is being used, does it have a load chart?
Part 10: Catheads
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Is cathead mounted properly and securely?
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Is rope hook installed properly?
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Is rope lock being used?
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Are operator controls in good working condition? (Foot Pedal or Switch)
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Is rope of sufficient size, strength and type for load being lifted?
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Is S.W.L. visible on the cathead?
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Is the manufacturer's labeling indicated load rating legible?
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Is there sufficient anchorage for the load rating of the unit?
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Is the capstan free of grooves?
Part 11: Rigging and Blocks
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Are proper rigging practices being utilized?
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Is rigging equipment in good condition?
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Are the tags on synthetic slings legible?
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Is rigging equipment being inspected daily and the inspection document?
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Are tag lines in good condition?
Part 12: Gin Poles
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Is gin pole rigging in good condition? (If visible)
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Does the gin pole have an identification tag? (if visible)
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Is the gin pole pre-job inspection form filled out and on-site or readily available?
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Does the sheave in the rooster head match the wire rope?
Part 13: Trenching & Excavating
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Are open holes properly guarded?
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If employees are in the trench is it properly sloped and/or benched?
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If employees are in the trench is there proper entry and egress?
Part 14: Heavy Equipment
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Is back-up alarm working properly?
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Is Roll Over Protection installed and in good condition?
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Are Safety Interlocks operational? (If applicable)
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Are Hazard Lights working properly?
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Are buckets and booms free of cracks and defects?
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Are personnel clear of the danger area or working radius?
Part 15: Hand/Power Tools
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Are electrical tools in good condition?
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Are they properly grounded or double insulated?
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Are proper guards in place?
Part 16: Ladders
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Are ladders rated 1A or greater?
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Are units well-maintained and in good working order?
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Are ladders at the proper slope? (4:1 ratio)
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Does the ladder extend 36 inches past the landing?
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Is the ladder stable, on good ground?
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Is the ladder set up correctly?
Part 17: Vehicles
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Is vehicle interior clean?
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Is vehicle exterior clean?
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Is there any interior or exterior damage? If so, explain below.
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Is the windshield in good condition?
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Are tires in good condition?
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Is there documentation stating last and next oil change date and mileage?
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Date:
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Mileage:
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Does the vehicle have a fire extinguisher with a rating of 10ABC and equipped with a current monthly inspection tag?
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Is the fire extinguisher location identified?
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Is a well-stocked first-aid kit complete with CPR airway located in the vehicle?
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Is the vehicle safety book in the vehicle?
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Are all inspection stickers current?
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Is the insurance and registration certificate current and readily available?
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If your company uses a driver's accident report form, is it in the glove box in case of an accident?
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Is there a monthly/daily inspection report?
Part 18: DOT Drivers and Vehicles
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Is CDL valid for equipment being used?
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Do drivers have CDL/DOT medical cards?
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Is Drivers Daily Log (hours of service) current? (If applicable)
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Are Daily Vehicle Inspection Reports (DVIR) current?
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Is vehicle properly labeled on each side?
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Are emergency reflectors in the vehicle?
Overall:
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Comments:
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Result:
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Amount of time spent on site:
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Necessary to follow up with written documentation?
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If any deficiencies, we're they corrected immediately?
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Report was reviewed with:
Supervisor:
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Supervisor:
Auditor:
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Auditor: Cris Casteel, CHST