Information
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Audit Title (Daily Weekly Monthly)
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Job Site Number
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Audit Date
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Prepared by
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Location (Street Area City)
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Superintendant
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Employeee(s)
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Weather (Temperature)
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Heat Index
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What is being done to keep employees cool & hydrated?
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Today's JSA reviewed,complete understood & signed by all employees
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Why isn't the JSA completed?
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Traffic Control Signage Displayed per MUTCD
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Underground utilities marked/identified before digging?
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Warning vests or highly visible clothing worn by employees?
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Who or Why are they not being worn?
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Employees wearing appropriate PPE? Ex. Hard hats, safety glasses, gloves, boots etc
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First Aid Kits on job-sites?
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Fire Extinguisher on all Motorized equipment & in Operational condition
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Fuel Tanks Properly Labeled?
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What is the Soil Classification per the Competent Person
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Is there Silica Overexposure on the Site
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Was the Excavations Inspected after returning from Lunch or after Rain?
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Excavations/trenches over 5' deep, properly sloped, trench box or shields used?
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If trench boxes are used, is tabulated data on site?
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Workers, working within trench box at all times?
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Spoil piles at least 2' away from edges of cut?
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Ladders placed within 25' of workers?
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Properly excavated ramp for egress? (employees able to walk upright )
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Back-up alarms functioning on all equipment?
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What Equipment, and has it been reported to the Shop?
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Is Heavy Equipment in Operation, have lights operational, and mud free from under pedals?
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Seat Belts Worn by Operators
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What Employee was not wearing seatbelt and why?
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Any Slip, Trips or Fall hazards?
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What was hazard
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Is there electrical equipment being used?
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Is the Electrical Cord free from damage and connected to a GFCCI?
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Any Miscellaneous unsafe work practices?
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What was the Danger, and was it made safe?
Replacement PPE & Equipment / Training Topic
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Any PPE issued?
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Check the PPE issued
- Gloves
- Safety Glasses (Tinted & Clear)
- Ear Protections
- Safety Vests
- Class 2/3 Shirts (Long & Short Sleeves)
- Hard Hats
- P100 Respirators
- Sqwinchers (Electrolyte)
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Any other items issued?
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What was issued?
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Was Training conducted during Safety Audit?
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What topic was covered?
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Pictures upload here
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I, Christopher Lee, certify that, in my capacity as Senior Director of Safety Compliance and Training, I inspected the jobsite area and found it to be safe. If any unsafe conditions were encountered, they were corrected, and the site was made safe prior to my departure.
