Information

  • Audit #:

  • Project

  • Foreman

  • Conducted on

  • Prepared by

  • Location

Previous Jobsite Safety Survey

  • Review daily tailboard talk

  • Was previous survey reviewed?

  • Are there any outstanding items?

  • Project JHA signed and clinic directions posted

Personal Protective Equipment

  • Hard Hat<br>

  • Safety Glasses

  • Gloves

  • High-Visibility Vest

Material Handling & Ergonomics

  • Material Handling Aids

Electrical

  • GFCI Inspections Current

  • Proper Support for Cables

  • Enclosures Intact

  • Cord & Cable Condition

  • Weather Protection

  • Temporary Lighting

  • LOTO & Electrical Safe Work Practices

Walking & Working Surfaces

  • Housekeeping

Ladder Use

  • Stepladders

  • Extension Ladders

Fall Protection

  • Guardrails

  • Holes Covered

  • Personal Fall Arrest System

  • Safety Chains Used on Lifts

Fire Protection

  • Fire Extinguishers

  • Hot Work Procedures

Employee Health

  • Dust Control

  • Sanitation

Scaffolding

  • Inspected by Competent Person

  • Baseplates & Mudsills

  • Guardrails

  • Working Level Completely Decked

  • Diagonal Brace on Rolling Tower

  • Proper Access (Ladders & Stairs)

  • Miscellaneous (pins, wind clips, anchorage)

Excavations

  • Proper Slope & Shore

  • Egress within 25 Feet

  • Ladder Use

Cranes & Rigging

  • Equipment grounds installed, where applicable

  • Crews Under Loads

  • Tag lines used on all loads

  • Sling Condition & Storage

  • Protection setup for equipment below work area

Employee Safety Contacts

  • Name & Comments:

  • Name & Comments:

  • Name & Comments:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.