Information
-
Audit Title
-
Document No.
-
Client / Site
-
Conducted on
-
Prepared by
-
Location
-
Personnel
JSA/JHA
-
Appropriate for Task/Task Covered
-
Performed
-
Reviewed
-
Signed
Environmental/Emergency Response
-
Emergency Action Plan
-
Spill Response Kit
-
Certified Responders
-
First-Aid Kit
Hazardous Communication
-
MSDS Available
-
MSDS Reviewed
-
Containers Labeled Properly
-
Handling Procedures Followed
PPE
-
Hard Hat
-
Hard Hat worn correctly
-
Eye/Face
-
Hand
-
Hearing
-
Footwear
-
Hi-Vis Vest
-
FRC
-
Monitors Available, In Use, Calibrated (4-Gas, H2S or Other)
-
Other:
Material Handling
-
Body Mechanics
-
Manual Lifting Devices (Come-a-Longs, Chain falls, etc )
-
Safety Latch
-
Slings
-
Hooks & Shackles
-
Wire Rope
-
Lifting Chains
-
Load Secure, Rigged Properly
-
Tag Lines Used
-
Other:
Worksite Protection
-
Is the OSHA Jobsite Poster Posted
-
Signs and crosswalks available for pedestrians
-
Adequate cushion/warning for drivers
-
Flagger present if necessary
-
Flagger is wearing/using proper PPE/Equipment-hard Hat, Vest, Paddle
-
Flagger positioning visible to drivers
-
Signage is properly placed
-
Cones are properly placed
-
Retro reflective equipment and flashers in use at night
-
Adequate clearance from overhead and other hazards
Vehicle/Equipment/Crane
-
Authorized/Qualified Operator
-
Designated Signal Person
-
Seatbelt Used
-
Backup Alarm
-
Daily/Weekly/Annual Inspection
-
Inspection Completed Properly
-
Other:
Material Storage
-
Material Stored Properly
-
Flammable/Combustible Storage
-
Pipe Chocked
-
Other:
Fall Prevention/Protection
-
Access/Egress
-
Fall Protection
-
Fall Protection Inspected
-
Scaffolds/Ladders - Proper Type
-
Scaffolds/Ladders - Inspected
-
Scaffolds/Ladders - Use
Hand Tools
-
Condition
-
Guards/Handles
-
Proper for Job/Use
Electrical
-
GFCI/Assured Grounding Program
-
Cords/Tools Inspected
Hot Work
-
Permit
-
Permit Conditions Followed
-
Fire Watch
-
Gas Cylinder Management
-
Leads/Hoses/Gauges
-
Other:
Fire Protection & Prevention
-
Extinguisher inspection tag present and current
-
Properly Rated/Size (BC versus ABC)
-
Combustible/Flammable Material Away from Hot Work
-
Fire Extinguishers at least 25ft away but no further than 75ft away from Fuel Cells
Excavation
-
Hand digging used when approaching/crossing buried facilities
-
Spill kits on board and stocked
-
Sloped Properly
-
Benched Properly
-
Trench Box/Shoring Proper
-
Trench Box Certifications
-
Access/Egress Points
-
Spoil Pile Minimum 2-Feet From Excavation
-
Signs, Signals & Barricades
-
One Call Made
-
Utilities Identified
Signs/Barricades
-
Condition
-
Proper Type
-
Marking Hazards
Housekeeping
-
Worksite free of clutter
-
Equipment, machines/tools do not block pathway
-
Tripping and slipping hazards
-
Tools properly stored/staged
-
Crew Trucks/Trailers clean and free of clutter
Ergonomics/ Jobsite
-
Proper lifting techniques used
-
Employees positioned away from hazards, moving parts and equipment
-
Pinch points
-
Proper body positioning
Walking Surfaces
-
Pathways
-
Trip Hazards
-
Holes Guarded
Overhead Power Lines
-
Power Lines Marked with Goal Post and Signs
-
Designated Spotter
-
Proper Equipment for Spotter (Air Horn, Vest, etc )
Radiation Sources
-
Signs, Signals & Barricades
-
Film Badges for X-Ray Crew
Pressure Testing
-
Equipment Integrity
-
Whip Checks/Connections Pinned
-
Signs, Signals & Barricades
Confined Space
-
Permitted
-
Personnel Trained
-
Emergency Rescue Plan
-
Rescue/Retrieval Equipment (Anklets, Harness, Life Line, etc... )
Equipment/ Tools
-
Availability and condition of tools
-
Adequate lighting/visibility
-
Grounding of tools/pipe/containers
-
Air tools/hose connections/pins in place
