Information

  • Audit Title

  • Date Conducted

  • Location
  • Job Number

  • Foremen

  • Superintendent

  • Project Manager

  • Work Being Conducted?

  • Prepared by

Job Set-Up

  • Trailers kept in clean and orderly condition?

  • OSHA posters or booklet are visible?

  • "In Case of an Injury" sheet made and posted?

  • No smoking signs posted outside of trailer and at flammable storage areas?

  • Trailer has an available broom?

  • First Aid kit is mounted and stocked?

  • Chains and straps are hung up or kept separate when stored?

  • Daily Huddle completed by Forman and job hazard analysis is being utilized?

Hazard Communication

  • All containers are labeled as to the contents and hazards?

  • Safety Manual readily available?

  • MSDS are readily available?

Welding and Compressed Gas Cylinders

  • Stored and secured in an upright position?

  • Regulators removed and caps placed on tank when stored?

  • Full and empty cylinders are separated and identified?

  • Gauges are functional and have covers?

  • Oxygen and acetylene are separated by distance or barrier?

  • Welding leads and torch hoses are in good condition?

  • "No Smoking" sign is posted at or near the compressed gas cylinders?

  • Cylinders have back-flow preventers and torches have flash suppressors?

Locates

  • All utilities should be marked and properly protected.

  • All utilities should have documented Call-ins.

PPE

  • All workers wearing hard hats on site (exception is inside tight tunnels)?

  • All workers wearing safety glasses on site?

  • All workers wearing steel toe shoes on site?

  • All workers wearing high-vis-tee-shirts or safety vests?

  • Workers wearing safety vests on DOT sites, working near traffic or flagging?

Fire Safety

  • Fire extinguisher's monthly inspections are up to date?

  • A fire extinguisher is kept within 10 feet of each torch and hot work area?

  • Fuel tank has a fire extinguisher located between 25 and 75 feet from the tank?

  • Generator(s) have fire extinguisher(s) located within 20 feet?

  • Safety cans and all flammables are stored properly?

  • Fire extinguisher kept at the entrance to the trailer and visible?

Electrical Safety

  • GFCI's are used on all power cords?

  • Power cords are in good condition?

  • Portable generators are grounded?

  • If overhead electrical power-lines are present are precautions taken?

Excavations

  • If a PE stamped drawing of the pit is required, it is on site and visibly posted?

  • Tabulated Data sheets are on site during construction of protection system?

  • Trench Box Sheet Ratings are available on site?

  • Spoils edge is a minimum of two (2) feet from the edge of the pit?

  • Bottom grade is no more than two (2) feet below bottom of shield?

  • Top of trench box is extended a minimum of eighteen (18) inches above the grade?

  • Workers are protected by either shielding, trench boxes or sloping/benching?

Ladders

  • Ladders are in good condition and without defects?

  • Ladder is secured properly?

Fall Protection

  • Workers use fall protection restraint harnesses and lanyards when needed?

  • Openings to ladders have a sliding bar or gate that is closed?

Underground Construction 1926.800

  • Tag boards are in place, readable and current?

  • Communication methods are in practice between top man, pit and tunnel?

  • Each person in the tunnel has a Self-Rescuer immediately available?

  • A designated person is on duty whenever an employee is working underground?

  • Each worker underground has a cap-light?

  • Rescue services have been coordinated and posted?

  • Air monitors are located in the shaft and at the face of tunnels?

  • Air readings are taken and documented at a minimum of every four hours?

  • Fresh air is properly provided into the tunnel or pipe? (Min. 200 c.f.m. per employee)

  • Illumination requirements (5 foot-candles) have been met?

  • A fire extinguisher is provided at the head and tail pulley of the conveyor?

  • Rescue basket is on site and accessible?

  • Flashing light is used to indicate overhead loads during tunnel work?

  • Ladder placement is correct?

  • Midwest Mole's accepted pit is protected by guard rails?

  • Ankle straps on site and available?

Cranes/Excavations/Trucks

  • Kept in reasonably clean and maintained condition?

  • Daily inspections are conducted on cranes?

  • Daily inspections are conducted on excavators?

  • Daily inspections are conducted on backhoe/loaders?

  • Outriggers have foot pads in place and mats if needed?

  • Crane's swing radius properly barricaded?

  • Excavator's Quick Coupling is being properly used and/or safety pin is in place?

  • Crane's anti two-block inspected by operator?

  • Crane annual inspection date is up-to-date?

Air Monitors

  • Monitor Number

  • Calibration Date

  • Whose

  • Condition

  • Returned to Shop

  • Is there another?

  • Monitor Number

  • Calibration Date

  • Whose

  • Condition

  • Returned to Shop

  • Is there another?

  • Monitor Number

  • Calibration Date

  • Whose

  • Condition

  • Returned to Shop

  • Is there another?

  • Monitor Number

  • Calibration Date

  • Whose

  • Condition

  • Returned to Shop

  • Is there another?

  • Monitor Number

  • Calibration Date

  • Whose

  • Condition

  • Returned to Shop

  • Is there another?

  • Monitor Number

  • Calibration Date

  • Whose

  • Condition

  • Returned to Shop

  • Is there another?

  • Monitor Number

  • Calibration Date

  • Whose

  • Condition

  • Returned to Shop

  • Is there another?

  • Monitor Number

  • Calibration Date

  • Whose

  • Condition

  • Returned to Shop

  • Is there another?

  • Monitor Number

  • Calibration Date

  • Whose

  • Condition

  • Returned to Shop

Equipment

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

  • Number

  • Type

  • Fire Extinguisher

  • Operators Manual

  • Defects/Problems

  • What

  • Is there another piece of equipment you wish to add?

DOT Vehicles

  • Vehicle Number

  • Type

  • What type?

  • Color

  • What color?

  • DOT Date

  • Current

  • Is there anther DOT vehicle?

  • Vehicle Number

  • Type

  • What type?

  • Color

  • What color?

  • DOT Date

  • Current

  • Is there anther DOT vehicle?

  • Vehicle Number

  • Type

  • What type?

  • Color

  • What color?

  • DOT Date

  • Current

  • Is there anther DOT vehicle?

  • Vehicle Number

  • Type

  • What type?

  • Color

  • What color?

  • DOT Date

  • Current

  • Is there anther DOT vehicle?

  • Vehicle Number

  • Type

  • What type?

  • Color

  • What color?

  • DOT Date

  • Current

  • Is there anther DOT vehicle?

  • Vehicle Number

  • Type

  • What type?

  • Color

  • What color?

  • DOT Date

  • Current

  • Is there anther DOT vehicle?

  • Vehicle Number

  • Type

  • What type?

  • Color

  • What color?

  • DOT Date

  • Current

  • Is there anther DOT vehicle?

  • Vehicle Number

  • Type

  • What type?

  • Color

  • What color?

  • DOT Date

  • Current

  • Is there anther DOT vehicle?

  • Vehicle Number

  • Type

  • What type?

  • Color

  • What color?

  • DOT Date

  • Current

Self Rescuers

  • Number

  • Date of manufacturing

  • Whose?

  • Condition

  • Is there another?

  • Number

  • Date of manufacturing

  • Whose?

  • Condition

  • Is there another?

  • Number

  • Date of manufacturing

  • Whose?

  • Condition

  • Is there another?

  • Number

  • Date of manufacturing

  • Whose?

  • Condition

  • Is there another?

  • Number

  • Date of manufacturing

  • Whose?

  • Condition

  • Is there another?

  • Number

  • Date of manufacturing

  • Whose?

  • Condition

Rigging

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

  • Is there another one?

  • Number

  • Type

  • Size

  • Grade

  • Length (Feet)

  • Length (Inches)

  • Condition

  • Taken out of service by?

Comments/Concerns

  • Comments?

  • Photo?

  • Add media

  • Comments?

  • Photo?

  • Add media

  • Comments?

  • Photo?

  • Add media

  • Comments?

  • Photo?

  • Add media

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.