Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

A. GENERAL WORK AREAS

  • 01. FLOORS (clean, no tripping hazards)

  • SEVERITY

  • PROBABILITY

  • 02. AISLES / WALKWAYS (clear)

  • SEVERITY

  • PROBABILITY

  • 03. STAIRS (clear, rails secure)

  • SEVERITY

  • PROBABILITY

  • 04. LADDERS (rungs, feet, tied, hung)

  • SEVERITY

  • PROBABILITY

B. HAND TOOLS

  • 05. GENERAL CONDITIONS OF TOOLS

  • SEVERITY

  • PROBABILITY

  • 06. ELECTRICAL TOOL CORDS (undamaged)

  • SEVERITY

  • PROBABILITY

  • 07. GUARDS (in place and working)

  • SEVERITY

  • PROBABILITY

  • 08. AIR HOSES (proper clamps)

  • SEVERITY

  • PROBABILITY

C. ELECTRICAL

  • 09. CORDS (GFI, three pronged)

  • SEVERITY

  • PROBABILITY

  • 10. LIGHTING (clean, adequate)

  • SEVERITY

  • PROBABILITY

  • 11. PANELS (doors closed, clear)

  • SEVERITY

  • PROBABILITY

  • 12. EMERGENCY EXIT SIGNS (lit)

  • SEVERITY

  • PROBABILITY

D. CRANES / HOISTS / RIGGING

  • 13. SLINGS, ROPES, CHAINS (undamaged)

  • SEVERITY

  • PROBABILITY

  • 14. HOOKS (not spread, safety latches)

  • SEVERITY

  • PROBABILITY

  • 15. CRANE / HOIST (rating clearly marked)

  • SEVERITY

  • PROBABILITY

  • 16. SPREADER BARS (rating marked)

  • SEVERITY

  • PROBABILITY

  • 17. SUSPENDED LOAD (clear under load)

  • SEVERITY

  • PROBABILITY

  • 18. DAILY CRANE LOGS BEING COMPLETED

E. MOBILE EQUIPMENT

  • 19. FORK TRUCK (logbook up to date)

  • SEVERITY

  • PROBABILITY

  • 20. AUTHORIZED OPERATORS (certified)

  • SEVERITY

  • PROBABILITY

  • 21. BACK UP ALARMS (operating)

  • SEVERITY

  • PROBABILITY

  • 22. HYDRAULIC SYSTEM (operational)

  • SEVERITY

  • PROBABILITY

  • 23. ELECTRICAL SYSTEMS (operational)

  • SEVERITY

  • PROBABILITY

  • 24. MECHANICAL SYSTEMS (operational)

  • SEVERITY

  • PROBABILITY

  • 25. PNEUMATIC SYSTEMS (operational)

  • SEVERITY

  • PROBABILITY

  • 26. FUEL SYSTEMS (no leaks)

  • SEVERITY

  • PROBABILITY

  • 27. TIRES (in good shape)

  • SEVERITY

  • PROBABILITY

  • 28. FIRE EXTINGUISHER INSTALLED

  • SEVERITY

  • PROBABILITY

F. MATERIAL STORAGE

  • 29. RACKS / SHELVES (secured down)

  • SEVERITY

  • PROBABILITY

  • 30. STACKED MATERIAL (stable)

  • SEVERITY

  • PROBABILITY

  • 31. FLAMMABLES (in fire proof cabinet)

  • SEVERITY

  • PROBABILITY

  • 32. COMPRESSED GASES (upright, tied)

  • SEVERITY

  • PROBABILITY

  • 33. FLAMMABLE MATERIAL (away from heat)

  • SEVERITY

  • PROBABILITY

G. CONTROLLED PRODUCTS

  • 34. LABELED CLEARLY

  • SEVERITY

  • PROBABILITY

  • 35. MSDS'S (available for all products)

  • SEVERITY

  • PROBABILITY

  • 36. WORKERS (WHMIS)

  • SEVERITY

  • PROBABILITY

H. PPE

  • 37. HARD HATS (wearing)

  • SEVERITY

  • PROBABILITY

  • 38. SAFETY GLASSES (wearing)

  • SEVERITY

  • PROBABILITY

  • 39. FACE SHIELDS / GOGGLES (wearing)

  • SEVERITY

  • PROBABILITY

  • 40. HEARING PROTECTION (wearing)

  • SEVERITY

  • PROBABILITY

  • 41. RESPIRATORY PROTECTION (wearing)

  • SEVERITY

  • PROBABILITY

  • 42. HAND / ARM PROTECTION (wearing)

  • SEVERITY

  • PROBABILITY

  • 43. STEEL TOED SHOES (wearing)

  • SEVERITY

  • PROBABILITY

  • 44. NO JEWELRY (rings, watches, necklaces etc.)

  • SEVERITY

  • PROBABILITY

  • 45. NO LOOSE CLOTHING

  • SEVERITY

  • PROBABILITY

I. HAZARD CONTROLS

  • 46. LOCK OUTS (in place)

  • SEVERITY

  • PROBABILITY

  • 47. CONFINED SPACES (procedures)

  • SEVERITY

  • PROBABILITY

  • 48. COLOR CODING (piping marked)

  • SEVERITY

  • PROBABILITY

  • 49. SCAFFOLDING (properly erected)

  • SEVERITY

  • PROBABILITY

  • 50. SIGNS & TAGS (in place)

  • SEVERITY

  • PROBABILITY

J. FACILITIES

  • 51. VENTILATION / HEAT (adequate)

  • SEVERITY

  • PROBABILITY

  • 52. EMERGENCY LIGHTS (operational)

  • SEVERITY

  • PROBABILITY

  • 53. FIRE HOSES (nozzles closed, hung)

  • SEVERITY

  • PROBABILITY

  • 54. FIRE EXTINGUISHERS (charged)

  • SEVERITY

  • PROBABILITY

  • 55. YARDS / ROADS (signs posted, gate)

  • SEVERITY

  • PROBABILITY

  • 56. PARKING LOT (clean, lit)

  • SEVERITY

  • PROBABILITY

  • 57. WASHROOMS (clean)

  • SEVERITY

  • PROBABILITY

  • 58. FIRST AID AREA (cleaned, stocked)

  • SEVERITY

  • PROBABILITY

  • 59. OFFICES (clean, tidy)

  • SEVERITY

  • PROBABILITY

  • 60. WASTE DISPOSAL (clean, removed)

  • SEVERITY

  • PROBABILITY

K. EMPLOYEE KNOWLEDGE

  • 61. 1st AID KITS (supplies, eyewash stations)

  • SEVERITY

  • PROBABILITY

  • 62. ACCIDENT REPORTING (procedures)

  • SEVERITY

  • PROBABILITY

  • 63. MEDICAL EVALUATION REPORTS

  • SEVERITY

  • PROBABILITY

  • 64. REPORTING UNSAFE ACTS (conditions)

  • SEVERITY

  • PROBABILITY

  • 65. EMERGENCY EVACUATION (procedure)

  • SEVERITY

  • PROBABILITY

  • 66. JOINT SAFETY COMMITTEE (rep)

  • SEVERITY

  • PROBABILITY

  • 67. Safe Work Procedures (understand the SWP for the work they are performing)

  • SEVERITY

  • PROBABILITY

L. MISCELLANEOUS

  • 68. CONVEYORS (emergency stops)

  • SEVERITY

  • PROBABILITY

  • 69. COMMUNICATION (radios working)

  • SEVERITY

  • PROBABILITY

  • 70. WORKING ALONE (procedure)

  • SEVERITY

  • PROBABILITY

  • 71. EMERGENCY NUMBERS (posted)

  • SEVERITY

  • PROBABILITY

  • 72. FIRST AIDERS (names posted)

  • SEVERITY

  • PROBABILITY

  • 73. WATER COOLERS (clean, tidy)

  • SEVERITY

  • PROBABILITY

  • Add media

  • SEVERITY

  • PROBABILITY

  • Add media

  • SEVERITY

  • PROBABILITY

  • Add media

  • SEVERITY

  • PROBABILITY

INSPECTION SIGN - OFF

  • SUPERVISOR

  • MANAGEMENT REP

  • WORKER COMMITTEE MEMBER REP

  • ADDITIONAL MANAGEMENT REP

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