Information

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Personnel

General

  • Is the general impression of the work area safe

  • Was a JHA completed for the work

  • Barriers/Fencing Maintained

  • Construction debris in work area cleaned up

  • Are trash cans available for crews

  • Is access/egress to the work area clearly defined

  • Does the access/egress have tracking pads installed

  • Is there a clear line of site to the access/egress point

  • Misc items: (Describe)

Safety Documentation

  • Daily pre task plan conducted (STAC, Morning Huddle, SPTP, etc)

  • Equipment inspections completed

  • Critical pick plan completed

  • Excavation entry permit compelted

  • Confined space entry permit or certificate completed and posted at entry

  • Hot work permit completed

Personal Protective Equipment (PPE)

  • Proper PPE selected for task at hand

  • Hardhats

  • Eye Protection

  • Ear Protection

  • Respiratory Protective Equipment

  • Hi-Viz Vests/Shirts

  • Proper Footwear

  • Proper Hand Protection

  • Face Protection (Face Shield)

  • Misc items: (Describe)

Cranes and Rigging

  • Swing radius adequately barricaded

  • Tag lines used to control load

  • Rigging in good condition

  • Crane operator signaling that load is coming (horns)

  • Rigger using proper hand signals

  • Are the outriggers fully extended

  • Is the crane set up on firm level ground

  • Are there adequate crane pads installed under outriggers

  • Is the crane free from drips or leaks

  • Is the operator required to conduct any blind lifts

  • Rigger is qualified

  • Loads being hoisted at safe speeds

  • Crane shutdown during high wind

  • Proper rigging techniques used

  • Misc items: (Describe)

Confined Space Entry

  • Completed permit or certificate posted at space entrance with JHA

  • Entrants/Attendants verify that all requirements of the permit or certificate have been satisfied.

  • Entry supervisor and Attendant assigned

  • Monitoring results documented on permit or certificate

  • Confined Space properly barricaded

  • Misc items: (Describe)

Concrete

  • Adequate Impalement Protection

  • Nails removed immediately from formwork when removing forms

  • Wet cutting to control dust

  • Concrete trucks equipped with audiable backup alarms

  • Concrete pumping operation safe

  • Misc items: (Describe)

Electrical

  • GFCI (ground fault circuit interrupter) working

  • Extension Cords in good Condition

  • Heavy Duty Extension Cords used

  • Portable lighting adequate

  • Light plants properly staged

  • Employees working a safe distance from above ground energized electrical

  • Employees are not exposed to underground energized electrical

  • Misc items: (Describe)

Excavations

  • Excavation Entry Permit completed & updated

  • Excavation Entry Permit Followed

  • Safe means of egress/access provided

  • Material and spoils at least 2' from excavation edge

  • Cave in protection system in place

  • Underground utility lines located

  • Underground utility lines supported

  • Barricades and adequate fall protection systems in place for excavations

  • Misc items: (Describe)

Fall Protection

  • Top-Rail is 39"-45" above working surface

  • Mid-Rail installed and splitting the difference from Top-Rail to working surface

  • Toe-boards installed

  • Fall Protection equipment in safe and serviceable condition

  • Personnel using 100% tie off with double lanyards

  • Personnel using fall protection correctly

  • Personnel not using material hoists as fall protection

  • Personnel calculating fall distance

  • Entry location properly maintained

  • Guardrails in good condition

  • Overhead work is properly barricaded to protect workers/public below

  • Misc items: (Describe)

Fire Prevention

  • Fire Extinguishers provided with 100' from ANY work area

  • Fire Extinguisher provided within 50' of any fuel source

  • Fire Extinguisher provided in immediate hot work area

  • Flammable/Combustible liquids stored properly

  • Containers are properly labeled

  • Hot work areas kept clear from anything flammable

  • Area in front and around Fire Extinguishers kept clear

  • Misc items: (Describe)

Heavy Equipment

  • Operating at safe speeds

  • Loads not hoisted overhead

  • Blade/Bucket/Fork/Boom landed and equipment shutdown when operator is out of equipment

  • Operator making eye contact with employees on ground

  • Operator using seatbelt

  • No visible leaks on equipment

  • Are the floor boards kept clear of all trash and other debris

  • Is a spotter in use when required

  • Personnel maintaining safe distance from equipment

  • Back up alarms functioning & audible

  • All operators following distracted driving policy

  • Operators are conducting daily equipment checklists

  • Misc items: (Describe)

Scaffolds

  • Daily inspection conducted by Competent Person

  • All Scaffold access has tag (Green, Yellow, Red) and is signed off daily

  • Safe means of egress provided

  • Work platform fully planked

  • Scaffold planks in good condition

  • Toe boards with no visible gaps below

  • Misc items: (Describe)

Stairways and Ladders

  • Any break in elevation 19" or greater has a step or ladder

  • Extension ladders at 4:1 ratio

  • Extension ladders extend 3' above landing surface

  • Extension ladders secured at the top, bottom and middle

  • User not straddling step ladder

  • Step ladders used properly

  • User is facing ladder at all times

  • Three points of contact continuously made while climbing

  • Belt buckle kept between side rails of ladder

  • Ladders are in good condition

  • Defective ladders tagged and removed from service

  • Area below and above ladder kept clear of debris

  • Misc items: (Describe)

Welding and Cutting

  • Hot work permit completed and posted near hot work area

  • Suitable fire extinguisher available in hot work area

  • Oxygen and fuel gas cylinders stored properly

  • Welding shields used when necessary

  • Proper PPE worn

  • Misc items: (Describe)

  • Signature

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