NASATKA Safety inspection Checklist (Rev 0)

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Work area

• Is worksite clean, orderly and free of trip hazards?

  Yes

  No

  N/A

• Is layout of the work area suitable for task and reduces bending/twisting/overreaching?

  Yes

  No

  N/A

• Are persons protected from sharp objects?

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• Is all required PPE readily available at the worksite location and in good condition?

  Yes

  No

  N/A

• Eye protection:

  Yes

  No

  N/A

• Hard hat / bumpcap (document which one is used):

  Yes

  No

  N/A

• Hearing protection:

  Yes

  No

  N/A

• Face shields:

  Yes

  No

  N/A

• Gloves:

  Yes

  No

  N/A

• Respirators:

  Yes

  No

  N/A

• Safety Shoes/Boots (Steel Toe):

  Yes

  No

  N/A

• FR clothing / overalls:

  Yes

  No

  N/A

• Fall arrest system (harness / lanyard):

  Yes

  No

  N/A

• Is the employee(s) wearing all PPE required to perform the work at the time of the inspection?

  Yes

  No

  N/A

Lock out / tag out

• Has all equipment been LO/TO and tested?

  Yes

  No

  N/A

Ladder safety

• Is the employee(s) using the correct ladder(s) for the work task?

  Yes

  No

  N/A