Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

General

  • JHA/Job Briefing Complete?

  • Competent Person on Site?

  • Qualified Workers?

  • Personal Protective Equipment Properly Used?

  • Are Rubber goods properly stored?

  • Are there any Falling Hazards?

  • Harness/Lanyard being properly used?

  • 100%Fall Arrest Utilized?

  • Is rescue equipment available and ready? (Rescue Blocks/Handline)

  • Does the crew have an AED?

  • Enter test date

  • Are there any AC Tools being used?

  • GFCI Protected?

  • Cords in Good Shape?

  • Guards in Place?

  • Electrical Hazards Present?

  • Is Minimum Approach Distance Maintained?

  • Is FR Clothing being worn?

  • Protective Cover-Up Installed?

  • Rubber Gloves/Sleeves required?

  • Enter Test Date.

  • Are Hot Sticks Being Used?

  • Enter Test Date.

  • Is The Crew working behind protection? (One shot, fuse)

  • Are Grounds being used?

  • Enter Test Date.

  • At least 2 employees certified in First Aid/CPR?

  • First Aid Kit Fully Stocked?

  • Drinking Water and Ice on site?

  • House Keeping?

  • Seat belts?

  • Safety Cans Utilized/Labeled?

  • Is Traffic Control Equipment in Place?

  • Safe Temp Monitor?

  • Fire extinguisher inspected?

System De-Energized.

  • Has the system been de-energized, tested, and grounded?

  • Has an EPZ been established?

  • Are the ground locations recorded?

Lifting/Rigging

  • Lifting/Rigging?

  • Lift Plan?

  • Boom Visual Appearance OK?

  • Load Charts?

  • Signal Charts?

  • Load Line/Hook Condition?

  • Winch Rope/Line Condition?

  • Sheave Condition?

  • Turn Table Condition?

  • Tag Line Used?

  • Rope/Hand Line Used?

  • Sling/Shackle Condition?

  • Control Labeling?

  • Bucket Liner/Insert Condition?

  • Bucket Jib Rope Condition?

Excavation/Trenching/Shoring

  • Are there any underground operations on site?

  • Soil Classification?

  • Trench Inspected?

  • Ladder(s)/Ramp in Place?

  • Trench box?

  • Sloping/Benching/Shoring Adequate?

  • Spoil Piles Two Feet Back from edge?

  • Underground Facilities Marked?

VEHICLE/DOT

  • Are vehicles/equipment properly set up?

  • DVIR complete?

  • Proper load securement?

  • DOT Inspection Current?

Signatures

  • Foreman

  • Auditor

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