Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Job hazard checklist (mark at risk if applicable NA if not applicable)
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Slipping/ tripping
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water/dust/oil on floor
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body position ( bending,twisting,kneeling,squatting,repetitive motion)
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ventilation
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Poor lighting
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Fire
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Hot/cold climate
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Fall
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Pressure systems (steam/air/water)
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Chemical
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Electrical
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Mechanical (moving parts)
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Line of fire/pinch points
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Confined space
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Job site clutter
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Blocked isle ways
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Pa/telephone not working in area
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Condition of tools
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Vehicle condition
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Asbestos
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Lead paint
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Explosives
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Lifting heavy or awkward objects
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Human hazards (mark at risk if applicable NA if not applicable)
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Time pressure
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Distractive environment
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High work load
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First time evolution
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First day back after ads off
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1/2 hr after wake up or meal
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Over confidence
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Communication
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Vague/ wrong guidance
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Stress-work/personal
Emergency info/equipment location
ALL EMERGENCIES CALL CONTROL ROOM 6310
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Fire exstinguisher in area
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Safety shower/ eye wash station
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Evacuation route known and open
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Emergency phone location
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Portable radio required chemical/biological measures
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Chemicals
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Reviewed MSDS
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IH monitoring required
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Safety shower/eyewash in area
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Flammable combustables
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Nuclear source/radiation safety
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Biological hazard- cooling tower
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Biological hazards condenser
General safety preventive measures
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ADE reuired
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Hot work permit required
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Per-use inspection completed
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Communication signal equipment
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Depressurized vented drained
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Barricade signs installed
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Inspected prior to use ( guards switched,ect.)
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Slings inspected
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Grounds connected/ secured
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One person job/ help required
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Hot area/ heat stress prevention measures
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Mechanical assistance
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Stretching
Personal protective equipment
Minimal required hard hat, safety glasses, steel toe boots,
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Fire retarded clothing
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Gloves
- Leather
- mechanics
- cut resistant
- chemical resistant
- welding
- cold weather
- electrical
- dexterity
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Added foot protection
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Face shield
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Respirator
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Hearing (ear plugs/muffs)
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Fall protection equipment
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Seat belts
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Goggles
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Flash gear( hood, face shield with chin cup, hood, coveralls, arc rated gloves)
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Other PPE (chemical suit, extraction suit)
Plants and animals
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Poison ivy / poison oak
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Snakes, animals,insects, bees
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Other hazards
Permits
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Work authorization
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Confined space
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Hot work
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Clearance required
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Clearance accepted and signed on
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Open hole/grating removal
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Clearance permit tags verified
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Excavation permit required
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Other permits required
Fall protection
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Safety harness inspected
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Proper anchorage point
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Lifeline personnel platform ( man basket)
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Daily inspection
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Other
Excavation
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Review policy
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Proper barricade
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Shoring/slopping/benching required
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Proper access
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Inspected by competent person
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Other
Welding
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Welding machine leads inspected
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Combustibles
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Welding screens
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Grounded
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Fire blanket
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Fire extinguisher /inspected
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Proper clothing
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Welding gloves/sleeves/jacket
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Fire watch
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Heavy metals
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Other
Electrical
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Gfci test
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Electrical cord inspection
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Electrical tool inspection
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Lighting
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Ground clearance
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Other
Scaffold /ladder
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Scaffolding inspected
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Ladder inspected
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Tagged
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Special provisions
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Access
Crane lifting equipment
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Cranes/lifts inspected
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Proper maintenance
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Operator/oiler in place
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Outrigger extended
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Manual lifting equipment
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Proper rigging practice
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Personal platform per lift form
