Information

  • Audit Title

  • Site Location
  • Contractor Name

  • Specific On-Site Location
  • Conducted on

  • Prepared by

  • Team Members Present

1. Working at Heights

  • 1.1. Employees are properly protected from fall risks of 6 feet or more.

  • 1.2. Sharp edges are protected in case they contact fall protection devices.

  • 1.3. Guard rails are installed properly.

  • 1.4. Warning lines/Barricades installed properly and complete.

  • 1.5. Personal fall arrest equipment is appropriate for exposure and used properly.

  • 1.5.1. Harnesses and equipment is safe to use.

  • 1.5.2. Anchor points are safe to use.

  • 1.5.3. Fall distances are figured into current system.

  • 1.6. Fall exposure and mitigation is appropriately addressed on JSA.

  • 1.7. Fall protection/arrest components are stored/stowed properly.

2. Equipment

  • 2.1. Tools, equipment, and accessories are safe to use (guards, grinding discs, cutting blades, etc.).

  • 2.2. Operators are trained in safe operation, clean-up and maintenance.

  • 2.3. LOTO procedures are followed for cleaning, servicing and maintenance of tools/equipment and is conducted per policy and is verified.

  • 2.4. Aerial work platform is being used properly / per manufacturer requirements.

  • 2.4.1. Fall protection is in place (lanyards, gates, etc.).

  • 2.4.2. Aerial work platform was inspected before use and was documented.

3. Scaffolds

  • 3.1. Competent persons are erecting/altering scaffold.

  • 3.2. Scaffold viewed is properly erected and as complete as possible.

  • 3.3. Competent person inspected scaffold before use and was properly documented.

  • 3.4. Scaffold viewed is erected properly to include proper bracing and tie-back.

  • 3.5. Safe Work Load (SWL) was provided and not exceeded (tools, stored materials, number of persons, etc).

  • 3.6. Scaffold viewed has suitable access, to include swing gate and retractable when exposure exceeds 24'.

4. Lifting/Rigging Equipment

  • 4.1. Crane and devices are safe to use.

  • 4.2. Loads are lifted to safely clear power lines, people, hazardous materials storage, etc.

  • 4.3. Maintenance, testing and inspection completed as required prior to use.

  • 4.4. Lift plan was completed prior to lift.

  • 4.6. Lifting equipment, including ropes, slings, chains, hooks etc. are in good condition.

  • 4.7. Lifting equipment has proper manufacturer labeling.

  • 4.8. Rigging is used per manufacturer requirements.

  • 4.9. Operator/Rigger is properly trained/certified.

  • 4.10. Safe rigging practices are being followed.

6. Ladders

  • 6.1. Ladder viewed is safe to use (inspected before use, proper labeling, not damaged, etc.).

  • 6.2. Ladders viewed is correctly positioned, secured, etc.

  • 6.3. Ladder viewed is suitable for the task (eg. metal ladder not used for electrical work, scissor lift better for the job, etc).

  • 6.4. Ladder viewed is proper tool for job.

7. Hazardous Manual Tasks

  • 7.1. Stretching was completed before shift.

  • 7.3. Risk were properly controlled (examples: job rotations, lighter loads, trolleys, lifting equipment, etc).

  • 7.4. Team members were trained to safety lift items.

  • 7.5. Material handling was evaluated on JSA.

8. Hazardous Chemical (including fuel and oil)

  • 8.1. Hazardous materials are properly stored (flammables distance to ignition source, storm water controls, location to compatible materials, labeled, out of traffic, etc).

  • 8.2. Spill containment procedures and equipment are adequate for exposure present.

  • 8.3. Safety Data Sheets are accessible and on site.

  • 8.4. PPE is adequate for the exposure present.

9. Confined space entry

  • 9.1. Procedures are being followed.

  • 9.2. Emergency rescue is available.

  • 9.3. Atmospheric testing is conducted and documented.

11. Personal Protective Equipment (PPE)

  • 11.1. Required PPE is available and in use (safety glasses, sun protection, face shield, etc.).

  • 11.2. PPE is in good condition.

  • 11.3. Team members have been trained in safe use, clean-up, and inspection of PPE.

12. Work Environment

  • 12.1. Amenities are adequate (toilets, wash areas, lunch rooms, etc).

  • 12.2. Lighting is sufficient.

  • 12.3. Housekeeping is adequate.

  • 12.4. Noises and vibration are controlled.

  • 12.5. Site security and signage is in place and clearly visible.

  • 12.6. Suitable overhead protection is in place.

13. Electrical Hazards

  • 13.1. Electrical leads are in safe/good condition (damaged, out of test date or untested).

  • 13.2. Assured grounding requirements followed and up to date.

  • 13.3. Underground utilities were located and uncovered by hand prior to excavating.

  • 13.4. Minimum distances have been designated from overhead electrical lines delineated and maintained.

  • 13.5. Temporary electrical panels are safe (no voids, labeled, and GFCI protected).

  • 13.6. Leads and cords are properly suspended.

  • 13.7. Electrical equipment is protected from wet conditions/ GFCI in place.

  • 13.11. Electrical leads grounded directly to work?

15. Administrative Procedures

  • 15.1. JSA is completed and fully addresses exposures.

  • 15.2. Permits are approved and up to date (Council, EPA, Hot Works, Confined Space etc).

  • 15.3. Suitable orientation for workers, contractors, visitors?

  • 15.4. Supervisory arrangement are adequate.

  • 15.5. Weekly safety meetings and OSHA required training is conducted.

  • 15.6. Contractor Job Hazard Analysis (JHA) was completed.

Risk Improvement Action Items

  • Enter any planned risk improvement action items

General Risk Improvement Notes

  • General Notes

  • General Notes

  • General Notes

  • General Notes

  • General Notes

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.