Pacific Waterproofing

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Safe places of work

• Can everyone reach their work area safely?

  Safe

  At Risk

  N/A

• Are all work areas adequately lit?

  Safe

  At Risk

  N/A

• Are all holes and opening covered and marked to prevent falls?

  Safe

  At Risk

  N/A

• Is the work area free of tripping hazards and walkways clear of stored materials and waste?

  Safe

  At Risk

  N/A

• Is our site tidy and materials stored safely?

  Yes

  No

  N/A

• Are there guardrails in place at the immediate work area?

  Yes

  No

  N/A

• Is Fall Protection required?

  Yes

  No

  N/A

• Is Fall Protection being used?

  Safe

  At Risk

  N/A

• Have workers inspected their personal fall protection system?

  Yes

  No

  N/A

• Does all fall protection gear appear to be in good condition?

  Safe

  At Risk

  N/A

• Is work at a height of 25' or more?

  Yes

  No

  N/A

• Is there a site specific fall protection plan in place?

  Safe

  At Risk

  N/A

• Are the correct anchors being used to prevent swing factor?

  Safe

  At Risk

  N/A

• Can working in the space be avoided?

  Yes

  No

  N/A

• Has a risk assessment been carried out?

  Yes

  No

  N/A

• Have all hazards been identified?

  Yes

  No

  N/A

• Is mechanical ventilation required?

  Yes

  No

  N/A

• Are safe procedures in place?

  Yes

  No

  N/A

• Are procedures being followed?

  Yes

  No

  N/A

• Has the atmosphere been tested for toxic and flammable vapours prior to entry and documented on permit?

  Safe

  At Risk

  N/A

• Is continuous monitoring required whilst working in the space?

  Yes

  No

  N/A

• Bump test complete?

  Yes

  No

  N/A

• Is specialized PPE available and being used properly?

  Safe

  At Risk

  N/A

• Are ladders the only means of access for the work area?

  Yes

  No

  N/A

• Have the ladders been secured at top and bottom to prevent movement?

  Yes

  No

  N/A

• Is the ladder erected on firm solid ground?

  Safe

  At Risk

  N/A

• Is scaffold being used?

  Yes

  No

  N/A

• Has scaffolded been inspected? Documented?

  Safe

  At Risk

  N/A

• Are all workers wearing the required basic PPE?

  Yes

  No

  N/A

• Is all PPE in good condition?

  Safe

  At Risk

  N/A

• Is specialized PPE required for the work being performed?

  Yes

  No

  N/A

• Is specialized PPE available and being used?

  Safe

  At Risk

  N/A

• Is a hot rubber kettle being used on work-site?

  Yes

  No

  N/A

• Is it set up on firm level ground with wheels chocked?

  Safe

  At Risk

  N/A

• Are barricades set up around kettle to prevent other workers or public from entering kettle area?

  Safe

  At Risk

  N/A

• Is there a fire extinguisher available at the kettle?

  Yes

  No

  N/A

• Is the fire extinguisher fully charged and up to date?

  Safe

  At Risk

  N/A

• Bucket of clean water available in the event of a burn?

  Safe

  At Risk

  N/A

• Are propane torches being used?

  Yes

  No

  N/A

• Are there enough fire extinguishers available?

  Yes

  No

  N/A

• Are all fire extinguishers fully charged and up to date?

  Safe

  At Risk

  N/A

• Do workers know how to properly use a fire extinguisher? PASS (pull, aim, squeeze, sweep)

  Yes

  No

  N/A

• Are parkade coatings being applied on this site?

  Yes

  No

  N/A

• Yes

  No

  N/A