Audit

LIFE CRITICAL TOTAL

Work Platforms & Scaffolding

Corrective Action Due Date:

Fire Prevention & Protection

Corrective Action Due Date:

Electrical

Corrective Action Due Date:

Confined Spaces

Corrective Action Due Date:

Plant & Equipment

Corrective Action Due Date:

Working at Height

Corrective Action Due Date:

Lifting Operations

Corrective Action Due Date:

Excavations & Trenching

Corrective Action Due Date

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HEALTH & WELFARE TOTAL

Work Area

Corrective Action Due Date:

Trash Containers/Disposal

Corrective Action Due Date:

Rest Areas

Corrective Action Due Date:

Drinking Water

Corrective Action Due Date:

Toilets/Washing Facilities

Corrective Action Due Date:

First Aiders/First Aid Kits

Corrective Action Due Date:

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WORK ENVIRONMENT TOTAL

Heat Stress

Corrective Action Due Date:

Noise

Corrective Action Due Date:

Illumination

Corrective Action Due Date:

Dust Suppression/Control

Corrective Action Due Date:

Object/Line of Fire Hazards

Corrective Action Due Date:

Access/Egress

Corrective Action Due Date:

Traffic Management/Barricades

Corrective Action Due Date:

Safety & Road Signage

Corrective Action Due Date:

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EQUIPMENT & PROCEDURES TOTAL

Personal Protective Equipment

Corrective Action Due Date:

Hand & Power Tools

Corrective Action Due Date:

Management & Supervision

Corrective Action Due Date:

COSHH

Corrective Action Due Date:

People (Behaviors)

Corrective Action Due Date:

Method Statements/Risk Assessments

Corrective Action Due Date:

Permit to Work

Corrective Action Due Date:

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OTHER TOTAL

Observation #1:

Corrective Action Due Date:

Observation #2:

Corrective Action Due Date:

Observation #3:

Corrective Action Due Date:

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ADDITIONAL PHOTOS
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REPORT SUMMARY

Initial Action Report (IAR) Issued?

Reason for IAR:

Non-Compliance Report Issued?

Reason for Non-Compliance Report:

Was there a Work Stoppage?

Reason for Work Stoppage:

Contractor Representative Signature:
Supervising Consultant Signature:
Parsons Representative Signature:

Other Comments

VERIFICATION & CLOSEOUT:

Contractor Signature/Date/Comments:

Supervising Consultant Verification Signature/Date/Comments:

Parsons Review Signature/Date/Comments:

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.