1. Answer the applicable questions below.
2. Add photos and notes by clicking on the paperclip icon.
3. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
4. Complete audit by providing digital signature.
5. Share your report by exporting as PDF, Word, Excel or Web Link.

A. General

1. Are the public and other trades adequately protected from any dangers posed by our work?

2. Are the general work areas neat and orderly?

3. Is trash being placed in proper receptacles?

4. Does the foreman know the location of the closest hospital?

5. Have all employees taken part in a JHA discussion for their particular work task within the last week?

6. Do all employees have access to potable water?

7. Is a first aid kit available?

8. Are SDS readily available to all employees on site?

9. Are all flammable liquids stored in approved safety cans?

10. Are all flammable liquid storage containers labeled appropriately?

11. Is a fire extinguisher readily available, inspected monthly, and maintained annually?

12. Are all employees protected from accidental injury or impalement by sharp or slender objects (protruding nails, rebar, etc.)?

B. Slip, Trip, and Fall Prevention

1. Are all unattended manhole, catch basin, and similar openings protected with barricades or fencing, or covered securely with plywood or similar?

2. Are all hoses, cords, cables, nylon strapping, metal banding, shovels, rakes, etc., placed neatly outside of common employee travelways?

3. If hose, cable, cord, etc., must cross a common employee travelway is it securely fastened in such a manner as to prevent tripping?

4. Are all excavations where crews are not actively working protected either by barricades, fencing, or parked machine?

5. Are employees working on retaining walls higher than 6’ protected by guardrails or a personal fall arrest system?

C. Ladder Safety

1. If an employee is using a ladder have then been trained in ladder safety?

2. Does the ladder extend at least 3’ above the upper landing?

3. Is the ladder positioned such that the ‘run’ of the ladder is about 1/4 of the ‘rise’?

4. Is the ladder in good working condition?

5. Is the ladder securely fastened, either by embedment into earth or some type of rope or cable?

6. Stepladders are being used only in the open position?

7. Are all ladder rungs free from grease and oil?

8. Are employees facing the ladder and maintaining three points of contact?

D. Personal Protective Equipment (PPE)

1. Are hard hats being worn by all employees?

2. Are work boots being worn by all employees?

3. Are jeans, canvas, or similar long pants being worn by all employees?

4. Are gloves, traffic vests, earplugs, safety glasses, and similar PPE readily available to all employees?

5. Is hearing protection being worn where required?

6. Are gloves being worn where required?

7. Are traffic vests being worn where required?

8. Are safety glasses being worn where required?

9. Is all utilized and available PPE in good working condition?

E. Trenching and Excavation

1. Has the competent person inspected the excavation prior to any employee entering?

2. Has a Excavation Permit been filled out?

3. Is the crew aware of all potential existing utilities in the work area?

4. Is the crew aware of all overhead electrical lines in the work area?

5. Has the competent person inspected the trench prior to an employee entering?

6. Are all excavations 5’ or greater in depth protected from cave-in by proper shoring or sloping?

7. Are the sides of all trenches sloped at a rate no greater than 1.5H:1V?

8. Trench Box Safety

a. Is the tabulated data sheet on site for this trench box?

b. Is the excavation no greater than 2’ below the bottom of the trench box?

c. Does the trench box extend at least 18” above the top of the vertical sides of the trench?

9. Are spoils kept at least 2 feet away from the trench edge?

10. Is a ladder present in all excavations 4’ or greater in depth?

11. If a ladder is used is it positioned such that no employee has to travel greater than 25’ to access it?

12. Is the trench protected from water accumulation?

F. Hand & Power Tools

1. Are shafts and handles of all tools free from cracks and in good working condition?

2. Are all tools stored neatly and protected from damage?

3. Are the proper tools being used for the job?

4. Are all power cords and extension cords free from cuts, frays, or other damage?

5. Have the employees operating a power tool been trained on that specific tool?

6. Are all impact tools free from splinters or mushrooms?

7. Are all damaged or malfunctioning tools tagged out?

8. Are all guards on tools in place and working properly?

9. Are GFCI’s used for all portable electric tools?

G. Heavy Equipment/ Trucks

1. Are all backup alarms functioning properly?

2. Do all machines have inspected fire extinguishers.

3. Are all seat belts functioning and being used?

4. Are inspection sheets or pre-trip post trip sheets available and correctly filled out?

H. Material Handling and Rigging

1. Are employees using proper lifting techniques when lifting objects manually?

2. Are machines being used to lift heavy objects?

3. Do all chains and straps have a legible capacity rating tag?

4. Are all chains and straps being used according to their capacity rating?

5. Do hooks used for lifting have a safety latch in place?

6. Are tag lines available and being used when appropriate?

7. Employees are not allowed underneath any overhead load?

8. Are lifting chains being rigged properly?

9. Are loads that have the potential to swing during movement being secured?

10. Are all lifting apparatus stored neatly and protected from weather and other damage?

Inspected by