PREMIER SPECIALTY CONTRACTORS

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Project Name & Number

• Yes

  No

  N/A

General

• Daily JSA forms for each crew available for review?

  Yes

  No

  N/A

• Weekly Tool Box talk conducted and signed by crew?

  Yes

  No

  N/A

• First aid kit stocked?

  Yes

  No

  N/A

Housekeeping

• Adequate number of toilets available and clean?

  Yes

  No

  N/A

• Trash being removed daily?

  Yes

  No

  N/A

• Job site swept clean and free from related trash and debris?

  Yes

  No

  N/A

• Walkways and passages clear to walk?

  Yes

  No

  N/A

Personal Protective Equipment

• Employees wearing safety glasses at all times?

  Yes

  No

  N/A

• Employees wearing company issued safety vest?

  Yes

  No

  N/A

• Employees wearing hard hats?

  Yes

  No

  N/A

• Employees wearing gloves when exposed to cut/chemical hazards?

  Yes

  No

  N/A

• Employee wearing hearing protection?

  Yes

  No

  N/A

• Employee wearing face shield?

  Yes

  No

  N/A

• Respiratory Protection worn by employees when required?

  Yes

  No

  N/A

Electrical

• GFCI protection in use on all temporary power sources?

  Yes

  No

  N/A

• Extension cords in good condition?

  Yes

  No

  N/A

• Plug ends in good shape?

  Yes

  No

  N/A

Hand and Power Tools

• Power Tools free from damage (switches, cords, and guards)?

  Yes

  No

  N/A

• Crew member carrying certificate to operate powder actuated tool?

  Yes

  No

  N/A

• Hand tools free from damage ( shaft, head, splinters, etc.)?

  Yes

  No

  N/A

• Dustless attachment in use?

  Yes

  No

  N/A

Excavations

• Have utilities been located and protected?

  Yes

  No

  N/A

• Adequately sloped or shored if below 5' in depth?

  Yes

  No

  N/A

• Means of egress every 25 feet?

  Yes

  No

  N/A

• Spoil pile and equipment back at least 2 feet from edge?

  Yes

  No

  N/A

• Water being pumped out if present?

  Yes

  No

  N/A

• Documented daily inspection available for review?

  Yes

  No

  N/A

Fall Protection

• Employees using anchor capable of supporting 5,000 lbs?

  Yes

  No

  N/A

• Elevated work levels have guardrails or cables at 21" and 42"?

  Yes

  No

  N/A

• Is leading edge well defined and warning system in place at 15'?

  Yes

  No

  N/A

• Is employee wearing 100% fall protection when working outside 15' warning line and anchored to 5000 lb. anchorage?

  Yes

  No

  N/A

• Employees working above 6 feet using 100% fall protection?

  Yes

  No

  N/A

• All holes covered and labeled?

  Yes

  No

  N/A

Fire Protection

• Only NFPA approved containers used for fuel?

  Yes

  No

  N/A

• Flammable fluids stored in fire cabinet?

  Yes

  No

  N/A

• Are ABC fire extinguishers available and strategically place?

  Yes

  No

  N/A

• Adequate number of fire extinguishers in place?

  Yes

  No

  N/A

• Are fire extinguishers fully charged?

  Yes

  No

  N/A

Ladders

• Do extension or job built ladders extend 36 inches above landing?

  Yes

  No

  N/A

• Are ladders tied off at top?

  Yes

  No

  N/A

• Are spreader bars locked on step ladders?

  Yes

  No

  N/A

Powered Industrial Equipment

• All equipment have ROPS installed?

  Yes

  No

  N/A

• Back up alarm working on on equipment?

  Yes

  No

  N/A

• Operator wearing seatbelt?

  Yes

  No

  N/A

• Operator have training card available for forklift, Aerial Boom Lift?

  Yes

  No

  N/A

• Employees wearing fall protection when using aerial lift?

  Yes

  No

  N/A

Scaffolding

• Mudsill, base plate, and Screwjack in place?

  Yes

  No

  N/A

• Guardrails, Midrails and Toeboards installed?

  Yes

  No

  N/A

• Ladder access provided for employees on all working levels?

  Yes

  No

  N/A

• Rolling scaffold wheels locked?

  Yes

  No

  N/A

Hot Work

• Fire extinguisher available and inspected?

  Yes

  No

  N/A

• Gas cylinders separated when not in use?

  Yes

  No

  N/A

• Gas cylinders secured from falling over?

  Yes

  No

  N/A

Dustless Engineering

• Are dustless attachments being used for angle grinders?

  Yes

  No

  N/A

• Can fans be used to direct dust away from employee?

  Yes

  No

  N/A

• Is the public protected from dust exposure?

  Yes

  No

  N/A

• Is wet method to control dust being used?

  Yes

  No

  N/A

• Is floor sweep being used to control airborne dust when sweeping?

  Yes

  No

  N/A

On Site Management Review

• Superintendent signature

  Sign

• Safety Director signature

  Sign

• Foreman Signature

  Yes

  No

  N/A