Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

PERSONNEL INFORMATION

  • Employees trained in emergency procedures?

  • Equipment operators certified and trained?

  • Employees trained and qualified to perform their assigned duties?

JOB SITE INFORMATION

  • Tool box safety meetings being conducted?

  • JSA's being implemented?

  • Adequate first aid equipment available?

  • Employees wearing proper PPE?

  • Are applicable MSD'S available?

OVERALL WORK AREA

  • Safe work practices being followed?

  • Lay down areas neat and orderly?

  • Combustible/ flammable materials properly stored/ labeled?

  • General housekeeping in good order?

  • Passage ways/ walkways clear of obstructions?

  • Sanitary facilities adequate and clean?

  • Adequate lighting provided?

  • Work permit controls in place? "Safe work permit"

FIRE PREVENTION

  • Ample fire extinguishers present identified/ checked/ inspected?

  • "No smoking" and or "open flame" signage posted where needed?

  • Fire watch being utilized, are they trained?

  • Gas monitors being used, bumped daily and calibrated monthly?

  • Hot work permits procedure in place and being used?

  • Housekeeping and ample trash receptacles in place?

ELECTRICAL INSTALLATION/ ELECTRICAL SAFETY

  • All electrical cords are free of damage and not improperly spliced?

  • Lock-out/ tag-out procedures being used?

  • Attached to all electrical sources/ cords/ generators?

  • All tanks/ vessels/ generators grounded properly?

  • All electrical panels/ breakers/ wires labeled properly?

  • All electrical panels have covers?

  • "Danger overhead power lines" signage in place?

  • Proper clearance to access in all panels/ boxes?

EXCAVATION/ TRENCHING/ SHORING

  • Is trench excavation over 5 feet deep and being occupied by employees?

  • Is a competent person on site?

  • Who?

  • Trench properly shore/ trenched/ sloped/ configured to soil classification?

  • Site excavation checklist utilized?

  • Spoil piles are at least 2 feet beyond excavation?

  • Adequate egress and access provided every 25 feet ramps/ ladders?

  • Ladders extend 3 feet above excavation?

  • Crossovers/ walkways adequately/ properly built with hand rails?

  • Adjacent structures properly barricaded?

  • Equipment/ vehicles parked at a safe distance from excavation?

  • Is excavation considered to be a confined space?

WELDING AREAS

  • Is a hot work permit required?

  • Fire watch needed/ required/ present?

  • Fire extinguishers present?

  • All grinders have guards on them?

  • All pressurized bottles are secured?

  • All hoses/ leads are in good condition?

  • Welders have hardhats/ pancakes/ proper PPE?

  • Face shields are being utilized?

  • All screens and shields are up in place where needed?

  • Proper PPE worn by all?

  • All torches/ hoses/ regulators are not left unattended/ charged?

MOBILE EQUIPMENT

  • Pre-shift inspections completed and documented?

  • Operators are task trained?

  • All equipment is in good operating condition?

  • Fire extinguishers are mounted on all pieces of equipment?

  • All glass is in good condition?

  • Backup alarms are working properly?

  • All implements are on the ground while parked?

  • Wheels are chocked/ equipment is turned into the bank where applicable?

  • Seat belts are worn by all operators?

  • Roads/ travel ways well-maintained?

  • No major oil/ fluid leaks?

HAND TOOLS

  • The proper tools being used for the job?

  • Tools are in good working condition. Chisels mushroomed, handles cracked/ broken?

POWER TOOLS

  • All tools are in working condition?

  • All tools are properly guarded where applicable?

  • All power cords are in satisfactory condition?

LADDERS

  • All ladders are in good working condition?

  • All ladders are secured, both extended and stepladders?

  • The proper ladder is being used for the job?

SCAFFOLDING

  • Scaffolding is properly anchored with footing's and secured?

  • Scaffolding is properly tagged: red, green and yellow?

  • Scaffolding is being inspected daily by a competent person?

  • All toe boards, mid-rails, top rails are in place and our are OSHA compatible?

  • All planks are in place not less than 18 inches wide?

HOIST / CRANES

  • Cables/ sheaves/ slings/ hooks/ eyes are in good working condition?

  • Outriggers are in good working order?

  • Unit is properly secured/ proper pads are in place on outriggers?

  • Lift plan is in place?

  • Critical lift plan under/ permit in place where applicable?

  • Does pick fall under critical list guidelines/ criteria?

  • All controls are working properly, load limits, indicators?

  • Crane operators and riggers are certified?

  • Signal men are being utilized?

  • Tag lines are being utilized?

  • Swing radius and pic perimeter is properly barricaded?

  • Pre pick meetings held prior to guarded/ commencement of work?

  • Power lines are a safe/ proper distance from pics?

BARRICADES

  • Floor openings are playing over, barricaded?

  • Proper barricading of excavations, holes, hazards are properly done with either cautionary yellow, danger, keep out, red, or a physical barricade?

  • All hazards are identified?

FLAMMABLE/ COMBUSTIBLES

  • Flammables and combustibles are properly stored in a fire resistant cabinet/ box?

  • All containers clearly identified?

  • Fire hazards check?

  • Proper signage is in place?

  • Fire extinguishers present?

COMPRESSED GAS CYLINDERS/ TORCHES

  • All compressed cylinders are properly secured?

  • Proper signage is in place?

  • Adequate fire extinguishers/ protection is in place?

  • Proper storage/ spacing is OSHA compliant?

  • All caps are on non-invasive bottles?

  • All portable carts are secured with proper guards in place?

  • "Stored bottles" have not been used in 24 hours?

FUELING AREAS

  • Proper signage is in place "NO SMOKING" and "OPEN FLAME"?

  • All tanks/ vessels are properly grounded?

  • Adequate fire extinguishers/ protection are present?

  • All tanks/ vessels are in a containment (proper) that will contain the largest tank/ vessel unless self-contained?

  • All vessels/ tanks are clearly identified?

ADDITIONAL REMARKS

Contractor supervisor/ competent person :

  • Add signature

Pro-Pipe HSE representative :

  • Add signature

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.