Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Permits

  • Permit to work in place

  • Appropriate permits displayed at work site

  • Confined Space / standby personnel

  • JHA Availible

  • Hot Work, fire watch

  • Construction signage and cordoned off properly

PPE

  • Respiratory protection in place

  • Gloves

  • Equipment guards on equipment

  • Foot protection

  • Safety glasses in place

  • Hearing protection in place

  • Head protection in place

  • Protective clothing

  • Safety full-body harness (man-lifts, above grade, personnel baskets)

Electrical tools

  • Covers on boxes, switches, receptacles (tight-fitting) or double insulated

  • Power tools and appliances grounded

  • Welding machine grounded

  • Ground fault interrupters

  • Ground extension cord with good connectors

PNEUMATIC TOOLS/EQUIPMENT

  • Power tools secured to hose

  • Device at air source to reduce pressure if hose fails

EXCAVATIONS AND TRENCHING

  • Sloping, stair-stepping or shoring of walls

  • Ladder or steps in hole/trench for quick exit

  • Warning tape or barriers installed

  • All nails on boards removed or bent over

SCAFFOLDS / LADDERS

  • Ladders meet construction standards

  • Scaffolding is certified by competent authority

  • Scaffolds are plumb and secured

  • Adequate working platforms on scaffolds

  • Toe boards/guard rails in place

  • Access ladder to elevated work platform

  • Ladders tied off

COMPRESSED GAS CYLINDERS

  • Secure in an upright position

  • Metal valve caps must be in place on all cylinders not in use

  • Store spare oxygen and combustible gas cylinders separate

SUSPENDED LOADS

  • Secured by tag line to prevent swinging

  • No personnel working beneath load

  • Wire lines and connectors inspected/certified

FUEL CONTAINERS

  • Approved cans properly labelled

  • Storage of flammable liquids in designated areas only

  • Bulk storage of fuels vented, labelled

VEHICILE AND MOBILE EQUIPMENT

  • Backed-up alarms on mobile equipment

  • Load chart displayed inside equipment

  • Overhead guards on forklifts

  • Wheels chocked

WORKING SURFACES

  • Clear of tripping hazards

  • Non-slip surfaces on floors or ramps

  • Floor openings guarded

  • Stairs designed with hand rails, treads, risers, angles that meet standards

SPILL PREVENTION

  • Hazardous products only available at workplace in quantities required for daily use

  • Spill containment material available

  • Product packaging in good condition and closed when not in use

  • Material Safety Data Sheets available

WASTE DISPOSAL

  • Trash and rubbish removed daily

  • Hazardous wastes segregated for proper disposal

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.