Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Fall protection

  • Scaffold properly set up and tagged

  • Ladders in good condition and being used properly

  • Safety railings/ warning lines installed correctly

  • P.P.E. Used when needed and in good condition when above 6 feet

  • Scissor lift chains being used? Boom lift operators have harness's?

Caught in or between

  • Workers and equipment separated

  • Back up alarms working

  • Ditches properly benched back

  • Power tools have guards in proper working order

  • Confined space has been identified and a plan in place

Struck by

  • Break truck has designate area

  • Workers not exposed to falling objects or other workers overhead

  • Controlled access zones in place as needed to avoid falling objects

  • Designated parking for employees,subcontractors

  • Delivery routes established for semi's rental companies

Electrical hazards

  • Electrical rooms identified and locked out

  • Temporary power on a GFCI system

  • Temporary panels identified and locked out

  • Electricians identified to work in electrical rooms and temporary lights and panels

  • Disconnects locked out before energizing

  • Permanent power energizing meeting been held

General housekeeping

  • Site is secure? Temporary fencing installed?

  • SWPPP in place and being maintained?

  • Project site clean, material storage organized <br>

  • Entry into project established? Roads clean?

  • Entry points into building clean, solid surfaces into building ?

  • Temporary toilets clean? Organized,? Located from jobsite traffic?<br>Hand wash stations on site?

  • Stairs and entryways hazard free, clean from debris?

Additional notes

  • Add media

  • 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.