Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Personal Protective Equipment

  • Hard Hats

  • Safety Glasses

  • Sturdy Work Boots

  • Reflective Vests

  • Gloves

  • Hearing Protection

  • Face Sheilds

  • Burning Goggles

  • Welding Hood and Gloves

Housekeeping

  • Material Stacked in Orderly Fashion

  • Trash Cans Available in Work Area

  • Safe from Slip, Trip and Fall Hazards

  • Access Maintained

  • Fuels Properly Stored

  • Fire Extinguishers Available

Temporary Barricades

  • Proper Caution or Danger Tape in use

  • Guardrail System

  • Safety Signage

Electrical

  • Power Tools in Safe Condition

  • Cords in Safe Condition

  • Cords Protected from Traffic

  • GFCIs in Use

  • Electrical Panels Secured

  • Electrical Signage

  • Proper Temporary Lighting

Ladders, Stairs and Scaffolding

  • Ladders set up Properly

  • Ladders Used Properly

  • Ladders Stored Properly

  • Rails at Stairways and Landings

  • Slip, Trip Exposure Eliminated

  • Stairs Illuminated

  • Scaffolding Inspected and Tagged

  • Scaffolding Components in Place

  • Scaffolding Components Undamaged

Fall Protection

  • Harnesses and Lanyards

  • Horizontal Lifelines / Yoyos

  • Floor Openings Covered

  • Wall Openings Guarded

  • Impalement Hazards Protected

Mobile / Heavy Equipment

  • Seatbelts Used / Chain Gate Closed

  • Workers Trained

  • Equipment Inspected

  • Proper Use of Equipment

  • Audible Backup Alarms

Hoisting and Rigging Equipment

  • Daily Crane Inspection Information on Site

  • Sling / Chokers Stored

  • Certified Riggers Named

  • Inspection Tags on Rigging

  • Power Lines Marked or Delineated

  • Tag Lines in Use

  • Crane Signals Posted

Excavation

  • Competent Person Named

  • Shore/Slope/Bench

  • Proper Access/Egress

  • Spoil Pile at least 2' From Edge

Perimeter Public Protection

  • Adequate Lighting

  • Excavations Protected

  • Falling Object Protection

  • Perimeter Fencing

  • Public Protection Signage

  • Security System in Place

  • Street Closure Identified / Traffic Control Plan

Prework

  • Safety Meeting Minutes Last Performed / Attendance Roster on File

  • Safety Inspections on File

  • Site Orientations

  • RAFN Safety Audit

  • SSSP From Subcontractors on Site

  • Required Postings Posted

  • MSDS/SDS on Site

  • Hot Work Program in Use

  • Lock Out / Tag Out Program in Use

  • First Aid Kit Available

  • Employee Training Records Available For Work Being Performed

Comments

  • Comments/Concerns

Signatures

  • On Site Representative

  • Auditor

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.