Information
-
Document No.
-
Audit Title
-
Client / Site
-
Prepared by
Project Information
-
Project Name & Project Number
-
Assessment Date
-
Person Completing Assessment
-
R&M Personnel Results Reviewed With
-
Brief Project Description - Include Square Footage
-
Number of Robins & Morton Salaried Employees Currently on Project
-
Number of Robins & Morton Hourly Employees Currently on Project
-
Robins & Morton Self Performed Work
- Concrete
- Mechanical
- Electrical
- Drywall
- General Works
- Masonry
- Carpentry
- General Labor
- Other
-
Number of R&M Subcontractors Currently on the Project
-
Number of R&M Subcontractor Employees Currently on the Project
-
Were Assessment Results Reviewed with the R&M Project Team Prior to Leaving the Project?
-
Inspector's Signature
General Project Comments
Field Condtion Project Assessment
Compliant / Safe Observations Identified
-
Safe Observations
Observation
-
Observation Category
- Confined Space
- Cranes
- Hoisting Equipment
- Demolition
- Electrical
- Environmental
- Excavation / Trenching
- Falling Object Protection
- Fall Prevention / Protection
- Fire Protection
- Hazardous Materials
- Hazardous Energy Sources
- Heat Management
- Housekeeping
- Infection Control
- Interim Life Safety
- Ladders
- Lighting
- Line of Fire
- Lock Out / Tag Out
- Manual Material Handling
- Material Handling
- Motorized Equipment
- P.P.E.
- Body Position
- Rigging Equipment
- Sanitation
- Cold Management Plan
- Scissors Lift / AWP
- Concrete
- Stairways
- Site / Public Protection
- Steel Erection
- Welding / Cutting
- Work Zone / Traffic Control
- Work Positioning
- Other
-
Contractor
-
Safe Observation Comments
-
Safe Observation Photo
Non-Compliant / Non-Conforming Field Conditions Observed
-
Non-Compliant / Non-Conforming Field Conditions Observed
Observation
-
Observation Category
- Confined Space
- Cranes
- Hoisting Equipment
- Demolition
- Electrical
- Environmental
- Excavation / Trenching
- Falling Object Protection
- Fall Prevention / Protection
- Fire Protection
- Hazardous Materials
- Hazardous Energy Sources
- Heat Management
- Housekeeping
- Infection Control
- Interim Life Safety
- Ladders
- Lighting
- Line of Fire
- Lock Out / Tag Out
- Manual Material Handling
- Material Handling
- Motorized Equipment
- P.P.E.
- Body Position
- Rigging Equipment
- Sanitation
- Cold Management Plan
- Scissors Lift / AWP
- Concrete
- Stairways
- Site / Public Protection
- Steel Erection
- Welding / Cutting
- Work Zone / Traffic Control
- Work Positioning
- Other
-
Category Clarification
-
Hazard Classification
-
Contractor
-
Location
-
Observation Comments
-
Non-Compliant or Non-Conforming Observation Photo
-
Corrective Action Required / Discussed
-
OSHA or Company Policy Referenced
-
Has the Issue Been Corrected
-
Corrective Actions Taken & Date
-
Corrected Observation Photo
General Comments or Recommendations
- Comment or Recommendation
-
Comment or Recommendation
-
Photo or Attached Media
