Reliant Safety Solutions,LLC

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Previous Inspection

• Has the last inspection been reviewed?

  Yes

  No

  N/A

• Are there any outstanding safety deficiencies?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Administrative / Site Records

• Did company representative accompany inspector?

  Yes

  No

  N/A

• Are all Safety/GHS/Hazcom/Emergency Programs on site?

  Yes

  No

  N/A

• Emergency contact numbers posted?

  Yes

  No

  N/A

• OSHA and Federal/state/local posters posted in conspicuous place?

  Yes

  No

  N/A

• Are emergency procedures posted or available to all workers?

  Yes

  No

  N/A

• Company superintendent or foreman onsite when employees are working?

  Yes

  No

  N/A

• Company JSA's completed prior to work.

  Yes

  No

  N/A

• Are safety meetings held and documented?

  Yes

  No

  N/A

• Hot work permit obtained from the General Contractor prior to work?

  Yes

  No

  N/A

• General Contractor safety orientation completed prior to coming on site?

  Yes

  No

  N/A

• Employee training documentation available?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

General

• First Aid kit available and properly stocked?

  Yes

  No

  N/A

• Emergency eyewash station onsite?

  Yes

  No

  N/A

• Drinking water stations have disposable cups and waste containers available?

  Yes

  No

  N/A

• Other?

  Yes

  No

  N/A

Personal Protective Equipment

• Hard hats worn properly and in good condition?

  Yes

  No

  N/A

• High visibility vest worn by employees?

  Yes

  No

  N/A

• Protective clothing worn?

  Yes

  No

  N/A

• Proper ANSI Z87 safety glasses worn by employees?

  Yes

  No

  N/A

• Proper work boots worn by employess?

  Yes

  No

  N/A

• Approved and effective ear protection used?

  Yes

  No

  N/A

• Gloves used when required?

  Yes

  No

  N/A

• Safety harness inspected prior to use?

  Yes

  No

  N/A

• Safety harness as visible label/tag?

  Yes

  No

  N/A

• Safety harness worn properly?

  Yes

  No

  N/A

• Safety harness in good condition?

  Yes

  No

  N/A

• Respiratory protection used where required? Are workers trained?

  Yes

  No

  N/A

• PPE in good condition?

  Yes

  No

  N/A

• Additional specialized equipment provided, used and maintained?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Housekeeping

• Walkways clear of material and debris?

  Yes

  No

  N/A

• Trash and debris cleaned up?

  Yes

  No

  N/A

• Liquid spills cleaned up to avoid slip and fall hazards?

  Yes

  No

  N/A

• Gang-boxes neat and organized?

  Yes

  No

  N/A

• Material storage areas kept organized and clean?

  Yes

  No

  N/A

• Trash cans available where required?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Fire Protection

• Fire protection equipment available?

  Yes

  No

  N/A

• Fire watch used and employee trained?

  Yes

  No

  N/A

• Fire extinguishers charged and have a current annual inspection?

  Yes

  No

  N/A

• Flammable materials stored properly?

  Yes

  No

  N/A

• UL - Approved fuel containers used for storage of flammable liquids?

  Yes

  No

  N/A

• All containers (cans, drums, fuel tanks, gas cylinders, ect) are clearly marked with contents?

  Yes

  No

  N/A

• Combustible trash cleaned up properly?

  Yes

  No

  N/A

• Fire extinguishers located in area?

  Yes

  No

  N/A

• Fire blankets available?

  Yes

  No

  N/A

Material Handling and Storage

• Material stored neatly and stacked properly?

  Yes

  No

  N/A

• Clear walkways maintained around storage areas?

  Yes

  No

  N/A

• Storage areas kept free of trash and debris?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Barricades

• Protective barricades (cable rope, wooden posts and rail, ect) are provided and used to warn and protect personnel?

  Yes

  No

  N/A

• Warning barricades (high-visibility synthetic tape, yellow chain, ect) are provided and used to alert personnel to hazards?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Crane and Rigging

• Are riggers and signal person trained/qualified?

  Yes

  No

  N/A

• Slings, and chains, hooks and eyes, have no evidence of damage, defects, or excessive wear?

  Yes

  No

  N/A

• Wire ropes/slings/chains/ inspections are current?<br>

  Yes

  No

  N/A

• Chains inspected and have identification tag stating size, grade, rated capacity and manufacturer?

  Yes

  No

  N/A

• Are labels/tags legible on all rigging equipment?

  Yes

  No

  N/A

• Shackles free of damaged such as bent, twisted, distorted, stretched, elongated, cracked, nicks, pitting and corrosion?

  Yes

  No

  N/A

• Tag lines used to control the load?

  Yes

  No

  N/A

• Chain falls in good condition and working properly?

  Yes

  No

  N/A

• Proper hand signals used?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Steel Erection/Cranes

• Is the site access/layout/storage area proper?

  Yes

  No

  N/A

• Has GC provided all written documents for erection process to begin?

  Yes

  No

  N/A

• Is the steel erection plan required & in place?

  Yes

  No

  N/A

• Is the crane set up properly?

  Yes

  No

  N/A

• Are operations performed at least 10 feet from overhead power lines?

  Yes

  No

  N/A

• Is the crane properly maintained/copy of annual inspection available?

  Yes

  No

  N/A

• Are loads properly rigged/carried?

  Yes

  No

  N/A

• Is the crane operator qualified and has supported documentation for review?

  Yes

  No

  N/A

• Are areas under swinging loads properly barricaded & enforced?

  Yes

  No

  N/A

• Are the rigger and signal person trained/qualified?

  Yes

  No

  N/A

• Are steel erection procedures proper?

  Yes

  No

  N/A

• Are 2-bolt connections/4 bolt column anchor requirements followed?

  Yes

  No

  N/A

• Does controlled decking zone meet the standards?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Fall Protection

• Are fall protection plans required & in place?

  Yes

  No

  N/A

• Is fall protection provided at heights over 6 feet?

  Yes

  No

  N/A

• Toe boards installed with no more than a 1/4 gap?

  Yes

  No

  N/A

• Are access/egress locations with a change in elevation > 19 inches provided with stair, ladders or ramp?

  Yes

  No

  N/A

• Are stairways properly protected & used?

  Yes

  No

  N/A

• Top rail height at 42 inches - no more than 3 inches of deflection?

  Yes

  No

  N/A

• Mid-rail at proper height of 19 inches?

  Yes

  No

  N/A

• Holes covered, secured and labeled properly?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Hand and Power Tools

• Guards in place where required?

  Yes

  No

  N/A

• Power tools grounded properly?

  Yes

  No

  N/A

• Power tools cords in good condition?

  Yes

  No

  N/A

• Broken or defective tools taken out of service and tagged?

  Yes

  No

  N/A

• Proper tools being used for the correct task?

  Yes

  No

  N/A

• Hand tools proper maintained and inspected before use?

  Yes

  No

  N/A

• All compressed air equipment used is properly regulated?

  Yes

  No

  N/A

• Airlines/hoses secured to prevent whipping with cotter pin or tie wire?

  Yes

  No

  N/A

• Air hoses in good condition?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Welding and Cutting

• Compressed gas cylinders stored and secured properly?

  Yes

  No

  N/A

• Oxygen cylinders stored separately from fuel gas cylinders?

  Yes

  No

  N/A

• Cylinders equipped with safety caps when not in use?

  Yes

  No

  N/A

• Flash backs installed on torch or gauges?

  Yes

  No

  N/A

• Regulators and gauges free of damage and working properly?

  Yes

  No

  N/A

• Screens, shields, or eye protection provided and used to protect personnel from welding operations.

  Yes

  No

  N/A

• Welding lead free of damage and repairs with a minimum distance of 10 feet from electrode holder?

  Yes

  No

  N/A

• Proper welding lead material (electric tape, heat shrink, ect) used for repairs?

  Yes

  No

  N/A

• Fire extinguisher in work area

  Yes

  No

  N/A

• Fire watch in place where required?

  Yes

  No

  N/A

• Hot work permit obtained prior to start?

  Yes

  No

  N/A

• Gas Welding machine properly ventilated to prevent gas build up?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Electrical

• Electrical 3 ways used properly?

  Yes

  No

  N/A

• Extension cords free of damage (nicks, cuts, wear)?

  Yes

  No

  N/A

• Extension cords protected against accidental damage and kept clear of work spaces, walkways, ect. to prevent tripping or falling hazards?

  Yes

  No

  N/A

• Is temporary lighting used & proper?

  Yes

  No

  N/A

• Lock out - Tag out in place where required?

  Yes

  No

  N/A

• Do all employees have there pin tester and lock out tag lock?

  Yes

  No

  N/A

• Are generators over 5kv properly grounded

  Yes

  No

  N/A

• Are arc flash hazards identified & addressed?

  Yes

  No

  N/A

• Do all boxes/panels have covers & are circuits labeled?

  Yes

  No

  N/A

• Electrical equipment grounded properly?

  Yes

  No

  N/A

• GFCI's in use?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Ladders

• Job made ladders built properly?

  Yes

  No

  N/A

• Metal ladders not used around electrical hazards?

  Yes

  No

  N/A

• Extension ladders being used correctly?

  Yes

  No

  N/A

• A-Frame portable ladders being used correctly?

  Yes

  No

  N/A

• Extension ladders set up with the proper 4:1 slope?

  Yes

  No

  N/A

• Extension ladders exceed 3 feet above walking working surface for safe access?

  Yes

  No

  N/A

• Ladders properly maintained and stored?

  Yes

  No

  N/A

• Ladders secured when required?

  Yes

  No

  N/A

• Stickers/labels or legible and visible on all ladders?

  Yes

  No

  N/A

• Defective ladders taking out of service and tagged?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Scaffolds

• Is scaffold competent person on site?

  Yes

  No

  N/A

• Are scaffold users properly trained?

  Yes

  No

  N/A

• Are all scaffold frames/planks/parts free of damage & defects?

  Yes

  No

  N/A

• Are scaffold erection/disassembly procedures proper?

  Yes

  No

  N/A

• Is fall protection provided for erectors/dismantlers?

  Yes

  No

  N/A

• Are walk/work planks properly installed & set?

  Yes

  No

  N/A

• Are guardrails properly installed & used?

  Yes

  No

  N/A

• Are base plates/mud sills stable & proper?

  Yes

  No

  N/A

• Scaffold inspected before each shift with inspection tag in place?

  Yes

  No

  N/A

• Wheels on mobile scaffolds locked when in use?

  Yes

  No

  N/A

• Is scaffold access proper?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Boom Lifts / Scissor Lifts

• Trained personnel operating equipment?

  Yes

  No

  N/A

• Chain secured on scissor lift?

  Yes

  No

  N/A

• Is all equipment properly maintained & inspected?

  Yes

  No

  N/A

• Boom lift used on stable ground?

  Yes

  No

  N/A

• Are all operations performed at least 10 feet from overhead power lines?

  Yes

  No

  N/A

• Proper fall protection used when operating?

  Yes

  No

  N/A

• Equipment operated safely?

  Yes

  No

  N/A

• Do back up alarms work?

  Yes

  No

  N/A

• Are parts/equipment free from damage?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Forklift Operations

• Employee qualified to operate forklift?

  Yes

  No

  N/A

• Proper forklift inspection completed before use?

  Yes

  No

  N/A

• Is forklift properly maintained and inspected?

  Yes

  No

  N/A

• Seat belt worn when operating forklift?

  Yes

  No

  N/A

• Are forks on the ground when parked?

  Yes

  No

  N/A

• Are parts/equipment free from damage?

  Yes

  No

  N/A

• Are all operations performed at least 10 feet from overhead power lines?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Excavation and Trenching

• Competent person onsite during excavation?

  Yes

  No

  N/A

• Has the trench/excavating been evaluated as a confined space?

  Yes

  No

  N/A

• Excavations and trenches over 5 feet protected by shoring, benching, ect?

  Yes

  No

  N/A

• What is the soil type?

  Yes

  No

  N/A

• Excavations and trenches over 4 feet equipped with proper access and egress?

  Yes

  No

  N/A

• Employees working only in the protected shored area?

  Yes

  No

  N/A

• Spoil piles at a safe distance from edge? (3 feet)

  Yes

  No

  N/A

• Excavations and trenches inspected each shift before employees enter?

  Yes

  No

  N/A

• Excavations and trench shored properly for type of soil?

  Yes

  No

  N/A

• Gas monitoring in excavation been performed prior to work?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Notes and Comments

• Report conclusion including any recommendations.

Signature

• On site representative

  Sign

• Auditor's signature

  Sign