Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Personal Protective Equipment (PPE)

  • Hard Hats - Mandatory on sites with overhead work or other hazards - curb to door

  • High Visibility Garments - ANSI Class II - worn by all workers on sites with exposure to mobile equipment being operated

  • Eye / Face Protection worn when required by task or work area (hazard exposure)

  • Hearing Protection - when working in noisy areas (3 foot rule)

  • Respiratory Protection - audit when cutting concrete - spray-foam insulators

  • Proper Footwear - no open-toed shoes (i.e. sandals)

Housekeeping

  • Access & Egress Clear (Stairs, Isles, Walkways) - No trip hazards on stairs (cords, boxes, etc.)

  • Debris / Trash Removal - Food wrappers, cigarette butts, etc.

  • Nails, exposed rebar and other puncture/impalement hazards mitigated (bent, capped)

Ladders / Stairs

  • Handrails - on all stairs/steps with 4 or more risers or 30" of rise must have handrail

  • Extension ladder - Extends 3' Above Landing

  • Ladders use - proper use of stepladders - locked open and not working from top two steps

  • Ladder use - Workers climbing ladders use three points of contact (hands free for climbing)

  • 19" maximum before a step or ramp down to a lower level - otherwise guarded

Fall Protection

  • Employees not exposed to falls over six feet without use of guardrail or PFAS (tied-off)

  • Open doors or windows (sill <39") with fall distance >6 have guardrail protection

  • Personal fall arrest system - proper use and condition of harness, anchorage, connectors

  • Pumpjack scaffold (siders) - guardrail and net secured with endrails when necessary

  • Scaffold - free of trip hazards; fall protection at 10'; proper base/footings

Electrical

  • Adequate Lighting - Task / Area

  • GFCI protection on all portable cord and plug tools and equipment

  • Cords in good condition - extension cords three-wire

Fire Protection / Prevention

  • Extinguishers accessible near any spark/flame producing activities

  • Flammable liquids stored in approved containers

  • Temporary heaters do not pose fire hazard (clearance from combustible materials)

  • No smoking on jobsite

Tools - Hand & Power

  • Good condition / Manufacturer guards in place

Chemical - HazCom - MN Right-to-Know

  • All chemical containers labeled

  • Periodic Management Inspections

Mobile Equipment

  • Operators trained/certified on mobile equipment (forklift, etc)

  • Equipment inspected - backup alarms, lights, etc.

Excavations & Trenches

  • Utilities - located and marked before dig - one-call

  • Excavated soil (spoil) kept back > 2' from edge of excavation; egress (ladder or ramp) < 25'; protected from collapse (i.e. benched/sloped/shielded) if over 5' deep

Other / Misc.

  • Other / Misc.

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.