Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

EQUIPMENT

  • Horn functioning

  • Operator appears competent

  • Seat belts used

  • Strobe lights, where applicable

PPE

  • Glass/goggles

  • Face shields (grinding/overhead drilling)

  • Side shields

  • Gloves

  • Hard hat

  • Hearing protection

  • Hi visible construction vest

  • Proper clothing, 3" shirt sleeves

  • Work boots

SCAFFOLDS

  • Proper training

  • Bracing and pins in place

  • Compatible components used

  • Competent person present

  • Guardrails in place @ 6"

  • Inspected daily

  • Properly secured to structure

  • Proper access to platforms

  • Proper loading of materials

  • Safe work distances

  • Will, plates, jacks installed

  • Wheels locked

SCISSOR/AERIAL LIFT

  • Surface in safe condition

  • Equipment loaded properly

  • Inspected before each use

  • Platform free of debris

  • Gate or chain secured

  • Harness while in boom lifts

  • Nothing to increase height

  • Operating on flat surface

  • Operator training

  • Safe work distance

SITE

  • Surface free of holes

  • Adequate lighting

  • Barricades installed properly

  • Excavations protected

ELECTRICAL

  • Assured grounding used

  • Cords in good condition

  • Cords protected from traffic

  • EEW procedures followed

  • EEW tools/equipment available

  • Electrical room protected

  • Energized parts protected

  • GFCI's used

  • Under permanent power

  • LO/TO procedures

  • Proper use temp power boxes

  • Signage present

SITE PROTECTION

  • Falling object protection

  • Perimeter fences

  • Public/site protection signage

  • Security system in place

  • Proper locks and lock boxes in use

  • Are lock boxes in place where applicable

  • Traffic control plan

  • Street closure

WELDING/CUTTING

  • Bottles upright/capped and secure

  • Fire extinguishers present

  • Flash arrest on torches

  • Flash protection available

  • Gauges working properly

  • Leads in good condition

  • proper PPE in use

  • Torch hoses in good condition

  • Weld machine ventilation

CRANES & HOISTING EQUIPMENT

  • Annual inspection current

  • Anti two block devise

  • Boom angle indicator

  • Certificate or verify training

  • Crane supported and level

  • Daily inspections

  • Flagman identified

  • Distinguish power lines/de-energized

  • Fire extinguisher in crane

  • Lift plan on file

  • Load chart posted

  • Loads properly secured

  • Load weight verified

  • Means of communication

  • Operator appears competent

  • Operator manual in crane

  • Outriggers extended/cribbing

  • Rig inspected/rsted

  • Safety latch used

  • Swing radius barricaded

  • Tag lines used

  • Weight of load verified

EXCAVATIONS

  • Access/egress within 25"

  • Competent person present

  • Daily inspection documents available

  • Excavation >20? engineers

  • One call system used

  • Perimeter protection/barricades

  • Sloped, benched, or shored

  • spoils 2' from edge

  • Surface encumbrances

  • Surface traffic exposure

  • Water entering excavation

  • Operator trained on equipment

  • Utility locates performed

ADMINISTRATION

  • Document pre-construction meeting

  • Document weekly progress meetings

  • Blank incident forms available

  • Frequent/regular safety inspections

  • Pre job hazard analysis (JHA) completed

  • JHA's completed where applicable

  • Do employees have proper training for task

  • MSDS 3E stickers/information posted

  • OSHA 300 log posted

  • Safety manual

  • Safety meetings occur weekly

  • State/federal posters posted

  • Visitors PPE available

  • EEO posters posted

HOUSEKEEPING

  • Clear access to building/site

  • No oil on floor around threading machines

  • Nails removed from scrap

  • No loose nails/screws laying around site

  • Impalement protection

  • Proper material storage

  • Roadway around project clear

  • Slip, trip fall hazards

  • Conduit floor stub-ups properly marked

  • Trash containers available

  • Materials stored in proper locations

  • Walkways clear/cords out of aisles

  • Copy of program

  • Employees trained

  • Do employees have 3E cards

  • MSDA (site specific)

  • Proper labels on containers

FALL PROTECTION

  • External/internal guardrsils

  • Employee trained

  • JHA's completed where applicable

  • all fall protection inspected before use

  • Fall protection at 6'Or 4' Wash/Cal

  • Fall protection plan

  • Floor/wall opening protected

  • Floor covers adequately secured/labeled

  • Proper anchorage points

  • Roof edge protected

  • Safety harness and lanyards

  • Stair/ramp/walkway protection

ELECTRICAL

  • Cords in good condition

  • Cords protected from traffic

  • Cords out of doorways/aiseles/sharp edges

  • Energized electrical work procedures

  • Electric a room protected

  • Energized parts protected

  • GFCI's used

  • Cord grounding complete/copy on job site

  • Temporary power panels in good condition

  • Temporary lighting strung 8'

  • Temporary lighting hung by non-conductive material

  • Temporary lighting has cages/protection

  • No exposed energized parts/conductors

  • Proper use of temporary power boxes

  • Signage present

LOCKOUT/TAGOUT

  • All employees trained CE policies & site specific policies

  • Group lockout

  • Individual lockout

  • Lockout devices/boxes provided/tags

  • Proper test equipment used & available

  • Proper barricades in place

  • Signage present

  • Proper communication

NFPA 70E

  • Are all employees trained

  • Energized electrical policy/procedures available for review

  • Safety department notified

  • Energized electrical work permit complete

  • Job briefing & JHA complete

  • Face shields available

  • Hearing protection available

  • Proper fire retardant clothing on site

  • Proper gloves on site

  • Are gloves currently tested within 3 months

  • Proper test equipment on site

  • Are hot sticks currently tested

  • Proper rescue equipment available where applicable

  • Are signs and barricades posted/available

  • Insulated tools inspected & in good shape

ENVIROMENTAL

  • Asbestos/lead/mold/sillica

  • Concrete cut wet & vacuumed

  • Containers labeled

  • Hazard material properly stored

  • Nuisance dust

  • Spill containment adequate

CONFINED SPACE

  • Access within 25'

  • Employees trained

  • Competent person present

  • Daily inspection documented

  • Excavation >20' engineered

  • One call system used

  • Perimeter protected/barricade

  • Sloped, benched, or shored

  • Spoil 2' from edge

  • Surface traffic exposure

  • Surface encumbrances

  • Atmospheric testing where applicable

  • Water entering excavation

FIRE PROTECTION

  • Emergency vehicle access

  • Fire extinguisher charged/inspected

  • Fire suppression equipment available

  • Fire watch when applicable

  • Proper signs in store areas

  • Extinguisher within 50' of flammables

  • Proper fuel containers used

HAND/PWR TOOLS

  • Cords in good condition

  • Ground prong in place

  • Guards in place

  • Powder actuated tool training when needed

  • Proper tool for the job

  • Strain relief functioning

  • Tool in good condition

LADDER/STAIRS

  • 3' above landing

  • Ladder feet flat on floor

  • Access break >19"

  • Clear of debris/materials

  • Extension ladder 4:1 pitch

  • Inspected for defects

  • Job-built ladders constructed properly

  • Job-built ladders secure

  • Landings and trends filled

  • Proper use of ladder

  • Rails at stairs/landings

  • Safe work distance from hazards

  • Ladder positioned as close to work as possible

  • Remain at 3 points of contact

  • Slip/trip exposure eliminated

  • Stairs illuminated

MEDICAL

  • 1st aid kit

  • 1st aid/CPR person on site

  • Emergency action plan

  • Emergency numbers posted

  • Emergency supplies

  • Eye wash

  • Map to medical facilities available

  • Team contact numbers

MOTOR EQUIPMENT

  • Adequate training

  • Daily equipment inspections

  • Equipment used per manufacture recommendations

  • Back up alarm functioning

  • Flagman used if applicable

  • Glass free of obstructions

  • 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.