• Audit Title

  • Client / Site

  • Conducted on

  • Logan Kelsey

  • Location
  • Personnel

Pre-Job Check

  • Tailgate Topic

  • Add media

  • Permit if required (Hot work/Safe work)

  • JSA (filled out and signed by all on location

Heat Illness Prevention and Protection

  • Cooling Station

  • Cool Clean Water on Location

  • Employees Provides Heat Relief Breaks

Personal Protection Equipment

  • Add signature

  • Hard Hat- Head Protection

  • Gloves- Hand Protection

  • Safety Rated Safety Glasses- Eye Protection

  • Steel Toed Boots- Foot Protection

  • Ear Plugs- Hearing Protection

  • Gas Detection Monitor- H2S Personal Monitor

  • Gas Detection Monitor- Four Gas Monitor on Location

Emergency Response

  • Alarms & Shutdowns

  • Emergency Response Plan ( documented with primary and secondary muster areas)

  • Fire Extinguishers (in good condition, seals, labels, hoses)

  • Eye Wash Station

  • First Aid Kits (stocked with appropriate items, expiration dates)

Electrical Safety

  • Energy Isolation (LOTO)

  • Grounds

Fall Protection

  • Hand Rails (in use, cracks, breaks, bends)

  • Harness & Lanyard

  • SRL (Inspected and Tested

  • Escape Rope (Geronimo)

Lines & Slings

  • Hoisting Lines (inspected and checked for kinks breaks)

  • Guy Lines/Anchors (flagged, tightened, crossed, condition)

  • Slings wire/webbed (broken strands, cert tags, hooks)

  • Shackles/Pins

  • Chains

BLow Out Prevention Equipment (BOPE)

  • Hoses (holes, tears, hobbles, whip checks)

  • Test & Inspection

  • Bolts


  • Hand Tools

  • Power Tools


  • Hoses (condition, Fittings, Rating)

  • Safety Chains Whip Checks Hobbles


  • Mast (welds breaks ladder)

  • Drum

  • Rams

  • Cab

Chemical Hazards

  • Storage

  • SDS Sheets

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.