Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Job Information

  • OSHA 300 forms complete and posted from February 1- April 30?

  • Team huddles up to date and complete?

  • Daily stretches being completed by all crews?

  • Safety time outs being performed?

  • OSHA and DOL posters posted?

General

  • Excavations, adjacent areas, and protective systems inspected by a competent person daily before the start of work?

  • Competent person has authority to remove employees from the excavation immediately?

  • Spoils, materials, and equipment set back at least two feet from excavation?

  • Barriers provided at all remotely located excavations, wells, pits, shafts etc. ?

  • Employees required to stand at a safe distance from vehicles being loaded or unloaded?

  • Spotting and barricade system established and utilized when mobile equipment is operating near edge of excavation?

Fire Prevention

  • Adequate fire extinguishers, checked and accessible?

  • "No Smoking" signs posted and enforced near flammables?

Utilities

  • Utility companies contacted and/or utilities located?

  • Exact location of utilities marked?

  • Underground installations protected, supported, or removed when excavation is open?

Means of Access and Egress

  • Ladders located every 25 feet in trenches deeper than 4 feet?

  • Ladders extended 3 feet above landings and secured?

  • Structural ramps used by employees designed by a competent person?

  • Ramps constructed of materials of uniform thickness cleated together on the bottom, equipped with no slip surface?

  • Employees protected from cave ins when entering or exiting excavation?

Heavy Machinery

  • Fire extinguishers, checked and accessible on equipment?

  • Back up alarms functioning properly?

  • Operators of equipment wearing seat belts?

  • Access steps into cab of machine are in good condition?

  • Spotters used as needed?

  • Back up cameras are installed and functioning properly?

Wet Conditions

  • Precautions taken to protect employees from water accumulation?

  • Water removal equipment monitored by competent person?

  • Surface water or runoff diverted or controlled to prevent accumulation in the excavation?

  • Inspections made after every rainstorm or other hazard increasing occurrence?

Hazardous Atmosphere

  • Atmosphere within the excavation tested where there is a reasonable possibility of oxygen deficiency, combustable gas, or other harmful contaminant exposing employees to a hazard?

  • Adequate precautions taken to protect employees from exposure to an atmosphere containing less than 19.5 percent oxygen and/or to other hazardous atmospheres?

  • Ventilation is provided to prevent employee exposure to an atmosphere containing flammable gas in excess of 10% of the lower explosive limit of the gas?

  • Testing conducted often to ensure that atmosphere remains safe?

  • Emergency equipment such as breathing apparatus, safety harnesses and lifeline and or basket stretcher readily available where hazardous atmospheres could or do exist?

  • Employees trained to use PPE and other rescue equipment?

  • Safety harnesses and lifeline used and individually attended when entering bell bottom or other deep confined excavations?

Traffic

  • Traffic zones set up and maintained properly?

  • Pedestrian traffic is discouraged by signage and barricades?

Support systems

  • Materials and or equipment for support systems selected based on soil analysis, trench depth, and expected loads?

  • Materials and equipment used for protective systems inspected and in good condition?

  • Materials and equipment not in good condition taken out of service?

  • Protective systems installed without exposing employees to the hazards of cave ins, collapses, or threat of being struck by materials or equipment?

  • Members of support system securely fastened to prevent failure?

  • Support systems provided to ensure stability of adjacent structures, buildings, roadways, sidewalks, walls, etc. ?

  • Removal of support systems progresses from the bottom and members are released slowly as to note any indication of possible failure?

  • Backfilling progresses with removal of support system?

  • Excavation of material to a level no greater than two feet below the bottom of the support system and only if the system is designed to support the loads calculated for the full depth?

  • Shield system in place to prevent lateral movement?

  • Employees prohibited from remaining In shield system during vertical movement?

PPE

  • Hard hats being worn by all employees?

  • Safety glasses being worn?

  • Employees wearing proper hand protection as needed?

  • Task specific PPE being worn as required?

  • High visibility vests worn by employees?

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.