Information
-
Date
-
Project Number/Name
-
Safety Steward
-
Foreman
-
Field Superintendent
-
General Superintendent
-
Project Manager
-
Prepared by
-
Location
-
Risk Score
Operations
-
Operations at time of audit
1. Site and Storage Areas
-
1.01 Parking area identified and vehicles parked in an orderly fashion
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.02 Work areas and storage yards are organized
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.04 Does wildlife present a risk
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.05 Housekeeping
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.06 Adequate containers provided for waste
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.07 Welding Rod Cans Disposed Of
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.08 Drinking water available
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.09 Trip Hazards
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.10 Site Security
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.11 Tool vans and trailers monitored
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.12 Safety signs in place
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.13 SDS - Hazard Communication
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.14 Materials are in their original containers or if not are stored in properly labelled containers
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.15 Designated Smoking Signs Posted As Needed
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.16 Smoking in designated areas only and cigarette butts disposed of properly
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.17 Open Holes
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
1.18 Other
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
2. General Safety Practices
-
2.01 Quality JSA's completed with all required signatures
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.02 Prejob Safety Meetings conducted
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.03 Pre-Task Plans Followed
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.04 Hazards Recognized
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.05 First Aid kits in office/tool trailer with adequate and non-expired contents<br>
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.06 PSSP / Emergency Response Plan posted
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.07 Adequate phone signal for emergency communication
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.08 Adequate number and contents of spill kits on site (Including pads and buoys)
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.09 Stop work authority utilized and Good Catches are being submitted
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.10 Self audits being conducted
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.11 Pinch Points and Proper Hand Position
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.12 Proper Lifting/Pushing/Pulling/Turning/Reaching Techniques
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.13 Body Position Hazards (Line of Fire, Overhead Hazards)
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.14 PPE in use (Hard hat, safety toe boots, safety glasses, gloves)
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.15 Hearing Protection Available
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.16 High visibility traffic safety vests
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.17 Respiratory Protection
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.18 Gas Detectors
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
2.19 Other
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
3. Tool Storage, Power and Hand Tools
-
3.01 Tool storage trailer is organized and walkways are free from trip hazards
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
3.02 All cords and hoses not in use are coiled and stored properly
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
3.03 All extension cords have been inspected, have not been modified, and are free of cuts or damage
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
3.04 Ladders have been inspected, are free of damage or cracks, and meet minimum OSHA weight requirement of 250 pounds (29 CFR 1926.1053)
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
3.05 All harnesses and fall protection systems inspected and are in serviceable condition
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
3.06 Power Tools inspected and are in serviceable condition (not modified, factory guards in place, cords in good condition, etc...)
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
3.07 Hand tools are not modified or show evidence of "cheater bar" use
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
3.08 Proper tools are available and utilized on the job
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
3.09 Propane bottles are not stored inside tool trailer/connex
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
3.10 Other
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
4. Hot Work & Fire Protection
-
4.01 Fire extinguishers provided and inspected
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
4.02 Flammable liquid storage
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
4.03 Designated welding and cutting areas
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
4.04 Housekeeping, clutter or combustible materials in Hot Work area<br>
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
4.05 Hot Work Permit
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
4.06 Welding / Cutting hoses and cords
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
4.07 Gauges
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
4.08 Cylinders
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
4.09 Acetylene cylinder storage
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
4.10 Labeling
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
4.11 Other
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
5. Excavation & Trenching
-
5.01 Overhead Power Lines Identified
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
5.03 Current 811 Locate
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
5.04 Line Crossings on Job
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
5.05 Proper sloping / trench box
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
5.06 Proper Access Every 25 Feet
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
5.07 Spoil piles 2 feet from edge
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
5.08 Trench Box Manufacturing Data Posted
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
5.09 Ladders used properly in trenches
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
5.10 Trench box condition
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
5.11 Adequate trench guard / barrier
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
5.12 Trenching competent person present
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
5.13 Other
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
6. Fall Protection
-
6.01 100% tie-off over 4 feet
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
6.03 Guard Rails
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
6.04 Harness / Personal fall protection
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
6.05 Other
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
7. Equipment: Track-Hoe, Loaders, Forklifts, etc....
-
Equipment
-
Add media
-
Equipment Type
-
ID#
-
7.01 Overall Operating Condition
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
7.02 Daily Equipment Inspection Completed (All deficiencies noted)
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
7.03 Slings, chokers, and safety latches on hooks
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
7.04 Seatbelts used at all times
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
7.05 Leaks
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
7.06 Spotter Present & Alert
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
7.07 Clutter in cab
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
7.08 Butter Bar With Rounded Edges (If Required)
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
7.09 Equipment Properly Secured
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
7.10 Other
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
7.11 Compressor Hoses Wired & Whip Checks Installed
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
7.12 Trailer decking
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
7.13 Lifting/Suspended Loads
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
8. Special Operations
-
8.01 Traffic Control
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
8.02 Confined Space Operations
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
8.03 Crane Operations
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
8.04 Other
-
Hazard Type
- People
- Environment
- Assets
- Reputation
-
Risk Score
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
Risk Severity Matrix