Safety Audit - Concrete Formwork & Placement

• Client / Site

• Conducted on

  Date

• Prepared by

• Location Number

General

• Select site weather conditions at time of this inspection (select all that apply)

  Select Clear Sky Cloudy Raining Windy Hazy Snow / Hail Sunny Cold Hot Muddy

  • Clear Sky
  • Cloudy
  • Raining
  • Windy
  • Hazy
  • Snow / Hail
  • Sunny
  • Cold
  • Hot
  • Muddy

• Describe weather conditions on site today

  Select Clear Sky Cloudy Raining Windy Hazy Snow / Hail Sunny Cold Hot Muddy

  • Clear Sky
  • Cloudy
  • Raining
  • Windy
  • Hazy
  • Snow / Hail
  • Sunny
  • Cold
  • Hot
  • Muddy

• Current activities being undertaken on site (select all that apply)

  Select General Demolition Pile Driving Formwork Reinforce Steel Steel Erection Electrical Sitework Excavation Stair Installation Cleanup OTHER Finishing Stripping Walls/Columns Stripping Shoring Decking Setting Shoring Setting Walls Pouring Concrete

  • General
  • Demolition
  • Pile Driving
  • Formwork
  • Reinforce Steel
  • Steel Erection
  • Electrical
  • Sitework
  • Excavation
  • Stair Installation
  • Cleanup
  • OTHER
  • Finishing
  • Stripping Walls/Columns
  • Stripping Shoring
  • Decking
  • Setting Shoring
  • Setting Walls
  • Pouring Concrete

Site Safety Inspection

Rigging and Signaling

• Are rigging inspections being conducted daily?

  Yes

  No

  N/A

• Are riggers qualified by Cleveland Cement management?

  Yes

  No

  N/A

• Are Signal persons qualified by Cleveland Cement management?

  Yes

  No

  N/A

• Are signal persons keeping their hands off loads as its being directed ?

• What form of communication are signal persons using?

  Hand

  Radio
First Aid Facilities

• Are first aid facilities to be inspected in this audit?

  Yes

  No

  N/A

• Are first aid cabinets and contents clean and orderly?

  Yes

  No

  N/A

• No first aid contents past their expiration date?

  Yes

  No

  N/A

• First aid cabinets clearly labeled?

  Yes

  No

  N/A

• Is there easy access to first aid cabinet?

  Yes

  No

  N/A

• Are employees aware of location of first aid cabinet?

  Yes

  No

  N/A

• Are first aid officers known to workers and accessible?

  Yes

  No

  N/A

• Are emergency numbers displayed?

  Yes

  No

  N/A

Fire Prevention & Emergency

• Do all workers have fire extinguisher training (P.A.S.S.)?

  Yes

  No

  N/A

• Are fire and emergency procedures to be inspected in this audit?

  Yes

  No

  N/A

• Evacuation plan displayed and understood by all employees?

  Yes

  No

  N/A

• Extinguishers clear of obstructions?

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• Is Personal Protective Equipment to be inspected in this audit?

  Yes

  No

  N/A

• Is head protection worn correctly and where required?

  Yes

  No

  N/A

• Is eye protection worn where required?

  Yes

  No

  N/A

• Are the correct forms of eye protection worn for tasks being completed?

  Yes

  No

  N/A

• Is hearing protection worn in designated areas?

  Yes

  No

  N/A

• Are the correct forms of hand protection worn for manual tasks

  Yes

  No

  N/A

• Is respiratory protection available and worn in necessary areas?

  Yes

  No

  N/A

• Are sturdy boots above the ankle with or without steel toe worn onsite?<br>

  Yes

  No

  N/A

• Are high-vis vests or clothing worn at all times onsite?

  Yes

  No

  N/A

• Are safety harnesses appropriately worn at height?<br>

  Yes

  No

  N/A

• Is additional PPE used where required?

  Yes

  No

  N/A

• Are foremen aware of correct PPE for tasks they are trained to perform?

  Yes

  No

  N/A

Housekeeping

• Is site housekeeping to be inspected in this audit?

  Yes

  No

  N/A

Work Areas with Saw Horses

• Do Saw Horses have a nail installed to hang skill saws?

  Yes

  No

  N/A

Waste & Trash

• Waste and Trash to be inspected in this audit?

  Yes

  No

  N/A

• Are bins/dumpsters located at suitable points around site?

  Yes

  No

  N/A

• Is site generally orderly, with trash or waste materials disposed of correctly?

  Yes

  No

  N/A

• Are bins/dumpsters emptied regularly?

  Yes

  No

  N/A

• Is the loading / delivery area kept clear of objects?

  Yes

  No

  N/A

• Is work areas routinely picked up?

  Yes

  No

  N/A

• Is rolling stock kept up in work areas?

  Yes

  No

  N/A

Trip and Fall Safety

• Trip and fall safety to be inspected in this audit?

  Yes

  No

  N/A

• Are floor surfaces uncluttered?

  Yes

  No

  N/A

• Are entry and walkways kept clear?

  Yes

  No

  N/A

• Are walkways spacing adequate?

  Yes

  No

  N/A

• Are stairs and risers kept clear?

  Yes

  No

  N/A

• Are guard rails with toeboards supported, at the correct heights, and in good condition?

  Yes

  No

  N/A

• Are appropriate measures in place to prevent falls ie. barriers (preferred) or harnesses/SRL's?

  Yes

  No

  N/A

• Is all fall protection equipment is visually inspected prior to use?

  Yes

  No

  N/A

• Is all work above 6ft, or within 6ft of an edge being done safely?

  Yes

  No

  N/A

• Is all fall protection equipment visually inspected prior to use?

  Yes

  No

  N/A

• Are all floor openings fully barricaded or are protected with a secured cover and labelled?

  Yes

  No

  N/A

• Are personnel below protected from falling materials (i.e. tools, bolts, etc.)?

  Yes

  No

  N/A

• Is all protruding rebar, stakes, or pipe properly protected

  Yes

  No

  N/A

Scaffolding

• Are scaffold or scaffold platforms to be inspected in this audit?

  Yes

  No

  N/A

• Are scaffolds constructed and erected only by qualified and trained personnel?

  Yes

  No

  N/A

• Have all scaffold plans been submitted and approved?

  Yes

  No

  N/A

• Are scaffolds accessible and clear of unstable objects and trip hazards?

  Yes

  No

  N/A

• Is scaffold adequately secured to building (or appropriately secured with alternative method)?

  Yes

  No

  N/A

• Are guard rails installed on all scaffolds above 10 feet and on wall platforms?

  Yes

  No

  N/A

• Are scaffold footings stable, secure and free of unstable propping objects (barrels, boxes, loose brick or concrete blocks etc)?

  Yes

  No

  N/A

• Are scaffold footings and anchorages designed to support the maximum intended load without settling or displacement?

  Yes

  No

  N/A

• Are scaffolds generally safe and orderly?

  Yes

  No

  N/A

• Are scaffold platforms regularly inspected and tagged (green, yellow, red)?

  Yes

  No

  N/A

Concrete

• Are there washing facilities available for cleaning off concrete from exposed skin?

  Yes

  No

  N/A

• Are finishing workers wearing PPE properly?

  Yes

  No

  N/A

• Is there a wash out area designated for clean out?

  Yes

  No

  N/A

• Are spotters used to direct concrete trucks?

  Yes

  No

  N/A

• Are we pumping, truck dump, or bucketing concrete?

Generators, Hand and Power Tools

• Hand and power tools to be inspected in this audit?

  Yes

  No

  N/A

• Are all tool guards in place and operable?

  Yes

  No

  N/A

• Are power cords in good condition?

  Yes

  No

  N/A

• Are all tools double insulated or have a ground plug?

  Yes

  No

  N/A

• Are ground fault circuit interrupters in place at the source of electricity?

  Yes

  No

  N/A

• Are all power tools in good condition?

  Yes

  No

  N/A

• Are defective pieces of equipment and tools red tagged and removed from service?

  Yes

  No

  N/A

• Are tools stored correctly and in the right place when not in use?

  Yes

  No

  N/A

• Are employees using the proper tool for the task they are performing?

  Yes

  No

  N/A

• Are hand tools manufactured to standard?

  Yes

  No

  N/A

• Are employees using two hand on tools that are designed to do so?

  Yes

  No

  N/A

• Are HEPA Vacuums provided for tools that produce silica dust?

  Yes

  No

  N/A

Ladders

• Ladders to be inspected in this audit?

  Yes

  No

  N/A

• Are all ladders Industrial strength with capacity label? (Rated 250lbs-300lbs.)

  Yes

  No

  N/A

• Are ladders in good condition and built correctly?

  Yes

  No

  N/A

• If used for electrical work are ladders non conductive? ( fiberglass.)

  Yes

  No

  N/A

• Are ladders being used according to instructions?

  Yes

  No

  N/A

• For extension ladders: are ropes, pulleys and treads in a good state of repair?

  Yes

  No

  N/A

• Are ladders not used to access heights when higher order controls should be used?

  Yes

  No

  N/A

Electrical Safety

• Electrical safety to be inspected this audit?

  Yes

  No

  N/A

• Has portable equipment and extension cords been tested and taped for Assured Program?

  Yes

  No

  N/A

• Were all extension cords found in good order?

  Yes

  No

  N/A

• Were power leads removed from walkways?

  Yes

  No

  N/A

• Are portable power tools in good condition?

  Yes

  No

  N/A

Hazard Communication Safety

• Chemical safety to be inspected this audit?

  Yes

  No

  N/A

• Are Safety Data Sheets available for all chemicals?

  Yes

  No

  N/A

• Are all containers labeled correctly?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Are unused substances disposed of?

  Yes

  No

  N/A

• Are spill kits or other clean up arrangements available?

  Yes

  No

  N/A

Confined Spaces

• Confined spaces safety to be inspected this audit?

  Yes

  No

  N/A

• Do all applicable confined space works have adequate permits granted and documented?

  Yes

  No

  N/A

• Is a confined space emergency plan in place?

  Yes

  No

  N/A

• Are confined spaces being continually monitored?

  Yes

  No

  N/A

• Are all workers undertaking confined space works trained in confined space entry and activities?

  Yes

  No

  N/A

Incident, Injury & Accident Procedures

• Incident, Injury & Accident Procedures to be inspected this audit?

  Yes

  No

  N/A

• Are Incident, Accident, Near Miss and Injury procedures in place?

  Yes

  No

  N/A

• Are adequate reporting forms for for these events in place?

  Yes

  No

  N/A

• Are all incidents investigated?

  Yes

  No

  N/A

• Are Corrective Actions then implemented?

  Yes

  No

  N/A

• Are Workers Compensation, Rehabilitation and Return to Work Programs in place?

  Yes

  No

  N/A

• Is an "If you are injured" poster displayed?

  Yes

  No

  N/A

General Comments

• Any further comments or recommendations arising from this inspection?

• Have all required corrective actions been added as Actions to this inspection?

  Yes

  No

  N/A

• Please add any corrective actions to the appropriate questions above before completing this report

Sign Off

• Name of Inspector

• Name of Site Supervisor

• Safety Representative

• Foreman

• Foreman

• Foreman

• Field Engineer

• Field Engineer