Safety Audit Report

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

JOB INFORMATION

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

  Yes

  No

  N/A

• OSHA and DOL posters posted?

  Yes

  No

  N/A

• Emergency phone numbers posted?

  Yes

  No

  N/A

• Tool box safety talks log up to date?

  Yes

  No

  N/A

• MSDS filed?

  Yes

  No

  N/A

• Work areas properly signed and barricaded?

  Yes

  No

  N/A

HOUSEKEEPING

• Work areas neat?

  Yes

  No

  N/A

• Projecting nails or screws bent over or removed?

  Yes

  No

  N/A

• Waste containers provided and used?

  Yes

  No

  N/A

• Passageways and walkways clear?

  Yes

  No

  N/A

• Cords and leads off the floor?

  Yes

  No

  N/A

FIRE PREVENTION

• Adequate fire extinguishers, checked and accessible?

  Yes

  No

  N/A

• Phone no. of Fire Department posted?

  Yes

  No

  N/A

• "No Smoking" posted and enforced near flammables?

  Yes

  No

  N/A

ELECTRICAL

• Extension wires with bare wires or missing ground prongs taken out of service?

  Yes

  No

  N/A

• Ground fault interrupters being used?

  Yes

  No

  N/A

• Terminal boxes equipped with required covers?

  Yes

  No

  N/A

HAND, POWER & POWDER ACTUATED TOOLS

• Tools and equipment shall be inspected prior to use.

  Yes

  No

  N/A

• Tools and equipment shall be used for the appropriate task.

  Yes

  No

  N/A

• Guards and safety mechanisms shall not be damaged or removed.

  Yes

  No

  N/A

• Damaged tools and equipment shall be tagged "out of service" until they are repaired.

  Yes

  No

  N/A

• Proper lockout/tagout procedures shall be used when necessary to isolate an energy source.

  Yes

  No

  N/A

• Only trained and authorized personnel are allowed to operate skid steers, forklifts, and cranes.

  Yes

  No

  N/A

FALL PROTECTION

• Safety rails and cables secured properly?

  Yes

  No

  N/A

• Safety harnesses worn properly?

  Yes

  No

  N/A

• Fall protection shall be used when work is performed at heights exceeding 6 feet above the next lowest level. Guard rails and personal fall arrest system shall be the primary means of fall protection.

  Yes

  No

  N/A

• Employees below protected from falling objects?

  Yes

  No

  N/A

LADDERS

• Ladders extended at least 36" above landing?

  Yes

  No

  N/A

• Ladders are secure to prevent slipping, sliding or falling?

  Yes

  No

  N/A

• Ladders with split or missing rungs taken out of service?

  Yes

  No

  N/A

• Stepladders used in fully open position?

  Yes

  No

  N/A

• No step at top two rungs of stepladder?

  Yes

  No

  N/A

SCAFFOLDING

• All scaffolding inspected daily?

  Yes

  No

  N/A

• Erected on sound rigid footing?

  Yes

  No

  N/A

• Tied to structure as required?

  Yes

  No

  N/A

• Guardrails, intermediate rails, toe boards and screens in place?

  Yes

  No

  N/A

• Planking is sound and sturdy?

  Yes

  No

  N/A

• Proper access provided?

  Yes

  No

  N/A

• Employees below protected from falling objects?

  Yes

  No

  N/A

FLOOR & WALL OPENINGS

• All floor openings planked over or barricaded?

  Yes

  No

  N/A

• Perimeter protection in place?

  Yes

  No

  N/A

• Deck planks secure?

  Yes

  No

  N/A

• Materials stored away from edge?

  Yes

  No

  N/A

TRENCHES, EXCAVATION & SHORING

• Competent person identified and present?

  Yes

  No

  N/A

• Excavations are shored and sloped back?

  Yes

  No

  N/A

• Materials are stored at least 2' away from trench?

  Yes

  No

  N/A

• Ladders provided every 25' in trench?

  Yes

  No

  N/A

• Equipment is at a safe distance from edge of trench or excavation?

  Yes

  No

  N/A

MATERIAL HANDLING

• Materials properly stored or stacked?

  Yes

  No

  N/A

• Employees using proper lifting techniques?

  Yes

  No

  N/A

• Tag lines used to guide loads?

  Yes

  No

  N/A

• Proper number of workers for each operation?

  Yes

  No

  N/A

WELDING AND BURNING

• Gas cylinders stored upright?

  Yes

  No

  N/A

• Proper separating distances between fuels & oxygen?

  Yes

  No

  N/A

• Goggles or shields used?

  Yes

  No

  N/A

• Fire extinguishers readily available?

  Yes

  No

  N/A

• Hoses in good condition?

  Yes

  No

  N/A

CRANES

• Outriggers extended and swing radius barricade in place?

  Yes

  No

  N/A

• Operator is familiar with load charts?

  Yes

  No

  N/A

• Hand signal charts on crane?

  Yes

  No

  N/A

• Crane operator logs up to date?

  Yes

  No

  N/A

• Employees kept from under suspended loads?

  Yes

  No

  N/A

• Chains and slings inspected and tagged as required?

  Yes

  No

  N/A

CONCRETE CONSTRUCTION

• When dry cutting concrete, HEPA filter (3M 6200 Series - P100) respirator will be worn.

  Yes

  No

  N/A

• Exposed skin covered?

  Yes

  No

  N/A

• Runways are adequate?

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Bump caps shall be worn at all times in the factory. Hard hats shall be worn in the field when an employee is exposed to an overhead hazard.

  Yes

  No

  N/A

• Appropriate eye protection shall be worn at all times. Employees wearing prescription glasses shall wear side shields. When cutting or grinding metal, a face shield shall be worn in addition to glasses. Goggles shall be worn when applying glue in the wall and roof build stations.

  Yes

  No

  N/A

• Respirators used when required? Proper respirator documentation available?

  Yes

  No

  N/A

• Ear plugs shall be worn at all times for employees who are working south of the pit, and at the garage build, roof build, mill room, wall build, and floor build stations.

  Yes

  No

  N/A

• Shoes in good working order, with covered toes, and adequate soles for traction and stability.

  Yes

  No

  N/A

• Traffic vests or high visibility clothing material being worn?

  Yes

  No

  N/A

Company Policy

• Safety belts shall be used at all times while operating a company vehicle. Texting is prohibited while operating a company vehicle or equipment.<br>

  Yes

  No

  N/A

• Tobacco products are prohibited in the factory and also on the job site in the field.

  Yes

  No

  N/A

Sign Off

• Date & Time

  Date

• Comments

• Additional Media

  Media

• Company Representative

• Company Representative's signature

  Sign

• Safety Auditor

• Safety Auditor's signature

  Sign