Information

  • Location Name:

  • Client / Site

  • Conducted on

  • Prepared by

  • On Site Representative or Person In Charge

  • Supervisor or Forman on site

HOUSEKEEPING/ENVIRONMENTAL

  • Are all pathways clear of rubbish or obstructions and slip free?

  • Are all stairs and steps in good/safe condition and have suitable non-slip surfaces?

  • Are hand rails secure and in good condition?

  • Are emergency contact numbers posted and readily available?

  • Are spills reported promptly?

  • Is spill clean-up materials readily available ? (Absorbent pads, spill booms, etc.)

LIGHTING

  • Is there adequate lighting in the area?

  • Are all lights functional and in good working order?

  • Where needed are explosions proof lights available ?

ELECTRICAL

  • Are all electrical cords in good repair with no broken or damaged plugs or sockets?

  • Are quarterly electrical tool and cord inspection being completed and visibly marked with the proper color for the quarter?

  • Are breakers properly labeled and kept closed?

EQUIPMENT

  • Does heavy equipment such as track cranes, forklifts, dozers, etc. have back-up alarms that are functional?

  • Are crane and heavy equipment inspections up to date?

  • Are guards in place on all machinery?

  • Is there evidence of spills or discharges from the crane, spud unit, or other heavy equipment?

PPE

  • Are employees wearing secondary eye protection when grinding/chipping?

  • Are employees wearing the appropriate PPE for the job task at hand? ( Hard Hat, Hearing Protection, Chain Saw Chaps, PFD, Gloves, Etc.)

  • Is the correct PPE available?

FIRST AID

  • Does the First Aid Kit appear to be fully stocked?

  • Is the Gurney in place and accessible?

  • Is there someone on site that is First Aid/CPR trained?

GENERAL SAFETY

  • Are compressed cylinders secured with a chain and caps on?

  • Are ladders in good condition with no apparent damage?

  • Are lockout/tagout materials readily available on site if needed?

  • Are surface openings properly guarded?

  • Are Lift Slings in good condition and stored properly? (Random Checks)

  • Is a tag line used when a load could swing or needs guidance?

  • Are hand tools in good condition?

  • Are guards in place on shafts, pinch points, power tools, etc?

  • Are storage areas properly secured?

  • Are any containers (Drums, Pails, Etc.) damaged?

  • Are all containers labeled with its proper contents?

  • Are fire extinguishers properly mounted and present?

  • Are man-hole covers/hatches marked confined space?

DOCUMENTATION

  • Are safety training and meetings being held and documented?

  • Are monthly fire extinguisher inspections being documented?

  • Are employees completing the monthly BBS observation cards?

  • Are JSEA's being completed daily or before each new job task?

  • Do employees have a current safety training card (PEC, Safe Gulf, Safe Land, EnCosha, Etc.)?

  • Are material safety data sheets available on all substances on site?

  • Are evacuation procedures displayed or available for employees/visitors to review?

  • Are evacuation drills/fire practiced and date of last drill?

  • Are new employees given a site specific orientation?

  • Are visitors to job sites or vessels given an orientation of safety rules and informed of current work hazards?

Comments and Signatures

  • SITE SUPERVISOR'S COMMENTS

  • SITE SUPERVISOR'S SIGNATURE

  • CORRECTIVE ACTION TAKEN OR NEEDED

  • COMPLETION DATE AND RESPONSIBILTY

  • CLOSING COMMENTS

  • PERSON COMPLETING THE AUDIT

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.