Safety Audit

• Document No.

• Contractor

• Client

• Site number

• Photo of structure

  Media

• Conducted on

  Date

• Aaron Steeneck

• Location
  Address

• Site Number(s)

• Add media

  Media

Jobsite documentation

• Daily safety tailgate meetings taking place? (JSA)

  Yes

  No

  N/A

• Posting OSHA and other regulatory posters?

  Yes

  No

  N/A

• Current competent climbing cards up-to-date and available?

  Yes

  No

  N/A

• Are competent rigging cards available and up to date?

  Yes

  No

  N/A

• Has climbing harness been inspected and documented prior to use?

  Yes

  No

  N/A

• Does foreman have minimum OSHA 30 hr?<br>

  Yes

  No

  N/A

• Do all crew members have minimum OSHA 10 hr?

  Yes

  No

  N/A

• Is there a minimum of 2 personnel certified in CPR/first aid?

  Yes

  No

  N/A

• First aid kit available?

  Yes

  No

  N/A

• Is an MSDS book onsite?

  Yes

  No

  N/A

• Additional comments/remarks

• Photos

  Media

Fall protection

• Ground person present for crew on tower?

  Yes

  No

  N/A

• 100% fall protection used

  Yes

  No

  N/A

• Is work being done at ground level when crew is on tower?

  Safe

  At Risk

  N/A

• Does crew have rescue kit/first aid at base of tower?

  Yes

  No

  N/A

• Additional comments/remarks

• Photos

  Media

Personal protective equipment

• Head protection?

  Yes

  No

  N/A

• Proper work clothing including but not limited to long pants and shirts with sleeves and boots?

  Yes

  No

  N/A

• Eye protection in accordance to ANSI Z 87.1?

  Yes

  No

  N/A

• Additional comments/remarks

• Photos

  Media

• Rigging and equipment

  Media

• Is a rigging plan in place?

  Yes

  No

  N/A

• Has a 150% load test been preformed and documented prior to any lifts?

  Yes

  No

  N/A

• Is rope that is used for personnel inspected and documented prior to use?<br>

  Yes

  No

  N/A

• Is rope or cable used for tools and equipment being inspected and documented prior to use?

  Yes

  No

  N/A

• Are blocks of adequate size and capacity for the job?

  Yes

  No

  N/A

• Is cathead in good working order?

  Yes

  No

  N/A

• Slings that are being used of adequate size in working order with all tags legible?

  Yes

  No

  N/A

• Are carabiners being used on load line?

  Safe

  At Risk

  N/A

• Additional photos

  Media

Latter's

• Is step latter fully open and locked before climbing?

  Yes

  No

  N/A

• Latter is a least 1ft away for every 4ft of height?

  Yes

  No

  N/A

• Latter rails should extend at least 3ft above top landing?

  Yes

  No

  N/A

• Not climbing past the top 3 rungs or steps from the top?

  Yes

  No

  N/A

• Is latter securely fastened or ground stakes used to prevent slipping?

  Yes

  No

  N/A

Fire protection

• Fire blankets in use and are 3000 degree NFPA 701?

  Yes

  No

  N/A

• Designated fire watchers are on site?

  Yes

  No

  N/A

• Is welding being done at base of structure while Ariel work is being done?

  Safe

  At Risk

  N/A

• Fire watcher signature

  Sign

• Proper sized Waterwagon on site minimum 300 gallons?

  Yes

  No

  N/A

• Proper size and quantity fire extinguishers present with current inspection tags minimum five #4?

  Yes

  No

  N/A

• Interior of structure cleaned out and free of debris?

  Yes

  No

  N/A

• No more than one person welding at a time

  Yes

  No

  N/A

• Was monopole scope done?

  Yes

  No

  N/A

• Cutting and welding plan on site and filled out?

  Yes

  No

  N/A

• Additional comments/remarks

• Photos

  Media

Job site conditions

• Worksite clean and free of debris?

  Yes

  No

  N/A

• Are open holes barricaded?

  Yes

  No

  N/A

• All chemical flammable and combustible items identified?

  Yes

  No

  N/A

• Are proper gas cans being used? No plastic cans.

  Yes

  No

  N/A

• Are Overhead electrical lines present?

  Safe

  At Risk

  N/A

• Additional comments/remarks

• Photos

  Media

• Signature of foreman being audited

  Sign

• Signatures of General contractors being audited

  Sign

• Signatures of General contractors being audited

  Sign

• Signatures of General contractors being audited

  Sign

• Customer signature

  Sign

• Signature of auditor

  Sign

• Additional comments/remarks

• Additional photos

  Media