Safety Inspection/Audit Report DNI

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Are directions to the Medical Clinic available?

  Yes

  No

  N/A

Documentation

• Are applicable MSDS/SDS on site?

  Yes

  No

  N/A

• Is a copy of the Kodiak IIPP on site?

  Yes

  No

  N/A

• Is a Site Specific Safety Plan on site?

  Yes

  No

  N/A

• Is the Kodiak Heat Illness Prevention Plan Checklist on site?

  Yes

  No

  N/A

• Is it completed and specific for this jobsite?

  Yes

  No

  N/A

• Has a Tailgate Safety meeting been completed for this jobsite?

  Yes

  No

  N/A

• Water Cooler Present?

  Yes

  No

  N/A

• Is the water cooler being maintained?

  Yes

  No

  N/A

• Has a source of potable water replenishment been identified?

  Yes

  No

  N/A

• Are drinking cups provided?

  Yes

  No

  N/A

• Waste container available and being utilized for used drinking cups?

  Yes

  No

  N/A

• Is a Fire Extinguisher available?

  Yes

  No

  N/A

• Is(are) fire extinguishers charged and monthly inspection tag(s) current?

  Yes

  No

  N/A

• Is a first aid kit onsite?

  Yes

  No

  N/A

• Are the contents in good condition and sterile?

  Yes

  No

  N/A

• Is an eyewash station required for this jobsite?

  Yes

  No

  N/A

• Is an eyewash station onsite and ready for use?

  Yes

  No

  N/A

• Are safety glasses in use by all Kodiak and Kodiak sub-contractor employees?

  Yes

  No

  N/A

• Are hard hats in use by all Kodiak and Kodiak sub-contractor employees?

  Yes

  No

  N/A

• Are workers compliant with Kodiak/OSHA required dress standards(workboots, pants, shirts, Hi-Vis vests etc.)?

  Yes

  No

  N/A

• Is hearing protection required?

  Yes

  No

  N/A

• Is hearing protection available?

  Yes

  No

  N/A

• Is hand protection available and in use?

  Yes

  No

  N/A

• Are activities requiring face/eye protection in progress(cutting, grinding, hot work etc.)?

  Yes

  No

  N/A

• Is a faceshield available and in use?

  Yes

  No

  N/A