Safety inspection

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Site Information

• What type of operation is being observed?

  Select Excavation Pour Conrete Crane Work Soil Nailing Vertical Ancors Drilled Shafts

  • Excavation
  • Pour Conrete
  • Crane Work
  • Soil Nailing
  • Vertical Ancors
  • Drilled Shafts

• Who is the Foreman of the operation?

  Select Rodolfo F. Joan Lira Diamantino Alejandro Alcalá Jose Nuñez Antonio Simoes Luis Teixeira Daniel lucero

  • Rodolfo F.
  • Joan Lira
  • Diamantino
  • Alejandro Alcalá
  • Jose Nuñez
  • Antonio Simoes
  • Luis Teixeira
  • Daniel lucero

• Date & Time of Inspection

  Date

• Is a JHA/ Work Plan completed for the operation?

  Yes

  No

  N/A

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  Media

• Was this corrected?

  Yes

  No

  N/A

• Does this operation require a Dig Permit?

  Yes

  No

  N/A

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  Media

• Does this operation require a Lift Plan?

  Yes

  No

  N/A

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  Media

• Has the Lift Plan been filled out properly and been reviewed by the crew?

  Yes

  No

  N/A

• Was this corrected?

  Yes

  No

  N/A

Personal Protective Equipment

• Is the Proper PPE for the operation being worn?

  Yes

  No

  N/A

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  Media

• Was this corrected?

  Yes

  No

  N/A

• Is there task specific PPE for the operation?

  Yes

  No

  N/A

• Describe task specific PPE.

• Is the PPE in good condition?

  Yes

  No

  N/A

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  Media

• Are employees wearing PPE properly?

  Yes

  No

  N/A

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  Media

• Was this corrected?

  Yes

  No

  N/A

Welding/Burning

• Are fire extinguishers available?

  Yes

  No

  N/A

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  Media

• Have flammable combustibles been remove or stored at a safe distance from work?

  Yes

  No

  N/A

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  Media

• Was this corrected?

  Yes

  No

  N/A

• Are Gas cylinders stored in an upright position and secured as to prevent displacement?

  Yes

  No

  N/A

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  Media

• Was this corrected?

  Yes

  No

  N/A

Fall Protection

• Are ladders being used?

  Yes

  No

  N/A

• Are the ladders being used in accordance with safety procedures?

  Yes

  No

  N/A

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  Media

• Are ladders inspected and in good condition?

  Yes

  No

  N/A

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  Media

• Is the proper type of ladder being used for the task performed?

  Yes

  No

  N/A

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  Media

• Access/egress locations adequate?

  Yes

  No

  N/A

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  Media

• Is Fall protection being used?

  Yes

  No

  N/A

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  Media

• Which type/s of fall protection is being used?

  Select Guardrail System PFAS Warning Lines Safety Monitor

  • Guardrail System
  • PFAS
  • Warning Lines
  • Safety Monitor

• Are the Anchor points able to withstand a pulling force of at least 5000lb?

  Yes

  No

  N/A

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  Media

• Is inspected and in good condition?

  Yes

  No

  N/A

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  Media

Work Zone

• Are restrooms clean and maintained?

  Yes

  No

  N/A

• Are trash and materials disposed off properly?

  Yes

  No

  N/A

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  Media

• Are walkways/walk paths kept clear of hoses/cords/debris?

  Yes

  No

  N/A

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  Media

• Is the work area "housekeeping" clean?

  Yes

  No

  N/A

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  Media

• Was this corrected?

  Yes

  No

  N/A

• Does the work area have proper access?

  Yes

  No

  N/A

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  Media

• Have all fire extinguishers been inspected?

  Yes

  No

  N/A

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  Media

• Is potable drinking water available to all employees and in accordance with sanitation guidelines?

  Yes

  No

  N/A

Rigging procedures

• Is rigging equipment properly being stored when not in use?

  Yes

  No

  N/A

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  Media

• Are tag lines being used on all lift and hoisting maneuvers?

  Yes

  No

  N/A

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  Media

• Is personnel kept clear of swing radius/lifting zone/landing zone?

  Yes

  No

  N/A

• Is there a signalman/Flagger?

  Yes

  No

  N/A

• Are barricades being used to designate lifting area?

  Yes

  No

  N/A

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  Media

Electrical/Hand tools/Power tools/Equipment

• Proper tool for task performed is being used?

  Yes

  No

  N/A

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  Media

• Are all tool and machine guards in place?

  Yes

  No

  N/A

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  Media

• Are electric cords and welding leads in good condition and properly grounded?

  Yes

  No

  N/A

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  Media

• Are all hoses in good condition and secured?

  Yes

  No

  N/A

• Add media

  Media

• Are cords/hoses protected from traffic and sharp edges?

  Yes

  No

  N/A

• Add media

  Media

Sign Off

• Auditor's signature

  Sign