Information
-
Audit Title
-
Document No.
-
Client / Site
-
Conducted on
-
Prepared by
-
Location
-
Personnel
-
Select date
1.0 PPE Correct
-
1.1 Hard hat/ bump cap
-
1.2 Eye/Face Protection
-
1.3 Hand/Foot Protection<br>
-
1.4 Hearing Protection
-
1.5 Clothing/ meets GMP, High Vis
-
Steel toe footwear
2.0 Manual Lifting
-
2.1 Correct body position
-
2.2 Help for heavy items
-
2.3 Hand placement
-
2.4 Weight known
-
2.5 Use of equipment
3.0 Line of Fire
-
3.2 Overhead hazards
-
3.3. Rotating equipment
-
3.1 Hand/Body position
-
3.4 Eyes on work or path
-
3.5 Pinch/Shard edges identified & protected
4.0 Housekeeping
-
4.1 Trash/Debris
-
4.2 Cord/lead control
-
4.3 Protruding items
-
4.4 Correct barricades
-
Contractor lot utilization
5.0 Fall protection
-
5.1 Trip hazard
-
5.2 Fall arrest equip. use
-
5.3 Correct ladder use
6.0 Tool Use
-
6.1 Correct tool
-
6.2 Used correctly
-
6.3 Material secured
-
6.4 Guards in place
-
6.5 GFCI used
7.0 Equipment/Vehicle Use
-
7.1 Seat belt use
-
7.2 Inspection
-
7.3 Equip. used properly
-
7.4 Backing
8.0 Adjacent Work
-
8.1 Equipment startup
-
8.2 Vehicle traffic
-
8.3 Work scope known
9.0 Procedures
-
9.1 Lockout/blinding
-
9.2 Confined space
-
9.3 Other procedure<br>
Near misses
-
Any near miss situations to report?
-
Identified parties require retraining?
-
Actions taken?
10.0 Other
-
Item # - What is positive or at risk? / Corrective action or commendation?
