Title Page
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Audit Title
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Document No.
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Site
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Conducted on
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Prepared by
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Location
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Contractor/Subcontractor
Positive Behaviors Observed/Actions taken to encourage safe behavior
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Opportunities for Improvement
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What topic(s) are you covering?
- Admin
- IIPP Assessment
- Disposal facility
- Aerial Scissor Lifts
- Asbestos
- Confined Space
- Cranes/ hoist
- Demolition
- Electrical Safety
- Excavation/ Trenching
- Fall Prevention/ Protection
- Fire Prevention/ Protection
- Hand and Power Tools
- Hazard Communication
- Heavy/Motorized Equipment
- Hot Works Operations
- Housekeeping
- Ladders/Stairs
- Material Handling
- Rigging
- Medical/First Aid/Emergency
- Occupational/Environmental
- PPE
- Scaffolding
- Site/Public Protection
- Steel Erection
- Heat Illness Prevention
- Wildfire Smoke
- JHA/Pre-Task Plan
Category: Administration
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Accountability Plan Utilized
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Annual Program Evaluation
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Competent Person List
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DART/TRC Compliance Goals Met
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Employee Involvement
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Incident Investigation Program
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Monthly Reporting Up-To-Date
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SDS Manual Current
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Orientation Program Documented
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Post-Incident Review Held
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Pre-Con Meeting Documented
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Return To Work Program
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Safety Inspections Completed
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Safety Recognition Program
Category: IIPP Assessment
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Persons with authority and responsibility for implementing program are properly identified
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System for ensuring employees comply with safe and healthful work practices
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System for communicating with employees in a form readily understandable by all affected employees about safety and health
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Procedures for identifying and evaluating workplace hazards to include scheduled inspections
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Procedure to investigate occurrence of injuries or illnesses
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Methods for correcting unsafe work conditions, work practices, in a timely manner based on seriousness of hazard
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Training program to instruct on general and job-specific safety and health practices
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Adequate documentation for inspections, training, and other standard-specific requirements
Category: Aerial/Scissor Lifts/Personnel Lift
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Proper Clearance From Overhead Lines
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Controls Legible and Functioning
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Daily Inspections Documented
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Fall Protection In Use
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Equipment loaded properly
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Gate Or Chain Secured
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Surface Free Of Holes/Flat
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Operators Trained
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Area Below Protected
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Nothing to increase height
Category: Asbestos
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Area Air Monitoring Conducted
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Worker Licenses Posted
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SDS Manual Available
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Manometer Present
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HEPA Machine Cert. Available
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Fire-Retardent Poly Used
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Decon Established
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Dumpster Secured
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Fire Extinguisher Present
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Emergency Response Plan
Category: Confined Space
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Respiratory Protection
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Entry Supervisor
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Confined Space Inventory
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Permit Posted/Completed
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Proper PPE In Use
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Authorized Entrant
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Air Monitoring Conducted
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Monitor Calibrated/In Use
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Rescue Plan/Equipment Present
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LOTO Required/Completed
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Entry Trained/Documentation
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Attendant Present
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Adequate Ventilation
Category: Cranes and Hoisting Equipment
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Signal Person Trained
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Hoist/Lift Plan On File
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Annual inspection current
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Daily Inspections Documented
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Valid Hoisting License
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Load chart posted
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Boom Angle Indicator On Crane
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Operators Manual In Crane
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Weight of load verified
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Rigging Inspected/Rated/Tagged
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Safety Latches On Hooks
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Swing Radius Barricaded
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Tag Lines Used
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Proper Clearance from Overhead Lines
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Crane Leveled On Firm Surface
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Proper Sized Cribbing
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No Overhead Loads
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Fire extinguisher in crane
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Load Secured/Rigged Properly
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Outriggers Fully Extended
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Anti-Two Block Device
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Means of Communication
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No Personnel under a load
Category: Demolition
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Engineering Survey/Demolition Plan
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Hazardous Materials Survey
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Pre-Demo Checklist/Walkthru
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Utilities Clearly ID'd/Protected
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Demolition Debris Removed
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Fire Protection Addressed
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Systems Drained/Locked Out
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Access Controlled/Restricted
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Dust Control
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Fall Protection In Use
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Housekeeping/Access Maintained
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Flamm/Comb Materials Removed
Category: Electrical Safety
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Outlets/Panels Mounted Properly
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LO/TO Procedures Verified
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Generators Grounded
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Energized Parts Protected
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Cords In Good Condition
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Cords Protected From Traffic
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Elec Rooms/Panels Secured/Signage
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Energized Work Procedure/NFPA 70E
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GFCI's used
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Circuits Labeled
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Proper Temp Lighting/Guards/Cages
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Knock-outs Covered/Protected
Category: Excavation and Trenching
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Excavations >20' Engineered
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Competent Person Present
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Benched Appropriately (Type A/B Only)
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All Utilities Marked (Markings Must Remain)
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Utilities Protected/Supported
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Daily Inspections Documented
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Trench Box Installed Properly/Certs Available
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Sloped/Shored Properly
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4' Depth - Safe Access
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>6 - Fall Protection Installed
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Atmospheric Hazards
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Perimerter Protection/Barricades
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Soil Classified/Tested (A/B/C)
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Spoils 2' From Edge
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Surface Encumbrances Supported
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Surface Traffic Exposure Controlled
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Water Entering Excavation Controlled
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Access Within 25'
Category: Fall Prevention and Protection
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Top Rail 39-45"
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Proper Anchor Points (5,000#)
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Competent Person Present
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Workers Trained/Docum
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Equipment Inspected/Functioning
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Falling Object Protection
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Guardrails in Place (Floor/Wall Openings)
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Hole Covers Adequate/Secured/Marked
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Toeboards Present
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Contolled Access Zone Established
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Safe Ladder Use/Access
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Rescue Provisions In Place
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Harness/Lanyard Used Properly (PFAS)?
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Stair/Ramp/Walkway Protected
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Impalement Protection/Rebar Caps
Category: Fire Prevention and Protection
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Emergency Vehicle Access
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Extinguisher Charged/Inspected
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Extinguisher Mounted/Signed Properly
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Fire Suppression Equip Available
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Fire Watch Present
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Smoking in designated areas only
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Proper Signs In Storage Area
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Proper Liquid/Gas Storage
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Proper Comb. Material Storage
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No Propane Stored Indoors
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Proper Fuel Containers Used
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Tarps/Enclosures Flame Retardant
Category: Hand and Power Tools
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Whip Checks Installed
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Tool In Good Condition
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Cords In Good Condition
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Ground Prong/Double Insulated
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Guards In Place
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Manufacturer supplied handles used
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Information Label On Tool
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Proper Tool For The Job
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Strain Relief Functioning
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Emergency Shut-Off Switch
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Signage for Laser
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Powder Actuated Used Appropiately
Category: Hazard Communication
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Employees Trained
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SDS Readily available
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SDS (site specific)
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PPE per SDS
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Proper Labels On Containers
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Inventory List
Category: Heavy/Motorized Equipment
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ROPS (Roll-Over Protection)
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Moving Parts Guarded
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Inspections Completed
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Training Documentation Available
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Flagman Used If Applicable
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Equipment Manual Available
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Back-Up Alarm Functioning
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Seat Belts Used
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Hoisting/Operator's Licenses
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Glass free of obstructions
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Horn functioning
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Strobe Lights
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Secure loads prior to transport
Category: Hot Work Operations
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Fire Extinguisher Present
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Flamm/Comb Materials Removed
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Bottles Upright/Capped/Secured
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CG Cylinders Stored Properly
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Flash Arrest On Torches
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Welding Screens Provided
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Gauges Working Properly
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Leads In Good Condition
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Proper PPE In Use
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Torch Hoses in Good Condition
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Welding Machine Ventilated
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Hot Work Permit Issued/Posted
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Fire Watch Present
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Lead Terminals Covered
Category: Housekeeping
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Work Area Clean
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Clear Access to Building/Site
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Cords/Hoses On Floor/Walkway
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Proper Material Storage
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Slip/Trip/Fall Hazards
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Walkways/Aisles Clear & Clean
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Designated employee parking
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Impalement protection
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Roadway Around Project Clear
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Trash In Protected Containers
Category: Ladders/Stairs
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Ladder Set-Up Appropriate
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3-Points Of Contact Maintained
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Extend 3' Above Landing
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Safe Access Break > 19"(>18"Cal)
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Extension Ladder 4:1 Pitch
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Inspected For Defects
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Job-Made Ladders Built Properly
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Ladders Secured In Place
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Proper Use Of Ladder
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Coral/Gate/Offset at Landing
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Top/Bottom Of Ladders Clear
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Safe Work Distance From Hazards
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Stair/Handrails Present (36-37")
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Landings And Stair Treads Filled
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Stairs Illuminated
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Slip Trip Exposure Eliminated
Category: Material Handling
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Assistance for Heavy/Awkward Items
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Use of Mechanical Aid
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No personnel under a load
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Safe/Efficient Work Station
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Proper Lifting Technique
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Pre-Fabrication Possible?
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No Twisting
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No Over-Reaching
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Material Stored On Rack/Dolly/Etc
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Manual Lifting In 'Power-Zone'
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Clear Paths/Housekeeping
Category: Medical/1st Aid/Emergency
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Team Contact Numbers
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Exits Marked/Signed
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Address Displayed On Perimeter
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Adequate 1st Aid Kits
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Eye Wash Station
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Coordination With Local FD
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Emergency Action/Crisis Management Plan
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Emergency Numbers Posted
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First-Aid/CPR On Site
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Map to Medical Facility
Category: Occupational & Environmental
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Ventilation Adequate
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Containers labeled
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Signage for Lead/Asbestos Posted
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Proper Lighting
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Hand Washing Station Present
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Hazardous Material Properly Stored
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Eye Wash Present
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Asbestos/Lead/Mold/Silica
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Moisture Control Plan in Place
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Noise Exposure/Monitoring
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Nuisance dust
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Concrete cut wet & vacuumed
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Air Monitoring for Contaminant
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Silica Control Plan in Place
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Spill Containment Adequate
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SWPP In Place
Category: P.P.E
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Safety Goggles
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Face Shield
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Safety Glasses
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Gloves
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Metatarsal protection
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Hard Hats
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Hearing Protection
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High Visibility Clothing/Reflective Vest
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Foot Protection
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Proper Clothing
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Respiratory Protection
Category: Scaffolding
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Toeboards
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Competent Person Present
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Suspended Scaffold Tiebacks
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Guardrails Installed
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Falling Object Protection
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Rolling Scaffold Brakes Set
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Inspection Daily & Documented
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Properly Secured To Structure/Tie-Backs
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Access To Scaffold Appropriate
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Proper Height To Base Ratio
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Bracing And Pins In Place
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Compatible Components Used
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Fully Planked
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Proper Loading Of Materials
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Sills, Plates, Jacks Installed
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Surface In Safe Condition
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Proper Clearance From Overhead Lines
- Compliant
- Improve it
- Reoccurring
- N/A
Category: Site/Public Protection
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Traffic Control Plan
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Walkways Clear
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Falling Object/Overhead Protection
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Public Protection Signage
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Pedestrian Crosswalk Appropriate
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Adequate Lighting
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Security Systems In Place
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Access Restricted
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Police Detail Present
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Walkways Delineated/Protected
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Excavations protected
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Site/Perimeter Fences
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Fencing Secured/Weighted
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Barricades Installed Properly
Category: Steel Erection
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Anchorage Points Meet Requirement
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Written Approval Concrete Strength
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Structural Flooring Requirements
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Site-Specific Steel Erection Plan
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Site Layout/Sequence Plan
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Proper Anchorage Of Columns/Beams
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Multi Lift/Rigging/Connector Training
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Multi Lift Procedure Utilized
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Falling Object Protection
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Fall Protection Training Provided
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Erector Notified Of Modification
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CDZ Training/Utilized
Disposal Facility
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Danger Signs Posted
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Daily Log Posted
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Critical Barriers Established
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Contractor License Valid
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Personal Air Samples Posted
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Work Plan Submitted
Heat Illness Prevention
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Heat Illness Prevention Program in place
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Cool, clean potable water available
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Competent person assigned
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Acclimatization
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Heat Wave Procedures
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Heat Wave Procedure
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High Heat Procedure
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Personnel training
Wildfire Smoke
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Program in place
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Identification of Harmful Exposure
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Exposure Communicated to employees
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Control of Harmful Exposure in Place
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Personnel Trained
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Other
Rigging Components
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Missing or Illegible Identification/Tag
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Excessive wear, nicks, cuts, gouges
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Acid or caustic burns
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Melting or charring of any part of the sling (Nylon)
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Broken or worn stitching on load bearing splice
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Discoloration and brittle - Ultraviolet/Sunlight damage
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Broken wires (wire rope)
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Kinking, crushing, bird caging (Wire rope)
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Heat damage/Weld spatter, arc strike
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Severe corrosion
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Cracks or bent components
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Damaged hardware/ missing hardware
Pre-Task Plan/JHA
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Pre-Task Plan/JHA Available
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Pre-Task Plan/JHA Complete
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All Crew members participate in Pre-Task Plan/JHA development
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Pre-Task Plan revisited when task changes
