Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Job #
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Sunny
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Rainy
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Cloudy
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Windy
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Hot
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Cold
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Temperature
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State and Federal Listing posted at the site<br>
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Daily Job Safety Analysis reviewed, updated and signed
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Emergency contact list posted
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Weekly safety meetings being completed
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Weekly equipment checklist completed
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Copy of safety manual, MSDS, tabulated data
Subcontractor Compliance
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Subcontractor per-construction meeting completed and documented.
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Drug testing information collected.
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Subcontractors have submitted training documentation for he task that will perform.
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Subcontractors have completed a JSA for the task that they will complete. <br><br><br><br>
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Subcontractors have completed and submitted weekly safety meetings.
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Subcontractors are complying with PPE requirements.
Personal Protective Equipment (PPE)
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Eye protection including side shields (100%)
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Head protection (100%)<br>
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Hearing protection required and worn
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High visibility clothing / vests worn by none burning or climbing employees.(100%)
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Respiratory protection equipment worn and stored properly where required.
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Speciality PPE (face shields, FR clothing)
Fall Protection
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Fall protection required (All work over 6' requires fall protection)
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Have all employees who are working at height (6' or greater) trained in fall protection.
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Have the fall hazards been addressed in a JSA
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Harnesses, SRL's, and fall protection equipment has been inspected before use and in good condition
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What form of rescue will be used in the event a fall takes place.
Holes
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Have all holes been properly protected. (2" or greater)
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Have all hole covers been properly secured, and markerd with the words" HOLE".
Guardrails
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Toprail 42+/- 3", Midrail 21+/3", Toe board.
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Cable Guardrail: Top rail 42" +/- 3", do not deflect below 39". <br>
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Stanstions on 8' centers. <br>
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Flagging placed every 6'.
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Free from laceration hazards.
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Completely protects against the hazard.
Ladders & Barricades
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Have all ladders been inspected before use.
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Do ladders have proper footing.
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Are ladders used in a dully opened position.
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Is the ladder positioned so the base of the ladder is one foot away for every four feet of height. (4:1 ratio)
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Do side rails extend 36" above the landing area.
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Have ladders been properly secured.
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Employees maintaining 3 points of contact when using the ladder.
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Can work be performed within the confines of the side rails.
Excavation Safety
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Has a Competent person been assigned to the task
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Has the Utility One Call been made. Are marking updates being made, and information being received.
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Have underground utilities been identified / located and marked
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Have adjacent structures / utilities been properly protected or supported. <br>
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Has the trench / excavation been inspected before entry's
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Is a ladder or acceptable means of egress provided in all trenches / excavations 4' or deeper
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Are excavations 5' deep or deeper properly protected. (Sloped, bench, shielded, or shored)
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Are trench boxes in good condition, spreaders properly installed, stacking pins in place. <br><br>List Box numbers:<br><br><br>
Vehicles & Equipment
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Is all equipment equipped with a fire extinguisher (Extinguishers inspected and up-dated)<br><br><br>
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Are all safety devices in place and working (Back-up alarms, etc..)<br>
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Power lines de-energized and/or safe distance from equipment (10 feet)
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Is demolition equipment equipped with safety cages (Including hammering operation)
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Aerial lifts inspected and used properly (Controls inspected and tested daily)
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Crane operators NCCO License current and on file.
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Daily crane inspection completed
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Swing radius protected
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Prelift form completed before all lifts.
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Rigging inspected before all lifts.
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All chains / nylon / wire rope slings labeled.
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Shackles and hooks inspected for deformation, keepers present.
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Loads rigged by a qualified rigger.
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Crane maintaining 20' from overhead powerlines, or if voltage is known, following Table A.
Material Handleing and Concrete Construction
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Men lifting correctly.
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Are form brackets inspected.
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Walkways over rebar mats.
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Has all reinforcement bar that presents an impalment, or cut hazard been protected
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Materials properly stored, labeled and stacked.
Housekeeping and Sanitation
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General neatness of the working areas
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Tool trailer & conex organized and clean.
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Proper and safe access and egress to tool trailers and offices.
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Waste containers provided and used.
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Adequate supply of drinking water on-site.
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First aid equipment on-site and accessible.
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Sanitary facilities adequate and clean.
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Traffic Safety
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Barricades
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Cones
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Signs
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Is signage properly placed
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Are pedestrian crossings good
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General comments about site.
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Superintendent Name
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Foreman signature