Audit

Directions:

When performing the safety audit answer yes, no, or n/a to the following. If the answer is no, double click the item to add the violation/concern and a corrective action.

Project Set Up

Tool-box talk had been conducted (daily)

Adequate supply of clean water and soap for washing (waterless soap is adequate)

Adequate supply of drinking water and cups (specific container for drinking water only)

Eyewash station, bottles, or other designated source is on-site and readily available

Shooter is in proper working condition

One person CPR/First Aid trained on site at all times

Scaffolding is properly erected and determined safe prior to us (fall restraint being utilized)

Emergency numbers are posted and crew members have the means to summon help in case of emergency

Is housekeeping neat and in order?

Equipment and tools neat and organized?

Supt/foreman have the necessary field handoff package?

Traffic & Vehicle Safety

Traffic control equipment, devices, and barricades are appropriately set up

Hose guards are protected with hose guards from traffic and other possibility of damage

Vehicles have serviceable fire extinguisher mounted and warning triangles/flares

Clean, serviceable first aid kit in each vehicle and job trailer

Vehicle pre-trip inspections are current and available

When necessary, vehicles and all mobile equipment (including pumps, compressors, etc.) have wheels chocked

Is equipment sake and in good working condition?

PPE and Personnel Hazards

Minimal PPE required is being worn (steel-toed boots, reflective vest, 3" sleeved t-shirt, jeans, hard hat)

Additional PPE is being utilized if need be (safety glasses/goggles, gloves, hearing protection)

Employees are not wearing inappropriate items such as shorts, baggy shirts, loose jewelry. Additionally long hair is pulled back and kept out of way.

Appropriate respirators are being used for the right environment and only being worn by employees that have been fit tested and are clean shaven

Storage area for respirators and they are being kept there

Subcontract employees are adhering to the safety rules of SAK

Temporary laborers are performing tasks only for which they have received training

Proper tool(s) being used for the task?

All tools in good working condition with guards in place?

Confined Space Entry

Appropriate work permits (hot work, confined space entry, etc.) are posted and in use at manhole

Qualified attendant is present during entries

Attendant is properly equipped and trained in rescue procedures

Entrants are wearing body harnesses, lanyards, and attached to fall restraint device (tripod)

Serviceable tripod is available for use

Gas detectors on site have been calibrated on 30 day cycles. Additionally have calibration stickers on front.

Two reliable forms of communication are being used and are available

Plugging is installed, secured, and is monitored with a working pressure gauge

Bypass pumping is installed and is monitored

Smoking is permitted in designated areas on (10ft or more away from manholes, away from fuels, chemicals, etc)

Open manholes are protected (barricades, signs, etc.)

SSSP is being followed if required and necessary steps are being taking to ensure implementation

Hazards Communication, Chemical, and Fuel Safety

Precautions against burns from steam burns are provided

Material Safety Data Sheets (MSDSs) are readily available for all chemicals/cleaners on site

Chemicals are stored in approved containers are are properly labeled

Company Hazard Communication Programs are being followed

Employees are aware of applicable chemical/physical/exposure hazards, and protective means

Gasoline and other flammable chemicals are in automatic closure containers with flame arrestor

Boiler Unit

Equipped with burn kit and/or water gel burn blankets and pads

Precautions against burns from steams bursts are provided

Precautions against splashing and other discharges of heated water (shooter, top-hat overflow, etc.) are provided

Are hoses in good condition?

Are drain valves in place?

Electrical

Electrical equipment is grounded as required and all three prong plugs are in good condition

Ground fault (GFCI) receptacles are being utilized with all electrical power tools

All electrical boxes are closed and in good condition

Only round construction grade extension cords are being used and are protected from damage

Extension cords are in good shape free from any damage/electrical tape

Are all the cords from power tools and equipment in good working condition?

Policy on ground fault?

Signature

Comments

After completing audit, there will be an overall score given for audit. What do you think this site scored on a scale from 1-low to 10-high?
By signing you are acknowledging that you have read and will make efforts to correct safety violations and hazards
Foreman
Superintendent
Safety Manager

Asking me to overlook a simple safety violation would be asking me to compromise my entire attitude toward the value of your life.

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.