Sample - Job Site Safety Survey

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Job Number:

• undefined

• Job Name:

• undefined

• Supervisor Name:

• undefined

• PM Name:

• undefined

• Inspected By:

• undefined

• Select date

  Date

• undefined

• Add location
  Address

• undefined

Housekeeping

• Appearance of job neat & orderly<br>CFR 1926.26(a,b,c)

  Safe

  At Risk

  N/A

• undefined

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• Regular disposal of waste & trash<br>CFR 1926.26(a)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Passageways & walkways clear<br>CFR 1925.26(a)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Oil & greased removed<br>CFR 1926.25(c)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Proper toilet facilities<br>CFR 1926.51.(c)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Drinking water & cups<br>CFR 1926.51(a)(1),(2),(3) &(4)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Projecting nails removed<br>CFR 1918.91(a)

  Safe

  At Risk

  N/A

• undefined

• Add media

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Power & Hand Tools

• Tools & cords in good condition<br>CFR 1926.300 and CFR 1926.301(a)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• All mechanical safeguards in place<br>CFR 1926.300(b)(1)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Proper grounding<br>CFR 1926.302(a)(1)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Tool being used for its intended purpose<br>CFR 1926.301(a)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• right tool for the right job<br>CFR 1926.301(a)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• eye, face, & hearing protection used<br>CFR 1926.300(c)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• damaged tools repaired or replaced<br>CFR 1926.300(a) & 301(a)

  Safe

  At Risk

  N/A

• undefined

• Add media

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Ladders

• Do not use top step<br>CFR 1926.1053(b)(13)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Portable ladders extended 3ft above upper landing<br>CFR 1926.1053(b)(1)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• build to ANSI standards<br>CFR 1926.1053(a)(1)(i)&(ii)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Stepladders being used properly<br>CFR 1926.1053(b)(4)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Training on ladders<br>CFR 1926.1060(a)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Damaged ladder<br>CFR 1926.1053(b)(15)

  Safe

  At Risk

  N/A

• undefined

• Add media

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Fall Protection

• Guarding systems<br>CFR 1926.502(a)(2)&(b)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Employee training<br>CFR 1926.503(a)(1) thru (2)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Personal fall arrest system<br>CFR 1926.502(d)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Floor & wall openings<br>CFR 1926.502(i)(1) thru (4)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• inspection of Fall Arrest Equipment<br>CFR 1926.502(d)(21)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Unprotected sides & edges above 6 feet<br>CFR 1926.5501(b)(1)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Warning lines<br>CFR 1926.502(f)(1) & (2)

  Safe

  At Risk

  N/A

• undefined

• Add media

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Scaffolding

• Inspected by Competent person<br>CFR 1926.451(f)(3)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Platform construction<br>1926.451(b)(1)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Proper use<br>CFR 1926.451(f)

  Safe

  At Risk

  N/A

• undefined

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• Proper access provided<br>CFR 1926.451(e)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Guardrails & toe-boards in place /protect from falling objects<br>CFR 1926.451(h)(1) thru (4)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Employee training<br>CFR 1926.454(a)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Fall protection above 10 feet<br>CFR 1926.451(g)(1)

  Safe

  At Risk

  N/A

• undefined

• Add media

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Fire Protection

• Proper #, locations & access of fire extinguishers<br>CFR 1926.150(a)(2)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Employee training

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Periodic inspections & maintenance<br>CFR 1926.150(c)(viii)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Use of approved containers for flammable liquids<br>CFR 1926.152(a)(1)

  Safe

  At Risk

  N/A

• undefined

• Add media

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Excavations

• Competent person<br>CFR 1926.650(b)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Access provided within 25 feet of employee<br>CFR 1926.651(c)(2)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Proximity of materials to edge of excavation & barricades<br>CFR 1926.651(j)(1) & (2)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Proper protective systems in place<br>CFR 126.652(a) thru (c)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Frequent inspections<br>CFR 1926.651(k)(1)

  Safe

  At Risk

  N/A

• undefined

• Add media

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Equipment

• Back-up alarms or flagman<br>CFR 1926.601(b)(4)(i) & (ii)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Seat belts<br>CFR 1926.601(b)(9)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Roll-over Protective structures<br>CFR 1926.1001(a)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Fire extinguishers

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Horn<br>CFR 1926.602(a)(9)(i)

  Safe

  At Risk

  N/A

• undefined

• Add media

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Hoist & cranes

• Sling, hooks, shackles & eyes

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Outriggers used if necessary

  Safe

  At Risk

  N/A

• undefined

• Off

  On

• Add media

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• Barricade swing radius of crane structure

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Power lines de-energized, or removed at a safe distance -min. 10 feet

  Safe

  At Risk

  N/A

• undefined

• Add media

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Personal Protection

• Hard hat<br>CFR 1926.100(a,b,c) & ANSI Z89.1-1969 & Z89.2-1971

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Proper eye protection<br>CFR 1926.102(a) from 1-5 & ANSI Z87.1-1968

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Ear protection<br>CFR 1926.101(a,b,c)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Gloves<br>CFR 1926.65 Appendix B

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Proper foot wear<br>CFR 1926.96 & ANSI Z41.1-1967

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Reflective vest

  Safe

  At Risk

  N/A

• undefined

• Add media

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Electrical

• Temporary power installed correctly<br>CFR 1926.406(a)(2)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Temporary lights installed correctly<br>CFR 1926.405(a)(2)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• GFCI'S being used<br>CFR1926.404(b)(1)(i)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Extension cords have a good ground & plug in good condition<br>CFR 1926.405(2)(ii)(j) & 1926.404(b)(1)(iii)(c)

  Safe

  At Risk

  N/A

• undefined

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• Adequate task lighting & Access/ Egress lighting<br>CFR 1926.56(a)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Equipment installation & proper use<br>CFR 1926.403(b)(2)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Covers on boxes<br>CFR 1926.404(f)(7)(iii)[A]

  Safe

  At Risk

  N/A

• undefined

• Add media

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• LO/TO Program in effect<br>CFR 1926.417(a) thru (c)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• LO/TO Training

  Yes

  No

  N/A

• undefined

• Add media

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Welding & Cutting

• PPE, clothing, equipment, ETC.

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Hot work Permit

  Safe

  At Risk

  N/A

• undefined

• Add media

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• fire extinguisher

  Safe

  At Risk

  N/A

• undefined

• Add media

  Media

• Fire watch

  Safe

  At Risk

  N/A

• undefined

• Add media

  Media

• Storage of cylinders

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Inspection of torches

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Housekeeping

  Safe

  At Risk

  N/A

• undefined

• Add media

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Stairways

• Housekeeing<br>CFR 1926.1052(a)(6)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Handrails installed<br>CFR 1926.1052(c)(9)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Lighting<br>CFR 1926.56(a)

  Safe

  At Risk

  N/A

• undefined

• Add media

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Material Handling

• Material stacked, racked, etc.<br>CFR 1926.250(a)(1)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Materials at proper distance from edge of building or floor opening<br>CFR 1926.250(a)(1)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Non compatible fluids segregated<br>CFR 1926.250(b)(3)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Housekeeping<br>CFR 1926.250(c)

  Safe

  At Risk

  N/A

• undefined

• Add media

  Media

Aerial Lifts

• Employee Training <br>CFR 1926.453(b)(2)(ii) & 454(a)

  Safe

  At Risk

  N/A

• undefined

• Add media

  Media

• Lift in good working condition<br>CFR 1926.453(b)(2)(i)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Operating Manuals & inspection sheet<br>ANSI A92

  Safe

  At Risk

  N/A

• undefined

• Add media

  Media

• Fall restrain<br>CFR 1926.453(b)(2)(v)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Proper use<br>ANSI 92

  Yes

  No

  N/A

• undefined

• Add media

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Powder Actuated Tools

• Training documentation<br>CFR 1926.302(e)(1)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Face shields or goggles<br>CFR 1926.302(e)(4)

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Misfired cartridges disposed

  Safe

  At Risk

  N/A

• undefined

• Add media

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• Secured tool<br>CFR 1926.302(e)(6)

  Safe

  At Risk

  N/A

• undefined

• Add media

  Media

Environmental Issues

• MSDS files updated

  Safe

  At Risk

  N/A

• undefined

• Add media

  Media

• Review table of contents & index

  Safe

  At Risk

  N/A

• undefined

• Add media

  Media