Sample - Site Safety Inspection II

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1. General

• 1.1 Did company representative accompany inspector?

  Yes

  No

  N/A

• 1.2 Are all Safety/HazCom/Emergency Programs in place.

  Yes

  No

  N/A

• 1.3 Are OSHA posters/emergency numbers posted?

  Yes

  No

  N/A

• 1.4 Are Fall Protection Plans in place?

  Yes

  No

  N/A

• 1.5 Are safety meetings held/documented?

  Yes

  No

  N/A

• 1.6 Are first aid kits available & properly stocked?

  Yes

  No

  N/A

• 1.7 Are fire extinguishers available/charged/inspected?

  Yes

  No

  N/A

• 1.8 Is the terrain safe for normal walking?

  Yes

  No

  N/A

• 1.9 Are the gang boxes in good condition with appropriate materials stored inside?

  Yes

  No

  N/A

• 1.10 Is material storage proper?

  Yes

  No

  N/A

• 1.11 Is housekeeping and sanitation proper & enforced?

  Yes

  No

  N/A

• 1.12 Are flammable materials in approved containers & properly labeled?

  Yes

  No

  N/A

• 1.13 Are all hand/power tools and chop saws properly used/maintained/stored?

  Yes

  No

  N/A

• 1.14 Are access/egress locations with a change in elevation >19 inches provided with stairs, ladders or ramp?

  Yes

  No

  N/A

2. Equipment

• 2.1 Are the board carts free from damage?

  Yes

  No

  N/A

• 2.2 Are all safety guards in place & working properly (I.e. chop saw).

  Yes

  No

  N/A

• 2.3 Is all equipment properly maintained & inspected?

  Yes

  No

  N/A

• 2.4 Do backup alarms work?

  Yes

  No

  N/A

• 2.6 Are seatbelts operative & used?

  Yes

  No

  N/A

• 2.8 Are forks on the ground when parked?

  Yes

  No

  N/A

• 2.9 Is the forklift operator in the seat with a raised load?

  Yes

  No

  N/A

3. Personal Protective Equipment

• 3.1 Proper eye protection in use?

  Yes

  No

  N/A

• 3.2 Is respiratory protection proper? Fit testing done?

  Yes

  No

  N/A

• 3.3 Is hearing protection used & proper?

  Yes

  No

  N/A

• 3.4 Is proper foot protection worn?

  Yes

  No

  N/A

• 3.5 Is proper head protection worn?

  Yes

  No

  N/A

• 3.7 Is hand protection/clothing proper (class I hi visibility)?

  Yes

  No

  N/A

• 3.8 Is PPE hazard assessment complete & on file?

  Yes

  No

  N/A

4. Electrical

• 4.1 Are GFCI's or AEG Program in use?

  Yes

  No

  N/A

• 4.2 Is temporary lighting used & proper?

  Yes

  No

  N/A

• 4.3 Are Lockout/Tagout procedures in place & used?

  Yes

  No

  N/A

• 4.4 Are aerial lifts 50' from energized power lines?

  Yes

  No

  N/A

• 4.5 Are temporary cords properly used & maintained?

  Yes

  No

  N/A

• 4.6 Are all extension cords hung or protected from sharp edges?

  Yes

  No

  N/A

• 4.7 Other

  Yes

  No

  N/A

5. Fall Protection

• 5.1 Are fall protection plans required & in place?

  Yes

  No

  N/A

• 5.2 Is fall protection provided at heights over 6 feet?

  Yes

  No

  N/A

• 5.3 Is fall protection equipment inspected & maintained?

  Yes

  No

  N/A

• 5.4 Are stairways properly protected & used?

  Yes

  No

  N/A

• 5.5 Are ladders properly used, inspected, & maintained?

  Yes

  No

  N/A

• 5.6 Are all floors holes properly covered or protected?

  Yes

  No

  N/A

Perry Scaffold (mobile scaffold)

• 6.1 Are all users trained for use?

  Yes

  No

  N/A

• 6.2 Are all parts free of damage, or worn parts?

  Yes

  No

  N/A

• 6.3 Is the board tied down?

  Yes

  No

  N/A

• 6.4 Are the wheels locked during use?

  Yes

  No

  N/A

• 6.5 Are the guard rails in use properly?

  Yes

  No

  N/A

• 6.6 Other?

  Yes

  No

  N/A

7. Scaffolding

• 7.1 Is scaffold competent person on site?

  Yes

  No

  N/A

• 7.2 Are all scaffold users properly trained?

  Yes

  No

  N/A

• 7.3 Are scaffold erection/disassembly procedures proper?

  Yes

  No

  N/A

• 7.4 Are scaffold frames/planks/parts free of damage & defects?

  Yes

  No

  N/A

• 7.5 Are walk/work planks properly installed & set?

  Yes

  No

  N/A

• 7.6 Are guardrails properly installed & used?

  Yes

  No

  N/A

• 7.7 Are toe boards/warning line properly installed & used?

  Yes

  No

  N/A

• 7.7 Is scaffold access proper?

  Yes

  No

  N/A

• 7.8 Is the limited access zone set & enforced?

  Yes

  No

  N/A

• 7.9 Other

  Yes

  No

  N/A

9. Summary

• The overall rating for this audit is?

  Outstanding-no deficiencies

  Satisfactory-minor issues

  Unsatisfactory-major issues

• Comments

• Supervisor signature

  Sign