Information

  • Document No.

  • Audit Title

  • Site

  • Location
  • Job Number:

  • Conducted on

  • Conducted by:

  • Add signature

  • Personnel (Including Subcontractors)

HOUSEKEEPING AND SANITATION

  • Trash containers

  • Entity responsible for correction:

  • Toilets (1 per 20 employees and Females separate)/ Hand wash stations

  • Entity responsible for correction:

  • Adequate supply of drinking water & cups/ trash containers

  • Entity responsible for correction:

PERSONAL PROTECTIVE EQUIPMENT

  • Safety glasses, ear protection, vests, hard hats, boots, proper clothing

  • Entity responsible for correction:

  • Harnesses, lanyards and respirators

  • Entity responsible for correction:

POWER TOOLS AND CORDS

  • Tools in good condition and guards in place

  • Entity responsible for correction:

  • Damaged extension cords and plugs

  • Entity responsible for correction:

  • Welding leads in good repair/stingers insulated

  • Entity responsible for correction:

  • Lock Out/Tag Out practices in use

  • Entity responsible for correction:

  • Chaps and face guard worn when using a chain saw

  • Entity responsible for correction:

  • Whip - checks used on high pressure hoses

  • Entity responsible for correction:

  • GFCI protection in place

  • Entity responsible for correction:

LADDERS

  • In good condition

  • Entity responsible for correction:

  • No work on the top three rungs

  • Entity responsible for correction:

  • Secured correctly and correct height

  • Entity responsible for correction:

HEAVY EQUIPMENT (DAILY INSPECTIONS)

  • Fire extinguishers, brakes, horns, back up alarms

  • Entity responsible for correction:

  • Mirrors, windows, signals/Log books filled out

  • Entity responsible for correction:

TRAFFIC CONTROL

  • Flag person wearing proper PPE

  • Entity responsible for correction:

  • Slow/Stop paddles

  • Entity responsible for correction:

  • Signs, cones, lights and barricades

  • Entity responsible for correction:

EXCAVATIONS

  • Shoring and/or shields

  • Entity responsible for correction:

  • Sloped or benched properly

  • Entity responsible for correction:

  • Spoils two feet from edge of excavation

  • Entity responsible for correction:

  • Ladders in excavations 4+ feet deep/exit and egress no more than 25 feet away

  • Entity responsible for correction:

  • Employee/Public protection

  • Entity responsible for correction:

PILE DRIVING/STEEL ERECTION

  • 100% tied off

  • Entity responsible for correction:

  • Daily, quarterly crane logs filled and certs in cab

  • Entity responsible for correction:

  • Maintenance logs filled out and curent

  • Entity responsible for correction:

  • Inspections for rigging/chokers, slings, bridles, hooks, clevis

  • Entity responsible for correction:

CRANE/HOISTING (DAILY INSPECTION)

  • Current certification in cab

  • Entity responsible for correction:

  • Maintenance logs filled out and current

  • Entity responsible for correction:

  • Rigging and load charts in cab

  • Entity responsible for correction:

  • Fire extinguishers in cab with current inspections (Annual/Monthly)

  • Entity responsible for correction:

  • First-aid kit in good supply

  • Entity responsible for correction:

  • Proper warning signs on crane

  • Entity responsible for correction:

  • No operation within limits of High Voltage Lines

  • Entity responsible for correction:

  • Tag lines used for all picks

  • Entity responsible for correction:

  • Windows

  • Entity responsible for correction:

  • Swing radius protection

  • Entity responsible for correction:

  • Boom angle indicator operational

  • Entity responsible for correction:

  • Anti-two block device operational

  • Entity responsible for correction:

  • Rigging inspection

  • Entity responsible for correction:

REBAR PROTECTION

  • Job built

  • Entity responsible for correction:

  • Caps/Troughs/Carney System

  • Entity responsible for correction:

CONFINED SPACE

  • Tested before entry and as needed there after

  • Entity responsible for correction:

  • Positive air flow

  • Entity responsible for correction:

  • PPE

  • Entity responsible for correction:

  • Rescue plan and equipment

  • Entity responsible for correction:

  • Permits

  • Entity responsible for correction:

SCAFFOLDS & AERIAL LIFTS

  • Level, guardrails, base plates and fully planked and daily inspection sign off

  • Entity responsible for correction:

  • Tie off as required

  • Entity responsible for correction:

  • No working or standing on guardrails

  • Entity responsible for correction:

  • Toe boards as needed

  • Entity responsible for correction:

  • Overhead protection

  • Entity responsible for correction:

FLAMMABLE GASSES & LIQUIDS

  • Oxygen/Acetylene bottles separated by 20 feet

  • Entity responsible for correction:

  • Capped and secured

  • Entity responsible for correction:

  • All gasses and liquids ID and stored properly

  • Entity responsible for correction:

  • Fire extinguishers within 25-75 feet of storage

  • Entity responsible for correction:

  • Fire extinguishers serviced/current inspections (Annually/Monthly)

  • Entity responsible for correction:

  • Flashback arrestors in use

  • Entity responsible for correction:

  • #5 shade lens for cutting torch operations

  • Entity responsible for correction:

SAFETY SUPPLIES & GEAR

  • Emergency stretcher and rigging

  • Entity responsible for correction:

  • Emergency blankets

  • Entity responsible for correction:

  • First-aid kits in good supply

  • Entity responsible for correction:

PAPERWORK

  • Injury and Illness Prevention Plan (IIPP)

  • Entity responsible for correction:

  • SDS available/JHAs files

  • Entity responsible for correction:

  • Evacuation plan

  • Entity responsible for correction:

  • Site Specific Safety Plan

  • Entity responsible for correction:

CONTAINMENT

  • Permits/secured

  • Entity responsible for correction:

  • Regular pick-up

  • Entity responsible for correction:

  • Fire extinguishers within 25-75 feet

  • Entity responsible for correction:

OTHER OBSERVED PRACTICES

  • Entity responsible for correction:

  • Entity responsible for correction:

  • Entity responsible for correction:

  • COMMENTS:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.