Shirley Contracting

• Audit Title

• Job Site

• Job Number

• Conducted on

  Date

• Prepared by

• Personnel

Job Site Information

• Workers Comp poster posted?

  Yes

  No

  N/A

• SDS located on site?

  Yes

  No

  N/A

• Did crews go over SPA for scheduled work activity?

  Yes

  No

  N/A

1. Personal Protective Equipment.

• Safety Glasses?

  Yes

  No

  N/A

• Hard Hat?

  Yes

  No

  N/A

• Class 3 Vest?

  Yes

  No

  N/A

• Safety Toe Boots?

  Yes

  No

  N/A

2. Fall Protection

• Fall protection equipment is appropriate for working height?

  Yes

  No

  N/A

• Guard rail system is sturdy and in working condition?

  Yes

  No

  N/A

3. Mechanized Equipment and Vehicle Operation

• Seatbelts worn during operation of equipment?

  Yes

  No

  N/A

• Back up alarms operable?

  Yes

  No

  N/A

• Signal person used when necessary?

  Yes

  No

  N/A

4. Material Handling

• Team lifting used for awkward or heavy loads?

  Yes

  No

  N/A

• Clear path present for travels?

  Yes

  No

  N/A

• Equipment used when necessary?

  Yes

  No

  N/A

5. Housekeeping and Walking/Working Surfaces

• Work area free of trash and debris?

  Yes

  No

  N/A

• All exposed rebar capped?

  Yes

  No

  N/A

• Clear access and egress?

  Yes

  No

  N/A

• Are holes and openings covered properly?

  Yes

  No

  N/A

6. Stairways and Ladders

• Ladder extends at least 3 feet above landing?

  Yes

  No

  N/A

• Proper ladder used for job task?

  Yes

  No

  N/A

• Ladder at proper angle? 4:1

  Yes

  No

  N/A

• Ladder free from any damage? (Rungs, side rails)

  Yes

  No

  N/A

• Clear landing for ladder and stairway access/egress?

  Yes

  No

  N/A

• Ladder tied off to prevent from tipping or sliding?

  Yes

  No

  N/A

7. Trenching and Excavation

• Proper access and egress 4 feet in depth?

  Yes

  No

  N/A

• Proper sloping, benching and shoring used when 5 feet in depth for soil condition?

  Yes

  No

  N/A

• Spoil piles at least 2 feet from trench or excavation?

  Yes

  No

  N/A

8. Utilities

• Utility ticket located on site? (Hardcopy/Electronically)

  Yes

  No

• Utility ticket expiration date

• Clear Markings present?

  Yes

  No

  N/A

• Did crew test pit before excavation?

  Yes

  No

  N/A

• Overhead utilities signs present near work operation?

  Yes

  No

  N/A

• Work is not within 10 ft. overhead lines?

  Yes

  No

  N/A

9. Electrical Hazards

• Temporary power cords in working condition?

  Yes

  No

  N/A

• Power tools double insulated and working condition?

  Yes

  No

  N/A

• Generators grounded and GFCI protected?

  Yes

  No

  N/A

10. Temporary Traffic Control

• Are flaggers used and in proper location?

  Yes

  No

  N/A

• Channelizing devices in working condition?

  Yes

  No

  N/A

• Advance warning signs legible and visible?

  Yes

  No

  N/A

• Barrier and attenuators working condition and not impacted?

  Yes

  No

  N/A

11. Confined Space

• Is confined space permit or non permit?

  Non-Permit

  Permit

• Was air monitor used for atmospheric testing?

  Yes

  No

  N/A

• Is proper personnel used?

  Yes

  No

  N/A

• Is retrieval equipment used correctly?

  Yes

  No

  N/A

• Is proper ventilation used for confined spaces?

  Yes

  No

  N/A

• Was there a pre-entry meeting for duties of operation and personnel responsibility?

  Yes

  No

  N/A

12. Hand and Power Tools

• Is the proper tool used for the job?

  Yes

  No

  N/A

• OSHA Valve located on air compressor?

  Yes

  No

  N/A

• Tool is free of any damage or deficiency?

  Yes

  No

  N/A

• Are guards and shields used with work operation?

  Yes

  No

  N/A

13. Cranes and Hoisting Equipment

• Are outriggers fully extended with proper matting?

  Yes

  No

  N/A

• Are overhead hazards identified and out of working distance?

  Yes

  No

  N/A

• Swing barricade properly roped off along crane?

  Yes

  No

  N/A

• Is there proper communication between operator and signal person?

  Yes

  No

  N/A

14. Rigging Equipment

• Is proper rigging used for operation?

  Yes

  No

  N/A

• Rigging is in working condition free of defects

  Yes

  No

  N/A

• Proper angle used for load hoisted?

  Yes

  No

  N/A

15. Fire Protection

• Fire extinguishers inspected within past year with tag?

  Yes

  No

  N/A

• Fire extinguisher located near flammable storage area?

  Yes

  No

  N/A

• Are gas tanks properly stored upright?

  Yes

  No

  N/A

16. Job Site Security

• Is job trailer properly locked overnight?

  Yes

  No

  N/A

17. Pedestrian Protection

• Are walkways safe and clear of any trip hazards?

  Yes

  No

  N/A

• Proper signs used for pedestrian traffic?

  Yes

  No

  N/A

18. Scaffolding and Aerial Lifts

• Adequate stability and ground conditions?

  Yes

  No

  N/A

• Are fall hazards addressed with proper protection used?

  Yes

  No

  N/A

19. Sanitation and Health

• Are toilet facilities and handwashing located on site?

  Yes

  No

  N/A

20. Emergency Procedures

• Is 1st aid kit present on site?

  Yes

  No

  N/A

• Trained CPR and 1st Aid employee present?

  Yes

  No

  N/A

21. Subcontractors (Name, Trade, Hazards)

22. Environmental

• Construction entrances are installed and maintained?

  Yes

  No

  N/A

• Spill kit located on site and stocked?

  Yes

  No

  N/A

• Silt fence is properly installed and maintained?

  Yes

  No

  N/A

• Sediment bag is used properly and effectively?

  Yes

  No

  N/A

• Inlet protections are maintained and used accordingly?

  Yes

  No

  N/A

• Concrete washout pit has a sign and maintained?

  Yes

  No

  N/A

• Notes/Suggestions

• Signature

  Sign

• Signature

  Sign