Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

Aerial/Boom Lifts

  • Workers tied off to boom or basket? (1926.453)

  • Operator(s) trained and/or authorized? (1926.453)

  • Both feet on floor of basket when not tied off? (1926.453)

  • Boom/basket load limits not exceeded? (1926.453)

  • Aerial lift stationary when elevated? (1926.453)

  • Aerial lift controls clearly marked/identified? (1926.453)

  • Aerial lifts inspected daily/prior to use? (1926.453)

  • Access gate/opening closed when working in lift? (ANSI/SIA A92.5)

  • Operated on level surface per equipment specs? (ANSI/SIA A92.5)

  • Outriggers (when available) utilized as needed? (ANSI/SIA A92.5)

  • Work platform kept reasonably clear of debris? (ANSI/SIA A92.5)

  • Good compliance/no safety violations? (1926.453)

  • Comments

Behaviors

  • Eyes on path/looks in direction of travel?

  • Looks back when stepping backwards?

  • Pushes instead of pulls when possible?

  • Avoids overhead work when possible?

  • Lifts with legs not back when possible?

  • Forms a bridge with free hand when lifting?

  • Does not lift more than one can lift safely?

  • Keeps load close to body when lifting?

  • Uses lift assist device for heavy loads?

  • Avoids lifting unstable loads?

  • Does not subject coworker(s) to injury?

  • Works at safe pace/not rushed?

  • Comments:

Concrete/Masonry

  • Rebar guarded to eliminate impalement hazard? (1926.701)

  • Workers avoid working under buckets? (1926.701)

  • Troweling machines equipped with auto shut-off? (1926.702)

  • Handles on concrete buggy within wheel width? (1926.702)

  • Connectors used to secure pressurized air hoses? (1926.702)

  • Safety latches prevent accidental dumping of buckets? (1926.702)

  • Bull float handles nonconductive or insulated? (1926.702)

  • Masonry saw blades guarded? (1926.702)

  • Formwork capable of supporting vertical/lateral loads? (1926.703)

  • Shoring equipment inspected? (1926.703)

  • Base plates secured to foundation/formwork? (1926.703)

  • Jacks/supports do not exceed rated capacity? (1926.703)

  • Rebar adequately supported to prevent collapse? (1926.703)

  • Precast supported until permanent connections made? (1926.704)

  • Lifting inserts on tilt-up precast support 2x max. load? (1926.704)

  • Lifting inserts on precast (non-tilt-up) support 4x max. load? (1926.704)

  • Lifting hardware able to support 5x max. load? (1926.704)

  • Only erectors allowed under precast when lifted/tilted (1926.704)

  • Jacking synchronized to ensure level/uniform lifting? (1926.705)

  • Maximum jacks per slab does not exceed 14? (1926.705)

  • Temporary connections secured by tack welding? (1926.705)

  • Limited access zone equal to wall height plus 4 feet? (1926.706)

  • Limited access zone strictly enforced? (1926.706)

  • Walls over 8 feet braced to prevent collapse? (1926.706)

  • Good compliance/no safety violations? (Subpart Q)

  • Comments

Confined Space

  • Survey completed to identify hazards of PRCS? (ANSI Z117.1 Sec. 3)

  • Permit completed and signed for all PRCS entries? (ANSI Z117.1 Sec. 5)

  • Proper atmospheric testing in place? (ANSI Z117.1 Sec. 6)

  • Attendant on duty outside the permit space? (ANSI Z117.1 Sec. 7)

  • Attendant(s)/entrant(s) in constant communication? (ANSI Z117.1 Sec. 7)

  • Hazardous energy sources isolated/locked out? (ANSI Z117.1 Sec. 8)

  • Ventilation provided as required? (ANSI Z117.1 Sec. 9)

  • Proper PPE worn during entry as required? (ANSI Z117.1 Sec. 11)

  • Appropriate retrieval equipment in use? (ANSI Z117.1 Sec. 12)

  • Barricades provided at entrance as needed? (ANSI Z117.1 Sec. 12)

  • Signage placed at entrance of PRCS as required? (ANSI Z117.1 Sec. 13)

  • Emergency response plan developed/in place? (ANSI Z117.1 Sec. 14)

  • Personnel trained and documented? (ANSI Z117.1 Sec. 15 and 1926.21)

  • Good compliance/no safety violations? (ANSI Z117.1)

  • Comments:

Cranes/Rigging

  • Crane inspected/operated per manufacturer requirements? (1926.1417)

  • Workers kept clear of suspended loads? (1926.1425)

  • Ground conditions adequate to support crane? (1926.1402)

  • Power line safety requirements followed? (1926.1407-.1411)

  • Radius guard installed on crane? (1926.1424)

  • Crane load capacities/operator manual in cab? (1926.1417)

  • Hand signal chart available? (1926.1422)

  • Fire extinguisher located in cab? (1926.1433)

  • Rigging equipment inspected/good condition? (1926.251)

  • Lift capacities marked on rigging equipment? (1926.251)

  • Crane operator(s) meet certification requirements? (1926.1427)

  • Only qualified riggers allowed to rig loads? (1926.1425)

  • Signal person(s) trained, qualified and authorized? (1926.1428)

  • Adequate communication between signal person & operator? (1916.1419)

  • Anti two-blocking device inspected/functional? (1926.1416)

  • Good compliance/no safety violations? (Subpart CC)

  • Comments:

Demolition

  • Engineering survey completed, available for review? (1926.850)

  • Structure shored/braced if damaged by fire/flood/etc.? (1926.850)

  • Utilities shut off or controlled outside the building? (1926.850)

  • Glass fragmentation hazards removed? (1926.850)

  • Wall openings protected to height of 42 inches? (1926.850)

  • Debris landing area (w/o chutes) barricaded 6 ft. back? (1926.850)

  • Warning signs for falling material posted each level? (1926.850)

  • Non-debris floor openings properly guarded? (1926.850)

  • Entrances guarded 8 ft. out on multi-story building? (1926.850)

  • Stairs/passageways/ladders in clean & safe condition? (1926.851)

  • Debris landing area outside building protected? (1926.852)

  • Chute openings closed when not in use? (1926.852)

  • Chute openings do not exceed 48 in. in height? (1926.852)

  • Chute openings protected by guardrail? (1926.852)

  • Gate installed at chute discharge and monitored? (1926.852)

  • Discharge chute closed off when operations cease? (1926.852)

  • Space between chute and structure covered? (1926.852)

  • Bumper 4 in. thick/6 in. high at chute opening? (1926.852)

  • Floor openings curbed when equipment in use? (1926.856)

  • Periodic inspections made by competent person? (1926.859)

  • Good compliance/no safety violations? (Subpart T)

Electrical Safety

  • Equipment installed/used as listed or labeled? (1926.403)

  • Extension cords have ground pin? (1926.404)

  • GFCI used for temporary power connections? (1926.404)

  • Extension cords not worn/frayed? (1926.416)

  • Light bulbs protected from accidental breakage? (1926.405)

  • All sockets in temporary lighting have bulbs? (1926.416)

  • Temporary lights not suspended by electric cords? (1926.405)

  • Breakers/switches legibly marked to indicate purpose? (1926.403)

  • Cords protected/kept clear of work areas or walkways? (1926.416)

  • Employees avoid working near unprotected energized circuits? (1926.416)

  • Deenergized circuits locked or tagged out? (1926.417)

  • Signs posted restricting access to locations w/exposed live parts? (1926.403)

  • Electrical panels/circuits effectively enclosed? (1926.405)

  • Proper clearance (3 feet) maintained in front of panels? (1926.403)

  • Conductors entering boxes/cabinets protected from abrasion? (1926.405)

  • Good compliance/no safety violations? (Subpart K)

  • Comment

Exits/Egress

  • Exits available and free of obstructions? (1926.34)

  • Exits and access to exits marked with signs? (1926.34)

  • Comment

Fall Protection

  • Fall protection provided when working above 6 feet? (1926.501)

  • Steps taken to prevent falling object hazards? (1926.501)

  • Covers/barricades prevent workers from falling through holes? (1926.501)

  • Guardrails installed/maintained in good condition? (1926.502)

  • Top and mid-rail in place and at proper height? (1926.502)

  • Guardrails able to withstand 200 lb. force? (1926.502)

  • Toeboards erected to prevent falling objects? (1926.502)

  • Guardrail posts not more than 8 feet OC? (Subpart M App. B)

  • Harnesses maintained in good condition? (1926.502)

  • Harnesses worn/fitted properly? (1926.503)

  • Lanyards in good condition/no defects? (1926.502)

  • Suitable anchorage provided for fall arrest system? (1926.502)

  • PFA used/worker connected as required? (1926.501)

  • PFA rigged to prevent contact with lower surface? (1926.502)

  • PFA rigged to limit free fall to no more than 6 ft? (1926.502)

  • PFA not attached to guardrail system? (1926.502)

  • Safety monitor used when fall arrest/restraint not utilized? (1926.501/.502)

  • Safety monitor performs only monitoring duties? (1926.502)

  • Safety monitor same surface with visual/oral contact? (1926.502)

  • Floor hole covers secured, substantial, marked? (1926.502)

  • Warning line 6 feet back for roofing activities? (1926.502)

  • Warning line 15 ft. back for non-roofing activities? (OSHA Interp Letter)

  • Warning line erected on unprotected roof edge? (1926.502)

  • Warning line flagged and suspended at proper height? (1926.502)

  • Hoisting area adequately guarded? (1926.502)

  • Workers trained on recognizing/minimizing fall hazards? (1926.503)

  • Fall Protection training certified/documented? (1926.503)

  • Good compliance/no safety violations? (Subpart M)

  • Comment

Fire Safety

  • Fire extinguishers in good condition/fully charged? (1926.150)

  • Fire extinguishers inspected annually? (1926.150)

  • Travel distance to fire extinguisher within 100 feet? (1926.150)

  • Fire extinguisher within 50 ft. of flammables? (1926.150)

  • Minimum one fire extinguisher per floor? (1926.150)

  • Approved/UL listed fire extinguishers provided? (1926.150)

  • Fire extinguishers conspicuously located? (1926.150)

  • Flammables stored in approved/closed containers? (1926.152)

  • Smoking prohibited where fire hazard exists? (1926.151)

  • Scrap piles no closer than 10 ft. from buildings? (1926.151)

  • Flammable liquids protected from ignition sources? (1926.152)

  • Flammable not stored near emergency pathways? (1926.152)

  • Fire extinguisher kept near gas powered equipment? (Best Practice)

  • Good compliance/no safety violations? (Subpart F)

  • Comment

Forklifts

  • Forklifts inspected daily? (1910.178)

  • Forklifts free of known defects/damage? (1910.178)

  • Forklift operators trained/certified? (1910.178)

  • Forklift operators evaluated every 3 years? (1910.178)

  • No modifications affecting lift capacity? (1910.178)

  • Forks lowered when truck is unattended? (1910.178)

  • Nameplate/markings in place and legible? (1910.178)

  • Seatbelts worn on sit down rider trucks? (1910.132)

  • Comment

Fueling Operations

  • Dispensing unit protected against vehicle damage? (1926.152)

  • No Smoking signs in fuel dispensing area? (1926.152)

  • Motors shut off during fueling operation? (1926.152)

  • Fire extinguisher within 75 ft of fueling area? (1926.152)

  • Fueling area free of combustibles? (1926.151)

  • Tank(s) secured during off-work hours? (Best Practice)

  • Dispensing nozzle automatic-closing type? (1926.152)

  • Fuel tanks properly labeled? (NFPA 30)

  • Spill control means/method provided? (1926.152)

  • Good compliance/no safety violations? (1926.152)

  • Comment

Hazard Communication

  • SDS for hazardous chemicals readily available? (1910.1200)

  • Hazardous chemicals properly labeled? (1910.1200)

  • Chemical inventory list maintained? (1910.1200)

  • Training completed/workers demonstrate competency? (1910.1200)

  • GHS training completed by Dec. 1, 2013? (1910.1200)

  • Good compliance/no safety violations? (1910.1200)

  • Comments

Health

  • Noise exposures monitored/controlled? (1926.52)

  • Asbestos exposures monitored/controlled? (1926.1101)

  • CO exposures monitored/controlled? (1926.55)

  • Lead exposures monitored/controlled? (1926.62)

  • Silica exposures monitored/controlled? (1926.55)

  • Welding fume exposures monitored/controlled? (1926.353)

  • Extreme heat exposures monitored/controlled? (5a1)

  • Extreme cold exposures monitored/controlled? (5a1)

  • Comments

Housekeeping

  • Worksite reasonably organized/good housekeeping? (1926.25)

  • Combustible scrap/debris removed at regular intervals? (1926.25)

  • Job trailer clean and reasonably organized? (Best Practice)

  • Material staging area kept reasonably organized? (1926.25)

  • Containers used for oily/flammable waste covered? (1926.25)

  • Gang box(es) reasonably clean and organized? (Best Practice)

  • Garbage disposed of at frequent/regular intervals? (1926.25)

  • Loose scrap/light materials susceptible to wind secured? (5A1)

  • Good compliance/no safety violations? (1926.25)

  • No protruding nails on unused lumber? (1926.25)

Comments

Ladders/Stairs

  • Ladders inspected/no visible defects? (1926.1053)

  • Side rails extend 3 feet above landing surface? (1926.1053)

  • Ladders set up at 4:1 angle? (1926.1053)

  • Ladders set up on stable/level surface? (1926.1053)

  • Side rails secured (as needed) to prevent side slip? (1926.1053)

  • Base of ladder secured when conditions warrant? (1926.1053)

  • Ladders used for intended purpose? (1926.1053)

  • Stairs/ladder/ramp at elevation break of 19+ inches? (1926.1051)

  • Handrails on stairs with 4 or more risers? (1926.1052)

  • Spreaders fully engaged on stepladders? (1926.1053)

  • Top 2 steps of stepladder not used? (1926.1053)

  • Area at top and bottom of ladder kept clear? (1926.1053)

  • At least one hand free to grasp ladder? (1926.1053)

  • Treads/landings on pan stairways filled? (1926.1052)

  • Good compliance/no safety violations? (Subpart X)

  • Comments

Mechanized Equipment

  • Equipment in good condition/no obvious defects? (1926.601)

  • Seat belts provided on equipment with ROPs? (1926.602)

  • Seat belts worn on equipment with ROPs? (1926.28)

  • Parking brake set when equipment is parked? (1926.600)

  • Wheels chocked when parked on incline? (1926.600)

  • Bidirectional machines equipped with functional horn? (1926.602)

  • Reverse alarm and/or spotter when backing? (1926.601-602)

  • No passengers allowed on single-operator equipment? (1926.601)

  • Windshields in good condition/no cracks? (1926.601)

  • Personnel platform secured to carriage/forks? (1926.602)

  • Personnel on raised platform have access to operating controls? (1926.602)

  • Beacon light activated on equipment when conditions warrant? (Best Practice)

  • Slow Moving Vehicle placard when operating in traffic? (MUTCD)

  • Blades/buckets/dump bodies lowered or blocked when not in use? (1926.600)

  • Operator(s) competent/familiar with equipment controls? (1926.20)

  • Equipment/attachments at safe distance from energized power lines? (1926.602)

  • Good compliance/no safety violations? (Subpart O)

  • Comments

Medical/FA Services

  • First aid supplies easily accessible when required? (1926.50)

  • First aid supplies refilled/maintained? (1926.50)

  • Certified FA provider available at remote worksites? (1926.50)

  • Emergency numbers posted when 911 service unavailable? (1926.50)

  • Location of nearest medical facilities known/posted? (1926.50)

  • Eye/body flushing facilities available when needed? (1926.50)

  • Eye wash station(s) properly maintained? (ANSI Z358.1)

  • Good compliance/no safety violations? (1926.50)

Comments

Personal Protective Equipment

  • PPE provided/used as required? (1926.95)

  • PPE maintained in good condition? (1926.95)

  • Replacement PPE readily available? (Best Practice)

  • Eye protection used as required? (1926.102)

  • Hard hats worn as required? (1926.100)

  • Hand protection worn when needed? (1926.28)

  • Safety footwear worn as needed? (1926.28)

  • Respirators provided/used as required? (1926.103/1910.134)

  • Workers reviewed App D/voluntary dust mask use? (1910.134)

  • Hearing protection used as required? (1926.52)

  • High-visibility clothing worn as required? (1926.28)

  • Face protection used when required? (1926.102)

  • PFD worn when working over/near water? (1926.106)

  • Good compliance/no safety violations? (Subpart E)

  • Comments

Postings/Safety Signs

  • OSHA Workplace Poster displayed? (1903.2)

  • Emergency numbers/contacts posted? (Best Practice)

  • OSHA 300 Summary posted Feb. 1st to Apr. 30th? (1904.32)

  • Danger/caution signs posted as needed? (1926.200)

  • Warning signs around perimeter of worksite? (Best Practice)

  • Good compliance/no safety violations?

  • Comments

Public Protection

  • Public warned of potential for sudden/loud impact noises? (3.2.1.1)

  • Public exposure to airborne contaminants (dust/fumes/smoke) controlled? (3.2.2)

  • Construction operations near pedestrian/vehicular traffic controlled? (3.2.3)

  • Where pedestrian areas are closed, suitable and safe alternatives provided?<br>(3.2.4.1)

  • Lighting (including welding flash) directed/shielded to minimize impact on public?<br>(3.2.5)

  • Radiation exposure hazards controlled and shielded to protect public? (3.2.6)

  • Areas where public is exposed to mobile equipment are barricaded/guarded? (3.2.7.2)

  • Barriers, enclosures, netting used to protect public from falling/wind-borne objects? (3.2.8)

  • Measures taken to restrict public access to jobsite? (3.2.9)

  • Measures taken to restrict public access to hazardous equipment/supplies? (3.2.9.1)

  • Operations generating waste/debris controlled to minimize exposure to adjacent areas? (3.2.10)

  • Controls in place where water run-off may pose a pollution hazard? (3.2.10.2)

  • Utilities located and marked prior to start of construction? (3.2.11)

  • Hazardous materials stored away from public in approved/labeled containers or structures? (3.2.12)

  • Hazards associated with vibrations (pile driving, blasting, etc.) analyzed? (3.2.14)

  • When blasting occurs, an audible warning signal is established to warn public? (3.2.14.3)

  • Excavations/trenches in public areas backfilled as soon as practicable? (3.2.14.5)

  • Personnel trained on action to take if emergency arises affecting public? [3.3.1]

  • Comments

Safety Training

  • Toolbox talks completed daily? (1926.21)

  • Toolbox talks completed weekly? (1926.21)

  • Toolbox talks documented? (Best Practice)

  • Equipment/machine operator training documented? (Best Practice)

  • Job-specific safety training provided/documented? (OSHA Pub. 2254)

  • Safety Orientation Training provided? (OSHA Pub 2254)

  • Good compliance/no safety violations? (1926.20-.21)

  • Comments

Sanitation

  • Adequate supply of potable water provided? (1926.51)

  • Common drinking cup prohibited? (1926.51)

  • Non-potable water outlets clearly marked? (1926.51)

  • 1 toilet per 20 workers when fewer than 20 at jobsite? (1926.51)

  • 1 toilet/urinal per 40 workers when more than 20 at jobsite? (1926.51)

  • 1 toilet/urinal per 50 workers when more than 200 at jobsite? (1926.51)

  • Port-a-Johns kept in clean and sanitary condition? (Best Practice)

  • Washing facilities for employees exposed to harmful contaminants? (1926.51)

  • Washing facilities maintained in a sanitary condition? (1926.51)

  • Food/beverage consumption prohibited in toxic/hazardous areas? (1926.51)

  • Good compliance/no safety violations? (1926.51)

  • Comments

Scaffolds (Rolling/Baker)

  • Scaffolds inspected/free of defects? (1926.451)

  • Working platforms fully planked/decked? (1926.451)

  • Platform clean/free of excessive debris? (1926.451)

  • Fall protection provided above 10 feet? (1926.451)

  • Scaffolds and components do not exceed rated capacities? (1926.451)

  • Employee remains within wheels/supports of scaffold? (1926.452)

  • Scaffold bracing is secured, squared, aligned? (1926.452)

  • Wheel/caster brakes operable and set as required? (1926.452)

  • Caster/wheel stems pinned/secured to scaffold legs? (1926.452)

  • Employee only rides scaffold if surface is level/no obstructions? (1926.452)

  • Outriggers used when platform extends beyond supports? (1926.452)

  • Outriggers (if required) properly installed? (1926.452)

  • Workers trained on use of scaffolds? (1926.454)

  • 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.