Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Site Administration & Conditions

  • Incident Investigation Kit

  • MSDS Kit Onsite

  • First Aid Kits Available and Stocked

  • Fire Extinguishers Available, Inspected and Up-to-date

  • Flammable Material Properly Stored

Personal Protective Equipment

  • Eye/Face Protection

  • Hand Protection

  • Head Protection

  • Hearing Protection

  • Footwear

Energized Work

  • Employees Trained

  • Permits Completed

  • High Voltage Gear Used and Up-to-date

Tools & Cords

  • Assured Grounding

  • Cord Conditions and Placement

  • Power/Hand Tool Condition

Electrical

  • Temporary Service

  • GFCI Testing and Documentation

  • Temporary Lighting

Fall Protection

  • Proper Fall Protection In Use

  • Fall Protection Condition and Inspections

  • Guardrails Adequate

Aerial Lifts

  • Inspections Complete

  • Work Area Protected

Ladders

  • Labels Legible

  • Proper Placement

  • Proper Use

Housekeeping

  • Material Stored Properly

  • Walkways Clear

  • Holes >2" Covered, Secured

  • Slip, Trip, Fall Hazards

  • Proper Site Lighting

Equipment

  • Operators Trained

  • Inspections Completed

  • Proper Use

Lock Out / Tag Out

  • Locks and Devices Available

  • Proper Information on Locks/Tags

  • Proper Testing Performed

  • Group Lock Out In Use

Trenching & Excavating

  • Subcontractor In Use

  • Egress Available

  • Air Monitoring if needed

  • Collapse Protection In. Use

Confined Space

  • Employees Trained

  • Permits Filled Out

  • Monitor Available and Calibrated

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.