Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

1. General

  • 1.1 Did company representative accompany inspector?

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

  • 1.3 Are OSHA posters/emergency numbers posted?

  • 1.4 Are Fall Protection Plans in place?

  • 1.5 Are safety meetings held/documented?

  • 1.6 Are first aid kits available & properly stocked?

  • 1.7 Are fire extinguishers available/charged/inspected?

  • 1.8 Is the terrain safe for normal walking?

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

  • 1.10 Is material storage proper?

  • 1.11 Is housekeeping and sanitation proper & enforced?

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

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

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

2. Equipment

  • 2.1 Are the board carts free from damage?

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

  • 2.3 Is all equipment properly maintained & inspected?

  • 2.4 Do backup alarms work?

  • 2.6 Are seatbelts operative & used?

  • 2.8 Are forks on the ground when parked?

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

3. Personal Protective Equipment

  • 3.1 Proper eye protection in use?

  • 3.2 Is respiratory protection proper? Fit testing done?

  • 3.3 Is hearing protection used & proper?

  • 3.4 Is proper foot protection worn?

  • 3.5 Is proper head protection worn?

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

  • 3.8 Is PPE hazard assessment complete & on file?

4. Electrical

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

  • 4.2 Is temporary lighting used & proper?

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

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

  • 4.5 Are temporary cords properly used & maintained?

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

  • 4.7 Other

5. Fall Protection

  • 5.1 Are fall protection plans required & in place?

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

  • 5.3 Is fall protection equipment inspected & maintained?

  • 5.4 Are stairways properly protected & used?

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

  • 5.6 Are all floors holes properly covered or protected?

Perry Scaffold (mobile scaffold)

  • 6.1 Are all users trained for use?

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

  • 6.3 Is the board tied down?

  • 6.4 Are the wheels locked during use?

  • 6.5 Are the guard rails in use properly?

  • 6.6 Other?

7. Scaffolding

  • 7.1 Is scaffold competent person on site?

  • 7.2 Are all scaffold users properly trained?

  • 7.3 Are scaffold erection/disassembly procedures proper?

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

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

  • 7.6 Are guardrails properly installed & used?

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

  • 7.7 Is scaffold access proper?

  • 7.8 Is the limited access zone set & enforced?

  • 7.9 Other

9. Summary

  • The overall rating for this audit is?

  • Comments

  • Supervisor signature

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