SMART SAFETY GROUP: Safety Audit

• Date

  Date

• Company

• Job Name / Job #

• Controlling Contractor/Site Manager

• Manager

• Admin

• Prepared by

• Location
  Address

• 
  INSTRUCTIONS:
  -------------------------------------
  
  1. Answer "Pass", "Improvement Needed", "N/A" for the questions below.
  2. Fill out required fields and answer other questions as needed.
  3. Add photos and notes/comments by clicking on the paperclip icon.
  4. To add a Corrective Measure for items answered with "Improvement Needed", click on the paperclip icon then click on "Add Action". Provide the problem description and solution needed, assign to a member, set priority and then set the due date.
  5. Complete audit by providing a digital signature.
  6. Share your report by exporting as PDF, Word, Excel or Web Link.
  
  
  

PROBLEM IDENTIFICATION

Field Conditions

• Access

  Pass

  Improvement Needed

  N/A

• Air Quality

  Pass

  Improvement Needed

  N/A

• Electrical

  Pass

  Improvement Needed

  N/A

• Equipment

  Pass

  Improvement Needed

  N/A

• Excavation

  Pass

  Improvement Needed

  N/A

• Fall Protection

  Pass

  Improvement Needed

  N/A

• Hand / Power Tools

  Pass

  Improvement Needed

  N/A

• Housekeeping

  Pass

  Improvement Needed

  N/A

• Ladders

  Pass

  Improvement Needed

  N/A

• Lighting

  Pass

  Improvement Needed

  N/A

• Personal Protective Equipment

  Pass

  Improvement Needed

  N/A

• Scaffolding

  Pass

  Improvement Needed

  N/A

• Temperature/Water/Shade

  Pass

  Improvement Needed

  N/A

Management Activities

• First-Aid Kit

  Pass

  Improvement Needed

  N/A

• First-aid Personnel

  Pass

  Improvement Needed

  N/A

• Safety Program Available

  Pass

  Improvement Needed

  N/A

• OSHA Log 300

  Pass

  Improvement Needed

  N/A

• Medical Clinic map(s) available

  Pass

  Improvement Needed

  N/A

• Emergency numbers posted/known

  Pass

  Improvement Needed

  N/A

• Cal/OSHA postings/permit

  Pass

  Improvement Needed

  N/A

• Weekly Safety Meetings

  Pass

  Improvement Needed

  N/A

• Jobsite Inspections

  Pass

  Improvement Needed

  N/A

• Fire Protection

  Pass

  Improvement Needed

  N/A

• Sanitary Facilities

  Pass

  Improvement Needed

  N/A

• Safety Supplies

  Pass

  Improvement Needed

  N/A

• Other

  Pass

  Improvement Needed

  N/A

COMPLETION

• Auditor's Name and Signature

  Sign

• Supervisor's Name and Signature

  Sign