Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
1. Support Systems
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1.2 Is system counterweighted properly (4xLxR/B) and mechanically attached to beam?
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1.3 Are counterweights non-flowable material?
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1.4 All hardware in place and secure?
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1.5 Are roof rigs tied back to a substantial structure (4:1 safety factor)?
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1.6 Is the spacing of suspension points equal to hoist spacing?
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1.7 Is the roof rig loads on jacks, not casters?
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1.8 Is the maximum reach for beam not exceeded?
2. Cornice Hooks
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2.1 Are the hooks tied back to a substantial structure (4:1 safety factor)?
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2.2 Are the hooks on bearing blocks?
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2.3 Is the parapet wall structurally sound ( non-masonry)?
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2.4 Is the spacing of the hooks equal to hoist spacing?
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2.5 Is the load capacity decal legible?
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2.6 Is the hook capacity equal to or greater than hoist rated working load?
3. Parapet Clamps
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3.1 Are clamps tied back to a substantial structure (4:1 safety factor)?
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3.2 Are clamps securely attached to parapet wall?
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3.4 Is spacing of clamps equal to hoist spacing?
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3.5 Is load capacity decal ledgible?
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3.6 Is parapet clamp capacity equal to or greater than hoist rated working load?
4. Suspension Wire Rope and Hardware
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4.1 Is wire rope long enough to reach the bottom of the drop plus 4 feet of traction hoist for 4 turns on the drum?
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4.2 Is wire rope free of damage or defects?
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4.3 Is wire rope correct size, length, and construction for hoist (6:1 safety factor)?
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4.4 Is wire rope terminated with properly sized thimble?
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4.5 Is wire rope terminated with properly rated shackle?
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4.6 Is tip of wire rope properly brazed (no visible damage)?
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4.7 Are there any deformities in the swaged eye?
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4.8 Are there any fractures in the swage button?
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4.9 If used, are the fist grips properly torqued?
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4.10 Are fist grips properly spaced?
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4.11 Is the wire rope rigged with the correct number of fist grips?
5. Welding Protection
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5.1 Is wire rope protected 4' above hoist?
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5.2 Is wire rope protected below hoist past platform level?
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5.3 Is wire rope protected with insulated thimble?
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5.4 Is tail of wire rope protected with insulating material?
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5.5 Is platform to ground lead provided?
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5.6 Is insulating cover protecting hoist and overspeed brake in place?
6. Platforms
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6.1 Is platform in good condition and free from damage or defects?
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6.2 Is platform assembled per manufacturers instructions?
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6.3 Is load capacity decal installed and legible? <br>
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6.4 Is platform self weight listed on decal?
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6.5 Does actual working load exceed capacity of platform?
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6.6 Is top rail, mid-rail, and toe-board installed on all open sides?
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6.7 Verify that platform self weight plus working load does not exceed hoist capacities?
7. Hoist
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7.1 Hoist stirrup and platform connections properly secured with correct grade bolts, thread locking nuts, or cotter pins?
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7.2 Verify proper operation of hoist
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7.3 Verify proper operation of overspeed brake
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7.4 Is hoist rated working load listed?
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7.5 Verify that combined hoist capacity exceeds platform weight plus actual load
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7.6 Verify that combined hoist is in good condition, free of damage and defects
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7.8 Verify all warning and rating decals are in place and legible
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7.9 Is the operation manual attached to the hoist?
8. Electrical
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8.1 Is power supply adequate for the combined hoist loads (voltage and amperage)?
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8.2 Is each platform on dedicated circuit?
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8.3 Is circuit protected by circuit breaker?
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8.4 Are electrical connections in good condition?
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8.5 Is electrical cable free of damage or defects?
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8.6 Does power cord have strain relief at source and all connection points?
9. Fall Arrest
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3.3 Is parapet wall structurally sound?
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9.1 Verify that each anchorage point is independent
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9.2 Anchorage points meet 5,000 pound strength requirement
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9.3 Is anchorage directly above worker?
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9.4 Is lifeline in good condition, protected at each chaffing point, and reaches the lowest level?
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9.5 Is rope grab compatible with diameter and type off lifeline?
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9.6 Is rope grab arrow facing up?
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9.7 Is rope grab in good condition free of damage or defects?
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9.8 Is shock absorbing lanyard in good condition free of damage or defects?
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9.9 Is full body harness in good condition free of damage and defects?
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9.10 Is full body harness adjusted properly to fit worker?
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9.11 Is lanyard attached to "D" ring in back of harness, between shoulder blades (not to side or front of "D" rings)?
Corrective Actions
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List all corrective actions taken or to be taken by item number ( i.e. 1.1, 1.2, 1.3....)
Foreman
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Foreman Signature
Sign Off
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Auditor Signature
General Foreman
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General Foreman Name
