SPC Responsive Audit Version 3

• Job Number

• Audit Title

• Client

• Conducted On

  Date

• Prepared by

• Select date

  Date
Audit Team

Job Site Location

• Contract code

Personal Protection

• Hearing Protection

  Yes

  No

  N/A

• Eyes protection

  Yes

  No

  N/A

• Respiratory

  Fully Compliant

  Partial Compliance

  Non Compliance

• Hands and Arms

  Fully Compliant

  Partial Compliance

  Non Compliance

• Feet protection

  Yes

  No

  N/A

• PPE Storage / Care

  Fully Compliant

  Partial Compliance

  Non Compliance

House Keeping

• Standards Established

  Excellent

  OK

  Bad

• Walkway Obstructions

  Excellent

  OK

  Bad

• Standards Understood

  Excellent

  OK

  Bad

• All Safety Equipment Free from Obstruction?

  Yes

  No

  N/A

• Company Vehicle clean and tidy inside and out

  Excellent

  OK

  Bad

Tool and Equipment

• Right for the job?

  Yes

  No

  N/A

• Used correctly?

  Yes

  No

  N/A

• In safe condition?

  Yes

  No

  N/A

• Are barriers and signage used

  Yes

  No

  N/A

• Working at height equipment correct and adequate for the Job

  Yes

  No

  N/A

Procedures

• Adequate procedures

  Yes

  No

  N/A

• Procedures being followed?

  Yes

  No

  N/A

• Proper storage of all materials?

  Yes

  No

  N/A

Observations (positive and negative)

Observations

Comments

• Add drawing

  Drawing

• Add media

  Media

Signatures

• Audit Team Leader

  Sign

• Audit Team Member

  Sign

IA-04-36