Summit Utilities Site Assessment

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Previous Assessment

• Has the previous Assessment been reviewed?

  Yes

  No

  N/A

• Were all issues resolved?

  Yes

  No

  N/A

• What issues were left unresolved?

OSHA Posters

• Are Posters Current and readily available to employees?

  Yes

  No

  N/A

• Are Company information posters displayed?

  Yes

  No

  N/A

MSDS

• MSDS available and accessible ?

  Yes

  No

  N/A

Safety meetings

• Are weekly safety meetings recorded?

  Yes

  No

  N/A

First aid

• First aid kits properly supplied

  Yes

  No

  N/A

• Eye wash station available

  Yes

  No

  N/A

General housekeeping

• Illumination

  Yes

  No

  N/A

• Housekeeping

  Yes

  No

  N/A

• Sanitation

  Yes

  No

  N/A

Electrical

• Have electrical cords been inspected?

  Yes

  No

  N/A

• Have GFCI's been tested?

  Yes

  No

  N/A

• Electrical panels have proper clearance ?

  Yes

  No

  N/A

• Electrical panels circuits marked?

  Yes

  No

  N/A

• Outlets and covers I good order?

  Yes

  No

  N/A

Tools-Hand and Power

• Are all tools maintained in a safe condition

  Yes

  No

  N/A

• Are guards in place on tools

  Yes

  No

  N/A

• Hand tools in good condition

  Yes

  No

  N/A

• Electric tools double insulated or grounded?

  Yes

  No

  N/A

• Pneumatic power tools in compliance?

  Yes

  No

  N/A

• Powder actuated tools compliant?

  Yes

  No

  N/A

• Abrasive wheels and tools compliant?

  Yes

  No

  N/A

Gas welding and cutting.

• Are cylinders stored properly?

  Yes

  No

  N/A

• Is equipment properly maintained?

  Yes

  No

  N/A

• LP bottles stored properly?

  Yes

  No

  N/A

Personal Protective Equipment

• Hard Hats used by all personnel

  Yes

  No

  N/A

• Eye Protection used by all personnel

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Proper foot protection

  Yes

  No

  N/A

• Safety vests in use and in good condition?

  Yes

  No

  N/A

• Fire Resistant Clothing

  Yes

  No

  N/A

• Fall Protection

  Yes

  No

  N/A

• Respirators/Face Masks in good condition and used as required (Medical Evaluation and Fit Test)

  Yes

  No

  N/A

• Have monthly inspections been performed.

  Yes

  No

  N/A

• All PPE in good condition and clean

  Yes

  No

  N/A

Fire Protection

• Are fire extinguishers available in shop and office?

  Yes

  No

  N/A

• Are fire extinguishers locations marked?

  Yes

  No

  N/A

• Are Inspections up to date?

  Yes

  No

  N/A

• Are emergency exits identified?

  Yes

  No

  N/A

Flammable cabinet

• Approved Flammable Cabinet in use?

  Yes

  No

  N/A

• Are all Flammable items stored in cabinet?<br>

  Yes

  No

  N/A

• Are DOT approved fuel containers in use?

  Yes

  No

  N/A

Stairways and Ladders

• Stairways have proper handrails

  Yes

  No

  N/A

• Stairs have proper riser, tread and landings?

  Yes

  No

  N/A

• Ladders manufacture data legible?

  Yes

  No

  N/A

• Ladders stored neatly and to prevent falling?

  Yes

  No

  N/A

Heavy Equipment

• Daily inspections performed ?

  Yes

  No

  N/A

• Fire extinguisher mounted

  Yes

  No

  N/A

Vehicles and Trailers

• Back in drive out?

  Yes

  No

  N/A

• Daily inspection completed

  Yes

  No

  N/A

• Vehicles safe / good condition; DOT compliant

  Yes

  No

  N/A

• Trailers safe / good condition; DOT compliant

  Yes

  No

  N/A

• Vehicles clean and organized

  Yes

  No

  N/A

• Vehicles / Trailers on site (Unit #, Make, Model)

Four gas detectors

• Detectors calibrated?

  Yes

  No

  N/A

Comments /Observations

• Comments

  Yes

  No

  N/A

• Observations

  Yes

  No

  N/A

Reviewed by:

• Job Site Supervisor

  Sign

• Safety Representative

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