Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

  • Personnel

General

  • Is the TRC Project Specific Safety Plan (PSSP) available onsite?

  • TRC Signage in place for site control?

  • Pre-Job Briefing/Tailboard Complete?

  • Competent Person onsite?

  • Qualified Workers?

Housekeeping and Sanitation

  • General neatness of work areas?

  • Passageways and walkways clear?

  • Adequate lighting?

  • Adequate water provided?

  • Sanitary facilities furnished/maintained?

Aerial Lifts

  • Are there any aerial lifts onsite?

  • Workers standing firmly on platform floor?

  • Harness/lanyard worn in accordance with requirements?

  • Lanyard attached to manufactures specified anchorage point?

  • Minimum Approach Distance (MAD) from overhead power lines maintained?

  • Other?

Electrical (Subpart K)

  • Is work being performed on or with electrical equipment 600 volts or less?

  • Temporary wiring systems installed/protected?

  • Covers installed on energized panels?

  • Proper lockout/tagout procedures used?

  • GFCI protection used where required?

  • Extension cords in acceptable condition?

  • Extension cords routed to eliminate trip hazards?

  • Temporary lighting adequately routed and protected?

  • Other?

Electrical Transmission, Distribution and Substations (Subpart V)

  • Is there work being performed on or near power lines, substations or other high voltage components in excess of 600 volts?

  • Qualified electrical workers?

  • Line properly de-energized and grounded?

  • Adequate additional protections in place? (one shot, fuse, etc.)

  • Is Minimum Approach Distance (MAD) being maintained?

  • Is proper FR Clothing being worn?

  • Is adequate protective cover-up installed?

  • Adequate bonding and grounding (EPZ)?

  • 100% wood pole fall protection in place?

  • Pole top/Bucket/Tower rescue equipment available?

  • Other?

Excavation/Trenching/Shoring

  • Are there any underground operations on site?

  • One call contacted for location of existing utilities?

  • Utilities have been properly identified?

  • Soil classification made by competent person?

  • Trench inspected daily by competent person?

  • Proper access/egress provided for excavations with a depth 4 feet or greater?

  • Access/egress points within 25 feet of workers?

  • Proper sloping/shielding/shoring for excavations 5 feet (4 feet in CA) in depth or greater?

  • Spoil piles two feet back from edge?

  • Adequate barricades in place?

  • Stop logs/warning system in place for vehicles?

  • Other?

Fall Protection

  • Are workers exposed to falling hazards that are greater than 6 feet?

  • General trades - 6 foot 100% fall rule applies?

  • Workers utilizing adequate anchorage points?

  • Harness/lanyards in acceptable condition?

  • Standard guardrails in compliance?

  • Openings to lower level properly protected?

  • Floor openings covered, secured and marked?

  • Is there protection from falling objects?

  • Other?

Fire Prevention and Protection

  • Are fire extinguishers required for the work operation?

  • Fire extinguishers are fully charged and inspected?

  • Adequate number of fire extinguishers for work location?

  • Hot work permits issued when required?

  • Flammable liquids stored in approved containers?

  • Proper storage practices for flammables observed?

  • Other?

Hand and Power Tools

  • Are hand or power tools used at this location?

  • Visible physical damage to tool?

  • Shields and guards in place?

  • GFCI protection used?

  • Proper use of tool?

  • Certification for powder actuated tool operation?

  • Safety clips/pins in place on air hose connections?

  • Other?

Ladders

  • Are ladders in use at work location?

  • Ladders are in good condition?

  • Non-conductive ladders used when risk of contact with energized components is present?

  • Extension ladders properly secured when in use?

  • Side rails extend a minimum of 36 inches above top landing when used for access?

  • Step ladders are used in the fully open and locked position?

  • Other?

Lifting/Rigging

  • Are lifting/rigging operations occurring at the work location?

  • Crane operators have proper certifications?

  • Lift Plan performed?

  • Minimum approach distance (MAD) from overhead power lines maintained?

  • Outriggers/pads placed and used for all lifts?

  • Documented Inspections (annual/monthly/daily)?

  • Proper barricade around swing radius of crane?

  • Load charts available in crane cab?

  • Signal charts available?

  • Load Line/Hook/Crane Component Condition?

  • Sling/Shackle Condition?

  • Designated Rigger/Spotter?

  • Workers are not under suspended loads?

  • Tag Line Used?

  • Other?

Material Handling

  • Mechanical lifts used where practical?

  • Material staged to minimize lifting and carrying?

  • Are forklifts being utilized at the work location?

  • Operators properly trained/certified?

  • Alarm/Spotter is view is obstructed?

  • Seat belts worn by operators?

  • Operating horn and back up alarm?

  • Other?

Motor Vehicle/DOT/Earth Moving Equipment

  • Are motor vehicles being used at this location?

  • Seat belts properly worn?

  • Are vehicles/equipment properly set up?

  • Are vehicles parked where the first move is forward where possible?

  • Proper load securement?

  • Are there DOT regulated vehicles at this location?

  • Drivers log complete?

  • DVIR complete?

  • DOT inspection current?

Personal Protective Equipment (PPE)

  • Approved eye protection with side shields worn where required?

  • Head protection worn where required?

  • Hand protection worn when engaged in physical activity?

  • Reflective safety vest/clothing worn where required?

  • Approved safety footwear worn where required?

  • Hearing protection worn in designated areas?

  • Face shield worn where required?

  • Fire Resistance (FR) clothing utilized where required?

  • Are respirators being worn at this work location?

  • Did workers complete pulmonary function test and fit test?

  • Are respirators being worn in compliance with regulator requirements?

  • Other?

Scaffolds

  • Are scaffolds being used at the work location?

  • Competent person available onsite?

  • Scaffold properly tagged/inspected by competent person?

  • Guardrails/toe boards on scaffold over 10 feet?

  • Ladder provided for access to scaffold platform?

  • Platform fully decked and of scaffold grade?

  • Scaffold free of visible damage?

  • All pins/braces in place and locked?

  • Wheels locked on rolling scaffolds when in use?

  • Scaffold erected on firm and substantial surface?

  • Other?

Welding and Burning Operations

  • Are there welding or cutting operations at the work location?

  • Hot work permit completed if required?

  • Combustible's removed or cover with fire blankets?

  • Fire watch present with fire extinguisher when required?

  • Welding screen used when required?

  • Welding goggles, gloves and clothing being worn as required?

  • Areas inspected for fire hazards after welding stops?

  • Other?

Work Zones

  • Is there traffic concerns associated with the work operation?

  • Traffic control devices appropriate for work location?

  • Signage appropriate for work location?

  • Properly trained flaggers used where appropriate?

  • Other?

Other

  • Are there other unsafe acts or conditions that need to be documented?

  • Other?

Signatures

  • Supervisor

  • Auditor

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