Title Page
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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
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Select date
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MOT/Public Exposure (Logs, Signs, Barricades, Appearance)
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Overhead Power-lines (Permits in place, Signage Adequate, Addressed in HA, Designated Spotter in place)
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Excavation Safety ( Log, Fall Protection, Access, Slopes, Competent Person On Site,
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Equipment (Designated Operator, Seatbelts, Wheel Chocks, Visuals, Slow Moving Triangles, DOT Inspections, Cat Detect All workers have RFID in Hard hats )
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Crane Safety / Engineered picks ( Rigging, Level, Off Rubber, Permits, Pads, Tag Lines, Does everyone know the weight?)
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Fall Protection ( Anchor Point, Condition, Engineered System 100%, Open Holes)
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Confined Space (Permit, Air Testing Monitoring, Access, Communication, Blowers)
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Hazard Analysis (Signed, Up Dated, Pictures, W/Foremen Signature, Specific hazards addressed not blanket hazards Example - Pinch Points)
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Housekeeping (Access, Nails in Lumber, Tripping Hazards)
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PPE ( Safety Glasses, Gloves, Goggles, Face Shields, Back Belts, Cutting Goggles, Respirators, Tape on Boots, Chaps, Work Boots, Knee Pads)
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Training (TBM, Designated Operator, MSDS, Orientation, Crews understand what CVIS/VTSS is)
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Safe Operations (Impalement Hazards, Oxy/Acetylene, Safety Chains, Secured Loads, Assured Grounding, GFCI, False Work, Shoring Inspection, Ladders)
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CVIS/VTSS ( Members designated with colored Hard hat / Vest, Meeting with Project Director every week, Notes taken, CVIS Manual Reviewed and understood by members, Photos of members posted, You asked we did board)
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