Universal Forming Jobsite Safety Audit and Risk Assessment

• Location:
  Address

• Project Name:

  Select

• General Contractor:

  Select Barr & Barr Gilbane Building Company Robins & Morton DPR Construction Winter Park Construction Jack Jennings & Sons Whiting Turner Summit Contracting CPPI

  • Barr & Barr
  • Gilbane Building Company
  • Robins & Morton
  • DPR Construction
  • Winter Park Construction
  • Jack Jennings & Sons
  • Whiting Turner
  • Summit Contracting
  • CPPI

• Weather - Select all that apply

  Select

• Conducted on:

  Date

• Prepared by:

• Purpose of audit:

1. Universal Forming Program Requirements

• 1.1 UFI Safety Program Onsite?

  Yes

  No

• 1.2 SDS/Hazcom Program Current?

  Compliant

  Non-Compliant

  N/A

12. Scaffolds

• 12.1. OSHA competent person(s) erecting scaffold?

  Compliant

  Non-Compliant

  N/A

• 12.2. Unsafe or incomplete scaffold?

  Safe

  At Risk

• 12.3. Toe boards, hand rails and mid rails in place?

  Compliant

  Non-Compliant

  N/A

• 12.4. Safe Work Load exceeded? (tools, stored materials, number of persons)

  Safe

  At Risk

  N/A

• 12.5 Rolling scaffold wheels locked while used?

  Yes

  No

  N/A

• 12.6 Working level fully planked?

  Compliant

  Non-Compliant

  N/A

• 12.7 Each employee 6’ above a lower level protected by guardrails or lifelines?

  Compliant

  Non-Compliant

  N/A

• 12.8 Scaffold erectors and dismantlers tied off inside of scaffold?

  Compliant

  Non-Compliant

  N/A

• 12.9 All employees properly trained and documented?

  Compliant

  Non-Compliant

  N/A

• 12.10 Working level of scaffold fully planked with no more than 1” open space between planks?

  Compliant

  Non-Compliant

  N/A

• 12.11 Scaffold walkways at least 18” wide?

  Compliant

  Non-Compliant

  N/A

• 12.12 Scaffold planks extend at least 6” over a support brace and free from splits?

  Compliant

  Non-Compliant

  N/A

Corrective Actions

• Enter any corrective actions that will be undertaken