Valley Electric Safety Audit

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Safety Management Items

• Accident Prevention Program.

  Yes

  No

  N/A

• Tool-Box meeting minutes.

  Yes

  No

  N/A

• First Aid/CPR training certification cards- all supervisors.

  Yes

  No

  N/A

• Safety Bulletin Board and required posting. <br><br><br>

  Yes

  No

  N/A

• Emergency phone numbers posted.

  Yes

  No

  N/A

• Weekly Jobsite surveys.

  Yes

  No

  N/A

Confined Spaces

• Written log of entry is maintained.

  Yes

  No

  N/A

• Prior to entry, air quality test is taken.

  Yes

  No

  N/A

• Prior to entry, all moving machinery is locked out.

  Yes

  No

  N/A

• Attendant is present at entry of Permit Required confined spaces.

  Yes

  No

  N/A

PPE

• Hearing Protection

  Yes

  No

  N/A

• Foot Protection

  Yes

  No

  N/A

• Eye and Face Protection

  Yes

  No

  N/A

• Fall Protection

  Safe

  At Risk

  N/A

• Head Protection<br><br>

  Yes

  No

  N/A

• Is PPE supplied adequate for the task?

  Yes

  No

  N/A

• Comments

  Yes

  No

  N/A

Tools

• Are tools in good shape?

  Yes

  No

  N/A

• Are powder actuated tools being used?<br>are employees trained and certified for the tool being used

  Yes

  No

  N/A

• Have all instruments and test equipment been calibrated?

  Safe

  At Risk

  N/A

• Comments

  Yes

  No

  N/A

Hazard Communication

• Are all SDS/Hazcom for all on-site chemicals available?

  Yes

  No

  N/A

• Comments

  Yes

  No

  N/A

Emergency Response/Fire Protection

• Fire extinguishers inspected monthly and unblocked?

  Safe

  At Risk

  N/A

• Eyewash

  Safe

  At Risk

  N/A

• First Aid kit

  Yes

  No

  N/A

• Comments

  Yes

  No

  N/A

Trenching and Excavation

• Excavated materials are placed 2' back or more from excavation.

  Yes

  No

  N/A

• Safe access is provided by means of ladders , ramps, or stairs.

  Safe

  At Risk

  N/A

• All trenches over 4' deep have shields , sloping or shoring.

  Safe

  At Risk

  N/A

Scaffolding

• Green entry tag attached with inspection date and signed by competent person?

  Yes

  No

  N/A

• Safe access, guardrails, toe boards in place?

  Safe

  At Risk

  N/A

• Documented, job specific training for each user?<br>

  Yes

  No

  N/A

Electrical Hazards/Arc Flash

• Are all electrical cords in good condition?

  Safe

  At Risk

  N/A

• Are Temporary power Boxes being used?<br>Are they being inspected on a monthly bases?<br>Is the GFCI inspection form available?

  Yes

  No

  N/A

• High voltage signs in place and visible?

  Yes

  No

  N/A

• Debris/Tools not stored on top of electrical cabinets?

  Yes

  No

  N/A

• Electrical cabinets not blocked?<br> -Nothing within 36 inches of the front of the cabinet?<br> -Clear access/pathway to electrical cabinets?

  Yes

  No

  N/A

• Arc flash signage in place?<br> -Indicates arc flash category?

  Yes

  No

  N/A

• Proper arc flash PPE available and in use?

  Yes

  No

  N/A

Hazardous Energy Control (Lockout/Tagout)

• Employees expected to conduct lockout trained and equipped properly?<br> -Employees understand their role and requirements?<br> -Employees have locks available if needed?

  Yes

  No

  N/A

• Employees locked out during a change over and/or other tasks that require lockout?<br> -All employees who are working on the equipment have their own lock affixed to the proper energy source(s)?<br> -Lockout was verified, stored energy was dissipated and equipment will not operate?

  Yes

  No

  N/A

• Energy control procedures exist for all equipment in the area and employees know where to find them?

  Yes

  No

  N/A

General Safety and Housekeeping

• Trash, debris, and equipment not left laying around?

  Clean

  Needs attention

• General tripping hazards due to housekeeping, equipment, layout.

  Clean

  Needs attention

• Rebar caps in place?

  Yes

  No

  N/A

• Holes covered and marked?

  Yes

  No

  N/A

• Air quality

  Yes

  No

  N/A

Site conditions

• Sanitary facilities

  Clean

  Needs attention

• Noise levels at or above 85 decimals?

  Safe

  At Risk

  N/A

• Hand wash stations

  Yes

  No

  N/A

• Is lighting adequate and in safe operating condition?

  Yes

  No

  N/A

General Jobsite Safety Items

• Office trailers have railings.

  Yes

  No

  N/A

• Fuel gas cylinders are properly secured.

  Yes

  No

  N/A

• Only approved ladders in use.

  Yes

  No

  N/A

• Machine guarding-saws, grinding wheels, etc.

  Yes

  No

  N/A

• Gas and diesel fuel I approved and properly marked cans.

  Yes

  No

  N/A

• Backup alarms on motorized equipment.

  Yes

  No

  N/A

• Proper access and egress for buildings.

  Yes

  No

  N/A

• Guard rails, mid rails and Toe-boards in place?

  Yes

  No

  N/A

• Safety program available?

  Yes

  No

  N/A

Notes from crew or Steward

Signature and Finalization

• I have completed this assessment to the best of my knowledge. This audit is not intended to identify all safety and health hazards, but to identify all visible/known hazards as of the date printed on the completed assessment. assessment.

  Sign

• General Comments