Title Page
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Audit Title ( Val's Job #)
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City
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Conducted on
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Foreman
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Site conditions (weather/environmental)
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Prepared by
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Other Information
Site Audit
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JSA in place, reviewed and signed
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Other Site documentation
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Equipment has been Inspected
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Fire Tools in place
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Are all Fire tools serviceable
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If needed Are COVID-19 protocols being complied with
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Are employees performing their work in a safe manner
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Are walking surfaces even and uncluttered
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Is site orderly , with rubbish and waste disposed of correctly
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Is ALL mandatory PPE being worn
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Have mark-outs been performed
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Is template in use
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Is work area protected
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Are pins and whip checks in place on compressor hoses
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Is the public protected or shielded from hazards
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If needed, is additional required PPE in use
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If needed, are silica mitigation procedures being implemented
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Are spotters being used
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Is all PPE in ON
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If needed is fall protection in place
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Condition of equipment
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Are Precautions taken for working on a slope or grade
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If in close proximity to road, is Signage in place
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Is Traffic Control Set up properly
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Equipment has been properly greased
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Any additional photos
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Other site notes or comments
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Sign off
