Information

  • Client / Site

  • Audit Title

  • Document No.

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Field Safety Paperwork

  • Daily Maintenance: Aerial Work Platform

  • Daily Maintenance: Skytrak

  • Daily Crew/Safety Huddle

  • Meeting Attendance: Safety/Toolbox Talks

  • Safety Assessment Form

  • Task-Specific Safety Plan

  • Excavation Permit

  • Confined Space Hazard Assessment

  • Confined Space Permit

  • Ventilation & Air Sampling

  • Hot Work Permit

  • Scaffolding Inspection

  • Critical Lift Permit

Posters, Training, Communication

  • Site Board visible and current

  • OSHA Notice / 300 Log Posted As Necessary

  • Location of nearest Occupational Clinic

  • Stretching/Daily Warmup

  • GHS Information Posted

First Aid and Emergency

  • Stocked/Current First Aid Kit on-site

  • Crisis Management Program on-site

  • Stokes Basket on-site and accessible

PPE

  • Hardhat, Safety Glasses, Proper Boots

  • FR Clothing

  • High Visibility Clothing as Required

  • Respiratory protection used as necessary

  • Hearing protection used as necessary

  • Other PPE being used when necessary(face protection; gloves; specialty equipment; etc.)

Fall Protection

  • Proper fall protection at 6' or greater

  • Personnel below are protected from falling objects

  • Controlled access zones used

  • Warning lines 6'-10' from edge

  • Wall opening guarded

  • Open sided floors or platforms 6' or more from lower level equipped with proper guardrail

  • Floor openings 2" or more properly barricaded/protected/secured/marked/covered

  • Hoisting Operations: Guardrails in place/replaced after each load received

Stairways and Ladders

  • Properly Inspected, in good condition, and marked appropriately

  • Properly Secured

  • Necessary labels visible and legible

  • Straight ladders extend 3' above landing area

  • Step ladder properly used

  • Guard rails provided for stairway landing areas

  • Handrails provided for stairways with 4 or more risers

Scaffolding

  • Properly erected and supervised by competent person

  • Properly tagged

  • Daily competent person inspection documented

  • Fall protection/prevention used at 10' and above

  • Scaffolding tied to structure 30' horizontally and 20' vertically

  • Scaffolding plumb, cross bracing in place

  • Fully planked and toe boards in place

  • Plank spacing is 1" or less

  • Plank extends 6" or more (or) plank ends cleated

  • Base plates and mud sills used as necessary

  • Ladder access provided

Aerial Lifts

  • Proper Use

  • Fall Protection required?

  • Has equipment been inspected, appropriately selected, and worn correctly?

Concrete and Masonry

  • Safe hoisting equipment

  • Masonry walls over 8' braced if required/applicable

  • Limited Access Zone established (height of wall >=4')

  • All protruded rebar guarded

Excavations

  • Competent person on-site

  • Daily/change in conditions competent person inspection documented (Excavation Work Permit)

  • Was one-call system contacted

  • Holes, trenches, excavations, etc. are identified and protected

  • Surface encumbrances protected/supported

  • Ladder or ramp within 25' of all employees in trenches 4' or greater in depth

  • Utilities protected/supported

  • Spoil piles minimum of 2' from edge of excavation

  • Overhead power lines minimum distance of 20'

Motor Vehicles and Heavy Equipment

  • Horn and backup alarm operable

  • Seat belts used

  • Job traffic controlled

  • Adequate signage for safe travel

  • Inspected and charged fire extinguisher on equipment

  • Weights and loads controlled

Cranes, Rigging, Signal Person

  • Certified and Qualified Crane Operator

  • Critical Lift Permit used as necessary

  • Lift Director on-site

  • Swing Radius Controlled

  • Power lines deactivated, removed, protected, or safe distance

  • Qualified Rigger/Signal Person

  • Rigging Inspection by competent person prior to use

  • Rigging Inspection Log maintained

  • Annual Chain Sling Inspection Documented

Confined Space

  • Declared Permit or non-permit

  • Rescue Plan communicated and understood

  • Air monitor on site (properly calibrated, properly used)

  • Atmosphere test results documented

  • Energy sources locked out/tagged out

  • Adequate ventilation

Hot Work

  • Hot-work permit completed/posted

  • Welding screens provided

  • Fire extinguisher present

  • Proper additional PPE provided

  • Equipment in good repair, insulators, grounding, welding leads

  • Adequate ventilation or respirator utilized

  • Fire watch provided 30 minutes post work

Cylinders

  • Compressed gas cylinders stored and secured upright

  • Empty gas cylinders marked

  • Stored properly

  • Cylinders capped

Fire Protection & Prevention

  • 1 fire extinguisher/3000sqft

  • Fire extinguisher within 50' of flammable liquids

  • Bulk fuel - labeled, grounded, and stored >25' from construction operations

  • Approved metal safety containers for gasoline and diesel

  • Flammable and explosive materials stored and handled safely

  • Required number of fire extinguishers are inspected and tagged

  • All vehicles & other mobile equipment provided with fire extinguisher

Electrical

  • Assured Grounding Program up to date

  • All electrical equipment in good condition

  • Lighting cords and wiring secured with NON-conductive material

  • Power tools are protected with GFCI or internal grounding

  • Pinch/drive-over hazards eliminated

  • Terminal boxes properly covered

  • Exposed light bulbs equipped with protective cage and bulbs in place

  • Good work practices (cords out of pathways, kept out of water, etc.)

  • Adequate Arc Flash Protection

  • Arc Flash Equipment inspected and in good condition

Hand and Power Tools

  • Guards in place

  • Safe work practices

  • Stored safely

  • Maintained properly and in good condition

  • Correct tool used/used for intended purpose

Silica Exposure Control

  • Table 1 controls fully and properly implemented

  • Equipment inspected and in good condition

  • Filters changed as necessary

  • Proper respiratory protection as necessary

Housekeeping

  • Clean and organized work trailers

  • Trash picked up and disposed of regularly

  • Walkways and passageways clear

  • Portable toilets/handwashing stations - adequate, cleaned, and serviced

  • Work areas neat and organized

  • No projecting nails/screws

  • Material stored in orderly and safe manner

  • Potable water available

Other items found

Positive Insight

  • Comments

  • Safety Representative

  • Superintendent

  • Foreman

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.