Information
-
Document No.
-
Audit Title
-
Client / Site
-
Conducted on
-
Prepared by
-
Location
-
Personnel
1. Personal Protective Equipment
-
Eye Protection Utilized
-
Hard Hats Worn
-
Hi-Viz Safety Vests Worn
-
Gloves Available
-
Dust Masks Utilized
-
Hearing Protection Utilized
-
Proper Footwear
-
Harnesses & Lanyards Utilized
2. Vehicles
-
Inside of Truck Cab is Clean & Organized
-
Bed of Truck is Clean & Organized (Items in Bed are Secure)
-
Registration Tags on Plates are Current & Correct
-
Service is Not Overdue
3. Cutting & Grinding
-
Cutting/Grinding Area is Away from Flammable Gases/Liquids
-
Workers Aware of Spark Area when Cutting/Grinding
-
Proper Personal Protective Equipment Utilized (Gloves, Safety Glasses, Face Shield)
4. Scaffolding
-
Scaffold is Tied to Structure
-
Guardrails - Top, Mid, & Toe Boards are in Place
-
Protection from Falling Objects
-
Planking Cleats in Place
5. Ladders
-
Equipment is in Good Condition
-
Ladders Fully Open & Locked when in Use.
-
Proper Ladder for the Task & is Secure
-
Side-Rails Extend 36" (3') above Landing
-
Ladders in Good Working Condition
6. Excavation & Shoring
-
Excavation Barricaded or Fenced Off
-
Spoils Setback at Least 3 Feet
-
Necessary Access Provided (Ladders, Ramps, Steps)
-
Adjacent Structures Properly Shored
-
Shoring Proper for Soil & Depth
-
Equipment Away from Edge
7. Material Storage / Handling
-
Dust Protection Adequate
-
Materials Properly Stored/Stacked
-
SDS (MSDS) Books are Accessible
8. Barricades & Fencing
-
Work Area is Caution Taped or Roped Off
-
Access/Traffic Controlled
-
Roadways & Sidewalks Protected
-
Job-site Fenced
9. Heavy Equipment
-
Equipment Being Used is Right For the Task
-
No Apparent Damages, in Good Working Order
-
Operators Cockpit is Clear of Debris/Trash
-
Service/Maintenance Is Not Overdue
-
Equipment is Clean
-
Operators Using Equipment Have Been Trained
10. Hand & Power Tools
-
Tools Grounded or Double Insulated
-
Proper Tools Utilized for Each Job
-
All Safeguards are in Use
-
Cords in Good Condition
-
Hand Tools in Good Working Condition
11. Electrical
-
Extension Cords are In Good Condition, Not Damaged
-
Ground Plugs on Extension Cords are Not Missing
-
GFCI is Available & Being Used
-
Portable Generators are in Good Working Order
12. Fire Prevention
-
Fire Extinguishers Available
-
Extinguishers Clear of Obstructions
-
Correct Extinguishers for the Job
-
Extinguishers recently serviced (Annual Inspection Tag is Attached)
13. Housekeeping
-
Job-Trailers Organized & Clean (Tools Hung Up or Stored on Shelves)
-
Work Area Clear of Debris
-
Passageway & Walkways Clear
14. Environmental Hazards
-
Lack of/or Inadequate Erosion Control Plan
-
Lack of/or Inadequate Systems to Prevent Contaminates Entering Stormwater Drains
15. Corrective Actions
-
Any Corrective Actions that will be Undertaken
Sign Off
-
On Site Representative
-
Auditor's Signature
