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

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