Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Personal protective equipment

  • Hard hats worn on site

  • Safety glasses and/or goggles being worn

  • Face shield worn when cutting rebar, vibrating concrete, or overhead chipping

  • Hearing protection worn where required

  • Fall protection used/ worn as required

  • Respirators used when required

  • Employees lifting properly

Electrical safety

  • Are ground plug ends present

  • Are cords free of cuts and other damage

  • Are gfci devices present

  • Have all underground utilities been located and communicated with all workers

  • Are overhead power lines present

Hand tools / power tools

  • Grinders have guards in place

Excavations

  • Are excavations deeper than 5 feet properly shored, sloped, benched etc

  • Are excavations properly barricaded<br>

  • Are access ladders within 25 feet of all workers in excavations 4 feet or deeper

  • Are spoil piles, equipment, and materials at a minimum 2 feet from the excavation edge

  • Has the excavation been green tagged by competent person

Mobile equipment

  • Are backup alarms working

  • Are there any signs of hydraulic leaks

  • Are there any new signs of damage

  • Are forks and buckets positioned in the down position when not in use

  • Are operators wearing safety belts

  • Are tag lines being used when moving materials

  • Are Hercules lifts being used on forklifts

  • Are loads suspended over workers

Housekeeping

  • Are all rebar ends capped

  • Are nails removed from scrap lumber

  • Is trash properly placed in trash can

  • Are walkways clear of trip hazards

  • Are materials neatly stacked

Fall protection

  • Is any work being performed 6 feet or higher

  • Are workers properly using fall protection

Scaffolding

  • Are scaffolds green tagged

  • Are scaffolds fully planked

  • Are Baseplates properly nailed to mudsills

  • Are scaffolds near overhead powerlines

  • Are handrail, midrail, and toe board present

  • Are scaffolds plumb square and level

Ladders

  • Do ladders extend 3 feet above working level

  • Are ladders secured at the top to prevent tipping

  • Are bottoms secured

  • Are rungs free of damage

  • Are step ladder locking arms secure

  • Are step ladders fully opened when used by workers

  • Are top rungs being used correctly with workers not standing on or above

  • Are warning labels visible

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.