WMI Safety Site Visit (Construction) Master Template

• Audit Title & Customer Name

• Conducted on

  Date

• Prepared by

• Location
  Address

• Foreman Name:

Site Details

JSA?SPA Job Safety Analysis

• Are SPA's being completed every day?

  Pass

  Fail

  N/A

• Are the JSA/SPA's being submitted each day?

  Pass

  Fail

  N/A

• Use this audit to assess the following aspects of this site as Safe, At Risk or Not Applicable. Unsafe response indicate that attention is required to bring items to a satisfactory standard. Notes and photos should be attached where appropriate, particularly to At Risk items.

Work Areas

• Do you wish to examine work areas on this safety walk?

  Yes

  No

  N/A

• General Housekeeping (neat, tidy, dust free)

  Select All observed work site areas organized and neatly kept.

  • All observed work site areas organized and neatly kept.

• Impalement Hazards (none present, or adequately marked)

  Safe

  At Risk

  N/A

• Material Storage/Lay Down (neat and tidy)

  Safe

  At Risk

  N/A

Personal Protective Equipment (PPE)

• Do you wish to examine PPE on this safety walk?

  Yes

  No

  N/A

• Hard Hats (available, worn by crew and in safe condition)

  Yes

  No

  N/A

• Safety Glasses with Side Shields (available, worn by crew and in safe condition)

  Safe

  At Risk

  N/A

• Face Shield / Goggles (available, worn by crew and in safe condition)

  Safe

  At Risk

  N/A

• Respiratory Protection (available, worn by crew and in safe condition)

  Safe

  At Risk

  N/A

• Hearing Protection (available, worn by crew and in safe condition)

  Safe

  At Risk

  N/A

• Appropriate Clothing (in safe condition)

  Safe

  At Risk

  N/A

• Gloves (available, worn by crew and in safe condition)

  Safe

  At Risk

  N/A

• Foot Protection (fit for task, worn by crew and in safe condition)

  Safe

  At Risk

  N/A

Silica Exposure & Prevention

• Did you witness any examples of drilling or grinding?

  Select Informational Only. Not Scored Opportunity For Improvement (OFI)

  • Informational Only. Not Scored
  • Opportunity For Improvement (OFI)

• Observations

• Were HEPA filters or Vac's with HEPA filters being used during the cutting or drilling process?

  Select Yes No N/A Observation only. Discussed with crew. No points missed

  • Yes
  • No
  • N/A
  • Observation only. Discussed with crew. No points missed

• Is HEPA equipment available for use at this jobsite?

  Select Yes No N/A Observation only. Discussed with crew. No points missed

  • Yes
  • No
  • N/A
  • Observation only. Discussed with crew. No points missed

• undefined

  Select Yes No N/A Observation only. Discussed with crew. No points missed

  • Yes
  • No
  • N/A
  • Observation only. Discussed with crew. No points missed

Fall Protection Equipment

• Do you wish to examine fall protection equipment on this safety walk?

  Yes

  No

  N/A

• Fall protection equipment inspected inspected regularly and before use

  Safe

  At Risk

  N/A

• Appropriate for task and used properly by crew where applicable

  Safe

  At Risk

  N/A

• Suitable Anchorage Points

  Safe

  At Risk

  N/A

Ladders

• Do you wish to examine ladders on this safety walk?

  Yes

  No

  N/A

• Ladders are well maintained and in satisfactory condition

  Safe

  At Risk

  N/A

• Ladder base, footing and set up is to standard

  Safe

  At Risk

  N/A

• Proper Ladder for Task

  Safe

  At Risk

  N/A

Tools and Equipment

• Do you wish to examine tools and equipment on this safety walk?

  Yes

  No

  N/A

• General condition of tools

  Safe

  At Risk

  N/A

• Right tools are being used for tasks

  Safe

  At Risk

  N/A

• Crew members are trained to be competent in the tools appropriate for their work tasks

  Safe

  At Risk

  N/A

• Do all work carts, dollies and manual material moving equipment have locking wheels or locking mechanism to prevent unauthorized movement?

  Select Yes No N/A Observation only. Discussed with crew. No points missed

  • Yes
  • No
  • N/A
  • Observation only. Discussed with crew. No points missed

Electrical Safety

• Do you wish to examine electrical safety on this safety walk?

  Yes

  No

  N/A

• Ground fault circuit interrupters in use

  Safe

  At Risk

  N/A

• Extension Cords are not causing trip hazards or used inappropriately

  Safe

  At Risk

  N/A

Personnel

• Do you wish to check personnel and this safety walk?

  Yes

  No

  N/A

• Behavior is orderly and professional

  Safe

  At Risk

  N/A

• Clear communication is possible without needing to shout

  Safe

  At Risk

  N/A

• Team lifts being performed for any large/awkward or item weighing 50lbs or more?

  Safe

  At Risk

  N/A

LOTO

• Did you witness LOTO procedures?

  Select Yes No N/A Observation only. Discussed with crew. No points missed

  • Yes
  • No
  • N/A
  • Observation only. Discussed with crew. No points missed

• Were the proper LOTO tools being used?

  Select Yes No N/A Observation only. Discussed with crew. No points missed

  • Yes
  • No
  • N/A
  • Observation only. Discussed with crew. No points missed

• Were the LOTO tags signed or identified?

  Select Yes No N/A Observation only. Discussed with crew. No points missed

  • Yes
  • No
  • N/A
  • Observation only. Discussed with crew. No points missed

• Were there errors with LOTO process?

  Compliant

  Non-Compliant

  N/A

People Safety

• Do you wish to check work crew safety knowledge at this inspection?

  Yes

  No

  N/A

• Approach at least one team member and record their responses to the following. Make clear this is not an assessment of the team member themselves, but rather the safety procedures on site.

Team Member

• Add signature

  Sign

General Comments

• Any further comments or recommendations arising from this inspection?

• Add any additional relevant photos

  Media

• Have all required corrective actions been added as Actions to this inspection?

  Yes

  No

  N/A

• Please add any corrective actions to the appropriate questions above before completing this report

Sign Off

• Name & Signature of Inspector

  Sign

• Name & Signature of Site Supervisor / Foreman

  Sign