XL Construction Site Survey

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Safety

• Employee Orientation

  Safe

  At Risk

  N/A

• Communication Procedures

  Safe

  At Risk

  N/A

• Material Storage

  Safe

  At Risk

  N/A

• Operation/Pre-Work Planning

  Safe

  At Risk

  N/A

• Other

  Safe

  At Risk

  N/A

• Accident Investigation

  Safe

  At Risk

  N/A

• Excavation / Trenching

  Safe

  At Risk

  N/A

• Confined Space

  Safe

  At Risk

  N/A

• Fall Protection

  Safe

  At Risk

  N/A

• Crane and Rigging

  Safe

  At Risk

  N/A

• Ladders

  Safe

  At Risk

  N/A

• Housekeeping/Lighting

  Safe

  At Risk

  N/A

• Electrical

  Safe

  At Risk

  N/A

• Heavy Equipment

  Safe

  At Risk

  N/A

• Special Permits

  Safe

  At Risk

  N/A

• Scaffolding

  Safe

  At Risk

  N/A

• PPE

  Safe

  At Risk

  N/A

• Hand / Power Tools

  Safe

  At Risk

  N/A

• Lock Out/ Tag Out

  Safe

  At Risk

  N/A

Liability Exposures

• Fire prevention/protection

  Safe

  At Risk

  N/A

• Utility Lines

  Safe

  At Risk

  N/A

• Signage/Barricade Tape

  Safe

  At Risk

  N/A

• Emergency Response

  Safe

  At Risk

  N/A

• Other

  Yes

  No

  N/A