Yates Construction

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Safety Administration

• Is the OSHA 1926 Manual on site?

  Yes

  No

  N/A

• Is the EAP on file and is it current?

  Yes

  No

  N/A

• Is the Site Safety Manual up to date?

  Yes

  No

  N/A

• Has Site Safety Manual been reviewed with the team?

  Yes

  No

  N/A

• Are copies of all documentation present and current?

  Yes

  No

  N/A

• MSDS master list current?

  Yes

  No

  N/A

• Comments:...

• Site Specific Safety Plan on file and current?

  Yes

  No

  N/A

• Training reports on file and submitted?

  Yes

  No

  N/A

• Safety meetings?

  Yes

  No

  N/A

• STAs and SACs being used daily?

  Yes

  No

  N/A

• Have all Incidents and Near Hits been reported?

  Yes

  No

  N/A

• Safety incentive program being used effectively?

  Yes

  No

  N/A

• Safety pledge has been signed by all employees?

  Yes

  No

  N/A

• Is required signage is posted and is it current?

  Yes

  No

  N/A

• Is the family board up and is it current?

  Yes

  No

  N/A

Health and Medical

• Are First Aid & CPR trained personnel on site?

  Yes

  No

  N/A

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Is MSDS book complete and accessible?

  Yes

  No

  N/A

• Is First Aid kit on site and complete?

  Yes

  No

  N/A

• Is there potable water, toilets, and hand wash stations?

  Yes

  No

  N/A

• Is the site clean and is the housekeeping excellent?

  Yes

  No

  N/A

• Comments:

Ladders, Stairs, and Work Surfaces

• Are ladders properly tied off at top?

  Yes

  No

  N/A

• Where required, do all ladders extend 3 feet above platform?

  Yes

  No

  N/A

• Responsible Party:

  Yes

  No

  N/A

• Is there sufficient ladder access to all levels?

  Yes

  No

  N/A

• Are holes and openings covered, secured, labeled, and/or guarded?

  Yes

  No

  N/A

• Are handrails, mid rails and toe boards present, secure, and in good condition?

  Yes

  No

  N/A

• Is scaffolding built according to OSHA or manufacture's specifications?

  Yes

  No

  N/A

• Is scaffolding inspected and appropriately tagged daily?

  Yes

  No

  N/A

• Are walk/work surfaces free of slip/trip hazards?

  Yes

  No

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Access to work area / path of travel

  Yes

  No

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

Welding and Cutting

• Are all gas cylinders upright and secure?

  Yes

  No

  N/A

• Responsible Party:

  Yes

  No

  N/A

• Yates Rep:

  Yes

  No

  N/A

• Corrected By

  Date

• Corrective Action: Date: _______________

• Are torches equipped with flash protection?

  Yes

  No

  N/A

• Are hose and leads in good repair?

  Yes

  No

  N/A

• Are all gas cylinders in good repair?

  Yes

  No

  N/A

Training

• Have all employees seen the new hire CD?

  Yes

  No

  N/A

• Have all employees received site specific orientation and are aware of risk?

  Yes

  No

  N/A

• Is everyone on site up to date on training?

  Yes

  No

  N/A

• Are equipment operators trained and qualified/certified?

  Yes

  No

  N/A

• Are personnel performing rigging and signaling qualified?

  Yes

  No

  N/A

• Are personnel using respirators properly trained and equipped?

  Yes

  No

  N/A

Safe Work Permits

Excavations and Trenching

• Permit in place

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Yes

  No

  N/A

• Corrected By

  Date

• Corrective Action: Date: _______________

• Utilities located

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Competent person at excavation or trench

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Means of access and egress in place

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Utilities supported

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Excavation/trench barricaded

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

Hot Work

• Hot work permit in place

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Tools and equipment free from damage or defects (gauges, hoses, leads, etc.)

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Flash arresters in place on torch and on cylinder

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Fire extinguisher in place at least 35' from operation

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Fire watch in place

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Employee PPE in use

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

Confined Space

• Confined space program in place

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Confined space permit in place

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Competent person in the area

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Employees trained

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Air monitoring in place and used

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Rescue plan and equipment in place

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

Personal Protective Equipment

• Are all employees wearing head protection?

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Are employees approved wearing approved eye protection.

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Is all footwear appropriate for job requirements?

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Is hearing protection being worn wear required?

  Yes

  No

  N/A

• Is respiratory protection worn where required?

  Yes

  No

  N/A

• Are full body harnesses used as needed above 6 feet?

  Yes

  No

  N/A

• Is all PPE Inspected and in good repair?

  Yes

  No

  N/A

• Is all PPE provided as needed?

  Yes

  No

  N/A

• PPE USED

  Select Safety glasses Hard Hats Class II vest Gloves Work boots Faceshield Respirator Hearing Protection other

  • Safety glasses
  • Hard Hats
  • Class II vest
  • Gloves
  • Work boots
  • Faceshield
  • Respirator
  • Hearing Protection
  • other

• PPE USED

  Select Safety glasses Hard Hats Class II vest Gloves Work boots Faceshield Respirator Hearing Protection other

  • Safety glasses
  • Hard Hats
  • Class II vest
  • Gloves
  • Work boots
  • Faceshield
  • Respirator
  • Hearing Protection
  • other

• PPE USED

  Select Safety glasses Hard Hats Class II vest Gloves Work boots Faceshield Respirator Hearing Protection other

  • Safety glasses
  • Hard Hats
  • Class II vest
  • Gloves
  • Work boots
  • Faceshield
  • Respirator
  • Hearing Protection
  • other

• PPE USED

  Select Safety glasses Hard Hats Class II vest Gloves Work boots Faceshield Respirator Hearing Protection other

  • Safety glasses
  • Hard Hats
  • Class II vest
  • Gloves
  • Work boots
  • Faceshield
  • Respirator
  • Hearing Protection
  • other

• PPE USED

  Select Safety glasses Hard Hats Class II vest Gloves Work boots Faceshield Respirator Hearing Protection other

  • Safety glasses
  • Hard Hats
  • Class II vest
  • Gloves
  • Work boots
  • Faceshield
  • Respirator
  • Hearing Protection
  • other

Equipment

• Pre-Operation inspection performed and documented.

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Designated operator in place

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Seatbelt in use by operator and load charts are present?

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Back up alarm operational

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Equipment spotter in place

  Safe

  At Risk

  N/A

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Responsible Party:

  S/H

  KT

  FIORE

  AD

  COGGINS

• Fire extinguisher are present, charged, and tagged?

  Safe

  At Risk

  N/A

• Yates Rep:

  Select Terry Elder Dave Heston Matt Woodall Randy Wicke Bart Extrand Steve Gadberry Mike Keith

  • Terry Elder
  • Dave Heston
  • Matt Woodall
  • Randy Wicke
  • Bart Extrand
  • Steve Gadberry
  • Mike Keith

• Corrected By

  Date

• Corrective Action: Date: _______________

• Are slings and chokers inspected and in good repair?

  Yes

  No

  N/A

• Yates Rep:

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Corrected By

  Date

• Corrective Action:...

• Are tools being inspected daily?

  Yes

  No

  N/A

• Are safety latches present on all hooks?

  Yes

  No

  N/A

• Have all power lines been located and avoided?

  Yes

  No

  N/A

• Are all lifts zones identified and barricaded off?

  Yes

  No

  N/A

• Does all equipment have manufacturer's manual?

  Yes

  No

  N/A

• Are spotters trained and used as necessary?

  Yes

  No

  N/A

Other

• Housekeeping is being performed?

  Yes

  No

  N/A

• Assured grounding is in place?

  Yes

  No

  N/A

• Barricades are being used where appropriate?

  Yes

  No

  N/A

• Flammable liquids are in storage?

  Yes

  No

  N/A

• Spill containment is in place?

  Yes

  No

  N/A

• Waste disposal is proper?

  Yes

  No

  N/A

• Hazardous material labeling is correct?

  Yes

  No

  N/A

Acknowledgements:

• Select date

  Date

• Add signature

  Sign