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Safety Audit Form

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Unchecked boxes=Not applicable

GENERAL ADMINISTRATIVE
Written Safety and Hazard Communication programs (APP and SDS binders)(Required)
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    Required postings OSHA L & I, Emergency Numbers, Worker’s Comp, Code of Safe Practices, COVID 19, ETC.(Required)
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    Max. file size: 120 MB.
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      Adequate toilets/ washing facilities(Required)
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      Max. file size: 120 MB.
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        Record of Safety Meetings and Safety Inspections(Required)
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        Max. file size: 120 MB.
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          Hot/Cold stress to workers with proper access to water (H2O)(Required)
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          Max. file size: 120 MB.
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            Adequate lighting in work and walkways(Required)
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            Max. file size: 120 MB.
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              PERSONAL PROTECTIVE EQUIP / EMERGENCY
              Hard hats, vest, and safety glasses being used as needed or 100% of the time(Required)
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              Max. file size: 120 MB.
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                Hearing, face protection, along with respirators, being used when needed and workers medically cleared(Required)
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                Max. file size: 120 MB.
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                  Employees aware of emergency procedures(Required)
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                  Max. file size: 120 MB.
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                    First Aid kit on site- stocked and accessible(Required)
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                    Max. file size: 120 MB.
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                      First aid personnel on site and identified(Required)
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                      Max. file size: 120 MB.
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                        Proper work shoes being worn(Required)
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                        Max. file size: 120 MB.
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                          EXCAVATIONS
                          Competent person on site(Required)
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                          Max. file size: 120 MB.
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                            Collapse protection for all employees in excavation over 4ft. deep WA /5 ft. Fed(Required)
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                            Max. file size: 120 MB.
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                              No confined space issues with atmosphere(Required)
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                              Max. file size: 120 MB.
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                                Underground utilities located and lines maintained(Required)
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                                Max. file size: 120 MB.
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                                  Spoils and surcharges at least 2 feet from edge(Required)
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                                  Max. file size: 120 MB.
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                                    Seatbelts being worn while in equipment(Required)
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                                    Max. file size: 120 MB.
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                                      Proper walkway over trench (18 inches wide)(Required)
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                                      Max. file size: 120 MB.
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                                        SCAFFOLDING
                                        Competent person on site and scaffold signed off each day of use(Required)
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                                        Max. file size: 120 MB.
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                                          Plumb and level and fully braced(Required)
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                                          Max. file size: 120 MB.
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                                            Scaffold grade planking and fully planked(Required)
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                                            Max. file size: 120 MB.
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                                              Fall protection above 7.5 CA feet (10 WA&OR)(Required)
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                                              Max. file size: 120 MB.
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                                                Proper access(Required)
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                                                Max. file size: 120 MB.
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                                                  Falling object protection(Required)
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                                                  Max. file size: 120 MB.
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                                                    Tipping restraint at 4:1 ratio (i.e. attached to structure)(Required)
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                                                    Max. file size: 120 MB.
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                                                      14 inches or closer to structure (18 or closer for plastering)(Required)
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                                                      Max. file size: 120 MB.
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                                                        No employees propelling themselves on top of rolling scaffold(Required)
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                                                        Max. file size: 120 MB.
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                                                          Proper distance from electrical lines (3 feet for v less than 300)(Required)
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                                                          Max. file size: 120 MB.
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                                                            CRANES
                                                            Annual and daily inspection log up to date(Required)
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                                                            Max. file size: 120 MB.
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                                                              Outriggers properly positioned and supported(Required)
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                                                              Max. file size: 120 MB.
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                                                                Powerline rules followed(Required)
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                                                                Max. file size: 120 MB.
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                                                                  Pinch points from counterweight guarded(Required)
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                                                                  Max. file size: 120 MB.
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                                                                    Slings and rigging inspected daily and tagged(Required)
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                                                                    Max. file size: 120 MB.
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                                                                      Operator/ Rigger/ Signal person certification(Required)
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                                                                      Max. file size: 120 MB.
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                                                                        AERIAL LIFTS
                                                                        Inspect for damage and service prior to work shift(Required)
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                                                                        Max. file size: 120 MB.
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                                                                          Excessive weight(Required)
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                                                                          Max. file size: 120 MB.
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                                                                            All top and mid rails in place(Required)
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                                                                            Max. file size: 120 MB.
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                                                                              Fall protection used for articulating and reach platforms(Required)
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                                                                              Max. file size: 120 MB.
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                                                                                Climbing on mid or top rail(Required)
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                                                                                Max. file size: 120 MB.
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                                                                                  HOUSEKEEPING
                                                                                  Work area, passageways, and stairs clear of scrap and debris. Removed regularly.(Required)
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                                                                                  Max. file size: 120 MB.
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                                                                                    Site clean with proper trash receptacles(Required)
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                                                                                    Max. file size: 120 MB.
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                                                                                      Material storage areas kept orderly and free of debris(Required)
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                                                                                      Max. file size: 120 MB.
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                                                                                        Protruding nails in lumber kept cleared from work areas, passageways, and stairs, in and around buildings(Required)
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                                                                                        Max. file size: 120 MB.
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                                                                                          TOOLS, HAND AND POWER
                                                                                          Tool and Cord in good condition(Required)
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                                                                                          Max. file size: 120 MB.
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                                                                                            Guards in place(Required)
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                                                                                            Max. file size: 120 MB.
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                                                                                              Proper extension cord for tool(Required)
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                                                                                              Max. file size: 120 MB.
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                                                                                                Air lines good condition(Required)
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                                                                                                Max. file size: 120 MB.
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                                                                                                  Powder actuated tools – Proper cartridge storage/disposal and operator license(Required)
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                                                                                                  Max. file size: 120 MB.

                                                                                                    FALL PROTECTION
                                                                                                    Covers over holes and marked “hole” or “cover”(Required)
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                                                                                                    Max. file size: 120 MB.
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                                                                                                      Guardrails 42+ 3 inches midrail and toe boards Deflection less than 3 in. and cable flagged every 6 ft.(Required)
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                                                                                                      Max. file size: 120 MB.
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                                                                                                        Comments/Action required notes for Guardrails 42+ 3 inches midrail and toe boards Deflection less than 3 in. and cable flagged every 6 ft.
                                                                                                        Proper use of harness, lanyard and anchor(Required)
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                                                                                                        Max. file size: 120 MB.
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                                                                                                          Proper leading edge SRL(Required)
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                                                                                                          Max. file size: 120 MB.
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                                                                                                            Cover support 200# <12 in. 4x intended load > 12 in.(Required)
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                                                                                                            Max. file size: 120 MB.
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                                                                                                              PFA systems adjusted to keep fall less than 6 feet before arrest begins(Required)
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                                                                                                              Max. file size: 120 MB.
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                                                                                                                Wall openings guarded(Required)
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                                                                                                                Max. file size: 120 MB.
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                                                                                                                  FIRE PROTECTION/PREVENTION
                                                                                                                  Fire extinguishers provided at least every 3000 sq. feet of combustibles(Required)
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                                                                                                                  Max. file size: 120 MB.
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                                                                                                                    Monthly inspection completed(Required)
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                                                                                                                    Max. file size: 120 MB.
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                                                                                                                      No more than 50 feet from flammable liquid storage(Required)
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                                                                                                                      Max. file size: 120 MB.
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                                                                                                                        Fire extinguisher no more than 75 feet from ordinary combustibles(Required)
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                                                                                                                        Max. file size: 120 MB.
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                                                                                                                          No more than 50 feet from hot work(Required)
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                                                                                                                          Max. file size: 120 MB.
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                                                                                                                            Approved Safety cans in use(Required)
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                                                                                                                            Max. file size: 120 MB.
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                                                                                                                              ELECTRICAL
                                                                                                                              All temporary electrical cords are protected by GFCI or assured grounding program(Required)
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                                                                                                                              Max. file size: 120 MB.
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                                                                                                                                Cords are properly rated for construction use and protected(Required)
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                                                                                                                                Max. file size: 120 MB.
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                                                                                                                                  Cords are free from damage, have strain relief, and all prongs intact(Required)
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                                                                                                                                  Max. file size: 120 MB.
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                                                                                                                                    Panels are dead faced and contain all blanks where needed(Required)
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                                                                                                                                    Max. file size: 120 MB.
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                                                                                                                                      String lights are in good condition and hung properly(Required)
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                                                                                                                                      Max. file size: 120 MB.
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                                                                                                                                        MATERIAL HANDLING
                                                                                                                                        Forklift Operators are trained & certified(Required)
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                                                                                                                                        Max. file size: 120 MB.
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                                                                                                                                          Equipment is being operated w/proper clearances from workers & other equipment(Required)
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                                                                                                                                          Max. file size: 120 MB.
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                                                                                                                                            Seat belt worn(Required)
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                                                                                                                                            Max. file size: 120 MB.
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                                                                                                                                              Load properly secured on forks(Required)
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                                                                                                                                              Max. file size: 120 MB.
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                                                                                                                                                Forklift attended (operator within 25' and can see lift)(Required)
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                                                                                                                                                Max. file size: 120 MB.
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                                                                                                                                                  Flammable Materials properly stored/labeled(Required)
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                                                                                                                                                  Max. file size: 120 MB.
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                                                                                                                                                    Proper lifting techniques used(Required)
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                                                                                                                                                    Max. file size: 120 MB.
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                                                                                                                                                      HIGHWAY/WORK ZONES
                                                                                                                                                      Flagger properly placed on shoulder of road or in closed lane(Required)
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                                                                                                                                                      Max. file size: 120 MB.
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                                                                                                                                                        Warning signs properly spaced(Required)
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                                                                                                                                                        Max. file size: 120 MB.
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                                                                                                                                                          Channelization devices properly used and spaced(Required)
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                                                                                                                                                          Max. file size: 120 MB.
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                                                                                                                                                            Vehicle and pedestrian traffic properly controlled(Required)
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                                                                                                                                                            Max. file size: 120 MB.
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                                                                                                                                                              Proper PPE for flagging worn(Required)
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                                                                                                                                                              Max. file size: 120 MB.
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                                                                                                                                                                WELDING AND CUTTING
                                                                                                                                                                Proper PPE and shields used(Required)
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                                                                                                                                                                Max. file size: 120 MB.
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                                                                                                                                                                  Backflow valves on gas lines(Required)
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                                                                                                                                                                  Max. file size: 120 MB.
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                                                                                                                                                                    Separated by 20 feet or ½ hour firewall when stored(Required)
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                                                                                                                                                                    Max. file size: 120 MB.
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                                                                                                                                                                      Proper handling/labeling and storage of cylinders(Required)
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                                                                                                                                                                      Max. file size: 120 MB.
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                                                                                                                                                                        Fire extinguisher on site and in proper location(Required)
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                                                                                                                                                                        Max. file size: 120 MB.
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                                                                                                                                                                          Fire watch in place 30 minutes after last hot work(Required)
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                                                                                                                                                                          Max. file size: 120 MB.
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                                                                                                                                                                            Other workers protected/warned from falling slag(Required)
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                                                                                                                                                                            Max. file size: 120 MB.
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                                                                                                                                                                              Valve protection caps in place when not in use(Required)
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                                                                                                                                                                              Max. file size: 120 MB.
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                                                                                                                                                                                LADDERS
                                                                                                                                                                                No workers standing on top 2 steps of ladder(Required)
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                                                                                                                                                                                Max. file size: 120 MB.
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                                                                                                                                                                                  Folding step ladders must be open & locked when in use(Required)
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                                                                                                                                                                                  Max. file size: 120 MB.
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                                                                                                                                                                                    Ladders are set up on appropriate surface(Required)
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                                                                                                                                                                                    Max. file size: 120 MB.
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                                                                                                                                                                                      Straight ladders set up at correct pitch and secured(Required)
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                                                                                                                                                                                      Max. file size: 120 MB.
                                                                                                                                                                                        Photo for Straight ladders set up at correct pitch and secured
                                                                                                                                                                                        Comments/Action required notes for Straight ladders set up at correct pitch and secured
                                                                                                                                                                                        Extend at least 3 ft. above any upper landing level & secured(Required)
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                                                                                                                                                                                          Comments/Action required notes for Extend at least 3 ft. above any upper landing level & secured
                                                                                                                                                                                          Free from damage. Broken ladders are tagged out.(Required)
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                                                                                                                                                                                          Max. file size: 120 MB.
                                                                                                                                                                                            Photo for Free from damage. Broken ladders are tagged out.
                                                                                                                                                                                            Comments/Action required notes for Free from damage. Broken ladders are tagged out.
                                                                                                                                                                                            Non Conductive ladders near electrical hazards(Required)
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                                                                                                                                                                                            Max. file size: 120 MB.
                                                                                                                                                                                              Photo for Non Conductive ladders near electrical hazards
                                                                                                                                                                                              Comments/Action required notes for Non Conductive ladders near electrical hazards
                                                                                                                                                                                              Proper protection when using ladders around wall openings(Required)
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                                                                                                                                                                                              Max. file size: 120 MB.
                                                                                                                                                                                                Photo for Proper protection when using ladders around wall openings
                                                                                                                                                                                                Comments/Action required notes for Proper protection when using ladders around wall openings

                                                                                                                                                                                                CONCRETE
                                                                                                                                                                                                Rebar Capping(Required)
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                                                                                                                                                                                                  Comments/Action required notes for Rebar Capping
                                                                                                                                                                                                  Proper PPP during pour (rubber boots, long sleeves, gloves, eye protection)(Required)
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                                                                                                                                                                                                  Max. file size: 120 MB.
                                                                                                                                                                                                    Photo for Proper PPP during pour (rubber boots, long sleeves, gloves, eye protection
                                                                                                                                                                                                    Comments/Action required notes for Proper PPP during pour (rubber boots, long sleeves, gloves, eye protection
                                                                                                                                                                                                    Controlled access zone(Required)
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                                                                                                                                                                                                    Max. file size: 120 MB.
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                                                                                                                                                                                                      Proper hoisting/staging area protection (fall/overhead hazards)(Required)
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                                                                                                                                                                                                        Photo for Proper hoisting/staging area protection- fall
                                                                                                                                                                                                        Comments/Action required notes for Proper hoisting/staging area protection- fall
                                                                                                                                                                                                        Silica Dust Controls in place see Table 1(Required)
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                                                                                                                                                                                                        Max. file size: 120 MB.
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                                                                                                                                                                                                          Comments/Action required notes for Silica Dust Controls in place see Table 1

                                                                                                                                                                                                          HEALTH
                                                                                                                                                                                                          Lead or Asbestos controls in place with proper signage(Required)
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                                                                                                                                                                                                            Comments/Action required notes for Lead or Asbestos controls in place with proper signage
                                                                                                                                                                                                            Powder actuated tool warning signs in place(Required)
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                                                                                                                                                                                                            Max. file size: 120 MB.
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                                                                                                                                                                                                              Comments/Action required notes for Powder actuated tool warning signs in place
                                                                                                                                                                                                              Covid-19 rules followed(Required)
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                                                                                                                                                                                                                Comments/Action required notes for Covid-19 rules followed

                                                                                                                                                                                                                CONFINED SPACE
                                                                                                                                                                                                                Permit posted at space and properly filled out(Required)
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                                                                                                                                                                                                                  Comments/Action required notes for permit posted at space and properly filled out
                                                                                                                                                                                                                  Proper fall protection for hazard(Required)
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                                                                                                                                                                                                                  Max. file size: 120 MB.
                                                                                                                                                                                                                    Photo for proper fall protection for hazard
                                                                                                                                                                                                                    Comments/Action required notes for proper fall protection for hazard
                                                                                                                                                                                                                    Gas detector calibrated, bump tested and active in space(Required)
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                                                                                                                                                                                                                    Max. file size: 120 MB.
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                                                                                                                                                                                                                      Comments/Action required notes for gas detector calibrated, bump tested and active in space
                                                                                                                                                                                                                      Confined space procedures followed(Required)
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                                                                                                                                                                                                                        Comments/Action required notes for Confined space procedures followed

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                                                                                                                                                                                                                          Thank you for the opportunity to provide this audit report. If you have any questions, please contact me at the number or email below.

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