SAFETY INSPECTION / AUDIT CHECKLIST

DATE: LEGEND
A:-Adequate
REGION: PROJECT: B:-Need Consideration
within 2-5 days
Name of Project- C:-Need Immediate action
Name of Safety Officer / Representative: NA;-Not Applicable

. A B C NA
1 JOB SITE INFORMATION
Site fencing provided & entry restricted
Provision for visitors helmet & visitors record maintained
Job Site warning posters posted
Emergency Telephone numbers posted
Medical services, first aid kit and qualified first aider available
Safety Inuction & Tool box talks provided & documented
Scheduled safety committee meetings held & documented

2 HOUSEKEEPING & SANITATION

Working areas generally neat
Passageways and walkways clear
Waste & trash regurally disposed
Lighting adequate for all work task
Projecting nails removed or bent over
Waste container provided & used
Sanitary facilities adequate and clear
Portable water available for drinking

3 FIRE PREVENTION
Fire instruction provided to personnel
Adequate fire extinguishers provided, checked & accessible
NO SMOKING signs posted & enforced where needed

4 ELECTRICAL INSTALLATIOS
ELCB"s being used
Adequate wiring, well insulated, grounded, protected from damage
Extension cords with bare wires or missing pin plugs taken out of service
Terminal boxes equipped with required covers

5 HAND TOOLS & POWER TOOLS

Proper tools being used for each job
Tools regulary inspected and maintained
Good housekeeping where tools are used
Tools & cords in good condition
Proper grounding of all tools
Proper instruction in use provided
All mechanical guard in use
Right tool being used for job at hand
Wiring properly installed

6 FALL PROTECTION
Safety guard rails provided & secured properly
Adequate safety belts available
Employees exposed to fall hazards are using safety belt & tied off
Employees below protected from falling objects

7 LADDERS
Ladders extended at leas 3feet above the landing
Ladders properly secured to prevent slipping, sliding or falling
Job-built ladders properly constructed
Stepladders fully open when in use
Metal ladders not used around electrical hazards
Ladders with split or missing rugs taken out of service
 A B C NA
8 SCAFFOLDING
All scaffolding inspected daily & documented
Erected on sound rigid footing
Tied to structure as required
Guard rails, intermediate rails & toe board in place
Employyes protected from falling object
Adequate, sound working platform provided
Proper access provided
Employees below protected from falling objects

9 FLOOR & WALL OPENINGS

All floor openings or deck openings are covered or barricaded & secured
Perimeter protection in place
Material stored away from edge

10 TRENCHES, EXCAVATION & SHORING

Adjucent structures properly shored
Excavation shored, shoielded or slopped as required
Roads & sidewalks supported and protected
Materials are stored at leasy two feet away from excavation
Excavation barricades and lighting adequate
Equipment a safe distance from edge of trench / excavation
Access ladders provided every 25 feet distance
Equipment ramp adequate

11 HANDLING & STORAGE OF MATERIAL

Materials properly stored & stacked
Passageways clear
Stacks on firm footing, not too high
Materials protected from weather condition
Employees using proper lifting methods

12 WELDING AND CUTTING

Operators qualified
Screens and shields used when needed
Goggles, welding helmets, gloves, cloathing used as required
Equipment in safe operating condition
Electrical equipment grounded
Powercables and hoses protected
Fire extinguisher of proper type nearby
Flammable materials protected or removed
Gas cylinders secured upright

13 HEAVY EQUIPMENT
Inspection and maintenance records up to date
Lights, brakes, warning signals operative
Wheels chocked when necessary
Equipment properly escured when not in use
Noise arrestors in use

14 MOTOR VEHICLES
Roadways or walkways hazards effectively barricaded
Inspection and maintainence records up to date
Operators qualified for vehicles in use
Brakes, lights, warning devices operative
Reverse alaram provided
15 HOIST CRANES AND DERRICKS
Cables and sheaves regularly inspected
Slings & chains hooks and eyes bolts inspected before use and documanted
Equipment firmly supported
All lifting tackles & euipment load tested and certified & documented
Outriggers are extended and swing radius barricade in place
Operator is familiar with rated load charts and posted
Proper loading for capacity at lifting radius
Operators log up to date
Signal persons where needed
Employees kept away from under suspended load

16 STEEL ERECTION
Hard hat warn as required
Tools and materials secured from falling
Required PPE in use
Floor openings covered or barricaded
Ladders, stairs or other safe access provided
Daily inspection of hoisting apparatus

17 CONCRETE CONSTRUCTION
Forms properly installed and braced
Adequate shoring, plumbed and cross-braced
Hard hats, boots gloves and eye protection worn at all times
Nails bent over or removed and stripped material removed from area
Mixing and transport equipment properly routed
Employees protected from cement dust

18 PERSONAL PROTECTIVE EQUIPMENT MONITORED BY SUPERVISORS

Hard hats available on-site and are being worn
Safet belts available on-site and are being worn, securly anchored
Safety glasses being worn
Hearing protection being worn when required
Dust respirators worn when required
Other required PPE being used when required

19 ANYOTHER OBSERVATIONS

20 COMMENTS
As per attached photographs.

Signature of Auditor :

Signature of Project-in charge

NOTE
ATTACHED COMPLIANCE REPORT FORM MUST BE FORWARDED WITHIN SEVEN DAYS
 COMPLIANCE REPORT OF SAFETY INSPECTION / AUDIT
DATE

REGION: PROJECT

Name of Project-in-charge:
Name of Safety Officer / Representative

. COMPLIANCE ACTION TAKEN DATE

1 JOB SITE INFORMATION
Site fencing provided & entry restricted
Provision for visitors helmet & visitors record maintained
Job Site warning posters posted
Emergency Telephone numbers posted
Medical services, first aid kit and qualified first aider available
Safety Inuction & Tool box talks provided & documented
Scheduled safety committee meetings held & documented

2 HOUSEKEEPING & SANITATION

Working areas generally neat
Passageways and walkways clear
Waste & trash regurally disposed
Lighting adequate for all work task
Projecting nails removed or bent over
Waste container provided & used
Sanitary facilities adequate and clear
Portable water available for drinking

3 FIRE PREVENTION
Fire instruction provided to personnel
Adequate fire extinguishers provided, checked & accessible
NO SMOKING signs posted & enforced where needed

4 ELECTRICAL INSTALLATIOS
ELCB"s being used
Adequate wiring, well insulated, grounded, protected from damage
Extension cords with bare wires or missing pin plugs taken out of service
Terminal boxes equipped with required covers

5 HAND TOOLS & POWER TOOLS

Proper tools being used for each job
Tools regulary inspected and maintained
Good housekeeping where tools are used
Tools & cords in good condition
Proper grounding of all tools
Proper instruction in use provided
All mechanical guard in use
Right tool being used for job at hand
Wiring properly installed

6 FALL PROTECTION
Safety guard rails provided & secured properly
Adequate safety belts available
Employees exposed to fall hazards are using safety belt & tied off
Employees below protected from falling objects

7 LADDERS
Ladders extended at leas 3feet above the landing
Ladders properly secured to prevent slipping, sliding or falling
Job-built ladders properly constructed
Stepladders fully open when in use
Metal ladders not used around electrical hazards
Ladders with split or missing rugs taken out of service
 COMPLIANCE ACTION TAKEN DATE
8 SCAFFOLDING
All scaffolding inspected daily & documented
Erected on sound rigid footing
Tied to structure as required
Guard rails, intermediate rails & toe board in place
Employyes protected from falling object
Adequate, sound working platform provided
Proper access provided
Employees below protected from falling objects

9 FLOOR & WALL OPENINGS

All floor openings or deck openings are covered or barricaded & secured
Perimeter protection in place
material stored away from edge

10 TRENCHES, EXCAVATION & SHORING

Adjucent structures properly shored
Excavation shored, shoielded or slopped as required
Roads & sidewalks supported and protected
Materials are stored at leasy two feet away from excavation
Excavation barricades and lighting adequate
Equipment a safe distance from edge of trench / excavation
Access ladders provided every 25 feet distance
Equipment ramp adequate

11 HANDLING & STORAGE OF MATERIAL

Materials properly stored & stacked
Passageways clear
Stacks on firm footing, not too high
Materials protected from weather condition
Employees using proper lifting methods

12 WELDING AND CUTTING

Operators qualified
Screens and shields used when needed
Goggles, welding helmets, gloves, cloathing used as required
Equipment in safe operating condition
Electrical equipment grounded
Powercables and hoses protected
Fire extinguisher of proper type nearby
Flammable materials protected or removed
Gas cylinders secured upright

13 HEAVY EQUIPMENT
Inspection and maintenance records up to date
Lights, brakes, warning signals operative
Wheels chocked when necessary
Equipment properly escured when not in use
Noise arrestors in use

14 MOTOR VEHICLES
Roadways or walkways hazards effectively barricaded
Inspection and maintainence records up to date
Operators qualified for vehicles in use
Brakes, lights, warning devices operative
Reverse alaram provided
15 HOIST CRANES AND DERRICKS COMPLIANCE ACTION TAKEN DATE
Cables and sheaves regularly inspected
Slings & chains hooks and eyes bolts inspected before use and documanted
Equipment firmly supported
All lifting tackles & euipment load tested and certified & documented
Outriggers are extended and swing radius barricade in place
Operator is familiar with rated load charts and posted
Proper loading for capacity at lifting radius
Operators log up to date
Signal persons where needed
Employees kept away from under suspended load

16 STEEL ERECTION
Hard hat warn as required
Tools and materials secured from falling
Required PPE in use
Floor openings covered or barricaded
Ladders, stairs or other safe access provided
Daily inspection of hoisting apparatus

17 CONCRETE CONSTRUCTION
Forms properly installed and braced
Adequate shoring, plumbed and cross-braced
Hard hats, boots gloves and eye protection worn at all times
Nails bent over or removed and stripped material removed from area
Mixing and transport equipment properly routed
Employees protected from cement dust

18 PPE MONITORED BY SUPERVISORS

Hard hats available on-site and are being worn
Safet belts available on-site and are being worn, securly anchored
Safety glasses being worn
Hearing protection being worn when required
Dust respirators worn when required
Other required PPE being used when required

19 COMPLIANCE ACTION TAKE ON OBSERVATIONS

20 COMPLIANCE ACTION TAKEN ON COMMENTS

Name of Project-in charge

Signature of Project-in charge