Field Safety Audit – Compliance Management System

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Field Safety Audit

General Information

Date *

Time *

:

Division

Sub-Contractor

Safety Auditor

Superintendent *

Project Number *

Area Reviewed *

Area being audited.

Weather *

Weather conditions.

Conditions *

Working conditions.

Toolbox Conducted *

Yes

No

Toolbox Topic *

Safety Auditor (E-mail Address) *

Superintendent (E-mail Address) *

Safety Lead

If different from Safety Auditor

Safety Lead (E-mail Address)

If Different from Safety Auditor

Personal Protective Equipment

001 Hard Hats *

Compliant

Non-Compliant

N/A

002 Eye Face *

Compliant

Non-Compliant

N/A

003 Respirators *

Compliant

Non-Compliant

N/A

004 Hearing *

Compliant

Non-Compliant

N/A

005 Hand *

Compliant

Non-Compliant

N/A

006 Foot *

Compliant

Non-Compliant

N/A

007 FRC *

Compliant

Non-Compliant

N/A

008 H V Vests *

Compliant

Non-Compliant

N/A

Material Handling - Manual

009 Technique *

Compliant

Non-Compliant

N/A

010 Tools *

Compliant

Non-Compliant

N/A

Material Handling - Equipment

011 Inspections *

Compliant

Non-Compliant

N/A

012 Equipment *

Compliant

Non-Compliant

N/A

Material Handling - Use

013 SDS *

Compliant

Non-Compliant

N/A

014 PPE *

Compliant

Non-Compliant

N/A

Material Handling - Storage

015 Flammables *

Compliant

Non-Compliant

N/A

016 Combustibles *

Compliant

Non-Compliant

N/A

Job Safety Analyses

017 Completed *

Compliant

Non-Compliant

N/A

018 Signed *

Compliant

Non-Compliant

N/A

Hand/Power Tools

019 Condition *

Compliant

Non-Compliant

N/A

020 Guarded *

Compliant

Non-Compliant

N/A

Electrical

021 Grounding *

Compliant

Non-Compliant

N/A

022 Aux Generator *

Compliant

Non-Compliant

N/A

Scaffolds - Ladders

023 Inspections *

Compliant

Non-Compliant

N/A

024 Use *

Compliant

Non-Compliant

N/A

Working at Heights

025 FA Systems *

Compliant

Non-Compliant

N/A

026 FA Inspection *

Compliant

Non-Compliant

N/A

Hot Work

027 Permit *

Compliant

Non-Compliant

N/A

028 Fire Watch *

Compliant

Non-Compliant

N/A

Pressure Testing

029 Whip Check *

Compliant

Non-Compliant

N/A

030 Barricades *

Compliant

Non-Compliant

N/A

Signs and Barricades

031 Installed *

Compliant

Non-Compliant

N/A

032 Condition *

Compliant

Non-Compliant

N/A

Walking Surfaces

033 Holes Guarded *

Compliant

Non-Compliant

N/A

034 Surfaces *

Compliant

Non-Compliant

N/A

Hygiene

035 Rest Rooms *

Compliant

Non-Compliant

N/A

036 Pot Water *

Compliant

Non-Compliant

N/A

Traffic Control

037 Flaggers *

Compliant

Non-Compliant

N/A

038 Signage *

Compliant

Non-Compliant

N/A

Confined Spaces

039 Permitted *

Compliant

Non-Compliant

N/A

040 Rescue Plan *

Compliant

Non-Compliant

N/A

Excavations

041 Insp Report *

Compliant

Non-Compliant

N/A

042 Access Egress *

Compliant

Non-Compliant

N/A

Lockout Tag out

043 Program *

Compliant

Non-Compliant

N/A

044 Knowledge *

Compliant

Non-Compliant

N/A

Haz. Communication

045 SDS *

Compliant

Non-Compliant

N/A

046 Knowledge *

Compliant

Non-Compliant

N/A

Fire Protection

047 Smoking *

Compliant

Non-Compliant

N/A

048 Housekeeping *

Compliant

Non-Compliant

N/A

Welding Operations

049 PPE *

Compliant

Non-Compliant

N/A

050 Cylinders *

Compliant

Non-Compliant

N/A

051 Leads *

Compliant

Non-Compliant

N/A

052 Fire Protection *

Compliant

Non-Compliant

N/A

Drilling/Boring

053 JSA *

Compliant

Non-Compliant

N/A

054 PPE *

Compliant

Non-Compliant

N/A

Radiation

055 JSA *

Compliant

Non-Compliant

N/A

056 PPE *

Compliant

Non-Compliant

N/A

Attachments

Maximum file size: 516MB

Documents, pictures, drawings, etc.

Non-Compliance and Actions Taken

Include Line Number and Brief Description of Observation

Overview of Incidents During The Day

Simply Add N/A for No Incidents

Signature *

Clear

If you are human, leave this field blank.