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Health and Safety Audit Form

This document is a health and safety construction audit form for a job site at Winterset Health. It contains checklists to audit personal protective equipment, electrical safety, lifting, work area conditions, scaffolds, hazardous materials, hot work, worker training, supervisors, and allows for comments. The form is used to ensure safety standards are met and identifies any issues that require retraining or notification of supervisors.

Uploaded by

Engr Abdul Shakoor Shaikh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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404 views2 pages

Health and Safety Audit Form

This document is a health and safety construction audit form for a job site at Winterset Health. It contains checklists to audit personal protective equipment, electrical safety, lifting, work area conditions, scaffolds, hazardous materials, hot work, worker training, supervisors, and allows for comments. The form is used to ensure safety standards are met and identifies any issues that require retraining or notification of supervisors.

Uploaded by

Engr Abdul Shakoor Shaikh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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WINTERSET HEALTH and SAFETY

HEALTH and SAFETY CONSTRUCTION SAFETY AUDIT FORM

Job Location: Field Supervisor: Safety Representive Performing Audit:

Scope of Project: Has area been cleared by Safety: Date:

Yes No N/A

PERSONAL PROTECTIVE EQUIPMENT ELECTRICAL SAFETY


Yes No N/A Yes No N/A
Hard hat GFI in Use
Gloves Machine Guards in Place
Safety Glasses Electric Cords in Good Condition
Work Shoes Adequate Electrical Connections
Knee Pads Exposed Electrical Wires
Hearing Protectors
Respirator LIFTING
Face Shield Yes No N/A
Welding Shield Proper Technique
Other – List: Cart in Use
Other Mechanical Devices

STACKING
WORK AREA - GENERAL Yes No N/A
Yes No N/A Balanced
Orderly Top Loaded
Housekeeping
Lighting Conditions SCAFFOLDS
Hazardous Conditions Exist Yes No N/A
If YES – List Level
Braced
Fall Protection in Place
Qualified Person Present
Dust Control in Place
Proper Supports
Noise Control in Place
Scaffold Inspection
HEALTH and SAFETY CONSTRUCTION SAFETY AUDIT FORM

HAZARDOUS MATERIALS USED LADDERS


Yes No
Chemicals: In Use
Appropriate for Job
Used Correctly
Others – List:
Comments:
Yes No N/A
Odor Present
MSDS Available

HOT WORK
Yes No N/A
Burning, Torch, Welding Operations
Fire Extinguishers in Place
Fire Protection in Place
Proper PPE Worn
Fire Watch

WORKER TRAINING and PERFORMANCE

Yes No Workers Following Safety Practices


If No list problems:

Yes No Workers Need Retraining


List Names:

Yes No Supervisor Informed

SUPERVISORS
Yes No Supervisor was available and had reviewed project
If “No” Explain:

Yes No Supervisor Informed of Audit Results

COMMENTS:

Safety Officer Signature Date

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