HEALTH and SAFETY ENVIRONMENT (HSE) CONSTRUCTION SAFETY AUDIT FORM

PROJECT NAME :
PROJECT LOCATION :
DAY / DATE :
SUB / SEGMEN :

PERSONAL PROTECTIVE EQUIPMENT ELECTRICAL SAFETY

Yes No N/A Yes No N/A
Safety Helmet Machine guards in place
Gloves Electric cords in good condition
Safety glasses Adequate electrical connections
Work/safety shoes Exposed electrical wires
Knee pads Other - List :
Hearing protectors
Respirator
Face shield
Welding Shield
Safety belt LIFTING
Safety mask Yes No N/A
Safety uniform Proper Technique
Safety Signs Cart in Use
Others - list : Other Mechanical devices
Other - List :

WORK AREA - GENERAL SCAFFOLDS

Yes No N/A Yes No N/A
Orderly Level
Housekeeping Braced
Lighting conditions Fall protection in place
Dust control in place Qualified person present
Noise Control in place Proper Supports
Hazardous Condition Exist Scaffold inspection
if Yes - Lis Others - List

Note :

Contractor HSE Officer / Consultant Field Supervisor

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