2018 Vac Operations Audit Checklist

Information:

• Company Name:

  Banks Gas Services, Inc.

• Jobsite Foreman:

• Audit Type:

  Quality Control

  Quality Assurance

  Daily Checklist

• Prepared by:

• Audit Location:
  Address

• Conducted on:

  Date

Jobsite Classifications:

• Work Type:

  Problem Locate

  Corrossion Control

  Meter Protection

  Pipeline Adandonment

• Gas Company?

  Columbia Gas Of PA

  People's Natural Gas

• Required Training Completed

  YES

  NO

• OQ Valid

  YES

  NO

• Sub Contractor Involved?

  Yes

  No

• Sub Contractor Name:

  Flagger Force

  Wright Flagging

  Billy Thompson Utility Services

• Work Zone

Work Zone:

• Are Flaggers Required?

  Yes

  No

• Flagger 1- CHIEF FLAGGER:

• Class 2 Safety Vest worn

  Safe

  At Risk

  N/A

• Hardhat worn

  Safe

  At Risk

  N/A

• Safety Glasses worn

  Safe

  At Risk

  N/A

• Training card available

  Safe

  At Risk

  N/A

• Flagger 2- FLAGGER NAME:

• Class 2 Safety Vest worn

  Safe

  At Risk

  N/A

• Hardhat worn

  Safe

  At Risk

  N/A

• Safety Glasses worn

  Safe

  At Risk

  N/A

• Training card available

  Safe

  At Risk

  N/A

• Work Zone Set Up:

Work Zone Set Up:

• Is the Road Closed?

  Yes

  No

• Proper Signage placed

  Safe

  At Risk

  N/A

• Cones placed to barricade road

  Safe

  At Risk

  N/A

• Flaggers in proper position to monitor road access

  Safe

  At Risk

  N/A

• Work zone signs properly placed (100 feet apart in urban area, 200-300 feet apart in suburban area , 500 feet apart in rural area or high speed road)

  Safe

  At Risk

  N/A

• Flaggers positioned 40 feet in front of taper area

  Safe

  At Risk

  N/A

• Taper area contains at least 6 cones

  Safe

  At Risk

  N/A

• Work Zone contains a buffer area for errant vehicles

  Safe

  At Risk

  N/A

• Cones are properly placed around work area.

  Safe

  At Risk

  N/A

• Flaggers have an escape route

  Safe

  At Risk

  N/A

• Flaggers consider the curves of the road when setting up

  Safe

  At Risk

  N/A

• If applicable, arrow-board is properly positioned and correct signage is placed

  Safe

  At Risk

  N/A

• Flagging Operations:

Flagging Operations:

• Flaggers maintain adequate communications while flagging

  Safe

  At Risk

  N/A

• Flaggers are not on cell phone

  Safe

  At Risk

  N/A

• Proper flagging equipment selected for road type (slow/stop paddles used in one lane-two way road, red flag used in intersections)

  Safe

  At Risk

  N/A

• Flaggers use proper techniques when flagging

  Safe

  At Risk

  N/A

• Flagging Equipment meets proper standards

  Safe

  At Risk

  N/A

• Night Flagging

Night Flagging:

• Light stand positioned properly

  Safe

  At Risk

  N/A

• Flaggers wearing Class 3 vest

  Safe

  At Risk

  N/A

• Illumination disks used in taper area

  Safe

  At Risk

  N/A

• Red light wands used in addition with a slow/stop sign or red flag

  Safe

  At Risk

  N/A

• Crew properly places Road Work signs <br>

  Safe

  At Risk

  N/A

• Crew properly places cones around vehicle/ work area

  Safe

  At Risk

  N/A

• Work Site Orderly (minimal trip hazards)

  Safe

  At Risk

  N/A

• Pedestrian traffic addressed as necessary

  Safe

  At Risk

  N/A

• Personal Protective Equipment

Personal Protective Equipment:

• Employee 1- FOREMAN:

• Hardhat worn

  Safe

  At Risk

  N/A

• Safety Vest worn

  Safe

  At Risk

  N/A

• Safety Glasses worn

  Safe

  At Risk

  N/A

• Hearing Protection worn as appropriate (85 dB or higher)

  Safe

  At Risk

  N/A

• Gloves worn as appropriate

  Safe

  At Risk

  N/A

• Foot Protection

  Safe

  At Risk

  N/A

• Employee 2- LABORER:

• Hardhat worn

  Safe

  At Risk

  N/A

• Safety Vest worn

  Safe

  At Risk

  N/A

• Safety Glasses worn

  Safe

  At Risk

  N/A

• Hearing Protection worn as appropriate (85 dB or higher)

  Safe

  At Risk

  N/A

• Gloves worn as appropriate

  Safe

  At Risk

  N/A

• Foot Protection

  Safe

  At Risk

  N/A

• Employee 3- LABORER:

• Hardhat worn

  Safe

  At Risk

  N/A

• Safety Vest worn

  Safe

  At Risk

  N/A

• Safety Glasses worn

  Safe

  At Risk

  N/A

• Hearing Protection worn as appropriate (85 dB or higher)

  Safe

  At Risk

  N/A

• Gloves worn as appropriate

  Safe

  At Risk

  N/A

• Foot Protection

  Safe

  At Risk

  N/A

• Excavation Safety

Excavation Safety:

• Valid One Call

  Safe

  At Risk

  N/A

• Care taken while digging around utilities to prevent damages

  Safe

  At Risk

  N/A

• Proper safety procedures followed. Employees exercise caution while working around excavations.

  Safe

  At Risk

  N/A

• Equipment and Tools

Equipment and Tools:

• CGI Calibrated and working properly

  Safe

  At Risk

  N/A

• Equipment and tools in safe operative condition

  Safe

  At Risk

  N/A

• Tools are stored in designated staged area as appropriate to minimize trip hazards.

  Safe

  At Risk

  N/A

• All air hose connections contain a Safety Whip Cord to prevent accidental whipping if connection disengages.

  Safe

  At Risk

  N/A

• Employees use tools properly and precautions are taken while in use

  Safe

  At Risk

  N/A

• Proper tool grip/footing

  Safe

  At Risk

  N/A

• Vehicle Safety/DOT:

Vehicle Safety/DOT:

• Vehicle Number

• Cab Free of Clutter

  Safe

  At Risk

  N/A

• Crash Packet Available

  Safe

  At Risk

  N/A

• Registration/Insurance available

  Safe

  At Risk

  N/A

• Drivers License available

  Safe

  At Risk

  N/A

• DOT Medical Cards available

  Safe

  At Risk

  N/A

• First Aid Kit available

  Safe

  At Risk

  N/A

• Spill Kit available

  Safe

  At Risk

  N/A

• Flares/Triangles available

  Safe

  At Risk

  N/A

• In-Cab Fire Extinguisher inspected and secured if applicable.

  Safe

  At Risk

  N/A

• Vehicle functioning properly

  Safe

  At Risk

  N/A

• Wheel chocks in place

  Safe

  At Risk

  N/A

• Load Securement:

Load Securement:

• Jackhammers properly secured

  Safe

  At Risk

  N/A

• All tools/equipment properly secured.

  Safe

  At Risk

  N/A

• Ergonomics/Body Mechanics

Ergonomics/Body Mechanics:

• Safe Lifting practiced

  Safe

  At Risk

  N/A

• Employees ensure proper footing/grip

  Safe

  At Risk

  N/A

• Hazmat/Chemical

Hazmat/Chemical:

• Secondary containers labeled if applicable

  Safe

  At Risk

  N/A

• Fire Protection

Fire Protection:

• Fire Extinguisher Upwind of Excavation

  Safe

  At Risk

  N/A

• Fire Extinguisher Inspected

  Safe

  At Risk

  N/A

• Hazard Communication

Hazard Communication:

• Pre-Job Briefing completed (Job site and task hazards relayed to employees)

  Safe

  Best Practice

  N/A

• Initiate Stop Work Authority (SWA) if appropriate.

  Safe

  At Risk

  N/A

• Employees demonstrate hazard recognition, avoidance, and communication

  Safe

  At Risk

  N/A

• GPS/Problem Locating

GPS/Problem Locate:

• Air lance and vac hose used properly to expose utility

  Safe

  At Risk

  N/A

• Employees properly located the facility

  Safe

  At Risk

  N/A

• Employees dug in a manner to prevent damages

  Safe

  At Risk

  N/A

• Corrosion Control

Corrosion Control:

• Pipe cleaned to bare steel

  Safe

  At Risk

  N/A

• Properly prepared anode lead wire

  Safe

  At Risk

  N/A

• CGI taken to verify no gaseous atmosphere prior to burning anode onto pipeline

  Safe

  At Risk

  N/A

• Anode positioned at proper distance away from pipeline (1 foot beneath, 1 foot lateral)

  Safe

  At Risk

  N/A

• Exothermic weld properly performed

  Safe

  At Risk

  N/A

• Verified good lead wire connection

  Safe

  At Risk

  N/A

• Properly coated the weld

  Safe

  At Risk

  N/A

• Test station installed as required

  Safe

  At Risk

  N/A

• Meter Protection

Meter Protection:

• Is the Meter Set Remote?

  Yes

  No

• How Many Post are required?

  Select 1 2 3 4 5 6 7 8

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8

• Caution used when digging around meter set to prevent service line damage

  Safe

  At Risk

  N/A

• Meter posts installed at proper distance from meter set (1 foot)

  Safe

  At Risk

  N/A

• Meter posts installed at proper depth (2 feet)

  Safe

  At Risk

  N/A

• Meter posts installed using concrete mix

  Safe

  At Risk

  N/A

• Pipeline Abandonment

Pipeline Abandonment:

• Verified gas is shut off at accessible locations (Via: curb box, and meter shutoff valve)

  Safe

  At Risk

  N/A

• How was the gas stopped prior to separating?

  Wound Cutter Down in Punch Tee

  Squeezed Off Service Line with squeeze off tool

  Had to perform cut off on the fly

Stopping Gas Method: Using Punch Tee:

• Properly stopped gas using proper procedures by winding cutter down in punch tee

  Safe

  At Risk

  N/A

• Proper clothing used

  Safe

  At Risk

  N/A

Stopping Gas Method: Service Line Squeeze Off

• Selected proper squeeze off area. No closer than 12" from any fitting

  Safe

  At Risk

  N/A

• Anti-static spray used on pipe to dissipate charges accumulated on pipe

  Safe

  At Risk

  N/A

• Proper clothing used (long-sleeved cotton shirt)

  Safe

  At Risk

  N/A

• Squeeze tool properly grounded

  Safe

  At Risk

  N/A

• Squeeze off rate properly followed (1 inch per minute)

  Safe

  At Risk

  N/A

• Verified completion of squeeze (gas fully stopped)

  Safe

  At Risk

  N/A

• Release rate properly followed (1/2 inch per minute)

  Safe

  At Risk

  N/A

• Squeeze area properly marked and labeled after completion

  Safe

  At Risk

  N/A

• Separation of Steel Pipeline

Separation of Steel Pipe:

• Temporary bond cables used to achieve proper grounding

  Safe

  At Risk

  N/A

• Separated as close to the main as practical

  Safe

  At Risk

  N/A

• Capped live and dead end section of pipe

  Safe

  At Risk

  N/A

• Dismantled meter/regulator set

  Safe

  At Risk

  N/A

• Pipe Joining; Mechanical Fittings

Pipe Joining: Mechanical Fittings:

• What type of mechanical fitting was installed?

  Select Stab Fitting Compression Fitting Met Fitting

  • Stab Fitting
  • Compression Fitting
  • Met Fitting

• Properly cut and prepared pipe surface. Pipe/fitting clean and contaminant free

  Safe

  At Risk

  N/A

• Properly measured and marked pipe

  Safe

  At Risk

  N/A

• Installed as per manufacturers instructions

  Safe

  At Risk

  N/A

• Tapping

Tapping

• Proper PPE/clothing used (long sleeved cotton shirt)

  Safe

  At Risk

  N/A

• Fire extinguisher available

  Safe

  At Risk

  N/A

• Uses proper tapping tool

  Safe

  At Risk

  N/A

• Cutter is wound up and left in proper position

  Safe

  At Risk

  N/A

• Leak Testing

Leak Testing:

• Performed leak test with leak seek on all fittings after tapping

  Safe

  At Risk

  N/A

• Detected no leaks/bubbles

  Safe

  At Risk

  N/A

• Backfilling

Backfilling:

• Properly backfills hole using proper fill

  Safe

  At Risk

  N/A

• Install marker balls when applicable

  Safe

  At Risk

  N/A

• Compacts soil in intervals to prevent sinking

  Safe

  At Risk

  N/A

Additional Notes:

• Reviewed Gas Standard on the Task Being Performed

  Safe

  Best Practice

  N/A

• Pre-Job Pictures Taken

  Safe

  At Risk

  N/A

• Post-Job Pictures Taken

  Safe

  At Risk

  N/A

• Further Action Required

  Yes

  No

• General comments

• Years of Service

  0-5 Years

  5-10 Years

  10+ Years