2024 E-Mobility External Service Provider (ESP) Assessment Template

• Name of ESP Company

• Conducted on

  Date
• Location
  Address

• Name of ESP Assessed

• Assessor Name

• Rise Case Number?

Pre-Job Planning and Environmental Awareness

• Is scope of work defined and work instructions available?

  Safe

  At Risk

  N/A

• Did complete Stop Take 5 (Risk Assessment) or similar document?

  Safe

  At Risk

  N/A

• Has an emergency contact been defined?

  Safe

  At Risk

  N/A

• Did Person in Charge of Work conduct a toolbox safety discussion prior to start of, and/or, change in any maintenance activities?<br>(When multiple people are working.)

  Safe

  At Risk

  N/A

• Did ESP restrict access to the worksite by using cones / barriers / caution tape?

  Safe

  At Risk

  N/A

• Are first aid supplies available?

  Safe

  At Risk

  N/A

• Is access and egress unobstructed? (Traffic concerns addressed)

  Safe

  At Risk

  N/A

• Is sun/rain protection available and easy to put in place by one person?

  Safe

  At Risk

  N/A

• Is adequate water available?

  Safe

  At Risk

  N/A

• Are there concerns with the public? Have they been adequately addressed?

  Safe

  At Risk

  N/A

Personal Protective Equipment

• Did ESP remove all jewelry and other exposed metal prior to starting electrical work?

  Safe

  At Risk

  N/A

• Did ESP bring and wear safety glasses?

  Safe

  At Risk

  N/A

• Did ESP wear 8 calorie/cm2 (or higher) arc flash clothing at all times while onsite? Is clothing in good condition?

  Safe

  At Risk

  N/A

• Was 40 calorie/cm2 (or higher) arc flash clothing and hood available?

  Safe

  At Risk

  N/A

• Did ESP bring and use 8 calories/cm2 or higher face shield? (If needed.)

  Safe

  At Risk

  N/A

• Did ESP bring and inspect leather gloves?

  Safe

  At Risk

  N/A

• Did ESP bring electrically rated rubber gloves? Were electrically rated rubber gloves tested in the last 6 months? Were rubber gloves inspected prior to use?

  Safe

  At Risk

  N/A

• Did ESP wear leather EH rated work boots?

  Safe

  At Risk

  N/A

• Did ESP use hearing protection when required?

  Safe

  At Risk

  N/A

Tools & Equipment

• Does ESP have insulated tools available and in good working condition?

  Safe

  At Risk

  N/A

• Is test / measurement equipment in good working order and calibration valid?

  Safe

  At Risk

  N/A

Ergonomics

• Did ESP use knee pads / mats if in a kneeling position for more than 5 minutes?

  Safe

  At Risk

  N/A

• Was it necessary for ESP to use forceful exertion? Shoulder, elbow, wrist.

  Safe

  At Risk

  N/A

• Was work above shoulder height necessary for an extended period?

  Safe

  At Risk

  N/A

• Was ESP working in an awkward position for an extended period of time without taking microbreaks?

  Safe

  At Risk

  N/A

• Did ESP lift and place following proper back safety procedures?

  Safe

  At Risk

  N/A

Policies & Procedures. (Were the following company policies followed if used?)

• Proper Ladder Safety?

  Safe

  At Risk

  N/A

• Work Hours? Has ESP exceed 12 hours more than once in the last 10 days?

  Safe

  At Risk

  N/A

Electrical and Lockout Tagout

• Have all energy sources been identified and controlled via lock and tag?

  Safe

  At Risk

  N/A

• Do all members of team working on locked equipment have locks applied to equipment or in a group lock box?

  Safe

  At Risk

  N/A

• Is locked equipment verified to be in an electrically safe working condition via appropriate testing means? (Live, Dead, Live, ABB Seven Steps)

  Safe

  At Risk

  N/A

• What is the one thing we can do as an organization to make your job better?

• Comments from ESP or Assessor?

• Signature of ESP

  Sign

• Signature of assessor

  Sign

• Date of Signatures

  Date

• Pictures to be added

  Media