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2024 West Division SEA Template
2024 West Division SEA Template
Lindsay Van Woert

2024 West Division SEA Template

CRH AMAT Sustainability Excellence Awards inspection form.

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Free 2024 West Division SEA Template Checklist

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Title Page

  • Company name:

    • APAC
    • Central Sand & Gravel
    • Cessford Construction
    • Cohron
    • ConCo Companies
    • Des Moines Asphalt & Paving
    • Gerhold Concrete
    • Hallett Materials - Central
    • Hallett Materials - Western
    • Lyman Richey Sand & Gravel
    • Minnesota Paving & Materials
    • Omni Engineering
    • Ready Mixed Concrete
    • Siouxland Ready Mix
    • Standard Ready Mix

  • Site name:

  • Line of business

  • Inspection location:

  • Date of inspection:

  • Conducted by:

    • Clint Allen
    • Lindsay Van Woert
    • Thomas Silknitter
    • Rosa Mendoza
    • Andrew Wojtowitz
    • Sarah Blank
    • Jaxon Haynes
    • Andy Peeples
    • Wyatt Robinson
    • Austin Livingston

  • Others present:

  • Manager

    • Bob Bednarek
    • Bob Roos
    • Bryan Campbell
    • Caleb Morss
    • Chad Phillips
    • Concepcion Ortiz
    • Derek Fredericksen
    • Gary Loyd
    • Jonathan Nalevanko
    • Scott Bohm
    • Buck Houck
    • Keith Soper
    • Kerry Jeffries
    • Shane Davenport
    • Steven Sharp
    • Troy Holloway
    • Not Listed
    • Derek Berge

  • Site/Plant manager

  • Announced/Unannounced

Hazardous Materials

  • Hazardous Materials Section Applicable (Is this facility a shop?) (100% required for Gold Standard)

  • No regulatory issues since last coaching opportunity

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Waste streams properly characterized

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    haz4.jpg

  • Waste records available

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    haz2.jpg

  • Used oil, batteries, universal waste, and asbestos properly managed

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    haz3.jpg

  • Hazardous Materials comments

Air Quality

  • Air Quality Section Applicable (100% required for Gold Standard)

  • No regulatory issues since last coaching opportunity

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Air permit is available, operator familiar

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    air1.jpg

  • Air records available and up-to-date

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    air2.jpg

  • Air permit requirements being met

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    air3.jpg

  • Air Quality comments

Water Quality

  • Water Quality Section Applicable (100% required for Gold Standard)

  • No regulatory issues since last coaching opportunity

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • SWPPP available, operator familiar

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    water1.jpg

  • Water records available and up-to-date

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    water2.jpg

  • BMP's effective and maintained

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    water3.jpg

  • Water Quality comments

Spill Prevention

  • Spill Prevention Section Applicable (Does this site/plant have a SPCC Plan?) (100% required for Gold Standard)

  • No regulatory inspection since last coaching opportunity

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • SPCC plan available, operator familiar

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    spill1.jpg

  • Records available and up-to-date

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    SPCC Records.png

  • All plan requirements maintained and functional

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    spill3.jpg

  • Spill Prevention comments

Housekeeping

  • Trash picked up, properly contained

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    house1.jpg

  • Staining maintained

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    house2.jpg

  • Metal/parts properly managed

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    house3.jpg

  • Drums/containers closed, labeled, and properly stored

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    house4.jpg

  • Plant areas, entrance, and exits swept and free of dirt

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    house5.jpg

  • Tires, lumber, and miscellaneous items properly managed

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    house6.jpg

  • 5S process implemented and documented

    • -2
    • -1.75
    • -1.50
    • -1.25
    • -1.00
    • -0.75
    • -0.50
    • -0.25
    • 0.00
    • 0.25
    • 0.50
    • 0.75
    • 1.00
    • 1.25
    • 1.50
    • 1.75
    • 2.00

  • Things to look for...

    house7.jpg

  • Housekeeping comments

Training, Stewardship, and Overall Impression

  • Compliance Hotline

    • Hotline Posted
    • Missing Hotline - Copy Provided
    • See notes below

  • Hazardous Materials Section Applicable

  • Hazardous waste training completed within 24-months of inspection date

  • Air Quality Section Applicable

  • Opacity reader available (Someone on site has attended smoke school every other year.)

  • Does facility meet CRH baseline sustainability expectations?

  • Baseline Sustainability Guidelines

    Baseline.png

  • Is facility a CRH sustainability leader?

  • Sustainability Leader Guidelines

    Leader.png

  • Please type unique sustainability aspects of the facility (solar power on site, electric haul trucks, WHC certified site, etc.)

  • Community Perception score

  • Community Perception comments

  • Overall Impression score

  • Overall Impression comments

Overall Results

  • Gold Standard Score = 100% on applicable environmental compliance sections

  • Category

2024 West Division SEA Template
Lindsay Van Woert

2024 West Division SEA Template

CRH AMAT Sustainability Excellence Awards inspection form.

Use this Template
The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.

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