AECI ROW Audit Rev. 3

• Location (nearest town)

• Foreman

• Cooperative Name

• Conducted on

  Date

• Work being performed

• Prepared by

• Location
  Address

• Audit Guidance: -All unsafe acts shall be stopped immediately. -Field Observations shall include photos for both safe and unsafe operations. Photos should be annotated with what the observer is focused on at the time of the audit. -Any item marked as a deficiency shall have a photo (if possible) and a detailed description. -All comments should identify those crew members performing the task correctly and/or incorrectly. -Equipment being inspected shall be listed and/or have a photo with the unit number displayed. -All audits shall be reviewed with the PIC prior to departure from the site. Corrective actions shall be assigned with due dates and noted on the audit. -Any audits being forwarded to the client shall be reviewed by more than one safety team member prior to being sent.

• All audit findings shall have an assigned weight (1-4) assigned per the below matrix. Document the weighted number rating in the comment section associated with the applicable question.

  

Communication

• When was the last time you were coached from a member of management on safety?

  Safe

  At Risk

  N/A

• Prior to making a decision, do you think Likelihood or Consequences?

  Safe

  At Risk

  N/A

• Human Performance tools observed and bieng utilized correctly?

  Safe

  At Risk

  N/A

• Three part communication utilized?

  Safe

  At Risk

  N/A

• Proper use of hand signals and flagging techniques? Spotters used appropriately?

  Safe

  At Risk

  N/A

• Hand Held radios mounted, charged and being utilized properly?

  Safe

  At Risk

  N/A

Procedures and Documents

• Tailboard/Job Hazard/Driving assessment completed?

  Safe

  At Risk

  N/A

• Lessons Learned topic discussed?

  Safe

  At Risk

  N/A

• Paperwork (Private Motor Carrier License, Haz-Mat Registration, Vehicle Registration(s), Insurance Certificate, IFTA License & Stickers, Annual Inspections(s).392.2-396.17?

  Safe

  At Risk

  N/A

• Are SDS available for all hazardous chemicals on site ?

  Safe

  At Risk

  N/A

Displays and Labels

• Is the work site properly marked and/or barricaded? 5' rule in compliance?

  Safe

  At Risk

  N/A

• Early warning signs and/or flagging placed for overhead/underground hazards?

  Safe

  At Risk

  N/A

Environmental

• Spill kits available and stocked? Spill response understood and practiced? Spills reported?

  Safe

  At Risk

  N/A

Schedule

• Crew schedules identified and fatigue management addressed?

  Safe

  At Risk

  N/A

• Proper PPE (Hard Hat, Glasses, Hearing Protection, leather or insulated gloves, FR, Safety Vest, Steel toe boots)?

  Safe

  At Risk

  N/A

• Schedules communicated for multiple operations?

  Safe

  At Risk

  N/A

Work Practices

• TOC/DOC notified ?

  Safe

  At Risk

  N/A

• Taglines when moving suspended loads?

  Safe

  At Risk

  N/A

• Are proper lifting/carrying techniques utilized?

  Safe

  At Risk

  N/A

• Slip/trip and fall hazards identified and mitigated?

  Safe

  At Risk

  N/A

• Chipper Safety?

  Safe

  At Risk

  N/A

• Are employees using 3 points of contact when ascending, descending, and climbing?

  Safe

  At Risk

  N/A

• Are cell phones being use appropriately?

  Safe

  At Risk

  N/A

• Is employee mindful of line of fire and pinch points?

  Safe

  At Risk

  N/A

• Are all compartments and fill caps locked when machines are unattended?

  Safe

  At Risk

  N/A

• Proper rigging, lifting, hand signals, and good communication being utilized?

  Safe

  At Risk

  N/A

• Is the housekeeping good?

  Safe

  At Risk

  N/A

Work Planning

• Job Plan (does everyone know duties)?Have the job hazards been identified, prioritized, and documented?Work area clearly defined on JSA?Has an effective control/mitigation plan for identified hazards been developed?

  Safe

  At Risk

  N/A

• Poison Ivy mitigation plan?

  Safe

  At Risk

  N/A

• Has the emergency plan been documented and understood?

  Safe

  At Risk

  N/A

• Is fall protection equipment in good condition and rescue plan in place?

  Safe

  At Risk

  N/A

• If more than one crew present (contract or Entergy), lead(s) are identified and communication is occuring?

  Safe

  At Risk

  N/A

• Animals, insects and plants mitigated?

  Safe

  At Risk

  N/A

• One call locates completed?

  Safe

  At Risk

  N/A

Supervision

• Emphasis of schedule exceeding safe work?

  Safe

  At Risk

  N/A

• Designated person in charge and documented?

  Safe

  At Risk

  N/A

• Supervision interfacing with workers?

  Safe

  At Risk

  N/A

• Supervision verifying the job hazard analysis/job plan is being followed?

  Safe

  At Risk

  N/A

• Crew lead demonstrated leadership ability?

  Safe

  At Risk

  N/A

Training/Qualification

• Appropriate training complete and up to date?

  Safe

  At Risk

  N/A

• Crew Members qualified for task being performed?

  Safe

  At Risk

  N/A

• Crew knowledgeable of monthly safety topic?

  Safe

  At Risk

  N/A

Change Management

• JSA updated periodically and whenever work task changes? Time stamped at lunch?

  Safe

  At Risk

  N/A

External Influence

• Weather conditions discussed and documented?

  Safe

  At Risk

  N/A

• Heat/cold mitigation plan in use and documented?

  Safe

  At Risk

  N/A

• Public encrouchment on job site discussed and documented on JSA?

  Safe

  At Risk

  N/A

System/Equipment Operation

• Are seat belts being used on applicable equipment while in operation?

  Safe

  At Risk

  N/A

• Parking Brake (Apply) 393.41?

  Safe

  At Risk

  N/A

• All PPE in good order and utilized? hard hat, eye protection, hearing protection, vest, footwear, gloves, glove clips, face shield, chaps etc.

  Safe

  At Risk

  N/A

• Safe use of chainsaws?

  Safe

  At Risk

  N/A

• Outriggers and outrigger pads?

  Safe

  At Risk

  N/A

• Wheel chocks utilized?

  Safe

  At Risk

  N/A

• Vehicle Grounds and barricades?

  Safe

  At Risk

  N/A

• If applicable, Is FR clothing being worn?

  Safe

  At Risk

  N/A

• If applicable, 100% fall protection being utilized?

  Safe

  At Risk

  N/A

• Equipment Parked over bare dirt, end to end or side by side. N/A if not seen at time of audit

  Safe

  At Risk

  N/A

Personnel and Materials Management

• Sufficient personnel assigned to task?

  Safe

  At Risk

  N/A

• Adequate materials provided to complete task?

  Safe

  At Risk

  N/A

Equipment Selection and use

• Is all equipment set up for safe use (outriggers set up properly as applicable)?

  Safe

  At Risk

  N/A

• If applicable, Is PVD operational?

  Safe

  At Risk

  N/A

• Are fire extinguishers on site, within date, and in good working order?

  Safe

  At Risk

  N/A

• Are guards in place on grinders, portable saws, etc?

  Safe

  At Risk

  N/A

• Chainsaw guards and safeties in place?

  Safe

  At Risk

  N/A

• Fuel tanks full or left full? water drained from fuel system?

  Safe

  At Risk

  N/A

• Non-frayed winch lines? oiled?

  Safe

  At Risk

  N/A

• Are the proper tools for the job being utilized, and are tools in good condition with no modifications?

  Safe

  At Risk

  N/A

• Eye wash station or solution in good working order and readily available?

  Safe

  At Risk

  N/A

Management

• Short service employee's identified and assigned mentors? On JSA? Proper colored hard hat?

  Safe

  At Risk

  N/A

• Timely response to known problems?

  Safe

  At Risk

  N/A

• Policies, practices, procedures properly defined?

  Safe

  At Risk

  N/A

• incidents/near misses reported in a timely manner?

  Safe

  At Risk

  N/A

Design Configuration

• Are appropriate DOT signs and cones in place?

  Safe

  At Risk

  N/A

• Equipment properly barricaded when work is performed near live voltage or when grounded?

  Safe

  At Risk

  N/A

Summary and signatures

• Positive observations. List crew members and specific items they are doing correctly:

• # of Personnel-Personnel Present (first and last Names)

• Number of Trucks

• Number of Trucks Audited

• Inspectors signature

  Sign

• Crew lead signature

  Sign