Aggregate (MSHA) - Texas Materials Safety Audit Systems

• Site conducted

  Select

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Administrative

• Administrative MSHA Audit Questions:

• Does site have Legal ID on file?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• *Date on file:

  Date

• Is site filing quarterly MSHA Form and maintaining completed forms for 5 years?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• *Where Is quarterly MSHA forms kept?

• Do procedures exist for dealing with a Miner's Right to Refuse Unsafe Work?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Does that include an annual refresher training?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is plant recognizing "No Lost Time" milestones, at least annually?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Has the site implemented a hazard recognition program to reward employees for identifying hazards/suggestions to improve safety?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Does the plant participate in a disseminated Safety Alert program (T-5s) and other such acceptable communications?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Can the site provide a record of disciplinary actions for those workers who violate S/H & MSHA rules and regulations?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

Employee Training

• Employee MSHA Training Audit Questions:

• Are all "miners" or visitors receiving site specific hazard awareness training?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is the mine training plan available and up-to-date including list of current trainers, topics, etc.?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• *Date of last training:

  Date

• *Is hazardous chemicals used at site?

  Yes

  No

• Is the site training employees who work with hazardous chemicals in HazCom in compliance with the Global Harmonized Standard (GHS)?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is there evidence of hazard assessment and controls? (Such as Near Miss/Potential Hazard Reporting)

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Are employees who utilize lifting hoists, trained with documentation?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Does site have a training program for employees working around railcars for initial hire and annually thereafter?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Are employees completing the New Miner Training in accordance with applicable regulations?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is new task training conducted with all miners for work they have not been previous trained for?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is the site conducting 8-hour annual refresher with all applicable employees?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Have employees who perform electrical work successfully completed NFPA 70E training?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Does the site conduct bloodborne pathogen training for all new hires and annual refreshers? (Records are kept on file for a minimum of 3 years.)

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

Safety Inspection Program

• Safety Inspection Program MSHA Audit Questions:

• Are operators of mobile equipment completing pre-use checks correctly prior to the start of every shift?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is plant conducting daily work area inspections and keeping documentation of deficiencies for corrective action? (Site maintains work area inspections for all shifts for past 12 months)

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Are all items found during inspections (pre-use; workplace inspections, etc.) are tracked to completion?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• *Deficiencies that need to be tracked:

Deficiency

• Description of issue:

• Images to aid in description:

  Media

• Has the site conducted a survey of all lifting hoists and identified OEM and/or regulator inspection requirements?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is a inspection program developed for compliance with these requirements?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

Incident Investigation/ Reporting Program

• Incident Investigation/ Reporting Program MSHA Audit Questions:

• Does the site have a procedure for reporting incidents by end of shift and reviewed requirement with workers?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Are corrective actions identified within incident reports tracked to completion?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Are injured employees accompanied to medical treatment by salaried employee or designated shift leader?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is site aware of reporting requirements (e.g. MSHA & Internal) and has communicated requirements to staff?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Have all incident reports within the past 12 months that require follow-up action been completed and documented?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Does site consistently works with medical professionals and injured employee to provide and accommodate for modified duties?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Does site maintain essential functions and physical demands for each regular job?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Has select salaried employees and designated shift leaders been provided training in Modified Duty Program?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

Hearing Conservation

• Hearing Conservation MSHA Audit Questions:

• Has the site developed a Hearing Conservation Program (HCP) consistent with 30 CFR 62.150 ?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is training provided for the HCP for all affected site employees?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Are audiometric testing records being maintained for duration of employment plus 6 months?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Are audiograms conducted at least once every 12 months for facilities that are required to have a HCP?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

Fall Protection

• Fall Protection MSHA Audit Questions:

• Is there documented fall protection training, including rescue considerations, provided to employees prior to using fall protection, as well as annual refreshers?

  Yes

  No

  N/A

• Are full body harness and lanyard the only acceptable type of fall protection used on site by employees and contractors?

  Yes

  No

  N/A

• Is site using barricades to control or prevent access where there is risk of a fall or being hit by falling object? (hard/physical barriers)

  Yes

  No

  N/A

• Are elevated work platforms (EWP's) used? (Portable ladders only permitted when 3-point contact can be maintained at all times.)

  Yes

  No

  N/A

• Are quarterly inspections of fall protection equipment (harnesses, lanyards, anchor points) being conducted?

  Yes

  No

  N/A

• Are quarterly inspections of portable ladders being conducted?

  Yes

  No

  N/A

• Has the plant developed added precautions for workers on moveable surfaces? (maintenance on loaders)

  Yes

  No

  N/A

Confined Space Entry

• Confined Space Entry MSHA Audit Questions:

• Is there documented confined space training provided to employees prior to entering a confined space or acting as an attendant, as well as an annual refresher?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Are permits completed, signed and maintained on file for a minimum of 12 months?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Are harnesses and lifeline being used for entry into product bins, silos and tanks? (Verified by reviewing permits)

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

Electrical Safety

• Electrical Safety MSHA Audit Questions:

• Has the site developed an Isolation Plan for each individual piece of equipment that has potential for uncontrolled release of energy.

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is electrical safety training provided to all affected employees and contains all required elements?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Has the site developed a site specific lockout/tagout program in compliance with policy?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Has site communicated arc flash requirements to all electrical contractors?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is ground testing conducted and documented after installation/modification, as well as annually?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is ground field testing conducted and documented annually? (drop-down method)

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

Emergency Response

• Emergency Response MSHA Audit Questions:

• Does site have a documented evacuation plan and fire security plan?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Has site communicated with local emergency resources in planning for emergency resources?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Are drills being conducted annually for potential emergency situations pertaining to the plant/mine site.

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Has the site developed an emergency incident management plan?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is a person capable of providing first aid available on each shift?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is a person knowledgeable in use of the AED available on each shift?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

Contractor Management

• Contractor Management MSHA Audit Questions:

• Is the site maintaining an up-to-date sign in/sign out log for all contractors?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Have all contractors received site-specific hazard awareness training?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Are pre-job safety meetings conducted for all contractors?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Are all applicable training (e.g. Part 46, fall protection, confined space, etc.) for each contractor employee is verified prior to commencement of work activities?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Is a contractor log kept for contractors used on site?

  Select Not Compliant In Progress Compliant Best Practice (above and beyond) Not Applicable

  • Not Compliant
  • In Progress
  • Compliant
  • Best Practice (above and beyond)
  • Not Applicable

• Check the box to approve that the audit was done by a Safety Representative?

• Safety Representative Signature:

  Sign

• Title:

• Have the Site Manager or Site Representative check the box, agreeing that they received a briefing after the completion of the audit.

• Site Manager/Site Representative Signature:

  Sign

• Title: