Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
IH Qualitative Survey
Description of Site Operations
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Overview of site production activities (annual tonnage, products, shipping methods, etc...)
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Number of employees, typical job tasks, mining method (stone quarry, excavated S&G, dredge, etc...)
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Insert rough sketch of site layout here:
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Add media
Air Contaminants and Chemical Hazards
Respirable Crystalline Silica (RCS)
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Is there any visible dust generated through site activities?
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If yes, what are the primary sources of visible dust?
- Plant & Process Emissions
- Work Task Emissions
- Haul Roads
- Multiple Sources
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What are the primary controls the site uses to control dust (water truck, spray bars, enclosed transfer points, etc...)?
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What are the primary housekeeping practices at the site (water hose, dry shoveling, compressed air blow down, vacuum, other)?
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Does all mobile equipment have enclosed cab and if so do operators keep windows and doors closed?
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Does the QC lab have controls in place to control dust during sample processing?
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Is respiratory protection available at the site?
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If so, what type(s) of respiratory protection are available for employee use?
Other Air Contaminants & Respiratory Hazards
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What are the typical welding methods and applications at the site (basic plant maintenance, mobile equipment wear parts, etc...)
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Are all welding tasks done in open air with adequate natural or mechanical ventilation?
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If welding is conducted in enclosed or confined spaces ( chutes, bins, hoppers, etc..) is supplemental mechanical ventilation provided during the task?
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Are MSDS available for all chemicals defined as hazardous under MSHA 30 CFR Part 47?
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Is a list of all hazardous chemicals available for the site as required under MSHA 30 CFR Part 47?
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Noise and Physical Hazards
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What are the primary noise sources at the site? (plant - screens, crushers, mobile equipment, etc...)
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What are the secondary noise sources at the site? (customer trucks, tools/maintenance, etc...)
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Is hearing protection available at the site?
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What type primarily (plugs or muffs) and noise reduction rating (NRR)?
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Is hearing protection worn by employees working in high noise areas (>85 dBA)?
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Have any standard threshold shifts been identified through audiometric testing or hearing loss claims been made through workers compensation system?
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If yes, was appropriate follow up and retraining provided in accordance with MSHA 30 CFR Part 62?
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Does the site have practices in place to address thermal stress (heat or cold) such as hydration and work-rest regimens?
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Add media
Audit of Group Standards Related to IH/OH
Group Standard - Respirable Crystalline Silica and Total Dust
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Has a qualitative and quantitative risk assessment been conducted in accordance with the Group H&S risk management standard to determine exposure potential for every job classification and task?
Group Standard - Workplace Noise
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Has a site noise survey been conducted?
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Has a noise map been developed for the site?
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Has noise dosimetry been conducted for employees anticipated to be exposed above 85 dBA?
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Has the hierarchy of controls (HOC) been applied in cases where TWA noise exposures exceed 85 dB?
Other Group Standards - Ergonomics, Whole Body Vibration, Hand-Arm Vibration
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Any ergonomic or other risks identified during survey? (QC sample collection & processing, maintenance, mobile equipment operation, etc...)
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Have any musculoskeletal injury/illness claims been reported to Health Bridge that are could be attributable to repetitive motion or other ergonomic risk factors?
Summary & Overall IH Risk Perception
Summary and Perception of Overall IH Risk
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Summary of Observations
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What is the perception of the overall risk for the site?
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Any significant safety-related issues or compliance deficiencies?
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Any best practices or other notable accomplishments the site has made with respect to H&S?
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Signature of H&S Professional Who Lead Survey/Audit