APX-SF-07H Site Safety Audit

• Site conducted

  Select

• HSE Representative:

• Client/Project:

• Supervisor/Lead:

• Nearest Medical Facility:

• Group:

• Job No:

• Location
  Address

• Conducted on

  Date

• Auditor:

Documentation

• Work permit signed and issued by customer?

  Yes

  No

  N/A

• Was work permit issued by Amerapex

  Yes

  No

  N/A

• Hot Work permit issued? If yes, see Fire Prevention (APX-SP-31 Fire Watch Safety)

  Yes

  No

  N/A

• Permit-Required Confined Space signed by On-Site Supervisor? OSHA 1910.146

  Yes

  No

  N/A

• EAP or SSP posted & Available? Muster point identified (OSHA 1910.38(a))

  Yes

  No

  N/A

• Date of last update to EAP or SSP

  Date

• JSA/HIRA Completed & Available?

  Yes

  No

  N/A

• Date of last site safety audit

  Date

• Are BBSO being Completed & Available?

  Yes

  No

  N/A

• Has the employees been trained on BBSO and given the resources to submit BBSO

  Yes

  No

  N/A

• Vehicle Inspection Completed & Available?

  Yes

  No

  N/A

• Date of last Inspection

  Date

• Equip. Inspection Completed & Available?

  Yes

  No

  N/A

• Date of last Inspection

  Date

• Harness Inspection Completed & Available?

  Yes

  No

  N/A

• Date of last Inspection

  Date

• Monitor Log Completed & Available?

  Yes

  No

  N/A

• Date of last Inspection

  Date

• Safety Meeting Completed & Available?

  Yes

  No

  N/A

• Date of last Meeting

  Date

• OSHA & other job-site warning posters posted as required?

  Yes

  No

  N/A

• Forms for job-site injury and accident records on-site or electronically accessible?

  Yes

  No

  N/A

• Were employees issued “Emergency Contact” cards?

  Yes

  No

  N/A

• Date of last recordable

  Date

• Date of last Incident

  Date

• Date of last near miss

  Date

Health & Environmental Controls (1910 Subpart G)

• Ventilation - Natural ventilation or COPPUS Fan working properly and bonded correctly to storage tank? - OSHA 1910.94

  Yes

  No

  N/A

• Noise Exposure - When an 8-hour time-weighted average of 85 decibels is projected, is the supervisor using an effective hearing conservation program to limit noise exposure to on-site employees? OSHA 1910.95

  Yes

  No

  N/A

Housekeeping and Sanitation (APX-SP-18)

• Vehicles, Offices & Job site clean and in order?

  Yes

  No

  N/A

• Waste containers labeled and utilized correctly (not overfull)?

  Yes

  No

  N/A

• Sanitary facilities adequate and clean?

  Yes

  No

  N/A

• Adequate supply of drinking water?

  Yes

  No

  N/A

Handling and Material Storage (APX-SP-18)

• Are materials properly stored or stacked?

  Yes

  No

  N/A

• Are passage ways and exits clear of obstructions?

  Yes

  No

  N/A

• Are fire extinguishers readily accessible and strategically placed to combat fire hazards? OSHA 1910.157

  Yes

  No

  N/A

• Proper fuel (safety) cans in accordance with OSHA 1926.155(l)?

  Yes

  No

  N/A

• Eyewash & Shower station available, installed and in good working condition

  Yes

  No

  N/A

Fire Prevention (APX-SP-31)

• Fire watch in accordance with Hot Work Permit?

  Yes

  No

  N/A

• Fire extinguisher identified & annual and monthly inspection current? OSHA 1910.157

  Yes

  No

  N/A

• Flammable & combustible materials within a 35' radius been removed? OSHA 1910.252

  Yes

  No

  N/A

• Is flammable storage cabinet available?

  Yes

  No

  N/A

• No Smoking” signs posted/enforced where needed?

  Yes

  No

  N/A

• Smoking area identified and in accordance with customer's smoking policy?

  Yes

  No

  N/A

• Proper types and number of fire-extinguishers nearby?

  Yes

  No

  N/A

• During refueling, bonding of metal fuel container or L-tank to equipment being refueled?

  Yes

  No

  N/A

• During refueling, equipment NOT running and properly grounded or bonded?

  Yes

  No

  N/A

Electrical (APX-SP-17)

• Wiring well insulated and fused properly?

  Yes

  No

  N/A

• All required electrical equipment properly grounded?

  Yes

  No

  N/A

• Lockout / Tagout - As LOTO been verified by supervisor and supervisor's locks placed in conjuction with customers? OSHA 1910.147

  Yes

  No

  N/A

• Extension cords 3-wire type or double-insulated tools used?

  Yes

  No

  N/A

• Extension cords inspected/identified prior to use?

  Yes

  No

  N/A

• Electrical danger posted with required signs?

  Yes

  No

  N/A

• GFCI or assured grounding programs in compliance? OSHA 1910.306

  Yes

  No

  N/A

Scaffolding (APX-SP-18)

• Scaffolding provided by 3rd party?

  Yes

  No

  N/A

• Scaffolding routinely inspected prior to use?

  Yes

  No

  N/A

• Tagging system in place and signed-off by designated personnel?

  Yes

  No

  N/A

• Personnel observing and adhering to scaffold tagging system?

  Yes

  No

  N/A

Hand and Power Tools (APX-SP-18 and APX-SP-30)

• Proper tools available for each job and operated correctly?

  Yes

  No

  N/A

• Tools routinely inspected and maintained as required?

  Yes

  No

  N/A

• Tools properly guarded (as required)?

  Yes

  No

  N/A

• Electrical tools grounded and/or double insulated?

  Yes

  No

  N/A

• Tethered tools available as required?

  Yes

  No

  N/A

Ladders (APX-SP-18)

• Ladder provided by 3rd party?

  Yes

  No

  N/A

• Ladder setup to 4:1 Ratio?

  Yes

  No

  N/A

• Ladders stored properly when not in use?

  Yes

  No

  N/A

• Ladders routinely inspected and in good condition?

  Yes

  No

  N/A

• Ladders fully open while in use?

  Yes

  No

  N/A

• Ladders tied-off and secured (as required) while in use?

  Yes

  No

  N/A

Man-Lift / Aerial Lift (APX-SP-35)

• Visual inspection guards and applicable warning signs in place?

  Yes

  No

  N/A

• Lights, breaks and warning signs operable?

  Yes

  No

  N/A

• Proper fire protection (fire extinguisher) located on/near equipment?

  Yes

  No

  N/A

• Personnel properly trained and qualified to operate man-lift (aerial lift)?

  Yes

  No

  N/A

• Equipment inspection checklist properly completed daily/before each use?

  Yes

  No

  N/A

• Equipment manual available?

  Yes

  No

  N/A

Motor Vehicles (APX-SP-025)

• Vacuum trucks chocked & grounded; drip pans in use to guard against fuel & oil contaminating environment? OSHA 1910.178(a)(1)

  Yes

  No

  N/A

• During transfer operations, drip pans & absorbent pads is use at all hose connections? Cotter pins being used?

  Yes

  No

  N/A

• Are air compressor hose connections guarded by whip arrestors?

  Yes

  No

  N/A

• All hoses exceeding 1/2" inside diameter, shall have a safety device at the source of supply or branch line to reduce pressure in case of hose failure. OSHA 1910.178(a)(1)

  Yes

  No

  N/A

• Does customer require all motor vehicles be contained inside secondary containment?

  Yes

  No

  N/A

• State inspection current?

  Yes

  No

  N/A

Company Vehicle(s)

• Is a vehicle binder available

  Yes

  No

  N/A

Vehicle Binder

• Vehicle inspection checklist completed daily?

  Yes

  No

  N/A

• Insurance card current?

  Yes

  No

  N/A

• Registration available?

  Yes

  No

  N/A

• Fuel Card available?

  Yes

  No

  N/A

• if DOT, Are applicable forms available

  Yes

  No

  N/A

Vehicle Inspection

• Photo of VIN#

  Yes

  No

  N/A

• Warning devices operable?

  Yes

  No

  N/A

• Breaks, lights, and horn working properly?

  Yes

  No

  N/A

• Fluid levels at minimum or full levels?

  Yes

  No

  N/A

• Vehicles(s) externally clean/washed recently?

  Yes

  No

  N/A

• Vehicle(s) internally clean with no trash?

  Yes

  No

  N/A

• Is Driver on the approved Driver list

  Yes

  No

  N/A

• Operator has current (non-expired) driver’s license on person?

  Yes

  No

  N/A

• Company Vehicles backed in according to Amerapex Vehicle Procedure

  Yes

  No

  N/A

• Does vehicle contain Orange Cone for 360 Walk Around and Vehicle 360 sticker on driver side window

  Yes

  No

  N/A

• Does vehicle have company logo and unit number per vehicle procedure

  Yes

  No

  N/A

Barricades

• Barricades on site provided by 3rd party?

  Yes

  No

  N/A

• Is barricade provided by Amerapex

  Yes

  No

  N/A

• What the reason for the barricade?

  Yes

  No

  N/A

• Are barricades in place where overhead, falls or other hazards exist?

  Yes

  No

  N/A

• Is magenta barricade appropriate for correct distance from radiation source?

  Yes

  No

  N/A

• Are radiation signs present on all four sides of barricade

  Yes

  No

  N/A

• Are barricades tagged with appropriate warning signs?

  Yes

  No

  N/A

• Do tags have name, company and contact information listed

  Yes

  No

  N/A

• Do barricades effectively control hazards in work areas?

  Yes

  No

  N/A

Gas Hazard (APX-SP-43)

• Are gas monitors being utilized?

  Yes

  No

  N/A

• Is monitor log available

  Yes

  No

  N/A

• Evidence of Serial #s, Model #s and Calibration Sticker

  Yes

  No

  N/A

• Picture of LOT # and Gas Expiration Date

  Yes

  No

  N/A

• Is a Benzene or PID available for Tank Entry

  Yes

  No

  N/A

• Is fixed monitoring available

  Yes

  No

  N/A

• Have employee trained in H2S awareness?

  Yes

  No

  N/A

Excavation and Shoring

• Has excavation permit been obtained?

  Yes

  No

  N/A

• Is excavation supervised by a competent person?

  Yes

  No

  N/A

• Are ladders provided where needed every 50’?

  Yes

  No

  N/A

• Have concealed utility lines been located and marked?

  Yes

  No

  N/A

• Is excavation barricaded and lighting provided where needed?

  Yes

  No

  N/A

• Excavation checklist been completed by a competent person?

  Yes

  No

  N/A

• Yes

  No

  N/A

Personal Protective Equipment (APX-SP-06)

• FR Clothing - Proper wear of FR clothing, ie, button up and sleeves NOT rolled up?

  Yes

  No

  N/A

• Personal Gas Monitors - are monitors being worn in the employee's "breathing zone"? Inspect monitor for proper operation and placement of breathing zone 6"-9"

  Yes

  No

  N/A

• Has personal/4 Gas monitors been bump tested per the manufacture and or site requirements?

  Yes

  No

  N/A

• Bloodborne patho kit - Can the employee protect him or herself from bodily fluids? OSHA 1910.1030

  Yes

  No

  N/A

• First aid kit - available and stocked

  Yes

  No

  N/A

• Eye protection-safety glasses and face shields utilized where required? OSHA 1910.133

  Yes

  No

  N/A

• Head protection-hard hats worn properly where required? OSHA 1910.135

  Yes

  No

  N/A

• Hearing Protection- earplugs, earmuffs, etc. worn where required?

  Yes

  No

  N/A

• Fall protection- safety harness and lanyard inspected, hung up, and stored in a dry place? OSHA 1910.66 App C

  Yes

  No

  N/A

• Respiratory protection-employees qualified and utilizing respirators where req.? Stored, cleaned and inspected? OSHA 1910.134

  Yes

  No

  N/A

• Does respirator size match employee fit test card and PFT?

  Yes

  No

  N/A

• Foot protection- adequate foot protection being worn? Steel toed or composite toe?

  Yes

  No

  N/A

• Specific/Additional PPE being utilized as required by permit/JSA?

  Yes

  No

  N/A

• Adequate supplies available for job use on site or in trailer?

  Yes

  No

  N/A

Procedures

• Have all employees completed Amerapex Orientation (verify by sticker)?

  Yes

  No

  N/A

• SSE program followed with SSE stickers (SSE “S” and Mentor “M”)?

  Yes

  No

  N/A

• Short-Term Orientation Checklist completed with employees?

  Yes

  No

  N/A

• Has each employee received an Amerapex Cardinal Safety Rule card?

  Yes

  No

  N/A

• Fatigue Policy being followed? (APX-SP-51)

  Yes

  No

  N/A

• Vehicle 360 being performed?

  Yes

  No

  N/A

• SDS book on-site and up to date? OSHA 1910.1200

  Yes

  No

  N/A

• Employees trained on SDSs kept and how to access them?

  Yes

  No

  N/A

• Accountability board being utilized for NDT sites?

  Yes

  No

  N/A

• Radio Traffic being monitored by HSP & Project Manager

  Yes

  No

  N/A

• 4-Gas/H2S monitor bump tested, tracked and issued out?

  Yes

  No

  N/A

• Windsock installed and in good working condition

  Yes

  No

  N/A

• Employees familiar with incident reporting procedures?

  Yes

  No

  N/A

• Employees familiar with emergency action plan?

  Yes

  No

  N/A

• Employees familiar with weather alerts, medical rescue, section alarms, toxic gas release, fire explosion?

  Yes

  No

  N/A

• Employees familiar with HAZCOM Program?

  Yes

  No

  N/A

• Employees familiar with Short Service Employee Mentor program and can confirm its use?

  Yes

  No

  N/A

• Employees familiar with Fall protection requirements?

  Yes

  No

  N/A

Confined Space (APX-SP-21)

• Confined Space Procedure available for all employees to review (APX-SP-21)

  Yes

  No

  N/A

• Have all employees who are involved in Confined Space operations been trained

  Yes

  No

  N/A

• Is card or training cert available

  Yes

  No

  N/A

• Permit-Required Confined Space signs posted at all tank entries; Signs removed after reclassification of tank?

  Yes

  No

  N/A

• Permit-Required Confined Space attendant properly trained and alert; Has a clear line of sight into tank?

  Yes

  No

  N/A

• Atmospheric monitoring - Is the atmosphere within the space periodically tested in accordance to OSHA 1910.146(c)(5)(ii)(F) and document on Confined Space Permit

  Yes

  No

  N/A

Confined Space Rescue (APX-SP-38)

• Rescue Services - certified and alert; All gear staged and ready? OSHA 1910.146

  Yes

  No

  N/A

• Confined space rescue equipment inventory list available?

  Yes

  No

  N/A

• Confined Rescue plan Available?

  Yes

  No

  N/A

• Do the employee knows the plan?

  Yes

  No

  N/A

Additonal Information not supported by audit

• Any additional items to report

  Yes

  No

  N/A

Sign Off

• HSE Representative (Name/Signature/Date)

  Sign

• HSE Representative 2 (Name/Signature/Date)

  Sign

• Supervisor/Lead (Name/Signature/Date)

  Sign