Information

  • Client

  • Project name:

  • Conducted on

  • Prepared by

  • Location

Documentation / Work Planning

  • Hazard Assessment <br>Properly completed and reviewed by workers

  • Line locates <br>Completed and valid?<br>All parties confirmation obtained?<br>Other parties notified? ( Shaw / persona)

  • A clear work plan review

  • Notification completed: Land owner, pipeline

  • Inspector on site?

  • Clubroot requirements Pipe line coating sample
    Pipe vintage 1940 - 1960 Construction Package
  • Work package complete?<br>Land work, approvals, crossing agreements, site walk throughs.

  • Drawing details and notes reviewed?<br>Drawing notes acurate compared to land work ?

  • Site Walk through completed

  • Comments

  • COVID
  • Signage placed where required

  • Workers wearing PPE as per policy

  • Maintain distance where possible.

  • Load securement
  • Trailer towing selection guide filled out or reviewed?

  • Proper type load binders are used?

  • Chains meet or exceed grade 70 requirement?

  • Worker stopped to check load securement at proper interval? 10 KM and no longer than 240KM or 3 hours

  • Proper load securement for items transported?

  • Tie downs located within the rub rails?

PPE and Emergency Response

  • Safety footwear

  • F.R. Coveralls

  • Hard hat <br>Suspension replace 1 year & shell replace 3 year Ball cap Z94.1-15. 5.74

  • Hand protection

  • Eye Protection

  • Hearing protection

  • Condition of PPE

  • Fire extinguisher <br>Label NFPA-10 4.1<br>Available / certified<br>NFPA-10 section 7.2.1.2

  • SDS & WHMIS Labels or work site label?

  • Spill Response Kit<br>Response kit complete?

  • First-Aid Kit and blankets as required?

  • Personal monitors: bump tested

  • Contractors minimum PPE requirements are met?

  • Emergency Action Plan

  • Environmental concerns?

  • Add media

  • Comments

  • Construction signs
  • Proper sign placement<br>Traffic accommodation in work zones

  • Traffic cones and or barricades utilized?

  • Traffic control person certified?

  • Traffic control is effective for site

  • Power Lines identified to warn workers

  • Add media

  • Comments

  • Excavation OH&S part 32

  • Excavation
  • Equipment inspection completed

  • Facilities exposed prior to excavation

  • Spotter and fire extinguisher around live lines

  • Pipeline right of way or pipeline no right of way. <br>Pipeline owner notification completed?<br>Proximity / Crossing agreement in place?<br>Controlled zone 30 M<br>Exposed prior - 5 M

  • Shoring / sloping <br>As per OH& S Part 32 & Schedule 9

  • Safe entry and exits at 8 meter

  • Spoil pile 1 meter away from excavation.

  • Proper depth achieved?

  • Soil separation completed?<br>

  • No equipment or materials stored at edge of excavation

  • Adequate separation from other facilities achieved?

  • Excavations left open are inspected prior to entry?

  • Add media

  • Comments

  • Directional drilling

  • Directional drilling
  • Buried facilities exposed prior?

  • Crossing buried facilities at sight hole?

  • Adequate size reamer?<br>The pilot hole is to be reamed 1.5 times larger than the largest outside diameter (OD) of the pipe installed.

  • Weak link to spec.?<br>Conforms to pipe manufactures allowable pull back pressure spec?<br>

  • Double tracer wire required? Used?<br>Type and size as per drawing or spec?

  • Required depth achieved?

  • Pipe free of damage after bore complete?

  • Add media

  • Comments

  • Cranes, hoists and lifting devices. Part 6 OH&S Code

  • Lift
  • Competent operator or Operator certification valid? Capacity of 5 tons or greater, or a boom length of 25' or more must be operated only by a person with a valid operator's certificate

  • Crane / boom truck maintenance up to date? Records available?

  • Crane / boom truck has Stability Test Completed? Must have a Professional Engineer’s stamped/sealed document stating that unit has been tested as per ANSI/SAE B30.22-2005 (J765) Stability Testing Requirements. Document will show if the crane is safe to operate in all positions (360 degree) with the crane manufacturers supplied load chart or if the crane has a reduced capacity “Custom Load Chart” provided.

  • Pre use inspection completed?

  • Set up on firm level ground

  • Over head hazards identified?

  • Travel path assessed?

  • Log book for crane reviewed and new lift entered.

  • Lifting cables, slings, chains rated, tagged and inspected?<br>ASME B30.9<br>Chapter 11 sub 11.2.4

  • Tag lines used?

  • No loads suspended over workers

  • Creek crossing
  • Plan of work reviewed,understood and signed?

  • Spill kit on site? Size and materials appropriate for the job?

  • Pictures taken as per plan of work?

  • Water samples taken as per the plan of work

  • Proper set back from the banks?

  • Creek monitored for frac out?

  • Add media

  • Comments

  • Pipe squeeze
  • Static control in place?

  • Squeeze and release rate as per SPM 6.13 or SPM 6.24

  • Downstream continuity ensured? Monitoring pressure constantly?

  • Squeeze points identified?

  • Add media

  • Comments

  • Hydro Excavation
  • Water pressure: max 2000psi(13790 Kpa)<br>Water temp: max 180 F ( 82 C)

  • Noise warning signs placed?

  • PPE Utilized<br>

  • Continuous wand motion

  • Bonding and grounding completed before start up within 1 meter of power line?

  • Public kept away from Hydrovac?

  • Adequate protection of holes

  • Power company orientation

  • Hydrovac slurry disposal at approved site

  • Add media

  • Comments

  • Confined space / Restricted space

  • Confine space
  • Permit

  • Personnel Trained

  • Emergency Rescue Plan

  • Atmosphere tested?

  • Rescue/Retrieval Equipment (Harness, Life Line, etc...)

  • Inspection of required equipment completed? Condition of equipment acceptable?

  • Hot work
  • Permit completed

  • Permit conditions followed?

  • Fire watch ready and available?

  • Welding
  • AUI certified welder<br>Welder knows procedure?

  • Performance Qualifications are valid?

  • Hot work permit as per Alberta OHS Code Part 10

  • Rod oven utilized? <br>Z662 7.5.2.4 1 hour max time exposed to atmospheric conditions

  • Condition of pipe is inspected?

  • Preheat is completed?

  • Correct electrodes used?

  • PPE and guards utilized?

  • Manned fire extinguisher

  • Bonding required?

  • Add media

  • Comments

  • Steel line stopping
  • Procedure reviewed? <br>When?

  • Downstream pressure monitored?

  • Proper fitting & tool selection?

  • Gate valve easy to remove?

  • Tested fitting?

  • Center punch used?

  • Mark depth of travel?

  • Handles removed when not in use?

  • Proper compression of rubber stopper?<br>Number of turns counted?

  • Purge isolated section?<br>Purge hose used?

  • Completion plug installed and tested for leaks?

  • Polyken & Denso tape completed properly?

  • Add media

  • Comments

  • P.E. Fusion

  • PE Fusion
  • Fusion type

  • Static protection on live lines

  • Equipment and tooling condition & certification adequate?

  • Proper pipe preparation?

  • Proper tooling used? ( EF clamps)

  • Pyrometers or temp sticks used to confirm iron temp?

  • Iron faces acceptable?

  • Cord condition and size appropriate? <br>25 ft # 10/3<br>50 ft # 8/3

  • Bell hole clear of garbage?

  • Passed visual inspection?

  • Caliber used? Beads within specified size?

  • Fuser info

  • Add media

  • Comments

  • Pressure testing
  • Stabilized for appropriate time?<br><100 m - 10 min<br>100 m - 500 m - 15 min<br>>500 m - 30 min

  • Valves open and plugged?

  • Available joints soap tested?

  • Site secure for high pressure test?

  • Adequate purge hose, with valve used? Lubo seal not used to control gas flow?

  • Add media

  • Comments

  • Backfill

  • Backfill
  • Trench free from objects?

  • Tracer wire installed no further than 15 cm

  • Proper pipe shading?

  • Back fill follows municipal requirements?

  • Proper tampers used?

  • Add media

  • Comments

  • Site securement
  • Equipment, materials secured and properly barricaded

  • Excavations properly fenced and barricaded?

  • Fenced excavations in close proximity of travelled areas clearly identified and marked with reflective capability for night time?

  • Pipe ends capped?

  • Flashing warning indicators working?

  • Action item
  • Action item

  • Hazard Risk rating

  • Hazard risk rating
    A: Hazards have the potential for causing immediate serious injury and or damage
    B: Hazards are less severe, but still have the potential for causing injury or damage
    C: Hazards that have the potential to cause minor injury or damage
    Category
    1: Environmental
    2: Safety
    3: Procedure
    4: Equipment

  • Complete by:

  • Assigned to:

  • Personal on site

  • Accepted by:

Audit wrap up discussion

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