Information
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Facility Name:
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Date:
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Prepared by
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* Begin with a pre- audit conference with the Facility Supervisor.
* Each section and question must be answered.
* If the answer to a question is No, an action plan shall be developed and documented during the post-audit conference with the Operations Foreman.
* If the answer is NA to the question, the reason the question is not applicable shall be noted and documented in the post-audit conference with the Facility Supervision.
Process Safety Management Elements
Section C - Employee Participation
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1. Does a site specific written employee participation plan exist?
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2. Does the written plan provide for access to the documentation generated by the PSM program including the hazards analysis information?
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3. Is there documentation that supports the participation of employees in the process hazards analysis?
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4. If safety committees are used to satisfy employee participation requirements, are management and employees represented on the committee?
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5. Is there documentation that supports the participation of employees in the development of the process safety information?
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6. Is there documentation that supports the participation of employees in the development of training programs including content and frequency?
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7. Is there documentation that supports the participation of employees in the Management of Change/Pre-Startup Safety Review process?
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8. Is there documentation that indicates the employees have been informed of and are aware of their rights regarding employee participation under the standard?
Section D - Process Safety Information
Hazardous Chemical Information
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1. Does the facility have Material Safety Data Sheets (MSDS) for very hazardous chemical on site?
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2. Does the facility have a plan for administration of the MSDS program?
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3. Does the plan have a person identified for being responsible for administration of the MSDS program?
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4. Are the MSDSs accessible to all employees?
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5. Does the facility maintain a Chemical Inventory List?
Technology Of The Process
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6. Does the facility have a block flow diagram or simplified process flow diagrams that accurately depicts an overview of the process?
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7. Does the facility have the applicable process chemistry available within the process safety information?
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8. Does this facility have the maximum intended inventory of the process listed as the design inlet capacity of the process?
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9. Does the facility have a list of the liquid volumes maintained within the process under normal operating conditions?
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10. Does the facility have the design capacity of the treating systems available within the process safety information?
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11. Does the facility have the maximum design capacity of the product storage including considerations for vapor space listed?
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12. Does the facility have a listing of the safe upper and lower operational limits of the process?
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13. Does the facility have an evaluation of the consequences of deviation from the upper and lower limits that could result in an uncontrolled release?
Equipment Information
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14. Does the facility have U-1 or U-1A forms for all the process vessels and heat exchangers?
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15. Does the facility have metal thickness, corrosion allowance, maximum allowable working pressure, temperature rating, hydrostatic test pressure, and the ASME codes used for the equipment where no U-1 or U-1A forms exist?
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16. Are the piping specifications for the piping systems throughout the process identified?
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17. Are equipment data books that contain performance data, materials of construction, parts lists, maintenance procedures and operating limits available for all rotating equipment?
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18. Is instrumentation specification data that contains performance data, materials of construction, parts lists, maintenance procedures and operating limits available for all instrumentation that contacts process fluids?
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19. Does an accurate set of Piping and Instrument Diagrams exist at the facility?
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20. Does the Piping and Instrument Diagrams include all plant piping components, equipment, controls and instrumentation which are directly involved in or support the process?
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21. Is there an accurate electrical classification drawing at the facility?
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22. Is there an accurate plot plan drawing at the facility?
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23. Does the relief volume information at the facility include flange size and the ANSI rating for each relief valve?
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24. Does the relief value information at the facility include the orifice size for each relief valve?
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25. Does the relief valve information at the facility include the set pressure for each relief valve?
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26. Does the relief valve information at the facility include the design back pressure for each relief valve?
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27. Does the relief valve information at the facility include the relieving capacity for each relief valve?
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28. Does the relief valve information at the facility include the basis for design for each relief valve?
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29. Is there a drawing which depicts the layout of the flare header and the relative location of the relief devices connected to the header?
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30. Is documentation which indicates the design capacity of the flare or vent piping system available?
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31. Are the Design Codes and Standards under which the facility equipment was manufactured or fabricated indicated in the process safety information?
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32. Is there a material and energy balance for any new process built after May 26, 1992?
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33. Is there a drawing (i.e. Cause and effect or fault tree diagrams) which depicts the alarm and shutdown system for the facility?
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34. Is there a description of any detection system (i.e. flame, H2S, etc.) including shutdown and alarm settings that exists within the facility?
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35. Is the process safety information maintained where it is accessible by affected employees?
Section E - Process Hazards Analysis
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1. Have 100% of the initial process hazards been performed prior to May 26, 1992?
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2. Did the hazards analysis team contain persons with expertise in engineering and process operations?
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3. Did the hazards analysis team contain persons knowledgable in the methodology utilized to complete the hazards analysis?
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4. Is there a system to address the action items identified in the hazards analysis?
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5. Are the actions taken as a result of concerns identified in hazards analysis documented?
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6. Is there documentation supporting employee access to hazards analysis results?
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7. Is there documentation supporting employee involvement in the hazards analysis?
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8. Does the facility have a system in place to update and revalidate process hazard analyses within five years of the initial PHA, including grandfathered studies?
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9. Have all initial PHAs been revalidated on time?
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10. Have revalidated PHAs been performed by a team meeting the same qualifications as the initial PHAs?
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11. Do the revalidated PHAs reflect the current design and operation of the process?
Section F - Operating Procedures
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1. Do written procedures for each process exist?
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2. Do the procedures contain instruction for initial startup?
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3. Do the procedures contain instruction for normal operations?
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4. Do the procedures contain instruction for temporary operations?
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5. Do the procedures contain instruction for emergency shutdown of the process?
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6. Do the procedures contain instruction for the conditions under which an emergency shutdown would be initiated?
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7. Do the procedures contain instruction for emergency operations?
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8. Do the procedures contain instruction for the normal shutdown of the process?
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9. Do the procedures contain instruction for startup after turnaround or after emergency shutdown?
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10. Do the procedures contain the operating limits of the process?
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11. Do the procedures contain the consequences of deviation form the operating limits?
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12. Do the procedures contain instruction on steps required to correct or avoid deviations from the operating limits?
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13. Do the procedures contain the properties and hazards presented by the chemicals used in this process?
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14. Do the procedures address the precautions necessary to prevent exposure to the hazardous chemicals?
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15. Do the procedures address control measures to be taken if physical contact or airborne exposure occurs?
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16. Do the procedures address inventory control of the hazardous chemicals
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17. Are any special or unique hazards associated with process addressed in the operating procedures?
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18. Do the procedures describe the safety system and its' function?
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19. Is there a written annual certification that the current procedures are accurate and reflect actual practice?
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20. Is there written safe work practice procedures in place that include lockout/tagout, confined space entry, line breaking, and controlled access to the process?
Section G - Training
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1. Is there documentation that demonstrates employees operating the process prior to May 26, 1992 were certified to safely perform their duties?
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2. Is there a written training procedure established for the initial training of employees operating the process?
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3. Is there a written training procedure established for the training of all affected employees in an overview of the process?
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4. Is there a written training plan for the refresher training of employees operating the process?
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5. Is the frequency of refresher training established in the plan every three years or less?
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6. Is there documentation supporting initial training of any employee who began operating the process after May 26, 1992?
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7. Does the documentation of initial training contain the content of the training and the method by which understanding by the employee was established?
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8. Is there documentation supporting refresher training of any employee who operates the process?
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9. Does the documentation of refresher training contain the content of the training and the method by which understanding by the employee was established?
Section H - Contractors
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1. Is there documentation that illustrates that each contract employer's safety performance was evaluated prior to selection?
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2. Is there a written procedure established to inform each contract employer's of the hazards associated with the process?
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3. Does the procedure explain the applicable provisions of the emergency action plan to each contract employer?
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4. Is there documentation which supports the procedures regarding each contract employer are active?
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5. Is there a system to control the entrance, presence and exit of contract employees in the process?
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6. Is there documentation which illustrates the safety performance do each contract employer has been evaluated?
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7. Is there a written contract employee injury/illness log?
Section I - Pre-Startup Safety Review
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1. Is there a written Pre-Startup Safety Review Procedure?
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2. Does the procedure include provisions for the update of process hazards?&
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3. Does the procedure include provisions for the update of the process technology?
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4. Does the procedure include provisions for the update of equipment specifications?
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5. Does the procedure include provisions for the update of operating procedures?
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6. Does the procedure include provisions for the update of maintenance procedures?
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7. Does the procedure include provisions for the update of emergency procedures?
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8. Does the procedure include provisions for the required employee training?
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9. Does the procedure include provisions for a process hazards analysis on a new process?
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10. Does the procedure include provisions for integrity assurance documents on a modified process?
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11. Does the procedure include assigning responsibility for authorization to startup a new or modified process?
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12. Is there documentation which illustrates an active Pre-Startup Safety Review program?
Section J - Mechanical Integrity
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1. Is there a written mechanical integrity program?
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2. Does the written mechanical integrity program include procedures to assure the integrity of pressure vessels?
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3. Does the written mechanical integrity program include procedures to assure the integrity of pressurized storage tanks?
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4. Does the written mechanical integrity program include procedures to assure the integrity of piping systems?
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5. Does the written mechanical integrity program include procedures to assure the integrity of the relief and vent system?
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6. Does the written mechanical integrity program include procedures to assure the integrity of the emergency shutdown system?
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7. Does the written mechanical integrity program include procedures to assure the integrity of instrumentation and controls?
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8. Does the written mechanical integrity program include procedures to assure the integrity of pumps?
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9. Does the written mechanical integrity program include procedures to assure the integrity of fired heaters?
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10. Does the written mechanical integrity program include procedures to assure the integrity of compressor/drivers?
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11. Is there documentation supporting training for employees maintaining the process in the hazards and procedures applicable to the job tasks?
Inspections and Test Documentation
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12. Does the inspection and test documentation include the date of the inspection or test?
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13. Does the inspection and test documentation include the name of the person(s) performing the inspection or test?
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14. Does the inspection and test documentation include a unique identifier for the equipment being inspected or tested?
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15. Does the inspection and test documentation include a description of the inspection or test being performed?
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16. Does the inspection and test documentation include the results of the inspection or test?
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17. Does the inspection and test documentation include actions taken to address deficiencies identified on the equipment?
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18. Is there a written procedure to address deficiencies identified on equipment?
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19. Is there a written procedure to assure spare or replacement parts meet design specifications?
Section K - Hot Work Permit
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1. Is there a written Hot Work Permit procedure?
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2. Does the procedure designate who may authorize hot work?
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3. Does the procedure designate when a hot work permit is required?
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4. Does the procedure designate the conditions required to be satisfied before hot work may begin?
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5. Does the procedure designate the conditions which require a person to be assigned as a fire watch?
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6. Does the procedure designate the duties of a person assigned as fire watch?
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7. Is there documentation which illustrates an active Hot Work Permit Program?
Section L - Management of Change
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1. Is there a written Management of Change procedure?
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2. Does the procedure include provisions for the description of the change?
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3. Does the procedure include provisions for the technical basis for the change?
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4. Does the procedure include provisions for time required to implement the change?
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5. Does the procedure include provisions for the start and ending date on temporary change?
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6. Does the procedure include provisions for responsibility designation or assignment?
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7. Does the procedure include assigning responsibility for authorization of change?
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8. Does the procedure address the review and/or update of design and construction specifications for the equipment?
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9. Does the procedure address the review and/or update of process chemistry?
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10. Does the procedure address the review and/or update of Material Safety Data Sheets?
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11. Does the procedure address the review and/or update of the piping and instrument diagrams?
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12. Does the procedure address the review and/or update of process flow diagrams?
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13. Does the procedure address the review and/or update of the facility plot plan?
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14. Does the procedure address the review and/or update of electrical classification drawings?
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15. Does the procedure address the review and/or update of the electrical classification of equipment?
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16. Does the procedure address the review and/or update of process operating limits?
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17. Does the procedure address the review and/or update of operating procedures?
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18. Does the procedure address the review and/or update of the relief and vent system?
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19. Does the procedure address the review and/or update of the ventilation system?
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20. Does the procedure address the review and/or update of the safety systems?
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21. Does the procedure address the review and/or update of the mechanical integrity program?
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22. Does the procedure address the review and/or update of the safe work practices in the facility?
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23. Is there documentation which illustrates an active Management of Change program?
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24. Are employees involved in operating a process, and maintenance and contract employees whose job tasks will be affected by the change informed if, and trained in, the change prior to startup?
Section M - Incident Investigation
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1. Is there a written incident investigation procedure?
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2. Does the procedure address the type of incidents which require an investigation be initiated?
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3. Does the procedure address the 48 hour maximum time by which an investigation must be initiated?
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4. Does the procedure designate an incident investigation team?
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5. Does the procedure establish the requirement for a written report on an incident?
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6. Does the incident investigation report include the date of the incident?
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7. Does the incident investigation report include the date the investigation began?
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8. Does the incident investigation report include a description of the incident?
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9. Does the incident investigation report include the factors contributing to the incident?
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10. Does the incident investigation report include recommendations resulting from the investigation of the incident?
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11. Does the procedure establish a system to address report recommendations and document any corrective actions taken?
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12. Does the procedure establish a system to review the report with affected employees and to document that review?
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13. Does the procedure establish a 5 year retention requirement for all incident investigations?
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14. Has each incident been investigated which resulted in or could reasonably have resulted in, a catastrophic release of highly hazardous chemicals in the workplace?
Section N - Emergency Response Plan
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1. Is there a written emergency response plan?
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2. Does the plan establish emergency escape routes and emergency escape route assignments?
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3. Does the plan address employees who remain to operate critical plant operations before they evacuate?
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4. Does the plan establish a system to account for all personnel after emergency evacuation has been completed?
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5. Does the system establish a contact list for any assistance which may be required in an emergency?
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6. Is there an established alarm system for emergency alerting and response procedures to be initiated?
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7. Is there documentation that employees have been trained in the emergency plan?
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8. Is there a wind sock/wind indicator installed in a highly visible location?
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9. Is there a written procedure for handling small, incidental releases?
Section O - Compliance Audits
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1. Is there a written compliance audit procedure?
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2. Does the procedure establish the qualification criteria for the person(s) conducting the audit?
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3. Does the procedure require the generation of a written report on the compliance audit?
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4. Does the procedure establish a frequency for the compliance audit of three (3) years or less?
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5. Does the procedure establish a system to address the audit findings and document any corrective actions taken?
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6. Have the two (2) most recent audit reports been retained? (Note: Only 1 Audit Report is required prior to 1998.)
