CLEAN HARBORS CATALYST TECHNOLOGIES - duplicate

• Conducted on

  Date
• Location
  Address

• CLIENT

• SUPERVISOR/FOREMAN

• HEALTH & SAFETY MANAGER

• JOB NUMBER

• JOB DESCRIPTION

HAZCOM (1910.1200)

• MSDS available on site?

  Yes

  No

  N/A

• Hazardous work permit completed and signed?

  Yes

  No

  N/A

• Have critical tasks been identified on permit?

  Yes

  No

  N/A

• Project specific JHA available?

  Yes

  No

  N/A

• Is JHA being followed?

  Yes

  No

  N/A

• Daily Safety meeting held & attended by crew?

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT (1910.132)

• PPE identified on permit or JHA matches what is being used?

  Yes

  No

  N/A

• PPE appropriate for task?

  Yes

  No

  N/A

• PPE being properly worn by crew ?

  Yes

  No

  N/A

• Respiratory Protection being utilized ?

  Yes

  No

  N/A

AIR MONITORING

• Does this task require air monitoring?

  Yes

  No

  N/A

• Appropriate air monitoring being conducted?

  Yes

  No

  N/A

• Air monitoring instruments properly calibrated?

  Yes

  No

  N/A

• Readings properly documented?

  Yes

  No

  N/A

• Action Levels being adhered to ?

  Yes

  No

  N/A

• Is continuos CO monitoring required?

  Yes

  No

  N/A

EMERGENCY PREPAREDNESS

• Appropriate size first-aid kits on site, available and stocked?

  Yes

  No

  N/A

• Minimum of two First-aid/CPR trained personnel on site? (where appropriate)

  Yes

  No

  N/A

• Safety shower, or hose and eye wash in immediate vicinity when working with acids or caustics?

  Yes

  No

  N/A

• Emergency numbers obtained, posted and means to contact emergency services posted?

  Yes

  No

  N/A

• Location of nearest hospital documented and known by crew?

  Yes

  No

  N/A

ELECTRICAL SAFETY

• Does this task require electrical safety?

  Yes

  No

  N/A

• Is an operable Ground Fault Circuit Interrupter (GFCI) used on all equipment? (Where appropriate)yes

  Yes

  No

  N/A

• Is equipment appropriate for the location (e.g. U/L listed Class 1 Division 1 for flammable locations?yes

  Yes

  No

  N/A

• Are equipment leads and extension cords in good repair? Yes

  Yes

  No

  N/A

LOCKOUT / TAGOUT (1910.147)

• Does this task require lock out/tag out?

  Yes

  No

  N/A

• Is a LO/TO Permit completed and available?

  Yes

  No

  N/A

• Have all types of energy been de-energized?

  Yes

  No

  N/A

• Do all affected employees have locks applied?

  Yes

  No

  N/A

• Are all other LO/TO Procedures being followed?

  Yes

  No

  N/A

FALL PROTECTION (GREATER THAN 6 FEET)

• Is fall protection required for this task?

  Yes

  No

  N/A

• Are anchor points of sufficient strength (i.e.. 5000 capacity)

  Yes

  No

  N/A

• Are harnesses and appropriate lanyards being worn?

  Yes

  No

  N/A

• If no harness/lifelines are utilized, has a warning line been placed at least 6 feet from the edge?

  Yes

  No

  N/A

MISCELLANEOUS SAFETY ITEMS

• Have appropriate smoking and eating areas been designated?

  Yes

  No

  N/A

• Is the work zone properly barricaded or secured?

  Yes

  No

  N/A

• Are appropriate work zones (hot deacon support) established and sufficient?

  Safe

  At Risk

  N/A

• Is the system of communication utilized by the crew sufficient?

  Yes

  No

  N/A

• Is the lighting utilized on the site sufficient to safely illuminate the work zone?

  Yes

  No

  N/A

GENERAL SITE CONDITIONS OR COMMENTS

• Site Conditions? Ok

  Excellent

  Good

  N.I.

  Poor

  Unsatisfactory

• Attach picture of site if applicable.

  Media

• Comments?

Action Items

• Site description?

• REVIEWED H&S MANAGER:

  Sign

• SUPERVISOR / FOREMAN

  Sign