Clearwater Hauling Inc.

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1. MANAGEMENT LEADERSHIP AND ORGANIZATIONAL COMMITMENT

• 1.1 Is there a written Health and Safety Policy for the organization? (5 points)

• a. Is there a declaration of management commitment to health and safety? <br>

  Yes

  No

  N/A

• b. Are there overall safety goals and objectives?

  Yes

  No

  N/A

• c. (i). Does it contain general responsibilities of managers regarding health and safety?

  Yes

  No

  N/A

• c. (ii). Does it contain general responsibilities of supervisors regarding health and safety?

  Yes

  No

  N/A

• c. (iii). Does it contain general responsibilities of workers regarding health and safety?

  Yes

  No

  N/A

• c. (iv). Does it contain general responsibilities of contractors regarding health and safety?

  Yes

  No

  N/A

• d. Does it stipulate a requirement to comply with applicable government regulations?<br><br>

  Yes

  No

  N/A

• e. Does it stipulate a requirement to comply with organization’s own health and safety standards?

  Yes

  No

  N/A

• 1.2 Is the policy signed by the current senior operating officer? (2 points)

• a. The signature must be that of the current senior operating officer.

  Yes

  No

  N/A

• 1.3 Is the policy readily available to employees? (0-3 points)

• a. Determine the method used by the employer to make the policy readily available.

  Yes

  No

  N/A

• b. The current policy may be posted on bulletin boards, in lunchrooms and or reception areas, and may be in employee handbooks, safety manuals, and or on computer.

  Yes

  No

  N/A

• c. Points are awarded based on the percentage of positive observations, or on the percentage of positive responses from interviews.

  Yes

  No

  N/A

• 1.4 Are employees aware of the policy’s content? (0-5 points)

• a. Employees should be able to explain, in general terms, the policy content.

  Yes

  No

  N/A

• b.Points are awarded based on the percentage of positive responses from interviews.

  Yes

  No

  N/A

• 1.5 (a) Have specific health and safety responsibilities been written for Managers? (5 points)

• Have specific health and safety responsibilities been written for Supervisors? (5 points)

• Have specific health and safety responsibilities been written for Workers? (5 points)

• Have specific health and safety responsibilities been written for Contractors? (5 points)

• Are Managers aware of their specific health and safety responsibilities covered by legislation and departmental policy?(0-5 points)

• Are Supervisors aware of their specific health and safety responsibilities covered by legislation and departmental policy?(0-5 points)

• Are Workers aware of their specific health and safety responsibilities covered by legislation and departmental policy?(0-5 points)

• Are Contractors aware of their specific health and safety responsibilities covered by legislation and departmental policy?(0-5 points)

• Are the following aware of their specific health and safety responsibilities covered by legislation and departmental policy: a. b. c. d. Managers? (0-5 points) Supervisors? (0-5 points) Workers? (0-5 points) Contractors? (0-5 points)

  Yes

  No

  N/A