Contractor Controls Audit

• Company Name

  Select

• Company Representative/Employee

• Work Location

  Select

• Scope of Work

• Date

  Date

• Conducted By

Safety and Environmental

• Were vehicle/equipment and tool inspections completed before entering and/or starting task on NGM sites?

  Yes

  No

  N/A

• Have any NGM standards/procedures have been provided for the task you're doing?

  Yes

  No

  N/A

• Do you know where to find them?

• Which Fatal Risk applies to the work you're doing today?

  Select Stored Energy Falling from Heights Lifting Blasting & Explosives Hazardous Substances & Chemicals Confined Spaces Mobile Equipment Fall of Ground Rotating Equipment Fire

  • Stored Energy
  • Falling from Heights
  • Lifting
  • Blasting & Explosives
  • Hazardous Substances & Chemicals
  • Confined Spaces
  • Mobile Equipment
  • Fall of Ground
  • Rotating Equipment
  • Fire

• Are Risk Assessments being completed? (JHA, FRA, FLRA, TRA, Pre-ops, etc.)

  Yes

  No

  N/A

• How would you handle an emergency/incident? (i.e. Incident Reporting Procedure)

  Safe

  At Risk

  N/A

• Who is your site emergency contact?

• Who is your company contact?

• Do you attend NGM safety meetings?

  Yes

  No

  N/A

• How often?

• Have you been invited to NGM safety meetings?

  Yes

  No

  N/A

• Near Miss Program/Close Call: Are you aware of the NGM Close Call program?

  Yes

  No

  N/A

• How would you report a close call?

• If a close call is experienced on site, do you notify anyone from NGM?

  Yes

  No

  N/A

• Do you carry/know where to find your training records? (i.e. task specific, equipment training)

  Yes

  No

  N/A

• Note where records kept. (i.e. truck, on person, in contractor office)

• Do you see/interact with a site (Cortez) representative?

  Yes

  No

  N/A

• How often?

• When is the last time you interacted with an NGM rep?

• Work area housekeeping

  Good

  Fair

  Poor

  N/A

• Is contractor wearing applicable PPE?

  Yes

  No

  N/A

Notes/Comments

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