Crew Observation - (Management)

• Company

  Select
Supervisor

• Client

  Select

• Date

  Date
• Location
  Address

• Prepared By:

Documentation (Complete for All Jobs)

• Are all sections of the THA completed?

  Yes

  Coaching Opportunity

  No

  N/A

• Are all equipment operators listed in the THA?

  Yes

  Coaching Opportunity

  No

  N/A

• Was previous work days Post Job Briefing completed as required?

  Yes

  Coaching Opportunity

  No

  N/A

High Energy Hazard Identification and Controls

• Are one or more high energy hazards present for work being performed (gravity, motion, mechanical, electrical, pressure, sound, radiation, biological, chemical, temperature)

  Select

• Were adequate direct controls in place for stored energy/ Line of Fire hazards

  Yes

  Coaching Opportunity

  No

• Were adequate direct controls in place for Gravity (Suspended Load/ Falls From Elevation)

  Yes

  Coaching Opportunity

  No

• Were adequate direct controls in place for Motion (Mobile equipment and workers on foot/ Motor Vehicle Accident/ Equipment Vehicle Roll Over)

  Yes

  Coaching Opportunity

  No

• Were adequate direct controls in place for Electrical (Electrical Contact With Source/ Arc Flash)

  Yes

  Coaching Opportunity

  No

• Were adequate direct controls in place for Temperature (Steam/ High Temperature/ Fire with Sustained Fuel Source)

  Yes

  Coaching Opportunity

  No

• Were adequate direct controls in place for Pressure (Explosion/ Excavation or Trench)

  Yes

  Coaching Opportunity

  No

• Were adequate direct controls in place for Mechanical (Heavy Rotating Equipment)

  Yes

  Coaching Opportunity

  No

• Were adequate direct controls in place for Chemical (High Dose of Chemical or Radiation/ Confined Space)

  Yes

  Coaching Opportunity

  No

Housekeeping (Complete for All Jobs)

• Is housekeeping in regards to trash/materials/debris satisfactory

  Yes

  Coaching Opportunity

  No

  N/A

PPE (Complete for All Jobs)

• All required PPE in use as required for tasks being performed

  Yes

  Coaching Opportunity

  No

Energized Work

• Are energized equipment or lines present?

  Yes

  N/A

• Are energized equipment or lines properly addressed and adequate mitigation in place?

  Yes

  Coaching Opportunity

  No

Grounding

• Lines de-energized, tested and grounded as required

  Yes

  Coaching Opportunity

  No

  N/A

• Grounding Log present

  Yes

  Coaching Opportunity

  No

  N/A

Clearance Orders

• Clearance Orders

  Clearance

  Non-Reclose

  N/A

Work Zone Protection

• Traffic Control present for operations being performed

  Yes

  Coaching Opportunity

  No

  N/A

• Are drop zone barricades set up appropriately?

  Yes

  Coaching Opportunity

  No

  N/A

Rigging

• Rigging equipment in use is in good condition/inspected

  Yes

  Coaching Opportunity

  No

  N/A

Excavations

• Excavations or excavating tasks present on job site inspected by competent person and have adequate protective systems in place

  Yes

  Coaching Opportunity

  No

  N/A

Environmental

• Are all environmental hazards identified and mitigated?

  Yes

  Coaching Opportunity

  No

Equipment

• Outrigger pads in place for all lifting equipment

  Yes

  Coaching Opportunity

  No

  N/A

• Equipment safety zone is properly delineated to control Step/ Touch Potential and/ or swinging mast pinch points

  Yes

  Coaching Opportunity

  No

  N/A

• Equipment is chocked as required

  Yes

  Coaching Opportunity

  No

  N/A

• Pre‐/post‐use inspections complete

  Yes

  Coaching Opportunity

  No

  N/A

Substation

• Qualified station-entry personnel onsite and crew reported into dispatch

  Yes

  Coaching Opportunity

  No

  N/A

Tools

• Have tools in use been inspected and used as intended?

  Yes

  Coaching Opportunity

  No

  N/A

Crew Member Names

• undefined

Additional Comments

• undefined

Sign-Off

• Supervisor/Foreman Signature

  Sign

• Auditor Signature

  Sign