Title Page
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Company Name:
- Central Sand & Gravel
- Cessford Construction
- Cohron
- Des Moines Asphalt & Paving
- Gerhold Concrete
- Hallett Materials - Central
- Hallett Materials - Western
- Lyman Richey Sand & Gravel
- Minnesota Paving & Materials
- Omni Engineering
- Ready Mixed Concrete
- Siouxland Ready Mix
- Standard Ready Mix
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Site Name
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Line of Business
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Inspection Location:
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Date of inspection:
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Conducted By:
- Clint Allen
- Lindsay Van Woert
- Thomas Silknitter
- Rosa Mendoza
- Andrew Wojtowitz
- Sarah Blank
- Kate Heine
- Bryce Hoppe
- Matt Haynie
- Allen Myers
- Dominiq Williams
- Dan Boomgarden
- Jason Hegerle
- Brian Knutson
- Randy Cooper
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Others present:
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Manager
- Adrian Johnson
- Bob Bednarek
- Bob Roos
- Caleb Morss
- Chad Phillips
- Concepcion Ortiz
- Dan Hubbard
- Derek Fredericksen
- Don Smith
- Doug Carroll
- Gary Loyd
- Greg Tischbirek
- Jarod Hendricks
- Kevin Bragg
- Kyle Timmer
- Scott Bohm
- Not Listed
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Manager present?
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Manager Name
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Site/Plant Manager
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Announced/Unannounced
Hazardous Materials
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Hazardous Materials Section Applicable (Is this facility a shop?)
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Things to look for...
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Things to look for...
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Things to look for...
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Hazardous Materials Comments
Air Quality
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Air Quality Section Applicable
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Things to look for...
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Things to look for...
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Things to look for...
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Air Quality Comments
Water Quality
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Water Quality Section Applicable
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Things to look for...
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Things to look for...
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Things to look for...
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Water Quality Comments
Spill Prevention
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Spill Prevention Section Applicable (Does this site/plant have a SPCC Plan?)
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Things to look for...
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Things to look for...
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Things to look for...
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Spill Prevention Comments
Housekeeping
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Things to look for...
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Things to look for...
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Things to look for...
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Things to look for...
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Things to look for...
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Things to look for...
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Things to look for...
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Housekeeping Comments
Risk Management
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Risk Management Section Applicable
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Equipment Safety LSR #2
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LOTO Procedure LSR #3
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CONSPACE Signage LSR #5
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Working at Heights LSR #6
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Employee engagement LSR #13
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Safety of materials under pressure
- Pressure reliefs in place, documents inspections, certifications renewed
- Need to renew pressure vessel certifications
- Need to document pressure relief inspections
- Not applicable, no pressure vessels on site
- Not applicable, exemption
- Other
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Explain "Other"
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Under Pressure LSR #10
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Presence of a start-up alarm
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Type of start-up alarm
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Current arc flash assessment and labels
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Date Arc Flash Completed
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Risk Management Comments
Environmental Stewardship (Extra Credit)
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Stewardship Project Examples
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Does facility have a current stewarship project that aligns with OpCo or CRH Sustainability Initiatives?
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Stewardship Project Type
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Details
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CRH's Sustainability Goals
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What sustainability projects would the site/plant like to see in the future
Other Considerations
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Compliance Hotline
- Hotline Posted
- Missing Hotline - Copy Provided
- See notes below
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Riskonnect
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Notes
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Extra Credit: Opacity reader available (Someone on site has attended smoke school every other year.)
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Extra Credit: Hazardous waste training completed within 12-months of inspection date
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Extra credit: Health assessment completed
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Extra credit is being scored differently due to the new inspection format. Your overall score percentage might be less than previous years, but that does not imply the site has not improved.
Overall Impressions
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Community Perception Comments:
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Overall Impression Comments:
Overall Results
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Gold Standard Score = 100% on compliance and 90% or greater overall
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Category
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Previous Score
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Outcome
- Improved
- Sustained
- Baseline
- Declined
- Compliance Issues - keep working
- Overall score declined slightly, but compliance greatly improved over last year
- Overall score declined, but compliance maintained
