D&L Incorporated

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General

• A copy of the 2015 D&L HSE Program is onsite and available for review by employees?

  Yes

  No

  N/A

• Site specific emergency action plan is updated, posted, and easily located in office shop areas?

  Yes

  No

  N/A

• OSHA poster is posted?

  Yes

  No

  N/A

• OSHA 300A is posted?

  Yes

  No

  N/A

• State specific workers compensation poster is posted?

  Yes

  No

  N/A

• Incident/Accident investigations are reviewed and kept?

  Yes

  No

  N/A

• Minutes of weekly safety meetings are recorded and kept?

  Yes

  No

  N/A

• Facility site inspections with documented corrective actions are recorded and kept?

  Yes

  No

  N/A

• Safety equipment inspections are recorded and kept?

  Yes

  No

  N/A

• Drug and alcohol testing is recorded and kept in a secure location?

  Yes

  No

  N/A

• Current drug and alcohol testing material on hand ( urine, hair follicle, shipping and packing materials ).

  Yes

  No

  N/A

• There is a current OSHA first aid kit on site ( office/shop )?

  Yes

  No

  N/A

Environmental

• A current copy of the Customer Environmental Program is onsite and available for review?

  Yes

  No

  N/A

• Refrigerant log is recorded and kept?

  Yes

  No

  N/A

• Spill protection/recovery material is on hand and readily available?

  Yes

  No

  N/A

• Employees know the location of spill kits and are trained in their use?

  Yes

  No

  N/A

• Waste storage tanks are labeled?

  Yes

  No

  N/A

• Fuel storage tanks are properly grounded?

  Yes

  No

  N/A

• Waste storage areas are free of debris and and are located away from open water runoff ( ditch, pond, stream )?

  Yes

  No

  N/A

• All spills and spill residue are reported, cleaned up, and disposed of in accordance with Customer site procedures?

  Yes

  No

  N/A

• New/Used refrigerant is stored in a locked, dry, and secure storage rack/cabinet?

  Yes

  No

  N/A

Fire Prevention

• Fire extinguisher inspections are current, recorded, and kept?

  Yes

  No

  N/A

• A fire extinguisher is provided for every 3000 sq. ft. of space that is rated 2A?

  Yes

  No

  N/A

• A properly classified portable fire extinguisher is within 100' of all working areas?

  Yes

  No

  N/A

• Portable heaters are being used in accordance with specifications?

  Yes

  No

  N/A

• All employees know the location of fire extinguishers?

  Yes

  No

  N/A

• Employees have been properly trained how to properly use fire extinguishers?

  Yes

  No

  N/A

• Fire extinguishers are are accessible, labeled, and maintained in good repair at all times?

  Yes

  No

  N/A

• No Smoking signs are posted in all possible fire hazard areas?

  Yes

  No

  N/A

• Flammable and combustible liquids are marked and properly stored in appropriate containers ( flammable lockers)?

  Yes

  No

  N/A

• Soiled or combustible rags are properly stored and disposed?

  Yes

  No

  N/A

• All emergency exits are kept clear of debris and properly marked?

  Yes

  No

  N/A

Housekeeping

• Office, shop, storage, and shop areas are clean and free of dangerous waste and material?

  Yes

  No

  N/A

• Photos of office and shop.

  Media

• Scrap materials are removed or stacked in an orderly fashion?

  Yes

  No

  N/A

• Photos of scrap yard.

  Media

• Trash and combustible materials are are placed in containers provided for that purpose?

  Yes

  No

  N/A

• Scrap lumber, hoses, cable wiring, & all other debris is clear from work areas, hallways, stairways, and exits?

  Yes

  No

  N/A

• There are no spills of liquid or materials that may cause an accident?

  Yes

  No

  N/A

• Work areas have an appropriate amount of lighting?

  Yes

  No

  N/A

Sanitation

• All sources of potable and non potable water are marked?

  Yes

  No

  N/A

• Personal garbage and food containers are removed from the site or properly disposed of so as not to attract rodents, pests, or insects?

  Yes

  No

  N/A

• Refrigerators and microwaves are kept clean and sanitary?

  Yes

  No

  N/A

• Photos of Refrigerators and Microwaves.

  Media

• Lay down yard and material storage areas are kept orderly with excessive materials disposed of so as not to attract rodents or pests?

  Yes

  No

  N/A

Electrical

• All equipment is either grounded or double insulated?

  Yes

  No

  N/A

• GFCI's are used on all 110V-120V temporary wiring?

  Yes

  No

  N/A

• Receptacles (attachment plugs) are not interchangeable with circuits of different voltages?

  Yes

  No

  N/A

• Replacement plugs are not permitted?

  Yes

  No

  N/A

• <14 gauge extension cords are not permitted?

  Yes

  No

  N/A

• Extension cords are not frayed, cut, or nicked and are in good repair?

  Yes

  No

  N/A

• Extension cords (designed for temporary use) are not attached to the wall or other structure in any fashion?

  Yes

  No

  N/A

• There are an appropriate number of outlets for the tools being used and circuits are not overloaded?

  Yes

  No

  N/A

• Electrical panels have at least 4 sq. ft. in front of it that is clear and unobstructed?

  Yes

  No

  N/A

• GFCI outlets are provided on all countertops with water and in all bathrooms?

  Yes

  No

  N/A

• Light weight surge protectors are not permitted for use in general industry?

  Yes

  No

  N/A

• Work areas are kept free from cords and excess equipment?

  Yes

  No

  N/A

• Adequate lighting is provided in all office, shop, storage, and designated work areas?

  Yes

  No

  N/A

Stairways and ladders

• Areas used for ingress and egress which have a change of elevation of more than 19" are provided with stairs, ladders, or properly designed ramps?

  Yes

  No

  N/A

• Stairs that have 4 or more steps have a handrail?

  Yes

  No

  N/A

• All ingress and egress are clearly marked and kept free of debris and material?

  Yes

  No

  N/A

• All guard rails include top rails of 42" high +/- 3", mid rails, and toe boards?

  Yes

  No

  N/A

• Guard rails are capable of withstanding 200 lbs. of force (downward and outward) anywhere along the top rail?

  Yes

  No

  N/A

• No metal ladders are allowed at any time?

  Yes

  No

  N/A

• Ladder inspections are up to date, recorded, and kept?

  Yes

  No

  N/A

• All ladders are in good repair with safety stickers in place?

  Yes

  No

  N/A

• Faulty ladders are tagged "Do Not Use" until which time they can be repaired or destroyed?

  Yes

  No

  N/A

• All ladders are free of grease, oil, paint, or other slipping hazards?

  Yes

  No

  N/A

Hand and Power Tools

• All hand and power tools are in good working order?

  Yes

  No

  N/A

• Hand held power tools are equipped with a constant pressure switch where appropriate?

  Yes

  No

  N/A

• Plant air and other power sources are labeled?

  Yes

  No

  N/A

• Tools are stored in a secure, dry place?

  Yes

  No

  N/A

• Tool cords are free of cuts or abrasions and are in good repair?

  Yes

  No

  N/A

• Saws, drills, grinders, and all other power tools have the appropriate guards in place?

  Yes

  No

  N/A

• All breaks, presses, and power tools are properly labeled (pinch point)?

  Yes

  No

  N/A

• Devices are provided on air power tools to prevent devices from becoming accidentally disconnected fro the air hose?

  Yes

  No

  N/A

• Tools are being used for their intended use?

  Yes

  No

  N/A

• Handles for hammers and other tools are in good condition and are free of cracks, splinters, and mushroomed heads?

  Yes

  No

  N/A

• All saw and grinder blades are in good condition and are free of cracks and/or chips?

  Yes

  No

  N/A

• All safety guards and devices are in place while tools are in use?

  Yes

  No

  N/A

• All air compressors are equipped with pressure gauges?

  Yes

  No

  N/A

• Are power actuated tools unloaded while not in use?

  Yes

  No

  N/A

Flammable Gasses and Liquids

• Correct containers used for the storage of flammable gasses and liquids?

  Yes

  No

  N/A

• Containers are clearly identified?

  Yes

  No

  N/A

• Flammable and combustible liquids are clearly marked and stored in appropriate containers?

  Yes

  No

  N/A

• All flammable lockers are grounded or bonded?

  Yes

  No

  N/A

• Designated work areas are clear of all combustible materials and the floor is swept clean?

  Yes

  No

  N/A

• A suitable fire extinguisher is located next to and maintained in a state of readiness within the designated work area?

  Yes

  No

  N/A

• Welding shall not be done near welding or degreasing areas or spray booths.

  Yes

  No

  N/A

• When the work permits, welding shall be done in a booth or non-combustible screens.

  Yes

  No

  N/A

• Gas cylinders shall be stored away from potential heat sources.

  Yes

  No

  N/A

• Cylinders shall be stored in a well protected, well ventilated, and dry location and at least 20' from highly combustible materials.

  Yes

  No

  N/A

• Empty cylinders shall have their valves closed.

  Yes

  No

  N/A

• Valve protection caps, where the cylinder is designed to accept a cap, shall always be in place & hand tight except when cylinders are in use or connected for use.

  Yes

  No

  N/A

• Oxygen cylinders in storage shall be separated from fuel gas cylinders or combustible materials a minimum distance of 20' or by a non-combustible barrier at least 5' tall and having a fire resistance of of at least 1/2 hour.

  Yes

  No

  N/A

• Cylinders shall be secured upright at all times.

  Yes

  No

  N/A

Employee Training

• All employees have been trained in company safety requirements and policies?

  Yes

  No

  N/A

• All employees know who to contact if they have questions or if they have seen unsafe working conditions or habits?

  Yes

  No

  N/A

• All employees understand that it is their personal responsibility to conduct themselves in a safe and professional manner at all times?

  Yes

  No

  N/A

• All employees understand that the creation or avoidance of safety hazards, or the failure to report incidents or accidents, could result in disciplinary action?

  Yes

  No

  N/A

• All employees understand that an infraction of major violations ( Fall Protection, LOTO, Confined Space, and Non-Reporting) will result in a minimum of a 3 day suspension for the first offense and termination for the second offense?

  Yes

  No

  N/A

• All employees have been properly trained in Safety & Health and understand the requirement to comply with Company Safety Standards, Customer Safety Requirements, or OSHA requirements, whichever is stricter?

  Yes

  No

  N/A

Vehicle and Equipment

• Construction equipment and vehicles are parked so as to prevent the release of stored energy ( bucket/forks down, brake applied, wheels chocked, etc...).

  Yes

  No

  N/A

• All equipment and vehicles have functioning signals, horns, and back-up alarms?

  Yes

  No

  N/A

• Back-up alarms are functioning properly?

  Yes

  No

  N/A

• Seat belts are in good repair and used?

  Yes

  No

  N/A

• All mirrors are in place and operational?

  Yes

  No

  N/A

• All windshields and glass are not broken or cracked so as not to obstruct the vision of the driver?

  Yes

  No

  N/A

• Equipment rollover protection systems are in good condition?

  Yes

  No

  N/A

• Trucks are clean?

  Yes

  No

  N/A

• All trash ( drink bottles, food containers/wrappers, etc...) and work debris are removed from vehicles daily?

  Yes

  No

  N/A

• Photos of Trucks neglected.

  Media

• Vehicle has the appropriate safety equipment ( fire extinguisher/ first aid kit )?

  Yes

  No

  N/A

• Findings and Corrective Actions:

• Remarks:

• Inspector:

  Sign

• Supervisor

  Sign