Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Safety and Job Site Evaluation

  • Take job site Photo

  • Are barricades in place with proper signage?

  • Was the job site evaluated and checked for critical systems in the immediate area?

  • Are proper tools available for the task, being used correctly and in good working condition? (ladders, Electrical Cords, Etc.)w

  • Are tool carts and work benches neatly originised?

  • Is PPE per SOW/JHA being worn (tyvek, gloves, respirator, fall protection, etc.) and in good working condition?

Management UTake 5

1. Stop and Look

  • Observe Work area and surroundings

2. Think through the task

  • Work scope / procedures / JHA understood and in use?

  • Correct permit requirements obtained and in use?

  • Correct PPE obtained and in use?

  • Correct tools / equipment used and in good order?

3. Identify the Hazards

  • Look wide

  • Look close

  • Look for the hidden

  • Hazards identified are?

4. Control and Communication

  • Hazard Control Details are?<br>

  • Hazard(s) controlled before the task started?

  • Share learnings with others in Crew / Team

5. Do the Task Safely

  • Can the job be done safely? (If not, stop the job and contact your supervisor.

Lockout /Tagout Procedures

  • Is LOTO required?

  • Has LOTO procedures been reviewed with employees?

  • Have the energy dissipation been verified?

  • Have LOTO measures been implemented effectively?

  • Is paper work reviewed and signed by workers before starting the work? (SOW / Daily JHA / LOTO, etc)

  • Are all LOTO isolation points identified?

Reliability, Manufacturing and Mechanical Systems

  • Do workers understand the job task?

  • Is the work scope described in the work permit consistent with the work being performed in the field?

  • Are EMO's covered with in the work zone?

  • Has the information been properly passed down from the morning work permit meeting?

  • Are spotters being used in congested areas and potential areas of interference been identified and accounted for?

  • Are slip rings being used properly? (Blue & Green)

  • Is 5's being implemented? (before, during and after)

  • Are work procedures adequate, up to date and allow for safe completion of task?

  • Have proper actions been taken to minimize risk to critical tools as shown on the Big Board?

  • Have proper actions been taken to minimize risk to critical tools?

Environmental

  • Are chemical containers properly labeled?

  • Is potential waste addressed for proper disposal? (recycling bins, waste bins or DSC)

  • Are storm drains protected from potential work run-off?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.