Information
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Location:
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Activity
- Operation
- Construction
- Rig Work
- Other
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CHK Rep/Office:
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Contractor:
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Auditor:
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Date/Time:
HAZCOM [EHS-101]
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MSDS's available and accessible at all times
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All liquid containers labeled with NFPA or HMIS labels
PPE [EHS-102]
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FRC utilized
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Hard hat(s) utilized
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Appropriate eye protection being utilized
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Safety toe boots being worn
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Personal Gas Monitor used
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Other required PPE items being utilized
Hearing Protection [EHS-104]
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Proper signage present at high noise areas
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Proper hearing protection worn by workers
Lockout/Tagout (LOTO) [EHS-105]
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LOTO required
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LOTO permit available on-site<br>{105-B}
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LOTO permit properly managed
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Locks/Tags properly managed
Hot Work Management [EHS-106]
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Hot Work required
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Hot Work permit available on-site<br>{106-A}
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Hot Work Qualified Individual on-site
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Hot Work permit properly managed
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Gas monitors properly used and managed
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Fire extinguishers available/maintained
Confined Space [EHS-107]
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Are confined spaces properly posted
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Confined Space Policy being followed (No confined space entry)
Trenching and Excavation [EHS-108]
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Trenching and Excavation Checklist required (depth > or = 48")
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Checklist available on-site<br>{108-A}
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Checklist properly managed
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Gas monitors properly used and managed
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Engineering Best Practices being utilized (sloping/benching/egress)
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One call being utilized
H2S [EHS-110]
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Site has an H2S concern (concentration in well stream > or = 10 ppm)
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Site is properly posted (signs at > or = 10 ppm/windsock at > or = 100 ppm)
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Workers are wearing monitors that are properly maintained
Chemical, Flammable and Combustible Liquids/Materials [EHS-111]
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All chemical containers are in good condition
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All chemicals are properly stored and in secondary containment if required
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All chemical containers are closed/sealed when not in use
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All containers are bonded/grounded in liquid transfer
Heat and Cold Stress [EHS-112]
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All workers taking proper precautions for heat/cold
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PJSAs state hazards of heat/cold stress and how to mitigate
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Controls/supplies in place to prevent heat/cold stress
Fire Protection [EHS-113]
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Fire extinguisher available in company trailer
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Monthly inspection tag on each fire extinguisher
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Annual Fire Extinguisher Maintenance Record available
Electrical Safety [EHS-114]
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Electrical equipment operating at a voltage of greater than 600V labeled as high voltage
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Work clearance of at least 36 inches maintained in front of electrical equipment
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Fixed equipment grounded properly
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Only 3-wired and GFSI extension cords and electrical power cords being used
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All extension cords and electrical power cords are in good working condition
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No flexible cord or wire going through windows or doorways
Powered Industrial Trucks (Forklifts) [EHS-115]
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Forklift operators certified and certificate available
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Seat belts provided (as per manufacturer)
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Backup alarm working
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Auxiliary lighting for use during nighttime operations
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Horn working
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Rated lifting capacity posted on the forklift
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Pre-Use Inspection Checklist available
Hoisting and Lifting Equipment [EHS-116]
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Workers operating hoisting and lifting equipment properly trained
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Monthly Hoisting Machinery Inspection Record (Overhead) available
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Straps and slings have been inspected and are in proper working condition
ATV/UTV [EHS-117]
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Proper PPE available of being utilized
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Equipment in good repair
Lifting and Carrying Safety [EHS-118]
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Proper lifting and carrying techniques being used (i.e., bending at knees, back straight, object close to body, etc.)
Walking-Working Surfaces Policy [EHS-119]
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Any working surface above 4 feet from the ground must be protected by a work platform with guardrails and toe boards or personal fall arrest system
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Guardrails must be at least 42 inches above the platform and have intermediate mid- rail and toe board
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Fall arrest system must have a full body harness, deceleration device and a lifeline.
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Anchorage used for fall arrest equipment must be capable of supporting at least 5,000 lbs.
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All walking/working surfaces are clear of debris and tripping hazards and/or tripping hazards have been identified
Ladder Safety [EHS-120]
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No wooden ladders allowed on site
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Metal ladders must have a warning label for electrical caution
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Ends/feet of ladder must be fitted with insulated non-slip material
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Extension ladders must extend 3 feet past the landing if used to access another working surface and be secured
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While on a ladder, workers are using 3-point contact procedure
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Fixed ladders are to be inspected annually and fill out a Fixed Ladder Annual Inspection Checklist
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Portable ladders are to be inspected monthly and fill out a Portable Ladder Monthly Inspection Checklist
Bloodborne Pathogen Exposure Control [EHS-121]
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First Aid Kit/Bloodborne Pathogen Kit available on site
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Bloodborne Pathogens Exposure training complete
Pre-Job Safety Assessment [EHS-122]
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Pre PJSA safety tour on site conducted
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Daily safety meeting being conducted
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Special safety meetings conducted when H2S/SO2 present
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Safety meetings properly documented
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Accidents, if any, are discussed during safety meetings
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PJSA filled out completely and properly
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Individual contractors conducting Job Safety Analysis (JSA) to identify task-specific hazards
Ground Disturbance Safety [EHS-124]
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One call is being utilized before any ground disturbance
Waste Management [EHS-202]
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All vendors are managing their waste appropriately
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Wastes are segregated in the proper containers
NORM Management [EHS-204]
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NORM surveys being conducted on a regular basis
Incidents
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Injuries and incidents reported and documented immediately
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All incidents resulting in injuries to employees investigated and documented to prevent recurrence
Housekeeping
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Walking/Working surfaces clean and clear of debris
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Equipment on location is neat
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No trash on the ground
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Tripping hazards have been identified and addressed
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Seasonal conditions have been identified and addressed
Extras
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Comments