FECT Mandatory Rule Audit

• Document No.

• HSE Mandatory Rule Audit

• Site

• Conducted on

  Date

Attendees

• List attendees

13 Mandatory Rules

• 1 - Lock-out tag-out

  OK

  NOK

  N/A

• 2 - Energy release & mechanical block

  OK

  NOK

  N/A

• 3 - Personal identification

  OK

  NOK

  N/A

• 4 - Safety Guards

  OK

  NOK

  N/A

• 5 - Fail Safe

  OK

  NOK

  N/A

• 6 - OK First Part

  OK

  NOK

  N/A

• 7 - Reaction Rule

  OK

  NOK

  N/A

• 8 - Fall from height

  OK

  NOK

  N/A

• 9 - Finger pinch

  OK

  NOK

  N/A

• 10 - Dangerous zone

  OK

  NOK

  N/A

• 11 - Hydraulic line burst

  OK

  NOK

  N/A

• 12 - Traffic

  OK

  NOK

  N/A

• 13 - Fire

  OK

  NOK

  N/A

3 PPE Guidelines

• 1 - Bump Caps

  OK

  NOK

  N/A

• 2 - Anticutting gloves & sleeves

  OK

  NOK

  N/A

• 3 - Face shield & Leather gloves & Safety apron

  OK

  NOK

  N/A

Other findings

Finding

• Description of finding

• Add media

  Media

Conclusion

• Rank<br>

  A Excellent!

  B Satisfied - Self improvement

  C+ Marginal Satisfied - Self improvement

  C- Marginal Satisfied - Audit again ( after 1 month)

  D Unsatisfied - Audit again (after 1 month)

• General comments

• Re-audit to be scheduled before:

  Date

• Action plan to be submitted before:

  Date

Signatures

• Signatures

  Sign