Information

  • Audit Title

  • Pad

  • CHK Rep

  • Location
  • Conducted on

  • Contractors Onsite

  • Prepared by

HAZCOM

  • SDS'S available and accessible at all times

  • All containers in work area properly labeled with NFPA and HMIS labels

PPE

  • FR clothing worn properly by crew, buttoned, zipped and sleeves down

  • Safety glasses with side shields used by crew

  • Hard hats used by crew

  • Hard toed shoes used by crews

  • Hand protection used when necessary

  • Hazardous jewelry not worn by crew

  • Long hair contained

  • Proper PPE worn while handling chemicals, based in SDS/HMIS

HEARING PROTECTION

  • High noise areas present and marked

  • Proper hearing protection available

LOTO

  • LOTO being used

  • Locks and tags available to crew

FIRST AID ANID CARDIOPULMONARY RESUSCITATION

  • First aid training provided

  • First aid supplies available onsite

  • Adequate 2-way radio or cell phone communication available

  • Emergency phone numbers posted

  • Provisions made for workers with known allergies

  • Provisions made for prompt medical attention

CHEMICAL, FLAMMABLE AND COMBUSTABLE LIQUIDS/MATERIALS

  • When not in use, flammable and combustibles are stored in designed area or cabinets

  • All containers are grounded and bonded, conforming to manufacturers specifications when dispensing flammable or combustable liquids

HEAT AND COLD STRESS

  • All workers taking precautions for heat and cold

  • Heat stress and cold stress training provided

FIRE PROTECTION

  • Fire extinguisher available is vehicles and all work areas

  • Annual inspection tag present

  • Monthly inspection tags present on each extinguisher

ELECTRICAL SAFETY

  • Electrical equipment 600V or greater labeled as HIGH VOLTAGE

  • Work clearance of 36" maintained in front of electrical equipment

  • Fixed equipment and portable equipment connect by cord grounded

  • Only 3 wire cords in good condition used onsite

POWERED AIND INDUSTRIAL TRUCKS (FORKLIFTS, HEAVY EQUIPMENT, AND TELEHANDLERS)

  • Operators certified and certificate available

  • OPERATOR QUALIFICATION

  • Seatbelt provided (per manufacturer)

  • Backup alarm working

  • Auxiliary lighting working

  • Horn working

  • Rated lifting capacity

  • Pre-use inspection checklist completed

  • Tires in good condition

  • Refueling and hydraulic lines checked with engine off

  • No damage to windows or mirrors

  • Parked with brake on, key removed and forks grounded

LIFTING AND CARRYING SAFETY

  • Proper lifting and carrying techniques being used

WALKING AND WORKING SURFACES

  • Any working surfaces above 4' from the ground must be protected by a work platform with guardrails at least 42" above platform, have a mid-rail and toe-boards or personal fall protection

  • Fall arrest system must have full body harness, deceleration device and a lifeline

  • Anchorage for fall arrest equipment must be capable of supporting 5,000lbs

  • All walking/working surfaces are clear of debris and tripping hazards and/or tripping hazards have been identified

LADDER SAFETY

  • No wooden ladders allowed onsite

  • Metal ladders must have a warning label for electrical caution

  • Ends or feet of ladder must be fitted with insulated non-slip material

  • Extension ladders must extend 3' past the landing if used to access another working surface and secured

  • 3 points of contact utilized by workers while on ladder

  • Fixed ladders and cellar ladders are inspected and in good condition

  • Portable ladders inspected monthly and noted on monthly ladder inspection

BLOOD BORNE PATHOGENS EXPOSURE CONTROL

  • Blood borne pathogen kit available onsite

  • Blood borne pathogen exposure training complete

PRE JOB SAFETY ASSESSMENT

  • Pre PJSA safety tour of site conducted

  • Daily safety meeting being conducted

  • Accidents, if any, are discussed during safety meetings

  • PJSA filled out properly and completely

  • Individual contractors conducting JSA to identify task-specific hazards

GENERAL

  • Proper incident reporting procedure known and utilized by workers

  • Stop Work Authority in use

  • Adequate communication between contractors onsite

  • Emergency response plan understood

  • Smoke point identified outside of gate

Takepoint/Booster Site

  • Containment in good condition

  • No visible leaks on pumps

  • Pumps are manned while running

  • Air compressor line secured with whipcheck

  • Tires chocked on wheeled units

  • Access road in good condition, no dirt/debris left on public roadway

  • Temporary fence in place when necessary at impoundment takepoints

ADDITIONAL COMMENTS

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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.