FM-OHS-001 HSE Monthly inspection template 2022 - v1

• Site conducted

  Select

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Area Inspected

• Date

  Date

• Inspected by

• Name

• Signature

  Sign

• Plant Superintendent

• HSE team (Safety Officer or Safety Supervisor or Safety Specialist or Safety Superintendent)

• Maintenance Superintendent

• She Rep

• The status of all items on this checklist should be indicated as conforn, non conform or not applicable. All non conform items must be given a written explanation and remedial action captured on log and to be registered on INX for follow up

• Important note: For the Mine, MSP and Jetty, the Plant Superintendent and the Operation Superintendent must attend at the same time this once a month inspection with the HSE Team. The plant SHE rep is highly advised to attend as well

• ITEM

• STATUS

ACCESS

(This section include the access, exits walkway, pontoon walkway, pathway, …to access the building/plant/area)

• Is there a board presenting the specific risks, precautions and PPE required to access the area/plant ?

  Yes

  No

  N/A

• Is there a color code board at the access?

  Yes

  No

  N/A

• Are exits properly marked and exit lights working?

  Yes

  No

  N/A

• Are the access obstructed?

  Yes

  No

  N/A

• Are access properly lighted/illuminated?

  Yes

  No

  N/A

• (Check all lights, bulbs, fluorescent tubes are clean and working)

  Yes

  No

  N/A

• Are unsafe access barricaded and signposted?

  Yes

  No

  N/A

• Are the pontoon walkways levelled? Are gang planks levelled? Are pontoons chains in place?

  Yes

  No

  N/A

• Are the anchore/emergency rope obstructing the walkway?

  Yes

  No

  N/A

• Are operational life ring available on the pontoon walkways and jetty platform?

  Yes

  No

  N/A

• Is there a system to register who is going to the plant?

  Yes

  No

  N/A

• Is there safe access from the barge to the plant ?

  Yes

  No

  N/A

HYGIENE and SANITATION

(Look at toilets, change rooms, tea rooms, cantines and hand washing facilities)

• Are tea rooms (cantines), change rooms and ablution facilities cleaned and sanitized ?

  Yes

  No

  N/A

• Are ablution facilities equipped with toilet papers and water?

  Yes

  No

  N/A

• Are ablution facilities equipped with hand wash bassin and soap?

  Yes

  No

  N/A

• Are ablution facilities for male and female separate and sign posted?

  Yes

  No

  N/A

• Is the ablution inspection sheet in place and up to date?

  Yes

  No

  N/A

• Are ablution facilities (including sewage treatment plant) part of the maintenance program?

  Yes

  No

  N/A

• Is the Sewage Systems operational?

  Yes

  No

  N/A

• Are employees/contractors only eating on authorized and designated area?

  Yes

  No

  N/A

• Are tea rooms (cantine) equipped with waste bins?

  Yes

  No

  N/A

• Ask an employee if he/she is feeling safe using the ablution facilities and tea rooms (cantine) ?

  Yes

  No

  N/A

HOUSEKEEPING

Check floors, grating, stairways

Open shelves, container storages,…

• Are the floors, gratings, stairways and aisles… free of debris and obstruction?

  Yes

  No

  N/A

• Are the floors, gratings, stairways and aisles… free of oil and grease?

  Yes

  No

  N/A

• Is cleaning done to prevent accumulation of unnecessary dust, chemicals, wastes…on the workplace?

  Yes

  No

  N/A

• Are individual work stations kept clean, organized and orderly?

  Yes

  No

  N/A

• Are pipelines, machinery and equipment free of drippings oil or grease?

  Yes

  No

  N/A

• Is there a dedicated and barricaded place to temporarily store unsused materials/scraps until they are removed from site?

  Yes

  No

  N/A

• Are staking of material stable and not creating obstruction and risk of fall of obect?

  Yes

  No

  N/A

• Are staking on shelves storage respecting load limits?

  Yes

  No

  N/A

• Is the stacking of materials on the service barge safe to avoid risk of fall of object to the operator/slinger?

  Yes

  No

  N/A

• Is the personnel barge clean and safe to use?

  Yes

  No

  N/A

REGUAR AND QUARTERLY INSPECTION

• Are lifting equipments and accessories checked and tagged according to the current color code and logged into a register?

  Yes

  No

  N/A

• Are working at height equipments (safety harnesses, lanyards, anchore points, portable ladders, …) checked and tagged according to the current color code and logged into a register?

  Yes

  No

  N/A

• Are confined space equipments, checked and tagged according to the current color code and logged into a register?

  Yes

  No

  N/A

• Are portable electrical equipments checked on monthly basis and logged into a register?

  Yes

  No

  N/A

• Are lifting, working at height, confined space equipments, portable electrical equipments stored appropriately while not in use?

  Yes

  No

  N/A

• Is a physical (pre-use) inspection performed before using these type of equipments?

  Yes

  No

  N/A

• Are pipelines coded in term of color coded standard?

  Yes

  No

  N/A

• Are wall plugs, switches and other switchgear checked and labelled?

  Yes

  No

  N/A

• Are unsafe equipments being red tagged and quarantined?

  Yes

  No

  N/A

PPE and MALARIA

• Are employees wearing properly their basic and specific PPE while performing their job?

  Yes

  No

  N/A

• Do supervision carry out regular inspections on their team to ensure that their PPE are in good condition?

  Yes

  No

  N/A

• Are employees with long hair respecting the agreed precaution to secure their hairs inside the hard hat?

  Yes

  No

  N/A

• Are employees having prescription glasses equipped with side shields? Otherwise, are overprotection used?

  Yes

  No

  N/A

• Are mosquito repellent products available on the workplace for employees to use?

  Yes

  No

  N/A

WASTE AND HYDROCARBON MANAGEMENT

• Soils contaminated with hydrocarbons to the bioremediation area. Empty chemical and explosive containers to hazardous waste container. Expired chemical to hazardous waste container

  Yes

  No

  N/A

• Is there adequate labelled bins per type of waste in the workplace according to the waste volume of the plant?

  Yes

  No

  N/A

• Is there no waste placed outside the bins?

  Yes

  No

  N/A

• Are waste bins kept closed ?

  Yes

  No

  N/A

• Is the waste segregation done according to Kenmare standards?

  Yes

  No

  N/A

• Are all used oil drums sealed?

  Yes

  No

  N/A

• Is the condition of the bund in compliance: no cracks, no deterioration, no direct release to the environment?

  Yes

  No

  N/A

• Is the drain equipped with impervious drain valve?

  Yes

  No

  N/A

• Is the net capacity of the bund posted and visible?

  Yes

  No

  N/A

• Is there accumulated spillage, water or rain water within the bunded area?

  Yes

  No

  N/A

• Is there enough spill kits for the quantity of chemicals present?

  Yes

  No

  N/A

SAFE STORAGE

• Chemical, flamable, explosive materials

  Yes

  No

  N/A

• Is there a register of hazardous chemicals ?

  Yes

  No

  N/A

• Are the MSDS (material safety data sheets) available in the workplace so that users can have access to them?

  Yes

  No

  N/A

• Are the involved employees trained on handling, storage, use and emergency procedures on the hazardous chemicals?

  Yes

  No

  N/A

• Are the mandatory signage ‘’No open flames" and "No smoking" displayed in the vicinity of the flammable liquid store ?

  Yes

  No

  N/A

• Is the maximum storage capacity of the flammable liquid store prominently displayed at the store entrance?

  Yes

  No

  N/A

• Are gas cylinders, the pipes, cutting torches, regulators, flash back arrestors and pressure indicators in good condition and safe to use?

  Yes

  No

  N/A

• Are gas cylinders storage labels in place (Name of the gas and manufacturers plate)?

  Yes

  No

  N/A

• Are gas cylinders kept upright and chained/strapped while stored or transported?

  Yes

  No

  N/A

• Is there ventilated system for the storage of chemicals?

  Yes

  No

  N/A

• Is there adequate fire-fighting equipment available in close vicinity of the flammable liquid store?

  Yes

  No

  N/A

VEHICLES AND MOBILE EQUIPMENT

• Are vehicles and mobile equipments clean (mainly interior,windows and lights?

  Yes

  No

  N/A

• Are pre-use checklist completed and available?

  Yes

  No

  N/A

• Are defects on vehicles and mobile equipments raised and adressed for repairs?

  Yes

  No

  N/A

• Is there a separate parking for LDV and HME?

  Yes

  No

  N/A

• Are HME active zone demarcated and signposted as no go zone for pedestrian and LDV?

  Yes

  No

  N/A

• Is the 20m rule respected for employee working around HME? Are employees not putting themselves on blindspot while working around HME?

  Yes

  No

  N/A

• Is the 50m rule respected?

  Yes

  No

  N/A

• Is positive communication respected to manage interaction between employee, LDV and HME?

  Yes

  No

  N/A

• Is radio available, operational and used to establish positive communication?

  Yes

  No

  N/A

• Are LDV and HME moving to the mining area equipped with reflective flag or beacon light?

  Yes

  No

  N/A

FIRE FIGHTING AND EMERGENCY RESPONSE

• Are fire extinguishers fixed and located on easily accessible positions ?

  Yes

  No

  N/A

• Are fire extinguishers labelled and safety seal in place?

  Yes

  No

  N/A

• Is the fire extinguishing equipments returned on its dedicated place after use?

  Yes

  No

  N/A

• Are fire extinguishing equipments tested, operational and inspections up to date?

  Yes

  No

  N/A

• Is there trained first aider and on site fire fighter in the area?

  Yes

  No

  N/A

• Is there a planned Fire drills for the area?

  Yes

  No

  N/A

• Are fire breaks in place?

  Yes

  No

  N/A

• Are the emergency alarms system operational? Provide monthly test certificate

  Yes

  No

  N/A

• Are ERT training and drills updated on the area?

  Yes

  No

  N/A

RISK MANAGEMENT

• All routine and non critical tasks are covered by General Task Assessment?

  Yes

  No

  N/A

• Each critical task is covered by an approved Task Based Risk Assessment?

  Yes

  No

  N/A

• Are the Critical Controls adhered to?

  Yes

  No

  N/A

• Are leaders (Superintendent) of the area scheduling Planned Task Observation or critical audits for Critical Tasks of their area?

  Yes

  No

  N/A

• Are near misses reported, recorded and managed properly? (To be marked as NA until Near miss campaign launched)

  Yes

  No

  N/A

• Are incidents resulting on Injuries, Significant Potential Incidents and Property Damages reported and investigated?

  Yes

  No

  N/A

NOSA CRITICAL CHECKS

• EHS Policy awareness done to all employees, attendance kept in file?

  Yes

  No

  N/A

• Appointments of people with EHS functions done and copies kept in file?

  Yes

  No

  N/A

• Toolbox talks & Training records for employees kept in files? Including new employees

  Yes

  No

  N/A

• EHS rep inspections done on monthly basis and actions addressed?

  Yes

  No

  N/A

• Copies of updated Risk Assessments, GTA and Take 5 kept in file?

  Yes

  No

  N/A

• Are EHS monthly meetings and risk register review performed on the sector?

  Yes

  No

  N/A

• Incident Records and Recalls awareness in file?

  Yes

  No

  N/A

• Emergency drills and fire test records done an in file?

  Yes

  No

  N/A

• Check the GPTW books and identify gaps

  Yes

  No

  N/A

• Check specific permits books (hot work, isolation, confined space, excavation) and identify gaps

  Yes

  No

  N/A

CRITICAL SAFETY SYSTEMS

• Are the critical safety systems/ interlocks on the plant/sector identified on a register (Example: critical process valves, Pontoon deeping, Safety interlocks, freeboard sensor, trip safety device ,

  Yes

  No

  N/A

• Are the frequency of test determined for the different type of critical safety systems?

  Yes

  No

  N/A

• Was the monthly test performed on the critical safety systems of the plant or equipment?

  Yes

  No

  N/A

• (Present signed certificate on the following test: Pontoon deeping, Safety interlocks, freeboard sensor, trip safety device ,

  Yes

  No

  N/A

• Is there a Planned Maintenance on these critical safety systems?

  Yes

  No

  N/A

• Are the findings from critical checks or inspections recorded on the system for urgent corrective action ? e.g. ONKEY Is the program adhered to?

  Yes

  No

  N/A

• Are the leaders of the sector peforming awarness to the team on the critical safety system?

  Yes

  No

  N/A

• Are emergency switch and/or equipment controls visible and operational?

  Yes

  No

  N/A

• Are pressure vessels regulatory inspection up to date?

  Yes

  No

  N/A

• Are guards in place for rotating equipments?

  Yes

  No

  N/A

• Are equipment calibrations done and defective equipment tagged?

  Yes

  No

  N/A

• Hazards identified during the inspection which cannot be fixed immediately and require expert skills or equipment to be ordered should to be recorded in the table below. The page should then be photocopied and logged into the work area hazard log file. Completed inspection forms are to be forwarded to the Head of Department for review, follow-up and filing

  Yes

  No

  N/A

• The Responsible Person is responsible for monitoring progress of the hazard log folder. At the end of each month the Responsible Person is responsible for updating progress to the hazard log and forwarding a list of outstanding actions to the Area Manager

  Yes

  No

  N/A

• HAZARD LOG

  Yes

  No

  N/A

• INSPECTION DATE:

  Date

• Area Inspected

• PARTICIPANTS:

ITEM No

• ACTION REQUIRED

• BY WHOM

• Target Date

  Date

• Reviewed by Head of Department

• Name

• Signature

  Sign

• Date

  Date