Title Page

  • Conducted on

  • Prepared by

  • Location
  • Organization

  • Division

  • Division

  • Division

  • What Job/ Task is being observed?

  • Audit Participants:

  • Is there a Best Practice present? (Critical Control Improvement)

  • Photo of Best Practice

  • Description of Best Practice

  • Which Fatal Risks exist?

  • Fatal Risk- Interaction with Aircraft

  • Do I have required competency to operate this vehicle/equipment and perform this task (current operator license, certification card, training certificate, etc.)?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I fit for duty (compliant with drug and alcohol policy, well rested and free from fatigue, free from stressful work-related or personal concerns that could potentially distract me from working safely)?<br><br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I conducted a pre-operational inspection prior to use (specific for the vehicle)?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I taken action where critical (safety) items have been identified during the pre-operational inspection?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I meet the recency requirements for this aircraft?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the appropriate aircraft type being used for the work purpose and flight conditions? <br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does the aircraft meet all maintenance and air-worthiness requirements?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I have appropriate storage for LiPo batteries? Is a fire extinguisher readily available?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have launch path and land/return path been evaluated during route planning?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does mission plan account for aircraft failsafe/return home/loiter contingencies?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have applicable authorities (site leads, program manager, air traffic control, etc.) been contacted as necessary and given authorization? <br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is software/firmware updated with the most recent version available? <br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are non-participants briefed and excluded from launch/land/loiter areas? Note: all personnel in the flight path must be protected by structures or stationary vehicles.<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Will line of sight be maintained throughout the flight? In the event of a return to home contingency, will the flight path be clear of all obstacles and hazards, and can line of site be maintained? Is a visual observer present if necessary?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has the area being traveled been barricaded or otherwise blocked to ensure unauthorized people/equipment will not enter the flight path/exclusion zone?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do all personnel have access to positive communication devices?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • All personnel have confirmed that they are competent in the use of the positive communication devices available at the work/activity area.<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is there an air traffic monitoring device in use? Note: a portable VHF receive only device is the only acceptable device for monitoring.<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are ground conditions adequate (stable, demarcated, approved pad, etc.) for aircraft in use? Has a plan been developed to address inadequate conditions? Note: Consider improved/unimproved landing surface conditions. <br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does the aircraft and crew meet the requirements as specified in BARS?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are weather conditions along the route acceptable? Are weather monitoring systems along the route functioning? Is a plan in place in the event of weather degradation?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has a plan been developed for passenger loading and unloading especially in remote and primitive areas? Has it been communicated?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Blasting

  • Is the blast site protected against unauthorized entry while explosive materials or initiating systems are on the blast site?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Before firing a blast, are all access routes protected against unauthorized entry?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Was sufficient warning given to allow all person to be evacuated from the blast site?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all persons evacuated the blast area prior to attaching a source of initiation?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Was the area inspected for misfires by an authorized/competent person after the blast and prior to resuming work in the blast site?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has sufficient time passed for gas to dissipate before approaching area after the blast?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the blast zone large enough to contain potential fly rock and other hazards per design?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • (Post blast) Did all the fly rock stay within the blast area?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the blast site protected against unauthorized entry while explosive materials or initiating systems are on the blast site?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are blast site activities limited to those directly related to blasting operations once loading begins?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is unused explosive material removed to a protected location after loading operations are completed?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have blast holes been checked for obstructions prior to loading?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are explosives and blasting agents kept separated from detonators until loading begins?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are primers made only at the time of use and as close to the blast site as conditions allow?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has a pre-use inspection been done on the vehicle containing the explosives and does it match the actual condition of the vehicle?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the transportation vehicle equipped with fire extinguisher(s) or fixed fire suppression equipment?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are placards and lights placed on the transportation vehicle indicating the contents?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does the vehicle explosives storage compartment meet regulatory requirements? Note: With proper separation for caps and explosives.<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Did the appropriate wait time lapse before the work area inspected for misfires after blasting?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Was post-blast communication provided to mining personnel that no misfires were detected?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the area free of indications of a misfire?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • If a misfire is suspected, are proper work area controls in place?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Was the misfire removal completed correctly?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Was the exclusion zone maintained until the misfire all clear signal is provided?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the transportation vehicle attended or have I verified that the cargo compartment is locked?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are detonators kept in original packaging as shipped from the manufacturer or in closed containers?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are detonators separated from explosive or blasting agents?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I checked the passenger area to verify that it is free from explosive material?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the explosive box constructed according to regulatory requirements? Note: Wood lined transportation boxes.<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the explosive storage area free of potential sources of ignition?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the explosives storage area properly segregated, fenced, signed and labeled?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the exclusion zone free and clear of non-permissible structures and activity?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I obtained permission to enter restricted areas?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the explosive storage magazines electrically grounded?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are all explosives secured by lock and key?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is access to the keys restricted only to authorized personnel?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Confined Space

  • Can I determine whether the gas monitoring equipment was calibrated?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Was a bump test completed on the monitor before use at this confined space?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has the confined space atmosphere been tested?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is gas testing being performed throughout the job covered under the permit and are results within the defined safe range on the confined space entry permit?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I know the hazardous substances that I may be exposed to in the Confined Space and the potential health effect of exposure to these substances?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I aware of the conditions that would trigger an evacuation of the confined space?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the area outside or adjacent to the space free of conditions that could affect safe entry?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is ventilation provided (per assessment and/or permit)?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the Confined Space Entry Permit complete and have I read and signed it?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I know the risks for the Confined Space?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has the team reviewed the rescue plan for this task? Does everyone know and understand the plan?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the rescue plan appropriate and are all necessary tools and equipment available?<br><br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are all entry and exit points to the Confined Space controlled by an attendant or barricading?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all energy sources been identified, isolated and de-energized?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have locks, tags and other isolation devices been installed so they cannot be bypassed or defeated?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has the "try out/test out" step been completed?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has "0 Energy" been verified?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all required employees locked out ?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all isolation points been accounted for?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all visible and concealed utilities been identified using utility location procedures?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Drowning

  • Have you considered drowning as a risk in your pre-task assessment or procedure for this task?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does everyone involved in the task have access to the required flotation devices for the task?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have you inspected the flotation device(s) prior to use? Check integrity, condition, damage in test/date etc.<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are you wearing the required flotation device(s) correctly?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do you and the team know what to do in the case of a required rescue?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has the team reviewed the rescue plan for this task? Does everyone know and understand the plan?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the rescue plan appropriate and are all necessary tools and equipment available?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I remain inside the confines of the handrails at all times (e.g. not stepping on mid-rails, leaning over handrails, etc...)<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the barriers adequate to prevent falling into water (or other liquids that a person could drown in)?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I inspected the access platform and/or barge before use? Check for missing/loose floor boards, corroded parts, secured handrails, etc.<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the work platform suitable for the job/task?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are physical controls and signage in place to prevent unauthorized access?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are all personnel present authorized to be in the location?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do you have a spotter in place for work on or near water?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do you have a spotter in place for work on or near water?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do you and the team know what to do in the case of a rescue?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do you have all the necessary rescue equipment ready to use at the job site? (Flotation Devices, Life Rings, Life Lines, Ladders, Rescue craft, etc.)<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Entanglement and Crushing

  • Have I performed effective mechanical blocking?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the mechanical blocks approved and safe for use?<br>

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  • Immediate Action

  • Description of Lacking Control

  • Have all energy sources been identified, isolated and de-energized?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have locks, tags and other isolation devices been installed so they cannot be bypassed or defeated?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has the "try out/test out" step been completed?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has "0 Energy" been verified?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all affected employees locked out?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all isolation points been accounted for?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are guards, barriers and/or barricades installed on the moving parts of equipment?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are guards, barriers and/or barricades secure and strong enough to provide protection?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I aware of all dead man switches, emergency stops and pull cords and are they confirmed as functional prior to work commencing?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I replaced all removed guards at the end of the task?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • For unguarded moving equipment, are safe distances maintained, or specific procedures in place for the activity I am about to perform?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I clear of potential line of fire situations?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Exposure to Electrical Hazards

  • Are the doors or gates on MCC (Motor Control Centers) and sub stations closed and secured as required?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I authorized to perform work in this area?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • When possible, is other energized equipment in the area either de-energized or blocked, covered, barricaded, or guarded to prevent accidental contact?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are flash boundaries being established and utilized as required?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are safe distances maintained for equipment and energized components?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • <br>Have I selected the correct category of Arc Flash PPE for the incident energy level? Note: Check PPE for the rating.<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the Electrical PPE in good condition (e.g. free from rips, cuts, damage, and free from contaminants such as grease and oil)?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are insulated rubber gloves being used and are they appropriately rated for the voltage? <br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I conducted an inflation test on my electrical insulated gloves?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have the rubber gloves (being used) been electrically tested and stamped within the last 6 months?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I have knowledge of the electrical circuit or system, or are the single line and electrical drawings or other schematics available?<br><br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is required labeling present and the information accurate and legible?<br><br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the tools being used rated for the voltage present or possible?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has the team reviewed the rescue plan for this task? Does everyone know and understand the plan?<br><br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the rescue plan appropriate and are all necessary tools and equipment available?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is a second qualified person or trained attendant present for duration of work?<br><br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has an arc flash analysis been conducted?<br><br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all energy sources been identified, isolated and de-energized?<br><br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have locks, tags and other isolation devices been installed so they cannot be bypassed or defeated?<br><br><br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has the "try out/test out" step been completed?<br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has "0 Energy" been verified in the components I will be exposed to?<br><br><br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all required employees locked out?<br><br><br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all isolation points been accounted for?<br><br><br><br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all visible and concealed utilities been identified using utility location procedures?<br><br><br><br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Hazardous Substance Acute

  • Are concentrated hazardous substances only stored & used in designated areas?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I authorized to work in this area and with this hazardous substances?

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  • Immediate Action

  • Description of Lacking Control

  • Do I have a personal monitor for hazardous gases, where needed?

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  • Immediate Action

  • Description of Lacking Control

  • Is the stationary and / or personal monitor working?

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  • Immediate Action

  • Description of Lacking Control

  • Do I know what the different alarms and tones mean?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I know where to evacuate, and is the evacuation route clear?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • If no alarms are available, do I know how to recognize an upset condition? (e.g. ventilation failure, elevated pH in cell line)

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the SDS readily available and do I understand what it requires?

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  • Immediate Action

  • Description of Lacking Control

  • Do I know the handling requirements of my hazardous substances?

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  • Immediate Action

  • Description of Lacking Control

  • Do I know what to do in the event of an emergency involving the hazardous substances being handled? Is emergency equipment available (e.g. shower, eyewash)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is equipment/containers labeled indicating the hazardous contents? (name of substance, and type of hazard)

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  • Immediate Action

  • Description of Lacking Control

  • Are precautions being taken prior to opening pipes, tanks, enclosed cells, etc. that could contain hazardous substances?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I authorized to be in the loading / unloading area?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have the contents of the delivery truck been verified?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I understand safe loading/unloading practices for the bulk hazardous substances?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are hazardous substances adequately stored and segregated?

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  • Immediate Action

  • Description of Lacking Control

  • Are pipes or other distribution systems used for hazardous substances clearly identified and in good operating condition?

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  • Immediate Action

  • Description of Lacking Control

  • Are ventilation systems working as designed, and effectively controlling airborne hazards?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I understand the operational conditions required to prevent unintended release? (e.g. safe pH range, operating temperature, cell voltage, solution concentration, etc.)

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I know the substances that I might be exposed to and the potential health effects of exposure to these substances?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I using the correct type of PPE for the task being performed? Note: check ratings, selection and use

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  • Immediate Action

  • Description of Lacking Control

  • Do I understand the identified health hazards in my area?

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  • Immediate Action

  • Description of Lacking Control

  • Have I ensured that the PPE is in good condition prior to use?

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  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Hazardous Substance- Chronic

  • Are concentrated hazardous substances only stored & used in designated areas?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I authorized to work in the area where the hazardous substance is present?

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  • Immediate Action

  • Description of Lacking Control

  • Do I know the composition of the material that I'm handling?

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  • Immediate Action

  • Description of Lacking Control

  • Is clean-up performed in a way that minimizes exposures to hazardous substances? (e.g. vacuum or wet clean-up of hazardous dust rather than compressed air)

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  • Immediate Action

  • Description of Lacking Control

  • Are components parts and equipment that might be contaminated with a high-hazard substance cleaned prior to maintenance activities?

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  • Immediate Action

  • Description of Lacking Control

  • Are ventilation systems working as designed, and effectively controlling airborne hazards?

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  • Immediate Action

  • Description of Lacking Control

  • Is my cab or control room properly maintained to ensure clean air, including effective air filters, weather stripping, door seals, etc.?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is water being used effectively to control dust emissions?

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  • Immediate Action

  • Description of Lacking Control

  • Do I understand the operational conditions required to prevent unintended release? (e.g. safe ph range, operating temperature, cell voltage, solution concentration, etc.)

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are process enclosures adjusted and maintained to ensure hazardous substances are contained properly (e.g. conveyor skirting, heat-retention balls, inspection doors closed, etc.)

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I know when and where respirators are required?

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  • Immediate Action

  • Description of Lacking Control

  • Am I using the correct type of PPE for the task being performed? Note: check ratings, selection and use

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  • Immediate Action

  • Description of Lacking Control

  • Do I understand all of the identified health hazards in my area?

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  • Immediate Action

  • Description of Lacking Control

  • Have I ensured that the PPE is in good condition prior to use?

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  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Fall from Heights

  • Have I visually inspected the anchor points prior to use?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I inspected my harness prior to use?

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  • Immediate Action

  • Description of Lacking Control

  • Have I inspected the connector/lanyard/shock absorber equipment prior to use?

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  • Immediate Action

  • Description of Lacking Control

  • Is my selected fall protection adequate for the task and am I wearing it correctly? Note: check length, compatibility with work from height (restraint vs. arrest)<br>

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  • Immediate Action

  • Description of Lacking Control

  • Has the team reviewed the rescue plan for this task? Does everyone know and understand the plan?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the rescue plan appropriate and are all necessary tools and equipment available?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Can I maintain 100% tie-off, if needed?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all team members reviewed and understood the rescue plan?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I inspected the fixed work platform before use? Note: check for missing/loose floor grating panels, secured handrails, toe boards, etc.

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is access/exit safe and easily accessible?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the fixed work platform suitable for the job/task?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I using the correct mobile work platform for the job/task? Note: check suitability of the equipment for task and position/placement, including function, and load limit, terrain, environment/weather, location, current inspection, fundamentally stable

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I correctly secured in the basket with proper fall protection equipment?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I completed a pre-operational inspection and addressed any critical safety issues?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I confirmed that weather conditions will allow for safe use?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I remain inside the confines of the basket at all times (e.g. Not stepping on mid-rails, leaning over the handrails, etc.)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have the ground conditions for mobile platform travel areas been inspected (e.g. Buried hazards, underground services, uneven terrain)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is access/exit safe and easily accessible?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the platforms travelling over the designated and inspected areas for the task?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is installed edge protection adequate to prevent falls? Note: Includes railings, horizontal life lines, rat lines, etc.

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I adequately protected from falling into of off of all openings or leading edges i.e. using barricades, guards or other fall prevention/protection?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I inspected the edge protection devices to ensure they are maintained and in good working order?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has the scaffold design and work plan been approved by a competent person?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the scaffold constructed according to the approved design and work plan?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does the scaffold have the load capacity posted?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has the inspection of the scaffold been completed by a competent person prior to use? Note: Daily inspection is required when a scaffold is in use.

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the scaffold protected from being hit by moving vehicles/equipment?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is access/exit safe and easily accessible?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does the scaffolding have complete floors, toe boards, mid rails and handrails?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Falling Objects

  • Have I considered the potential for objects/materials falling from heights for the specific job being performed?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is barricading and segregation in place for all dropped objects fall zones?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I verified that the barricading has 360 degree coverage to prevent unintended access to the potential drop/loading/unloading zone?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do barricaded areas have adequate notification, signage/tags?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are concurrent and adjacent work activities segregated from drop zones of falling objects?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I inspected the work area for any potential falling objects prior to commencing any work?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are equipment items and fixtures at height free from observable signs of securement failure? (e.g. beams, brackets, bracing, and/or support members)

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I inspected and verified that any pieces of equipment mounted at height show no signs of accidental impact from cranes or any other activities?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are devices that are used for securement adequate to prevent falling objects?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have securing devices been inspected prior to use?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are securing devices functioning as designed?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are observable mounts of fixed elevated equipment in good repair and as designed?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have concurrent activities been considered for the work activities being performed?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the flooring of upper level work platforms designed to prevent objects from falling through to the lower level?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Fire

  • Are combustible and flammable materials separated from each other?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are all combustible and flammable materials separated from ignition sources?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I inspected the work area for spills or leaks of flammable or combustible material? (e.g. leaks from pumps, vehicles, motors, other equipment)

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the Hot Work Permit complete and have I read and signed it?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I know the risks for the Hot Work Permit?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the work area protected from hot work activities as specified in the Hot Work Permit? (e.g. fire blankets)

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the area and or personal/portable monitor working?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I know what the different alarms and tones mean?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are suppression systems/fire extinguishers inspected properly and easily accessible?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are rescue systems (e.g. emergency response personnel available during high risk tasks, refuge chambers, etc..) available?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I know where the nearest refuge chamber is?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the Refuge chamber fully stocked with all emergency supplies and ready for use?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I have my Self Rescuer with me?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has my Self Rescuer been inspected and is it ready for use?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I checked that the evacuation routes and secondary egress inspections have been conducted?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I know where the muster points are in the event of an evacuation?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Ground Failure

  • Have I inspected the work area for geotechnical hazards?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are there visible field controls that indicate design limits?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the work being performed within the design limits?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Did I receive a detailed handover for the bench/wall hazards?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I understand the geotechnical requirements that need to be implemented for the plan?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I communicated updates in conditions to the appropriate individuals?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I received the latest geotechnical update and do I understand it?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I understand how to look for cracking or potential ground failures?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I know what to do if I identify cracking or potential ground failures?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I know what signage and alerts are in place to identify 'hazard zones'?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is signage in place around excavation?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does segregation/barricading limit access to the entire excavation or trenching?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is swing radius protection in place around excavation equipment to keep people out of swing zones?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are collapse protections/safeguards in place? (Slope, shore, rolling object protection, vehicle chocks, etc)

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is access/exit safe and easily accessible?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all visible and concealed utilities been identified using utility location procedures?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Lifting Operations

  • Is the lifting operation controlled by barricading?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I verified that the barricading has 360 degree coverage to prevent unintended access to the potential drop/loading/unloading zone?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the exclusion zone large enough to protect people in the event of a load falling?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the team or lifting equipment provided with horns, whistles or lights to warn others who may be in the path of travel?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I erected barricades as required?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do barricaded areas have adequate notification, signage/tags?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are there only authorized personnel inside the barricaded area during the lift?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • For personnel in controlled zone, are safe distances maintained?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • If there is a formal written lift plan, has it been completed and reviewed with the lift team?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I determined that the weather conditions will allow for a safe lift?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does the work team have agreed communication protocols (e.g. radio, spotter, lights)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the ground conditions stable for the position of the crane outriggers/tracks?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have underground and overhead hazards been identified within the lift zone (e.g. active or abandoned utilities or mine works, tanks, structures, power lines, trestles, etc.)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the load rigged/secured from shifting/sliding during lift?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I performed a walk around inspection of the lifting equipment prior to use?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the maximum safe working load indicated on the lifting equipment?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I verified that the annual certification of the lifting equipment to be used for the lifting operation is valid and current?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I performed a pre operational inspection on the lifting equipment prior to it being used?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has a competent person inspected the rigging and lifting equipment and is the inspection current?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does each piece of rigging equipment have a current tag or stamp on it indicating it has been checked on a planned schedule?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Rail Collision

  • Have I attained authorization to occupy this section of rail with this rail mounted equipment?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Prior to the commencement of this activity have I tested the access control mechanisms to prove all are operational?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I verified that remotely controlled systems are operational prior to the commencement of this activity?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I have authorization to access this area?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I fit for duty (compliant with drug and alcohol policy, well rested and free from fatigue, free from stressful work-related or personal concerns that could potentially distract me from working safely)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the personnel present free from visible illness or injury which may compromise safety?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I have required competency to operate this vehicle/equipment and perform this task (current driver/operator license, certification card, training certificate, etc.)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all contractors present been confirmed as rail safe working trained?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are all visitors inducted for rail network access?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are positive communication devices available at the work location?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are available positive communications functional and effective?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I know how to use the available positive communications devices

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Did the prestart briefing include actions to be taken if positive communications are lost?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I checked the schedule for rolling stock/Hi Rail traffic movement on this line?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are personnel acknowledging and responding correctly to alarms?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the field activity consistent with the current rail movement schedule?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the required signaling and signage in the area consistent with current standards and policies?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are critical signals in the area readily identifiable (visible/audible)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the signaling and signage operational?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Rail Impact on Person

  • Is the access control point operational?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are all personnel present authorized to be in the location?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have unauthorized 'on rail' vehicles and rolling stock been reported to controllers?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the maintenance log book for the equipment up to date?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does the rolling stock/equipment appear to be ready for use (free from defects)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has a prestart check been completed for this rolling stock/equipment?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all critical action items recorded in the equipment log been actioned to closure?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has a pre operation check list, that is specific for the equipment, been completed prior?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is a current maintenance acceptance form available with the equipment log/papers?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has the positive communication equipment to be used been checked prior to commencement of work/activity?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have the switches been verified to be in the correct position prior to commencement of work?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has the prestart briefing included a discussion on actions to be taken in the event of a communications blackout?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • All personnel have confirmed that they are competent in the use of the positive communication devices available at the work/activity location?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the personnel present competent in applying redundancy arrangements for positive communications?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do all the personnel present have access to positive communication devices?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • All personnel have confirmed that they are competent in the use of the positive communication devices available at the work/activity location?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is rolling stock in the vicinity safely secured (stabled)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have the brakes on the rolling stock been effectively applied?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does all of the equipment available at location present as serviceable for securing rolling stock?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is my work area protected by a derailer or other engineered control? Is the derailer or engineered control secured?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the separation rules understood by all personnel present?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Activation of switching, brakes and couplings has been progressed without being exposed to potentially moving rail equipment? Prohibition of riding on rail cars/rolling stock has been discussed and understood during the prestart briefing?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Prior to commencement of work/activity have safe zones been identified?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • During the prestart has the prohibition of loose shunting been communicated?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are danger zones clearly identifiable on this network section?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are safe zones clearly identifiable on this network section?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are personnel following the procedures that preclude uncontrolled movements of Rolling stock (e.g. loose shunting)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the signals and signage in the immediate area working?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the required signaling and signage in the area consistent with current standards and policies?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Uncontrolled Release of Energy

  • Are guards, barriers and barricades properly installed to protect personnel from uncontrolled energy release?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I inspected the guards, barriers and barricades?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I aware of all dead man switches, emergency stops and pull cords and are they confirmed as functional prior to work commencing?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does the work plan address reinstallation of guards, barriers and barricades prior to return to service?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does the work plan address reinstallation of guards, barriers and barricades prior to return to service?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I installed/checked that hose coupling safety clips/whip-checks are in place prior to starting my work?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does the hose assembly meet the requirements for material, pressure, and use?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all energy sources been identified, isolated and de-energized?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have locks, tags and other isolation devices been installed so they cannot be bypassed or defeated?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has the "try out/test out" step been completed?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has "0 Energy" been verified?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all required employees locked out?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all isolation points been accounted for?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have all visible and concealed utilities been identified using utility location procedures?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Did a competent person inspect the piping, hoses and equipment under pressure for mechanical integrity?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are preventative maintenance, inspections and testing current for the piping, hoses and equipment under pressure?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are Quality Assurance records available and current for piping, hoses and equipment under pressure?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has a competent person inspected the relief valve(s) and is the inspection current?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the relief valve discharge point positioned for safe venting and with no impact to personnel?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the pressure gauge indicating that the pressure within the vessel is in the safe operating range?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the safety valve integrity seal intact?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the pressure vessel or high pressure line free from external structural damage?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are all instrumentation gauges single unit measurements? (bar vs psi)

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I inspected equipment to be tensioned (e.g. Come alongs, snatch blocks, counterweight cables, mooring lines, etc.) prior to use?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do tensioned lines appear to be in good condition and well maintained?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is pipe being stored properly?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are pipe activities properly segregated from other personnel? (e.g. pipe cutting, fusing, transporting, loading, unloading)<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • If HDPE pipe is being transported is it being pulled and not pushed?<br>

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the appropriate pipe rigging utilized?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the tire deflated to the right pressure prior to wheel removal?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I checked that the replacement wheel is free from damage?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I checked that the rim flange and split ring are in good conditioned with no cracks, deformities, etc.?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Did I install a safety barrier prior to inflation?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is a remote inflation line used to inflate the tire?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I and others positioned ourselves in a safe location when a tire is being inflated?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Vehicle Collision or Rollover

  • Am I fit for duty (compliant with drug and alcohol policy, well rested and free from fatigue, free from stressful work-related or personal concerns that could potentially distract me from working safely)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I have required competency to operate this vehicle/equipment and perform this task (current driver/operator license, certification card, training certificate, etc.)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I wearing my seatbelt correctly?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I conducted a pre-operational inspection prior to use (specific for the vehicle)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I taken action where critical (safety) items have been identified during the pre-operational inspection?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are physical controls and signage in place to prevent unauthorized access?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I have authorization to access this area?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I using the required equipment for communication and is this equipment operational?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are all positive communication protocols being followed (e.g. Passing, Distance Rule)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are roads maintained in good condition?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the roads I intend to use safe for travel in current and expected weather conditions?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I performing road condition inspections as required?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the segregation controls suitable for the hazards (e.g. barriers, barricades, road dividers)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the segregation controls visible, secure, and in place? (barricades, mirrors etc.)

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are personnel following the segregation rules?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is segregation equipment accessible in work areas?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are segregation controls implemented in a way that doesn't introduce new hazards?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is signage/demarcation of pedestrian walkways, crossings, and restricted areas in place?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the signage visible and readable?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I following and adhering to signage and demarcation rules?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Vehicle Impact on Person

  • Have I conducted a pre-operational inspection prior to use (specific for the vehicle)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I taken action where critical (safety) items have been identified during the pre-operational inspection?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have I parked the vehicle correctly?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Did I test the braking system as part of my pre-operational inspection?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Am I using the required equipment for communication and is this equipment operational?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are all positive communication protocols being followed (e.g. Passing, Distance Rule)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the segregation controls suitable for the hazards (e.g. barriers, barricades, road dividers)?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the segregation controls visible, secure, and in place? (barricades, mirrors etc.)

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are personnel following the segregation rules?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are segregation controls implemented in a way that doesn't introduce new hazards?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is signage/demarcation of pedestrian walkways, crossings, and restricted areas in place?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is the signage visible and readable?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Fatal Risk- Underground Rock Fall

  • Are ground monitoring instruments operating correctly? Is unsupported ground clearly marked to prevent entry underneath it?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Do I have an approved development worksheet that clearly specifies ground support to be installed, and am I equipped to safely and successfully install it?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has pull testing been completed and results marked on maps or in the headings? Is shotcrete/concrete/backfill being installed according to the manufacturer’s directions and in compliance with the ground control management plan?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have you received and approved work sheet?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Does the work area ground control and ventilation allow for safe entry?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are identified hazardous conditions corrected? Have identified ground movement and failure issues been addressed before work resumes in those areas?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Has permission to enter a closed/restricted geotechnical monitoring area been given? Is the survey team checking heading breakage conformance and are the drill and blast crews adhering to the mine development plan?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Have ground control inspections occurred?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • When ground monitoring equipment identifies an issue, are actions taken to protect the team?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are the status of headings readily known and shown on mine maps?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Are up-to-date mine plans maintained in locations that are easily accessible?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is there a process for handover between shifts and technical and operations management?

  • Photo

  • Immediate Action

  • Description of Lacking Control

  • Is scaling performed in development cycles?

  • Photo

  • Immediate Action

  • Description of Lacking Control

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.