Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

FY15 Top Deficiencies

  • Does the SE have two pairs of insulating gloves? (one in use, one in sealed plastic bag)

  • If permitted (or required) by local law, does the SE have a hands free device?

  • Are all insulated tools in good condition and free of nicks and unmodified?

  • Are electrical gloves stored properly flat and segregated from leather protectors and other PPE?

  • Is all required Arc Flash ATPV calcm2 clothing free of holes damage and significant wear?

JOB SITE DOCUMENTATION FY16 V 1.0

  • Was a EHS Survey / Project Safety Tailgate Meeting / Job Site Risk Assessment conducted? Is the form properly filled and available onsite? Have all involved Service Engineers (SE) participated in the EHS Survey/ Tailgate Meeting?

  • Does the SE know what to do in the event of an emergency situation (evacuation routes, muster points, etc.)?

  • Does the SE know the onsite emergency phone number?

  • Does the SE know who the emergency contact is?

  • Does the SE know where the nearest medical facility is?

  • Did the SE receive/ inquire about any site specific procedures?

  • Can the SE demonstrate access to (M)SDSs?

  • Can the SE demonstrate access to the ENP-company safety and environmental manual?

  • Is the SE familiar with the Company work / rest notification rule?

  • If the Service Division has established a maximum safe lifting limit, did the SE understand and conform to the policy limit?

TRAINING

  • Has the SE received technical training related to the unit/equipment he is working on?

  • Has the SE received Arc Flash Training? Training Date__________

  • Has SE received Back Safety Training? <br>Back Safety Training Training Date_________

  • Has the SE received Blood Borne Pathogens training? Training Date__________

  • Has the SE been offered the Hepatitis B Vaccination?

  • Has the SE received Classes of Fire Extinguisher? ​ <br> Fire Extinguisher Training Date________

  • Has the SE received Confined Space Training? Training Date__________

  • Is the Service Engineer (SE) certified in First Aid, CPR and AED? ​ <br> First Aid Expiration Date________ CPR Expiration Date________<br>

  • Has SE received Defensive Driving / Drive Safe Training? <br>Defensive Driving / Drive Safe Training Date___________

  • Has the SE received Electrical Safety? Training Date__________

  • Has the SE received Fall Protection training? Training Date_________

  • Has the SE received Fire Prevention and Hot Work training? Fire Prevention Training Date_________

  • Has SE received Hazard Communication Training?<br> Hazard Communication Training Date__________

  • Has the SE received LOTO training? Training Date_________

  • Has the SE received PPE training? Training Date_________

JOB SITE CONDITIONS

  • Any conditions that present hazards at the jobsite (asbestos, hydrogen sulfide, lead, etc.), have been accounted for?<br><br>

  • Is there sufficient ventilation on site to carry out the work being performed (e.g. generator testing, load banks, hot work, etc.)?

  • Does the SE understand his responsibilities in case of fire?

  • Is the work site clean of trash, and maintained in an orderly manner?

  • Have unsafe conditions been communicated to the Customer and conditions resolved before work begins?

  • Are chemicals/combustible liquids identified ,stored properly and protected from accidental release?

  • Is the SE familiar with the fire suppression system? (e.g. Halon, FM 200, etc...)

PERSONAL PROTECTIVE EQUIPMENT

  • Does the Service Engineer (SE) have company issued hard hat and safety glasses as required? ​

  • Is the SE wearing appropriate safety/work shoes?

  • Is the SE conforming to customer’s required specific PPE requirements?

  • Does the SE have the appropriate PPE for the task being performed (electrolyte work, hot work, refrigerant, brazing/cutting, generator testing, batteries, etc.)?

  • Has the SE demonstrated the proper inspection technique for electrical gloves and sleeves?

  • Are electrical gloves stored properly (flat/ unfolded and segregated from leather protectors and other PPE)?

  • Are voltage insulating gloves marked with the current testing, MFG and or date placed in service?

  • Does the SE have two pairs of insulating gloves? (one in use, one in sealed plastic bag)

  • Are voltage insulating sleeves marked with the current testing, MFG and or date placed in service?

  • Are Electrical Sleeves stored unfolded and separate from other PPE?

  • Does the SE have all required Arc Flash ATPV cal/cm2 (Westex label) clothing and are they wearing the appropriate Arc Flash ATPV cal/cm2 for all tasks? ​

  • Is all required Arc Flash ATPV cal/cm2 clothing free of holes, damage and significant wear?

  • Does the SE have Arc rated face shield and is it in good condition, free of cracks and significant scratches, and stored in protective bag?<br>

  • Does the SE have the appropriate hearing protection for the task?

FALL PROTECTION

  • If work in areas requiring fall protection are identified as a job requirement, is the Service Engineer (SE) authorized to wear fall protection?​ <br>

  • If the work being performed requires fall protection, is the equipment available, has it been inspected prior to use, and certified for use as fall protection devices and tie offs?

  • Does the SE’s use retractable fall protection systems when working over 4 feet (1.2 m)?

HOT WORK

  • If job-required, has the Services Engineer (SE) obtained a Hot Work Permit?

  • If hot work is required, did another Person perform the Fire Watch duties?

  • Did the Fire Watch attend their post for the required amount of time after hot work was completed?

ELECTRICAL SAFETY / LOTO

  • Is the SE qualified to perform electrical work?

  • Has the SE removed all jewelry prior to beginning work?

  • Are prescription safety glasses non-conductive?

  • Does the SE know and understand the significance of the Approach Boundaries?

  • If required, has the safe work boundary been delineated using a safety barricade or tape?<br>

  • Has the SE coordinated with the customer to perform LOTO?

  • Have stored energy sources (capacitors, batteries, springs, charging mechanisms, etc.) been properly discharged, blocked or released?​

  • Have all energy sources (electrical & mechanical) been locked out and tagged?

  • When removing or installing panels on equipment, is correct PPE being used?

  • Require a demonstration of LOTO…did SE perform the procedure correctly?

  • Is all electrical test equipment calibrated and within current calibration date requirements?

  • Require a demonstration of "Live - Dead - Live", and was the demonstration preformed correctly?

  • Is the SE using insulated shielding if required?

  • Are extension cords in good condition and properly rated?

  • Does the SE have a Ground Fault Circuit Interrupter (GFCI)?

  • Has SE requested a current One Line diagram for the electrical distribution, from the Customer?

  • Does SE have a company issued Lockout/Tagout Kit?

  • Unless long tip probes are permitted by the business unit, are only short tip multimeter probes available for use and company supplied?​

  • Does the SE only have required company issued/approved insulated tools?

  • Are all insulated tools in good condition and free of nicks and unmodified?

LADDERS

  • Have ladders been visually inspected prior to each use and are they in good condition?

  • Are all SE ladders fiberglass and ANSI rated 1A (300 lbs/137 Kg) or 1AA (375 lbs/170 Kg)? OR<br>EN Class 131(150 Kg / 330 lbs), or Class 1 (175 Kg/385 lbs) maximum or Country specific standard?

  • Are customer ladders to be used by the SE, properly rated for electrical use / load and in good condition free of damage, defects and repairs?

  • If in use, have extension ladders been positioned so that the ratio of ladder height to distance from the wall / building is no greater than 4:1? ​

DOCUMENTATION

  • Does the SE have a valid Driver's license?

  • Does the SE have a current vehicle registration?

  • Does the SE have a current insurance and accident reporting documents?

  • If applicable, are vehicle inspection records up to date?

EXTERIOR VEHICLE CONDITION

  • Is vehicle exterior clean and undamaged?

  • Is the windshield in good condition (no cracks, stars)?

  • Vehicle not leaking fluids (water, oil, antifreeze, fuel, etc.)?

  • All exterior lights functional?

  • Outside mirrors attached and adjustable?

  • Are tires in good condition?

INTERIOR VEHICLE CONDITION

  • Is vehicle interior clean, organized and undamaged?

  • Are dashboard gauges functioning and warning lights out?

  • Does vehicle’s horn sound?

  • Are all interior lights functioning?

  • Is the vehicle safety shield/cage installed and all required materials stored behind?

  • If compressed gas cylinders are present, are they properly secured?

  • Are seat belts and rear view mirror in good condition?

VEHICLE SAFETY EQUIPMENT

  • If required, is vehicle equipped with an appropriate Fire Extinguisher?

  • If yes to A, is the monthly inspection record complete?

  • If permitted (or required) by local law, does the SE have a hands free device?

  • Are flashlights used in the workplace conforming with electrical safety best practices (arc rated, non conductive) and provided by the company?

  • Does the Service Engineer (SE) have a current First Aid Kit?

  • If required, is the vehicle equipped with Reflective Safety Triangles or other equipment as required by local law?

CORRECTIVE ACTIONS

  • 1.

  • 2.

  • 3.

  • 4.

  • 5.

AUDIT SUMMARY

  • COMPLIANT- All requirements are being met.

  • MINOR NON COMPLIANCE- Some requirements are not being met – work is still performed safely.

  • MAJOR NON COMPLIANCE - Significant issues not addressed or repeated non-compliance, work must not proceed until resolved.

  • Is follow up necessary? If YES by whom? <br>

SIGNATURES

  • Auditor Signature

  • SE Signature

  • Service Manager

FY15 Top Five

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.