Georgia Pacific CSM Audit

• Audit Title

• Document No.

• Prepared by

• Client / Site

CSM In Progress Work Safety Assessment

• General Information

• Project Name/Details

• Report date

  Date

• Contractor Name

• Owner Sites: Brunswick, GA Cellulose

• P.O.#

• GP Contractor Field Coordinator (or GP Designee)

• Start Work Date

  Date

• End Work Date

  Date

• Audit Checks

• Personal Protective Equipment

  Below Expectations

  Meets Expectations

  Exceeds Expectations

  NA

• Lockout/Tagout

  Below Expectations

  Meets Expectations

  Exceeds Expectations

  NA

• Hot Work

  Below Expectations

  Meets Expectations

  Exceeds Expectations

  NA

• Confined Space

  Below Expectations

  Meets Expectations

  Exceeds Expectations

  NA

• Safe Work Permitting

  Below Expectations

  Meets Expectations

  Exceeds Expectations

  NA

• General Work Area/House Keeping

  Below Expectations

  Meets Expectations

  Exceeds Expectations

  NA

• Additional Specialty Work Considerations (Other Permitting or Risk Assessments Required

  Below Expectations

  Meets Expectations

  Exceeds Expectations

  NA

• Additional Comments

• Corrective Action

• GP Contractor Field Coordinator (or GP Designee)

  Sign

• Contractor Representative

  Sign