Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Parking Area

  • Are all small vehicles backed into parking spaces?

  • Are there designated areas for RMX Truck Parking? (Signage? Plugs?)

  • Are there designated areas for Visitor Parking? (Signage?)

  • Are there designated areas for Employee Parking? (Signage?)

  • Are there clearly defined areas that are PPE Free? (Signage?)

Batch Office

  • Are there site specific Induction Forms? (blank)

  • Are there completed site specific Induction Forms? (Completed correctly with one portion (map) going to the visitor and the sign-off portion kept on-site)

  • Is there a clearly documented traffic flow (circulation) plan? (posted in the office or as part of the Induction process)

  • Is there a Plan or Record of Hearing Testing at the Plant? (WMC...)

  • Is the training Matrix posted with the Employee files?

  • Is the HSST training tracker posted with the Employee files?

  • Does the site have clear and organized employee files?

  • Is training information stored in the employee files? (Is it up to date?)

  • Are all RMX Truck Pre-Trip inspections correct?

  • How are Policies & Procedures share and communicated at site level? (Google Drive, Pocket Guides, Safety Wall...)

  • How are Incidents (Near Misses, First Aids, Medical Aids, MVAs...) tracked and communicated at site level? (EMEX, Safety Package, Emails...)

  • How does Management track Safety interactions with others? (VFL...)

Garage

  • Is Housekeeping adequate in the Garage?

  • Is MSDS information accurate and available in the Garage?

Safety Wall

  • Is the Safety Wall posted in an accessible area?

  • Is the Safety Wall neat and organized?

  • Are Inspections posted on the Safety Wall and up to date?

  • Are Safety Talks / Toolbox Talks posted on the Safety Wall and up to date?

  • Are the CPR / First Aiders posted on the Safety Wall? Is their training up to date?

  • Is the site specific Emergency Plan posted on the Safety Wall?

  • Has an Emergency Drill been completed within the past 12 months? (and documented?)

  • Is there an up-to-date MSDS book reflecting the chemicals used on-site?

FLRA

  • Are there blank Field Level Risk Assessments at the Plant?

  • Are there completed FLRAs at the Plant?

  • Are the FLRAs completed in their entirety? (pages 2, 3, & 4)

  • Is all required Permitting completed in its entirety? (pages 5, 6, & 7)

  • Has a Rescue Plan been documented for all Permit Driven activities? (page 8)

  • Has the "Work Authorization" been completed for all Confined Space and Working at Height activities? (page 1)

  • Has the "Project Closeout" been completed on all FLRAs? (page 1)

LOTOTO

  • Is there a complete list of Hazardous Energy Control Procedures (HECP) for all major Plant Components? (binder...)

  • Is there clear "Danger" or "Warning" signage on the door to the Electrical Room? Does the door lock?

  • Is there a LOTOTO station at the Plant?

  • Does the LOTOTO Station have blank LOTOTO Tags?

  • Are the electrical disconnects labelled? (clearly showing equipment and power)

  • Is the area in front and around the electrical disconnect clear? (no storage in front or on top of disconnects)

  • Are completed LOTOTO Tags correct and kept for future reference? (stapled to Quad Fold)

  • Does the LOTOTO Station have Uniquely Keyed Locks?

  • Is there a 9 Steps posted posted at the LOTOTO station or in the electrical (MCC) Room?

Confined Space

  • Are there Confined Space Entry Plans / Risk Assessments for each of the identified possible Confined Spaces on-site? (green binder)

  • Is there adequate equipment for the safe execution of Confined Space Activities? (davit arm, bases, ventilation...)

  • Is there a process to inspect Confined Space equipment prior to use?

WAH

  • Are there Fall Hazard Risk Assessments for all Working at Height tasks? (FLRA)

  • Is there adequate equipment for the safe execution of Working at Heights Activities? (harness, lanyards...)

  • Is there a process to inspect Working at Height equipment prior to use?

CSM

  • Are there CSM Packages (blank) at the site?

  • Are there completed CSM Packages at the site?

  • Can the site staff explain BROWZ and access the website?

Plant

  • Is Housekeeping adequate in the Plant?

  • Is there adequate berming or barriers on each side of the Hopper Ramp?

  • Is there evidence of up-to-date inspection of all Fire Extinguishers?

  • Is there a record of Annual Hydrostatic Testing of all Fire Extinguishers?

  • Is there a record of Annual Certification of all lifting devices? (cranes, block & tackle, loader...)

  • Has a Pre-Trip Inspection been done on the Loader that day?

  • Is there "Hearing Protection Required" Signage at the Loading Point?

  • Are all Ladders adequately guarded and functional?

  • Are all Walkways adequately guarded?

Conveyors

  • Are there means to prevent access / contact with Conveyor rollers?

  • Are there roller cages on all rollers positioned over a personal or mobile equipment travel way?

  • Is the Conveyor Tail Section properly guarded?

  • Is the Conveyor Head Section properly guarded?

  • Are the emergency pull cords functional (as per testing) and located in front of any guards?

Signage

  • Is there a Plant Sign at the entrance?

  • Is there a PPE Required Sign?

  • Is there any Stockpile signage? (no climbing, working face, loader has right of way...)

Good Practices

  • Are there good practices at this site which reflect best practices or ideas that could be shared with other Plants in the Area?

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.