Information

  • Audit Title

  • Format: Last name, First name

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Business Unit

  • Function/Entity

  • Workgroup

  • Number of Employees

  • Job Title/Work Being Performed

Accountability

  • 1a. When was the last time you were coached from a member of management on safety?

  • 1b. Can you describe the situation and did you consider it to be an effective coaching moment?

Safety Commitment

  • 2a. On a scale of 1-10, with 10 being the best, how committed are you to safety?

  • Select from range

  • 2b. On a scale of 1-10, with 10 being the best, how committed is your leadership to safety?

  • Select from range

Human Performance

  • 3a. On a scale of 1-10, with 10 being the best, how effective do you consider Human Performance to be?

  • Select from range

  • 3b. On a scale of 1-10, with 10 being very often, 5 being sometimes, and 1 being never, how often do you use Human Performance?

  • Select from range

Conservative Decision Making

  • 4a. Prior to making a decision, do you think Likelihood or Consequences?

  • 4b. What factors do you consider when making a decision?

Close Calls / Good Catch Reporting

  • 5a. When is the last time you reported a Close Call / Good Catch? What was the CC/GC pertaining to?

Vehicle Inspections

  • 1. Are weekly vehicle inspections (for GVW > 10K) properly documented and present in the vehicle?

  • 17B.2

Job Safety Assessment

  • 2. Is the Tailboard/Hazard Assessment complete?<br> <br>

  • Entergy Gas Safety Manual, General Subjects, 7D.1, 7E.1, 7E.2, 11A.2

  • 3. Have the job hazards been identified, prioritized, and documented?

  • Entergy Gas Safety Manual, General Subjects, Section 7E.2; ask to see crew's Enclosed Space (Non-Permit) Entry Checklist if applicable

  • 4. Has an effective control/mitigation plan for identified hazards been developed?

  • 5. Have the following key observation points been identified, if applicable? (Animal bite exposure, slips/trips/falls, ergonomic issues, Fatal rules, PPE, horseplay and professional conduct)

  • 6. Has the emergency plan been documented and understood? (Hospital location, route of egress, GPS coordinates, telephone number)

  • 7. Were required Human Performance tools discussed/identified/used?

  • 17A.19

Equipment and Work Place Setup

  • 8. Is all equipment set up for safe use, and grounded if underground utilities are present?

  • Entergy Safety Manual 17A.9; chocks necessary if on incline

  • 9. Is the work site properly marked or barricaded, including appropriate public safety measures in place?

  • 10. Are required high visibility safety vests utilized when working in a public street right-of-way and/or where the employee may be exposed to traffic?

  • Entergy Safety Manual 17F.6

  • 11. Are flagmen being utilized properly if needed?

  • 12. Is the work area free of clutter and tripping hazards mitigated?

  • 1D.1

  • 13. Are all fire extinguishers on site within date and in good working order?

  • 17A.18

  • 14. Are fire extinguishers staged near job site fully charged?

  • 18C.5

  • 15. Are seat belts being used on applicable equipment while in operation?

  • 17A.5

  • 16. Have One Call locates been obtained?

  • 23A.1

  • 17. Is area near suspected gas leak free of ignition sources?

  • 18. Are compressed gas cylinders stored and secured properly to prevent damage?

  • Entergy safety Manual 18F.a, 18F.b, 18F.c; butane and propane tanks and cylinders

  • 19. Is directional boring rig grounded? If working with live PE pipe, is pinch off tool grounded and is static charge being mitigated?

  • 20. Has voltage testing been completed before touching or working on meters and rectifiers?

  • 12J.2

  • 21. Is load and/or equipment properly secured to trailer?

  • 17E, Excavator needs 5 points of binding

PPE Requirements

  • 22. Are hard hats or bump hats being worn and in good condition, while performing assigned work within a construction site?

  • 23. Are safety glasses being worn?

  • Safety glasses to be worn when exposed to eye or face hazards from flying particles, molten metal, liquid chemicals, acids or caustics, gases or vapors, and light radiation. 12A.1

  • 24. Is a face shield being worn when required?

  • To be worn when cutting concrete, grinding, etc.

  • 25. Is hearing protection being worn when applicable?

  • To be worn when exposed to noises >85 db; 4A.b

  • 26. Is proper footwear being worn and is fire retardant clothing being worn?

  • Tennis shoes not allowed, must have 6 inch or taller leather or rubber boots. 4A.e

Chemical Safety, First Aid, Ergonomics

  • 27. Are SDS available for all hazardous chemicals on site, are they labeled correctly and stored properly?

  • 17A.6

  • 28. Are safety/medical/first aid equipment/goods on site and within date, including gel blanket?

  • 17A.4

  • 29. Are proper lifting/carrying techniques utilized and are proper pushing/pulling techniques being utilized?

  • 30. Are employees using 3 points of contact when ascending, descending, and climbing?

Tools and other Equipment

  • 31. Are guards in place on grinders and other portable saws, etc?

  • 32. Are appropriate tools with sharp blades being used properly, are they in good condition with no modifications and are they stored properly?

  • 33. Are the proper tools for the job being utilized, and are tools in good condition, with no modifications?

  • Examples: shovel handles, smart sticks in good condition

  • 34. Are fusing irons, pipe welders, portable electric tools, extension cords, and other fusing equipment in good condition?

  • 35. Are all extension cords in good condition?

  • No abrasions, three-prong ground plug must be intact

  • 36. Are employees properly using pipe clamps (when temporarily closing off section to weld or repair leak)?

  • 37. Are all welding safety measures being met?

  • Entergy Safety Manual 12F.6, 20

Enclosed/Confined Spaces

  • 38. Has a confined space permit been obtained if required?

  • 39. Are enclosed/confined spaces being appropriately monitored for gaseous environment using a calibrated monitoring device?

  • Entergy Safety Manual Section 21C.6

  • 40. Are all tools within calibration? (Personal monitors, CGIs, Betas, etc)

  • 41. Do personnel know what % of gas is considered a gaseous atmosphere according to Entergy standards (3% gas or 60% LEL)?

  • 42. Is an intrinsically-safe ventilation fan being used if required?

  • 43. Are non-sparking tools used in potentially gaseous atmospheres (i.e. brass tools)?

  • 44. Are enclosed/confined space procedures being followed (rescue equipment on site, qualified attendant, etc)?

Excavation Operations and Open Holes

  • 45. Are employees exhibiting safe operation of excavating equipment (operator aware of surroundings)?

  • 46. Has the blade and/or bucket been placed on the ground when excavator is not in use?

  • 47. Have proper shoring/sloping methods been used within excavations over 5 feet in poor soil conditions (Type C) and/or if inspection shows potential for cave-in?

  • 48. Is the housekeeping within 2' of open hole good, to prevent trips/falls into open excavation (tools, removed dirt from excavations, etc)?

  • 49. Are appropriate access/means of egress points present within excavations over 4 feet?

  • Examples: ladder which must be secured, fiberglass only, in good condition and tied off as applicable and provided every 25 feet.

  • 50. Is proper barricading being used near open excavations that are to be left unattended (snow fencing or barricades, caution tape, lights installed when required and so on)

  • 51. Are all personnel staying clear of the swing radius of the excavating equipment?

  • 52. Is a fire watch present when coworkers are in the excavation, along with staged fire extinguisher?

  • Entergy Safety Manual 12H.2, 12I.4

Other

  • 53. Do contractors on site have PowerSafe cards present at all times while performing work on Entergy property?

Human Performance Tools

  • 54. Self Checking

  • 55. Peer Checking

  • 56. Pre-Job Briefing

  • 57. Procedure Usage

  • 58. Questioning Attitude

  • 59. Place Keeping

  • 60. Effective Communication

  • 61. Coaching

  • 62. Post-Job Review

  • 63. Turnovers

  • Comments

  • Signature

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