Title Page
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Site conducted
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Previous Inspection
Previous Inspection Overview
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Last Inspection was conducted by:
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Score of previous Inspection
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Date of Previous inspection
Action Items
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Add all failed responses and corrective actions from the previous inspection:
Add Response
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Personnel Notified:
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Failed Response:
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Was action corrected?
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Corrective Action:
LSR 1. Risk Assessment
LSR 1. Risk Assessment
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Risk Assessment Audit Questions:
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Is a Risk Assessment being completed?<br>
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Is there evidence of T-5s or other forms of safety meetings being conducted and documentation made available?<br>
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Are emergency phone numbers posted near phones and kept up-to-date?<br>
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Are SDSs up-to-date and readily available?<br>
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Are first aid kits stocked with no expired products?<br>
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Are first aid kits easily accessible?<br>
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Is a trained first aider available on site?<br>
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Are CRH Life Saving Rules posted?<br>
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Are emergency lighting and exit signs routinely checked and properly maintained?<br>
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Are all emergency exits in buildings properly identified?<br>
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Are all emergency exits in buildings free of obstructions?<br>
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Are radio communication with loaders and ground employees being utilized?
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Do plant horns work for start up?
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Are control house windows clear, with no obstructions to silos or load outs?
LSR 9. Use of Personal Protective Equipment (PPE)
FFE 9. Use of Personal Protective Equipment (PPE)
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PPE Audit Questions:
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Are hard hats being used?
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Are high visibility safety vests or shirts being worn?
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Are safety glasses or goggles being used?
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Are safety toe boots being worn?
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Is hearing protection available and used when required?
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Are proper gloves available and worn when required?
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Are loose clothing, adornments, and hair suitably controlled/confined to prevent entanglement with any machinery and device?
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Are all PPE being worn in good condition?
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Are dust masks made readily available?
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Does the supervisor/foreperson have extra PPE?
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Is the appropriate PPE made available for welding?
Liquid AC Loading/ Offloading required PPE
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Liquid AC PPE Audit Questions:
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Is a hard hat for AC loading/offloading have an adequate face shield with chin guard in good condition and readily available?
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Is a flame-resistant jacket in good condition and readily available? (No lab coats because of pockets)
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Is neoprene rubber gloves or adequate heat resistant gloves in good condition and readily available?
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Is the H2S monitor available and functioning?
Arc Flash Required PPE
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Arc Flash PPE Audit Questions:
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Are the flash resistant clothing, coveralls or uniform in good condition and readily available?
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Are the Arc Flash hard hats with face shield in good condition and readily available?
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Are adequate gloves made available with Arc Flash equipment and in good condition?
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Document date on gloves:
LSR 3. Isolation of Operating Machinery and Electrical Safety
LSR 3. Isolation of Operating Machinery and Electrical Safety
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LOTO Audit Questions:
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Is Lockout/ Tagout manual/policy up-to-date and being used properly?<br>
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Are valves covers and lockout equipment devices available?<br>
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Does each employee have their own lock?<br>
Mobile Equipment During Maintenance
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LOTO for Mobile Equipment
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Are steering wheel covers and other lockout equipment devices available and being used?
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Are wheel chocks and jack stands available and used?
LSR 3. Isolation of Operating Machinery and Electrical Safety
Electrical Safety
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Electrical Audit Questions:
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Is all of the electrical wiring free of damage and fray?<br>
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Are extension cords in good condition?<br>
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Are electrical equipment operating between 50 and 600 volts protected against accidental contact by an approved cabinet or other enclosure?
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Are GFCI provided on outlets around water and all extension cords?<br>
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Is there a 3-foot clearance around electrical boxes?<br>
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Are all electrical panels, breakers and disconnect boxes identified properly with Arc Flash labels?<br>
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Are disconnects labeled to show what they control?
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Are permanent splices in cable insulated, in good condition, and sealed from moisture?<br>
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Are electrical cords across walk-ways protected/covered?<br>
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Are there extension cords used in place of permanent wiring?<br>
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Are all electrical switches, breakers, etc. properly labeled with what the operate?<br>
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Is the Motor Control Center (MCC) entrances clearly identified as DANGER and restricted to authorized personnel?<br>
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Is there sufficient access and working space provided and maintained around all electrical equipment including access to disconnect devices?<br>
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Are there no extraneous combustible/flammable materials stored in MCC rooms?<br>
Fire Protection/ Prevention
Fire Protection/ Prevention
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Fire Safety Audit Questions:
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Are smoke detectors working properly?<br>
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Are carbon monoxide detectors working properly, if applicable? Mechanic Shops, Offices Connected to Shops, Where Fuel Burners are used, etc.
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Are fire extinguishers strategically located?<br>
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Are all of the fire extinguishers visible and accessible?<br>
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Do fuel dispensing areas have proper signage and adequate fire suppression readily available?<br>
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Are monthly fire extinguisher inspections being logged? (Monthly punch tag is a best practice.)<br>
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Are "no smoking" signs/ labels posted around flammable materials?<br>
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Are flammable liquids stored in approved safety cans and containers?<br>
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Are containers of flammable/ combustible materials stored in a flammable storage cabinet or other isolated areas and proper signage in place?<br>
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Are flammable storage areas vented properly?
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Are spill kits/ absorbent available?<br>
LSR 6. Working at Heights
LSR 6. Working at Heights
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Working at Heights Audit Questions:
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Is fall protection in good working condition?<br>
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*Are employees/subcontractors working above 6 feet?<br>
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Are employees/subcontractors equipped with adequate fall protection?
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Are all ramps bermed half the distance of the largest equipment being used on ramps?<br>
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Are chains or self-closing gates in use at top of all Fixed Vertical Ladders (FVLs)?<br>
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Are all FVL more the 19 feet in length equipped with cage that extends at least 36 inches above the landing & starts not more than 7 feet from the bottom of the ladder, or are equipped with center-line fall protection?
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If an employee is working from heights, is the area below barricaded-off half the distance they are working from?<br>
Ladder Safety
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Ladder Safety Audit Questions:
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Are ladders in good condition, without damages?<br>
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Are ladders being inspected before each use?<br>
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Are ladders being inspected monthly? (Monthly inspection stickers are in place and up-to-date.)<br>
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Are labeling/marking on ladders legible?
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Do all ladders have the capacity rating posted?<br>
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Do all portable ladders have safety feet?<br>
Stairs and Walkways
Stairs and Walkways
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Stairs and Walkways Audit Questions:
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All stairs and walkways in good working conditions? (Kept clear and properly identified)<br>
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Are proper height on all handrails, at least 42 inches?<br>
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Are swing gates installed on all working platforms?
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Are non-slip mats, gratings, false floors, and other like materials used in areas where slipping is a concern?
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Are all mats, grates, etc. in good repair?
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Are there toe boards on all walkways?
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Do toe boards meet specifications and in good repair?
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Are housekeeping practices carried out to ensure work areas are safe from trip/fall hazards to employees?
LSR 10. Safety of Materials Under Pressure
LSR 10. Safety of Materials Under Pressure
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Safety of Materials Under Pressure Audit Questions:
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Are all compressed gas cylinders secured in safe manner and properly capped when not in use?
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Are oxygen cylinders stored from away flammable materials and at least 25 feet from flammable gas cylinders?
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Are required inspections performed on all pressure vessels/ compressors?
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Are storage areas for cylinder bottles labeled, "Full" or "Empty"?
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Does all high pressure lines have the approved high pressure clamp? No radiator clamps?
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Is compressed air used for cleaning purposes regulated to 30 pounds?
LSR 7. Lifting Operations
LSR 7. Lifting Operations
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Lifting Operations Audit Questions:
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Do all lifting implements such as straps, cables and chains have their load limit identified, as applicable?
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Are lifting hoists inspected prior to each use with proper load limits posted?
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Are employees only lifting objects less than 50 pounds on their own?
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Are all hooks equipped with safety latches in good working condition?
LSR 4. Machinery Guarding
LSR 4. Machine Guarding
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Machine Guarding Audit Questions:
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Are all points-of-operations and pinch points guarded?
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Is there barrier guards on moving machinery parts?
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Are all floor holes, floor openings, hatchways, manholes, wall openings and skylights properly guarded?
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Are all open sided floors, platforms and runways four feet or more above ground or floor level properly guarded and have toe boards installed?
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Are belts/pulleys enclosed?
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Are light bulbs guarded?
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Are all belts and pulleys within 42 inches from the ground fully guarded?
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Are all conveyor systems within 7 feet of walking/working surface equipped with a shut-off cable or guard?
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Are auto start systems are identified by signage and have audible or visual alarms to warn employees in the area?
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* Is there maintenance of silos occurring?
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Are barricades used under silo drop gate?
Hot Work
Hot Work
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Hot Work Audit Questions:
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Are welding operations screened to prevent flash injuries?
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Are extra fire extinguishers present for welding operations?
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Is proper eye protection being worn for work being done?
LSR 2. Equipment Safety
Mobile Plant Safety
Pedestrian/Vehicle Segregation
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Pedestrian/ Vehicle Segregation Audit Questions:
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Are traffic flow signs posted, positioned appropriately and visible?
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Are the appropriate signs in place around site? (Phone Use, Do Not Enter, Speed Limit, Pedestrian Crossing)
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Is there a Pedestrian Segregation written plan in place?
Mobile Equipment
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Mobile Equipment Audit Questions:
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Are daily pre-use equipment inspections being done?
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Is there a 3-Points of Contact decal in place on steps of all equipment?
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Are wheel chocks made available and used when required?
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Do employees understand and comply with the mobile phone policy?
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Do all pieces of mobile equipment have slow moving vehicle signs, strobe light, and reflective tape?
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Single Equipment Audit: (At a minimum, add one piece of equipment to the audit.)
Equipment
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Equipment Number:
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Is the equipment operator qualified?
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Is the Operator Manual present?
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Is good housekeeping practices being used in cab equipment?
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Are seat and seat belts in good condition?
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Are mirrors adjusted properly and in good condition?
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Does the back-up alarm work properly?
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Are access steps and railing in good working condition?<br>
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Are parking brakes capable of holding mobile equipment with typical load on max grade?
Company Vehicles
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Single Company Vehicle Audit: (At a minimum, add one company vehicle to this audit)
Company Vehicle
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Company Vehicle Number:
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Is the vehicle kept clean?
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Are tires in good condition, and have good tread depth?
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Are mirrors in good working condition?
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Does the driver have current proof of insurance and vehicle registration?
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Are seat belts in good condition?
LSR 5. Confined Space Entry
LSR 5. Confined Space Entry
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Confined Space Audit Questions?
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Is the Confined Space Manuel in place and being used properly?
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Is the Confined Space Monitor being calibrated and logged before use?
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Are bump tests being performed before each entry and logged?
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Are all confined space areas properly labeled?
Housekeeping
Housekeeping
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Housekeeping Audit Questions:
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Is the site practicing good housekeeping in all buildings?
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Are microwaves and refrigerators maintained in a sanitary and safe operational condition?
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Is the site practicing good housekeeping of restrooms?
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Is portable restrooms provided on-site if needed and maintained?
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Is the site practicing good housekeeping throughout the site?
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Are outside storage areas in good condition?
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Are garbage containers provided and used?
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Is the entrance to the yard and office clean and tidy?
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Are all containers labeled and labeled correctly?
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Are eyewash stations easily accessible and maintained?
Liquid AC Loading/ Offloading
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Liquid AC Audit Questions:
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Are hose and coupling in good working condition?
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Are wheel chocks in good working condition?
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Are unloading signs in place and legible?
Environmental Housekeeping
Housekeeping
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Housekeeping Audit Questions:
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Are all containers used to catch oil covered and or not exposed to the weather?
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Is containment in good condition with no leaks and cracks?
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Are there stains on the ground around the site that need to be cleaned up? (Check near fueling stations)
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Are areas where water runoff leaves the site free of visible silt? (Please use site map to locate these areas)
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Are dumpsters being kept closed?
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Is wind blown trash being removed and placed in trash containers?
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Are Used Oil tanks properly labeled as "Used Oil"? (Containers should not be marked as waste oil)
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Is there evidence of offsite tracking of materials or sediment?
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Are SDSs available for contents of all containers on-site?
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Are all on-site containers, containing fluids, labeled as to their content?
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*Does facility have proper structural controls? (berms, ponds)
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Is structural controls effective and maintained?
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Major concerns
concern
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Description:
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Photos to aid with description:
Documentation
Documentation On File
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Documentation Audit Questions:
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Where are Weekly Safety Talks including roster and materials kept?
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Is there proof of all employees operating equipment being trained on-site or at local safety office?
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Is there proof of all drivers being trained in the company safe driving programs (DDC or Smith System)?
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Is there documentation of all required employees completing LOTO training on-site or at local safety office?
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Is there documentation for all required employees who perform confined space entrance completing required training on-site or at local safety office?
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Is there proof of all employees completing fall protection on-site or at local safety office?
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Is there documentation that employees have received rigging and lifting training on-site or at local safety office?
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Is there documentation that employees have received pressurized system training on-site or at local safety office?
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Is there proof of employee engagement in Near Miss/Potential Hazard reporting, behavior observations, and/or mentoring program on-site or at local safety office?
Unsafe Conditions
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Other unsafe behaviors and conditions observed on site:
unsafe observation
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Description of observed:
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Pictures to aid in observation:
Signatures
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Check the box to approve that the above audit was done by a Safety Representative?
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Safety Representative Signature:
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Title:
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Have the Site Manager or Site Representative check the box, agreeing that they received a briefing after the completion of the audit.
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Site Manager/Site Representative Signature:
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Title: