HSE JSEA AUDIT

• Department

• Customer Name:

• Location

• Conducted on

  Date

• Evaluation Conducted By:

JSEA REVIEW

• Is the JSEA header filled out completely and reflect the correct date?

  Yes

  No

• ALL STOP. JSEA header must be completed before work can continue.

• Do the JSEA tasks identified match the work being performed?

  Yes

  No

• ALL STOP. JSEA must be updated to properly reflect the work being performed before work can commence.

• Have all hazards associated with each step been properly identified?

  Yes

  No

• Have corrective actions been identified for each step?

  Yes

  No

• ALL STOP. JSEA Must be updated to ensure that all hazards have been properly addressed.

• ALL STOP. JSEA must be updated to ensure that all hazards have been properly identified.

• Have all personnel assigned to the tasks signed the JSEA?

  Yes

  No

• Does each corrective action have an individual or group of individuals assigned to it?

  Yes

  No

• ALL STOP. JSEA Must be updated to ensure that all hazards have been assigned to at least one person.

• ALL STOP. JSEA must be updated to ensure that all corrective actions have been assigned to at least one person.

CLOSING

• Was the JSEA deemed acceptable according to the information provided to the auditor along with observations conducted on the jobsite?

  Yes

  No

• ALL STOP until the JSEA is updated to properly reflect the work being performed. Instruction must be provided to the PLW/PIC and crew to ensure understanding of the JSEA process before work is allowed to commence.

• Final comments:

• Evaluator signature:

  Sign

• PIC/PLW Signature:

  Sign