HSE Manager Walkthrough Audit Form

• AkerSolutions SubSea North America

• Conducted on

  Date
• Location
  Address

• Personnel

JUST RULES ISSUE

• Control of work (proper planning and execution of work properly supervised)

  Safe

  At Risk

  N/A

• Risk Assessment (JSA in place, signed by all, followed)

  Safe

  At Risk

  N/A

• Lifting operations / Techniques (use of cranes, forklift, pallet jack)

  Safe

  At Risk

  N/A

• Energy isolation (lockout tag-out of faulty equipment, isolation of hazardous chemicals, unsafe work area. Faulty electrical equipment)

  Safe

  At Risk

  N/A

• Confined space entry (permit in place, access/egress clear)

  Safe

  At Risk

  N/A

• Excavation operation (trenching using the right tools)

  Safe

  At Risk

  N/A

• Mobile equipment operation (forklift, cranes)

  Safe

  At Risk

  N/A

OTHER SAFETY ISSUE

• Slip/trip/fall (tools and equipment on workshop floor)

  Safe

  At Risk

  N/A

• Use of PPE (use of gloves, steel toe shoes, hard hats, etc.)

  Safe

  At Risk

  N/A

• Material handling (forklift, ladders, pallet jacks, conveyor)

  Safe

  At Risk

  N/A

• Use of tools and equipment (cranes, machines, etc.)

  Safe

  At Risk

  N/A

• Welding operation (use of glove and right face shield, co-workers protected)

  Safe

  At Risk

  N/A

• Grinding operation (machine safety guard, gloves, face shield as needed)

  Safe

  At Risk

  N/A

• Pressure testing operation(use air pressure / hydraulic system)

  Safe

  At Risk

  N/A

• Housekeeping (clean work area of rags, tools, spills)

  Safe

  At Risk

  N/A

• Falling objects (tools / equipment)

  Safe

  At Risk

  N/A

HEALTH ISSUE

• Health issue (spills of liquid that maybe harmful to workers, pollution, poor housekeeping)

  Safe

  At Risk

  N/A

• Ergonomics (awkward work positions, workspace positioning, repetitive stress)

  Safe

  At Risk

  N/A

• Noise (loud sound that may impaled ones hearing)

  Safe

  At Risk

  N/A

• Vibration issues (no gloves, loose parts)

  Safe

  At Risk

  N/A

• Work Environment (impact of hazardous chemical, spill, improper storage of tools)

  Safe

  At Risk

  N/A

• Chemical impact / use of chemical

  Safe

  At Risk

  N/A

ENVIRONMENTAL ISSUE

• Waste disposal (properly segregated, in proper containers, emptied regularly)

  Safe

  At Risk

  N/A

• Energy usage (water waste, faucets leaking)

  Safe

  At Risk

  N/A

• Outside storage (chemical stored properly)

  Safe

  At Risk

  N/A

• Chemical containers (good condition, not left open, properly secured, not leaking)

  Safe

  At Risk

  N/A

• Ground or soil (evidence of spill or contamination)

  Safe

  At Risk

  N/A

Comments, findings, or observations

Sign Off

• Management representative present during inspection

  Sign

• Auditor's signature

  Sign