HSE Vehicle, Equipment/Tools & PPE Inspection Report

• HSE Vehicle, Tool & PPE Inspection Report

• Country/ District, office location

• Date

  Date

• Prepared by

• Location
  Address

• Employee name and vehicle ID

• Instruction: for any deviation from standard and/ expectation enter " no" and an action to address the deficiency.

Vehicles

• Is a company vehicle in use?

  Yes

  No

  N/A

• Are all vehicles kept clean, neat and orderly and items adequately secured?

  Yes

  No

  N/A

• Inspect and test that all lights visible and operational ( low & high beam, brake, reverse, emergency, turning indicators, reversing souns and horn)?

  Yes

  No

  N/A

• Are all windshield wipers in good condition and operational, and is washer fluid container full?

  Yes

  No

  N/A

• Are seatbelts (airbag) in place and operational?

  Yes

  No

  N/A

• Are all windows clean, have no cracks that obstruct driver view, and are mirrors properly positioned?

  Yes

  No

  N/A

• Are all tires in good condition, appropriate (winter) and have appropriate tire pressure?

  Yes

  No

  N/A

• Are all fluid levels appropriate (oil, coolant, brake, transmission, etc.)?

  Yes

  No

  N/A

• Are the brakes functioning properly, and is the handbrake in good condition?

  Yes

  No

  N/A

• Are all doors and locks operating properly and can be secured?

  Yes

  No

  N/A

• Is all emergency equipment: fire extinguisher, first aid kit, winter survival and/ or summer gear, hi-visibility vest, readily available and in good condition?

  Yes

  No

  N/A

• Are chocks and cases available - as needed-?

  Yes

  No

  N/A

• Vehicle exterior is in good condition? Report any damage.

  Yes

  No

  N/A

• Is vehicle registration, insurance card, drivers license, company driver guide, fuel card present and current?

  Yes

  No

  N/A

• Are ladders and ladder racks (rungs, rails, feet, hardware) secure, available, in good condition and appropriate the work activities?

  Yes

  No

  N/A

• Is vehicle preventive maintenance completed per fleet schedule?

  Yes

  No

  N/A

• Other:

PPE

• Is PPE in use or expected to be used?

  Yes

  No

  N/A

• Is head protection used in good condition, clean and with no cracks, dents, labels, chin strap, cradle system intact and < 5 years in use (see manufacture date).

  Yes

  No

  N/A

• Is respiratory protection (dust mask, half-mask, full-face mask) appropriate for the work, environment, readily available, employee have completed medical and spirometry (not for dust mask), completed annual training, cleaned, inspected, +/- pressure tested before use, cartridge exchange date clearly indicated, and stored in sealed bag or container.

  Yes

  No

  N/A

• Is eye protection (safety glasses with side shield, face-shield, welding helmet, full-face respirator, etc.) appropriate for the task, readily available, used where required, clean, has good visibility (no scratches),

  Yes

  No

  N/A

• Is hand (gloves, gauntlets) and arm protection (cutproof sleeves) appropriate for the work, readily available, used where required, in good condition, proper size, Iclean, inspected and properly stored?,

  Yes

  No

  N/A

• Is foot protection (construction safety boots, safety shoes) appropriate for the work, readily available, environmental conditions, clean, soles and upper in good condition?

  Yes

  No

  N/A

• Is hearing protection appropriate for the task, readily available, clean, inspected, stored and used where required?

  Yes

  No

  N/A

• Other:

Tools & Equipment

• Are tools and/or equipment used or in area?

  Yes

  No

  N/A

• Are hand tools in good condition, appropriate for task - no mushroom heads, no-broken or cracked parts, secure grip?

  Yes

  No

  N/A

• Are pneumatic tools in good condition -hose/ whip secured by positive means, safety clips or retainers present and used?

  Yes

  No

  N/A

• Are fuel- powered tools/ equipment appropriate for task, securely stored to prevent fuel spills during transport, handling and storage, measures taken to prevent build- up of fumes and gases in enclosed spaces, and in good condition?<br>

  Yes

  No

  N/A

• Are power tools (plugs, cords, prongs, body) parts present and in good condition - guards in place, double insulated or grounded, and no missing parts-?

  Yes

  No

  N/A

• Other:

Electrical

• Are extension cords, plugs and prongs appropriate for task, used only for temporary work, grounded or double insulated, GFI readily available, and in good condition?

  Yes

  No

  N/A

• Are all required lockout tagout devices (single key) and tags appropriate for the work, readily available, and in good condition?

  Yes

  No

  N/A

• Are electrical mats/ barriers - no rips , tears, holes- in good condition and appropriate for work conditions and hazards?

  Yes

  No

  N/A

• Are Amp meters ( multimeter, etc.) clean, with no damage, calibrated if required, batter testes, properly stored, appropriately used, readily available and in good condition?

  Yes

  No

  N/A

• Is all electrical PPE (selected per NFPA 70E, clothing FR, or per local requirement)appropriate for work, readily available and in good condition?

  Yes

  No

  N/A

• Are all heaters equipped with tip-over protection, appropriately used and in good condition?

  Yes

  No

  N/A

• Are all portable blowers properly set up, appropriate rating and use , and in good condition?

  Yes

  No

  N/A

• Other:

Compressed Gases & Equipment

• Are compressed gases in use or stored?

  Yes

  No

  N/A

• Are all required permits (hot work, live electrical, confined space, etc.) in place, appropriate, properly filled out and communicated?

  Yes

  No

  N/A

• Is all fall protection equipment (harness, lanyard, SRLs, anchoring, etc.) a complete system ( 1 manufacturer) stored properly and within 5 year use limit?

  Yes

  No

  N/A

• Ia all PPE required for hot work (environment) - face- shield, body protection, gloves- elec. insulating gloves appropriate class, type, current inspection test date -less than 6 months- stored in. Ag with fingers upright, away from sunlight in designated bag- available and in good condition?

  Yes

  No

  N/A

• Are all gas cylinders turned off, stored upright with caps in place, secured and labelled appropriately, incompatible gases stored appropriately (distance and/ fire-rated wall), used with appropriate PPE, regulators and torches removed and/or disconnected from cylinders when not in use. And in good condition?

  Yes

  No

  N/A

• Is emergency response equipment for hot work - fire extinguisher, fire blanket etc. Readily available?

  Yes

  No

  N/A

• Are all torches, hoses, regulators and fittings (no leaks, auto shutoff tested, hoses and connections designed for expected pressures and service, equipped with backflow prevention or flash arrestor) in good condition?

  Yes

  No

  N/A

• Other:

High Risk Life Safety

• Are all hazardous materials approved by HSE, SDS available, all containers appropriate, labelled, stored and secured properly? -- refrigerant logs are available and up-to -date

  Yes

  No

  N/A

• Are outdoor/ inclement weather supplies and equipment appropriate for the hazards encountered (heat or cold stress, remote location - communication- no safe drinking water, no biological hazards ( insects, snakes, rodents, wildlife), di- electric spray, shovels, sand, sunscreen, water, food, shelter, winter clothing, PFD)

  Yes

  No

  N/A

• Are all hand lines and ropes in good condition and appropriate for task - no cuts, abrasion, decay, burns, signs of wear-?

  Yes

  No

  N/A

• Is all air monitoring equipment for confined space entry - appropriate for work conditions and hazards expected, tested and calibrated per manufacturer requirements, appropriate calibration gases and test equipment available, and in good condition?

  Yes

  No

  N/A

• Are emergency rescue plans, equipment, tools, designated personnel, trained, appropriate fir work conditions and hazards expected, for CSE, work at height and other high risk activities?

  Yes

  No

  N/A

• Are all fuels (gasoline, kerosine, etc.) and flammable liquids stored, transported and transferred in appropriate containers (NFPA or local rating) with self-closing lids, flame/flash arrestors, 2-dary containment,capacity of container less than 5 gallons (15L), and in good condition?

  Yes

  No

  N/A

• Is any work performed at 4ft (1.2m) above level ground/structure?

  Yes

  No

  N/A

• Other:

• Supervisor Name:

  Sign

• Employee Name:

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