Hydro-Vac operations audit

• Site conducted

  Select

• Personnel

• What is the scope of work to be performed?

• Conducted on

  Date

• Prepared by

• Location
  Address

• Is the JSA Filled out completely and have all hazards been identified?

  Yes

  No

  N/A

• Is the location, trucks and work area(s) clean and organized?

  Yes

  No

  N/A

• Is the work truck properly grounded?

  Yes

  No

  N/A

• Is there a Brass grounding rod and tamp tool available on the work truck?

  Yes

  No

  N/A

• Is there wheel chocks available on the work truck? If so, are the wheels properly chocked when the truck is stationary and ready for operations?

  Yes

  No

  N/A

• Had a red zone been properly identified and marked with safety cones or other visible and effective means?

  Yes

  No

  N/A

• Are there hazard triangles on the work truck?

  Yes

  No

  N/A

• Is the proper PPE utilized for the job scope? 1910.132.

  Yes

  No

  N/A

• Is the PPE being worn correctly?

  Yes

  No

  N/A

• Is there any actions that require the use of high visibility vests? (spotting vehicles or heavy traffic areas including SIMOPS and or heavy equipment) If so, are the employees wearing the vests?

  Yes

  No

  N/A

• Are 4 gas monitors required at this location if so, are they turned on and worn correctly?

  Yes

  No

  N/A

• Are the portable fire extinguishers in compliance? Fully charged, current on inspections and in good condition. 1910.157

  Yes

  No

  N/A

• Is any work being conducted that requires fall protection? If so, is the equipment in compliance? Is the worker trained and the condition safe? 1910.140

  Yes

  No

  N/A

• Is any confined space work being conducted? If so, is a permit filled out if required? Is everyone conducting the work trained and is the condition safe? 1910.146

  Yes

  No

  N/A

• Is any lifting or hoisting operations taking place? If so, is all lifting equipment in compliance? Are all workers trained and are tag lines and a spotter being utilized 1926.251

  Yes

  No

  N/A

• Is any excavation work being conducted? If so, is everyone trained and is the condition safe? 1926.650.

  Yes

  No

  N/A

• Is LOTO Being conducted? If so, is a lockout plan filled out? Is everyone trained and is the condition safe? 1910.147

  Yes

  No

  N/A

• Is an SDS binder available? 1910.151.

  Yes

  No

  N/A

• Is a first aid kit, blood-borne pathogens kit and eyewash solution available and fully stocked?

  Yes

  No

  N/A

• Is there personnel on the location trained and certified in first aid CPR? 1910.151

  Yes

  No

  N/A

• Is drinking water available? 1910.141.

  Yes

  No

  N/A

• Any near misses incidents or stop works reported?

  Yes

  No

  N/A

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