Jacobs AF Field Safety Evaluation Report (SER) - NEW

• Site conducted

  Select

Assessment Criteria

• 3 - Best Practise
  2 - Legal Compliance
  1 – Little to no evidence of compliance
  N/A - Not Applicable
  N/R - Not Reviewed

SER Details:

• Audit Title

• Date complete:

  Date

• Date Issued:

  Date

• Action close out date:

  Date

• Project Name

• Project Number

• Client:

• Auditor(s):

• Project HSE Lead:

• Project PM:

SER Summary:

• Project Hours worked:

• Project TRIR:

• Positive Observations:

• Improvements required:

• Observations Requiring Immediate Action: (to be issued verbally before leaving the project and in writing within 24 hours of leaving the project)

• SER HSE Lead comments:

• SER Ops Lead comments:

• Previous SER score %

A. Policy, Leadership & Engagement

• Project Leadership has communicated the BeyondZero vision and HSE expectations to relevant parties (client, contractors, project team), 2

  3

  2

  1

  N/A

  N/R

1 Policy:

• Is there evidence the project has been notified to the relevant statutory authorities? Are these posted?

  3

  2

  1

  N/A

  N/R

2 Leadership

• Project Leadership (PM & HSE lead) has communicated the BeyondZero vision and HSE expectations to relevant parties (client, contractors, project team). (Induction, BZ toolbox, site notices, JE visual standards, BZO/ SOR programme)

  3

  2

  1

  N/A

  N/R

• Project specific HSE Objectives/KPIs have been established and are being tracked and analysed in performance review meetings with project leadership? (Documented HSE objectives/ KPIs)

  3

  2

  1

  N/A

  N/R

• Is there evidence of Leadership engagement, supervision & management at all levels? (Including leadership walks, stand downs, town halls with specific HSE messaging, and co-facilitating I2BZ/ Induction sessions/ BZ leadership engagements, permit reviews etc.)

  3

  2

  1

  N/A

  N/R

• Have the appropriate HSE resources have been assigned to support the project. (As per the guidance chart included in HSE plan)

  3

  2

  1

  N/A

  N/R

• How is continual improvement being promoted?

  3

  2

  1

  N/A

  N/R

• Are workers comments / consultation being considered and implemented? (how)

  3

  2

  1

  N/A

  N/R

3 Engagement

• Is there evidence that all Jacobs project team members participate in the BZO/SOR programme (or equivalent)?

  3

  2

  1

  N/A

  N/R

• Is there an active rewards and recognition programme in place for exemplary employees, events, interventions, and initiatives? (e.g. BZO/SOR of the week or month/ TAP award/ BZ hero etc.)

  3

  2

  1

  N/A

  N/R

• Are project team members aware of the intervention and stop work policy? I.e. when they observe at risk behaviours and conditions, do they feel empowered. Is there evidence that interventions/ stop works are occurring. (Evidence example)

  3

  2

  1

  N/A

  N/R

• A pre-task planning process (Jacobs SPA & Stepback) is implemented and involves supervision and all workers. Pre-task plans are developed for each task and consider changes in the work environment or conditions, adjacent work activities and other factors that could impact the outcome of the task. The process includes a quality assessment of the plan by project leadership with feedback to the workers.

  3

  2

  1

  N/A

  N/R

B. Planning & Beyond Zero

• Relevant HSE compliance obligations, codes of practice and licenses/permits (to undertake work) have been identified in the HSE Plan and in accordance with local HSE compliance registers. (e.g., AF1/ AF2 Ireland)

  3

  2

  1

  N/A

  N/R

• Appropriate level of HSE Planning has been undertaken for the scope of work and Jacob’s risk exposure in accordance with local HSE project planning requirements (RAMP/PEP, emergency response plan) and reviewed regularly.

  3

  2

  1

  N/A

  N/R

• A Project Risk Register has been developed identifying HSE hazards relevant to the scope of work and activities been developed and controls implemented to reduce risk to ALARP?

  3

  2

  1

  N/A

  N/R

• An Emergency Response Plan has been developed to address event response associated with the project. Plan is signed off by site staff.

  3

  2

  1

  N/A

  N/R

• All internal Jacobs project team HSE documents have been reviewed and records are kept in local project folders. This includes but is not limited to training/induction/licenses, JSEA/SWMS, journey planning, equipment maintenance/inspection and pre-start meeting minutes etc.

  3

  2

  1

  N/A

  N/R

• If the Project has been running for more than 12 months is there evidence of a review of the Jacobs HSE Management Plan and where applicable the Managed Contractor?

  3

  2

  1

  N/A

  N/R

• Any change to the project has been risk assessed and managed accordingly. (Examples- Change of Project Manager ,introduction of new risk area, Jacobs conducting activity on construction/live operating site, direct engagement of contractors, inclusion of field activity for Jacobs staff or contractual safety obligations, risk register review, design changes, variations etc.)

  3

  2

  1

  N/A

  N/R

• Have all employees received onboarding and EBZ awareness?

  3

  2

  1

  N/A

  N/R

• Where appropriate, the BeyondZero program is integrated with the programs of other entities (client, contractor, etc.) to ensure there is a singular integrated approach to managing and implementing the HSE program. Expectations are aligned and roles and responsibilities are communicated. Periodic reviews are conducted to assure on-going alignment.

  3

  2

  1

  N/A

  N/R

• Has a Facility Siting Analysis been carried out? Has it been reviewed within the last 12 months?

  3

  2

  1

  N/A

  N/R

• Is there anyone the project on secondment? If so, Is there a secondment plan in place and has it been reviewed within the last 12 months?

  3

  2

  1

  N/A

  N/R

C. Risk Management

1. Subcontractor/ Supplier Management

• Is the person carrying out Supplier Pre Qualification trained to do so? (training in place)

  3

  2

  1

  N/A

  N/R

• Are all suppliers on the Jacobs HSE approved suppliers list including evaluation by HSE?

  3

  2

  1

  N/A

  N/R

• Is the approved supplier list held by Jacobs Procurement Team and not just at project level?

  3

  2

  1

  N/A

  N/R

• Has a pre-start safety meeting been undertaken prior to mobilisation of the supplier?

  3

  2

  1

  N/A

  N/R

• Have the suppliers project HSE plans, SSoW and HIIRA’s (JSEA,RAMS) been received, reviewed and approved prior to commencement of works?

  3

  2

  1

  N/A

  N/R

• Are tier 2 etc subcontractors reviewed by Jacobs before mobilising

  3

  2

  1

  N/A

  N/R

• Are suppliers (working as subcontractors) included in all safety related communications, learning opportunities and campaigns? (safety meetings / toolbox talks. standdowns, HVLs shared etc.)

  3

  2

  1

  N/A

  N/R

• All suppliers performing physical work either field/site work or office maintenance/refurbishment have completed the HSE Supplier pre- qualification process in Jacobs' supplier qualification system.

  3

  2

  1

  N/A

  N/R

• Are Jacobs HSE requirements are included in the contract?

  3

  2

  1

  N/A

  N/R

• Does site management communicate HSE expectations?

  3

  2

  1

  N/A

  N/R

• Is subcontractor safety performance monitored, measured, and given appropriate attention?

  3

  2

  1

  N/A

  N/R

• Are contractor audits being undertaking? Is performance measurement being carried out?

  3

  2

  1

  N/A

  N/R

• Are all Supplier’s HSE Performance Feedback collected and reviewed at practical completion of work? What system is there in place for this?

  3

  2

  1

  N/A

  N/R

2. HSE In Design

• Are Jacobs Appointed as PSDP?

  Yes

  No

  N/A

  N/R

• Has a Preliminary Health and Safety Plan been issued?

  3

  2

  1

  N/A

  N/R

• Is a residual risks document live / issued routinely to the CMT?

  3

  2

  1

  N/A

  N/R

• Has the Safety file / VTOP / CTOP requirements been issued?

  3

  2

  1

  N/A

  N/R

• Has a Designer register been issued?

  3

  2

  1

  N/A

  N/R

• Have routine PSDP/PSCS meetings ongoing and notes issued accordingly

  3

  2

  1

  N/A

  N/R

• Has a TWDC coordinator been appointed for the project?

  3

  2

  1

  N/A

  N/R

• Do Jacobs or their sub-contractors have a responsibility for design?

  Yes

  No

  N/A

  N/R

• Has a HSE in Design Representative been appointed for the Project? Who? (Note, this may be multiple people to facilitate Bio/API projects, a HSE lead and a Process Safety SME)

  3

  2

  1

  N/A

  N/R

• If the scope of work requires Engineering & Design, is there evidence of a documented, planned approach to managing HSE in Design relevant to risk included in the PEP?

  3

  2

  1

  N/A

  N/R

• Are Design Risk Assessments (DRA’s) complete for each work package and updated per issue?

  3

  2

  1

  N/A

  N/R

• Are Process Hazard Assessments (PHA) complete for relevant Process / Mechanical scope?

  3

  2

  1

  N/A

  N/R

• Are PHA design actions tracked until completion and actions / evidence recorded?

  3

  2

  1

  N/A

  N/R

• Is the design concern register up to date and items actioned?

  3

  2

  1

  N/A

  N/R

• Is the project undertaking 3D Reviews and construction ability reviews?

  3

  2

  1

  N/A

  N/R

• Is a Change control register issued routinely?

  3

  2

  1

  N/A

  N/R

3. Training & Competent Person Designation

• Has a site-specific HSE training program been developed, implemented and recorded. (E.g., Project Inductions, specific HSE training such as Critical Risk, job or task specific, First Aid/Driving, HSE online induction, I2BZ orientation, HSE Leadership and other awareness courses)

  3

  2

  1

  N/A

  N/R

• Is all reviewed employee training current?

  3

  2

  1

  N/A

  N/R

• Is there an adequate training needs analysis and matrix? Are we compliant with it?

  3

  2

  1

  N/A

  N/R

• Is there a process for designation of competent persons on site? (e.g. Temporary Works Coordinator, Lifting Ops AP, Electrical AP)

  3

  2

  1

  N/A

  N/R

• Are competent persons identified for hazardous activities?

  3

  2

  1

  N/A

  N/R

• Do the competent persons have the appropriate training?

  3

  2

  1

  N/A

  N/R

4. Fatigue Management & Wellbeing

• Has fatigue for workers been adequately assessed and control measures implemented? (i.e Fatigue Management plan/ Risk Assessment)

  3

  2

  1

  N/A

  N/R

• Is there a trained PMHC onsite?

  3

  2

  1

  N/A

  N/R

• Do PMHC have time and resources to carry out their roles with confidence?

  3

  2

  1

  N/A

  N/R

• Are employees aware of the EAP System? (Posters onsite)

  3

  2

  1

  N/A

  N/R

• Is the welfare of employees reviewed periodically and a system in place to report welfare issues? (example - Pulse survey)

  3

  2

  1

  N/A

  N/R

D. Incident Management

• Have there been any accidents/ incidents/ Near misses on site?

  Yes

  No

  N/A

  N/R

• Has the verbal reporting chain been communicated to all employees and subcontractors?

  3

  2

  1

  N/A

  N/R

• Do managers, supervisors and employees know what actions to take following an incident (notification, preservation of evidence, evidence gathering etc.)?

  3

  2

  1

  N/A

  N/R

• Incidents and near misses are reported and investigated in a timely manner (in accordance with Jacobs Incident investigation Document HS-HS-WI-0400-PC) Are these all available for review on Intelex.

  3

  2

  1

  N/A

  N/R

• Is there an incident/ accident register in place?

  3

  2

  1

  N/A

  N/R

• Actions resulting from investigations are addressed in a timely manner and lessons learned are communicated to the workforce and shared across the company as HVL. Evidence available.

  3

  2

  1

  N/A

  N/R

E. Auditing, Compliance & Performance Metrics

• Are there adequate weekly (onsite HSE) and HSE Senior Manager monthly inspections taking place? Are these being uploaded to Intelex?

  3

  2

  1

  N/A

  N/R

• Are action items being closed out adequately and in a timely manner? (Evidence of an action tracker or Intelex findings close out)

  3

  2

  1

  N/A

  N/R

• Are BZO’s/ SORs constantly monitored and evaluated to ensure effectiveness. Is data being used to identify and correct deficiencies and to drive improvement. Actions from the observations are taken in a timely manner and feedback is communicated to the workforce by site leadership.

  3

  2

  1

  N/A

  N/R

F. Operations Management (to be complete by the SER Operations Lead)

• Are Operational Project Reviews (OPRs) being carried out regularly, actions tracked and closed out?

  3

  2

  1

  N/A

  N/R

• When was the last Construction Readiness Review (CRR) complete - are actions being tracked and closed out?

  3

  2

  1

  N/A

  N/R

• Are all actions as details within JJ-HS-WI-0300-JJ Project Start Up Requirements completed?

  3

  2

  1

  N/A

  N/R

• Has the scope of work/risk profile changed since initial RAMP was completed? If yes, has the RAMP been revisited?

  3

  2

  1

  N/A

  N/R

G. Hazards, Procedures & Control Management

1.Electrical Safety/ Control of Hazardous Energy (Lockout/Tagout)

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Has a full Arc flash study has been conducted for all temporary electrical systems & permanent electrical panels and pieces of equipment?

  3

  2

  1

  N/A

  N/R

• The site has a list of designated persons who have been trained in the Jacobs Electrical Safety programme as per the Electrical Safety Procedure HS-HS-WI-0344-PC

  3

  2

  1

  N/A

  N/R

• An Arc flash study has been conducted for all temporary electrical systems & permanent electrical panels and pieces of equipment? All arc flash hazards have been identified, equipment is properly labelled, and the proper protective equipment is available as required. (Evidence – Arc flash study, labels installed). Where no Arc flash study has been conducted highest fault rating and PPE is expected as a minimum.

  3

  2

  1

  N/A

  N/R

• Temporary cords/ temporary electrical installation is in good condition and in date with a valid PAT Test, if required.

  3

  2

  1

  N/A

  N/R

• Electrical devices are appropriate for the location and hazard classification (ATEX,API site etc.)

  3

  2

  1

  N/A

  N/R

• Is a control of hazardous energy program required and if so, is in place and up to date?

  3

  2

  1

  N/A

  N/R

• Is the LOTO training current and delivered to all the appropriated personnel onsite. Is it reviewed periodically?

  3

  2

  1

  N/A

  N/R

2. Housekeeping, Sanitation & Welfare facilities

• Did you review this section?

  Yes

  No

  N/A

  N/R

• The general appearance of the site is neat and orderly, free from trip hazards. Trash & debris are disposed of adequately. Materials and equipment are stored properly.

  3

  2

  1

  N/A

  N/R

• Welfare facilities, including drinking water are in good order & away from industrial areas and possible sources of contamination.

  3

  2

  1

  N/A

  N/R

3. Fall Protection and Prevention

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Fall hazards are identified in the job hazard analyses and pre-task plans

  3

  2

  1

  N/A

  N/R

• Floor and wall openings are protected. Hole covers are secure, labelled and in good condition

  3

  2

  1

  N/A

  N/R

• Personnel are protected when working at elevation. Fall rescue plans are developed.

  3

  2

  1

  N/A

  N/R

• Personnel have been trained in the use, inspection, and care of the fall protection equipment.

  3

  2

  1

  N/A

  N/R

• Qualified persons supervise the installation of fall arrest systems.

  3

  2

  1

  N/A

  N/R

• Anchorage points are adequate and have been verified by a qualified person.

  3

  2

  1

  N/A

  N/R

• Horizontal and vertical lifelines, perimeter guarding, and handrails are properly installed.

  3

  2

  1

  N/A

  N/R

4. Scaffolds, Ladders, and Stairways

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Scaffolds are erected and maintained by qualified scaffold erectors.

  3

  2

  1

  N/A

  N/R

• Scaffolds are erected complete with appropriate scaffold boards, toe boards, bracing, and footings. All pins and connectors are in place, Scaffold wheels are locked or blocked when in use, Scaffold boards are of the proper materials and strength and installed properly

  3

  2

  1

  N/A

  N/R

• Appropriate ladders are used and are adequately inspected, used, and stored.

  3

  2

  1

  N/A

  N/R

• Stairways have appropriate handrails with adequate lighting

  3

  2

  1

  N/A

  N/R

5. Personal Protective Equipment

• Did you review this section?

  Yes

  No

  N/A

  N/R

• The site has a PPE policy that addresses minimum mandatory PPE requirements as well as PPE requirements for visitors

  3

  2

  1

  N/A

  N/R

• PPE requirements are identified on pre-task plans

  3

  2

  1

  N/A

  N/R

• Areas designated as PPE required areas are marked appropriately

  3

  2

  1

  N/A

  N/R

• Hazard assessments are performed to determine PPE requirements

  3

  2

  1

  N/A

  N/R

• Personnel are trained in the proper use and care of PPE

  3

  2

  1

  N/A

  N/R

6. Excavations and Trenching

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Excavations and trenches are properly sloped, benched, shored, or otherwise protected (trench boxes or other approved means)

  3

  2

  1

  N/A

  N/R

• Access/egress ladders are located appropriately and secured. Structural ramps are designed by a competent person

  3

  2

  1

  N/A

  N/R

• Excavations are properly barricaded or guarded and are protected from water accumulation

  3

  2

  1

  N/A

  N/R

• Daily inspections are performed and documented by a competent person

  3

  2

  1

  N/A

  N/R

• Equipment is either prevented from being operated in close proximity to excavations or is controlled

  3

  2

  1

  N/A

  N/R

• Underground utility clearance procedures are performed prior to excavating

  3

  2

  1

  N/A

  N/R

• Atmospheric testing is performed in excavations or trenches where there is potential for oxygen deficiency or a hazardous atmosphere

  3

  2

  1

  N/A

  N/R

• Soil type is properly identified by a competent person using an approved method

  3

  2

  1

  N/A

  N/R

• Excavation spoil material is properly placed (safe distance from excavation)

  3

  2

  1

  N/A

  N/R

• Trench or excavation crossings are used. The crossing structures are verified for the intended loads

  3

  2

  1

  N/A

  N/R

7. Hoisting/Rigging Equipment and Cranes

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Workers are trained in proper rigging, flagging, and hoisting procedures

  3

  2

  1

  N/A

  N/R

• Loads are properly rigged

  3

  2

  1

  N/A

  N/R

• Lifting equipment (chokers, slings, chain falls, come-along, etc.) are in good condition, properly inspected, and maintained

  3

  2

  1

  N/A

  N/R

• Tag lines are used appropriately

  3

  2

  1

  N/A

  N/R

• Load hooks, latches, and other rigging hardware are in good condition and properly inspected

  3

  2

  1

  N/A

  N/R

• Crane is set up properly including outriggers properly extended and outrigger pads used appropriately

  3

  2

  1

  N/A

  N/R

• Crane operators are trained, qualified, and have current certification

  3

  2

  1

  N/A

  N/R

• Crane inspections are current

  3

  2

  1

  N/A

  N/R

• Appropriate precautions are taken for crane operations in close proximity to overhead electrical lines or near other adjacent hazards

  3

  2

  1

  N/A

  N/R

• Signal persons are qualified. Hand signals are posted

  3

  2

  1

  N/A

  N/R

8. Motor Vehicles and Mobile Equipment

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Vehicle and equipment inspections and certifications are current

  3

  2

  1

  N/A

  N/R

• Vehicles and equipment are in good conditions (safety devices, windshields, mirrors, lights, etc.)

  3

  2

  1

  N/A

  N/R

• Driver's and operator's licenses are current

  3

  2

  1

  N/A

  N/R

• Vehicle and equipment controls are properly labelled. Warning labels are present and in good condition

  3

  2

  1

  N/A

  N/R

• Forklifts are inspected daily before use and the inspections are documented

  3

  2

  1

  N/A

  N/R

• Seat belts are used in vehicles and mobile equipment

  3

  2

  1

  N/A

  N/R

• Cell phones are not used by personnel when operating vehicles or mobile equipment

  3

  2

  1

  N/A

  N/R

9. Tools and Equipment

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Tools are appropriate for the task and being used for their intended purpose

  3

  2

  1

  N/A

  N/R

• Tool and equipment are in good condition

  3

  2

  1

  N/A

  N/R

• Hydraulic and/or pneumatic components including hoses, fittings, and connectors are in good condition

  3

  2

  1

  N/A

  N/R

• Tires, hose connections, welding leads, etc. are in good condition

  3

  2

  1

  N/A

  N/R

• Belt guards, fan blade guards, shaft guards and other guards are in place <br>

  3

  2

  1

  N/A

  N/R

• Powder activated tools are used properly by trained and qualified personnel

  3

  2

  1

  N/A

  N/R

10. Fire Prevention

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Flammables, oxidizers, and combustibles are stored properly

  3

  2

  1

  N/A

  N/R

• Fire extinguishers are properly located and are appropriate for the application

  3

  2

  1

  N/A

  N/R

• Fire extinguishers and firefighting equipment are properly inspected and maintained

  3

  2

  1

  N/A

  N/R

• Oxy-fuel rigs are properly set up and stored. The hoses are appropriate for the application and flashback arrestors are properly installed

  3

  2

  1

  N/A

  N/R

• Gas cylinders are properly secured

  3

  2

  1

  N/A

  N/R

• Cylinder gauges are removed and caps put in place when not in use

  3

  2

  1

  N/A

  N/R

• Outside storage tanks are properly located, installed, and protected

  3

  2

  1

  N/A

  N/R

11. Manual Material Handling and Ergonomics

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Manual material handling hazards are adequately identified

  3

  2

  1

  N/A

  N/R

• Effective controls for manual material handling are being employed including adequate supervision

  3

  2

  1

  N/A

  N/R

• Tasks that put personnel at risk for repetitive motion injuries have been evaluated

  3

  2

  1

  N/A

  N/R

• Lifting accessories are available to assist in manual material handling. They are used and maintained properly

  3

  2

  1

  N/A

  N/R

• Personnel use proper body position when performing tasks

  3

  2

  1

  N/A

  N/R

• Pre-task plans adequately address body position as a potential hazard

  3

  2

  1

  N/A

  N/R

• Personnel do not lift loads of 50 pounds (23 kg) or more (single person lift)

  3

  2

  1

  N/A

  N/R

• Overhead material handling hazards have been identified

  3

  2

  1

  N/A

  N/R

• Tasks do not require materials to be carried up/down stairs. Alternate means such as lifts, elevators, etc. are used

  3

  2

  1

  N/A

  N/R

• Tasks involving complex lifting and placing operations have ergonomic assessments

  3

  2

  1

  N/A

  N/R

12. Health Hazards and Hazardous Chemicals

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Potential chemical and biological hazards have been identified and evaluated

  3

  2

  1

  N/A

  N/R

• The location of hazardous chemical information (SDS or equivalent) is identified during worker orientation

  3

  2

  1

  N/A

  N/R

• The chemical information sheets (SDS) are shared on multiemployer worksites

  3

  2

  1

  N/A

  N/R

• An information sheet is available for each chemical

  3

  2

  1

  N/A

  N/R

• Hazardous materials are properly stored and labelled

  3

  2

  1

  N/A

  N/R

• Specific training on hazardous chemicals is provided

  3

  2

  1

  N/A

  N/R

• Worker training addresses accessing the chemical hazard information when developing SSoWs for tasks involving chemical hazards

  3

  2

  1

  N/A

  N/R

• Eyewash and shower units are located appropriately

  3

  2

  1

  N/A

  N/R

• Employees working around any regulated hazardous materials (asbestos, lead, etc.) are properly trained and qualified

  3

  2

  1

  N/A

  N/R

• Appropriate precautions are taken for working in adverse working environments (hot, cold, wet, snow, humid, windy, dusty, etc.)

  3

  2

  1

  N/A

  N/R

13. Welding, Cutting, and Grinding

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Hot work permits are obtained prior to performing work

  3

  2

  1

  N/A

  N/R

• A fire extinguisher or fire watch is stationed nearby

  3

  2

  1

  N/A

  N/R

• Appropriate controls are in place to prevent or limit personnel exposure to smoke and/or fumes

  3

  2

  1

  N/A

  N/R

• Controls are in place to prevent personnel and equipment exposure to Sparks, heat, and flames

  3

  2

  1

  N/A

  N/R

• Welding blankets and shields are being used appropriately

  3

  2

  1

  N/A

  N/R

• Welding machines are properly grounded

  3

  2

  1

  N/A

  N/R

• Appropriate PPE is worn by personnel performing welding and grinding

  3

  2

  1

  N/A

  N/R

• Welding and cutting gas cylinders are properly stored when not in use

  3

  2

  1

  N/A

  N/R

• Welding cables, leads, hoses, and connectors are in good condition

  3

  2

  1

  N/A

  N/R

• Portable grinders are in good condition, guards are in place, and wheels appropriate for grinder.

  3

  2

  1

  N/A

  N/R

14. Pressure Systems

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Piping and hoses are in good condition. Hose ends are restrained from whipping where appropriate

  3

  2

  1

  N/A

  N/R

• Relief devices are located appropriately and are inspected periodically in accordance with local standards

  3

  2

  1

  N/A

  N/R

• Relief device outlets and vent outlets are oriented appropriately (away from personnel)

  3

  2

  1

  N/A

  N/R

• Boiler and other speciality equipment inspections are current

  3

  2

  1

  N/A

  N/R

• Gauges and other process indicators are functional

  3

  2

  1

  N/A

  N/R

• The overall condition of the system is good (no unusual signs of wear, leaks, damage, corrosion, etc.)

  3

  2

  1

  N/A

  N/R

• Rotating equipment is properly guarded

  3

  2

  1

  N/A

  N/R

• Potential chemical hazards have been identified

  3

  2

  1

  N/A

  N/R

15. Workshop Tools and Equipment

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Bench grinder guards and rests are set properly

  3

  2

  1

  N/A

  N/R

• Guards on saws and other power tools are in place and are in good condition

  3

  2

  1

  N/A

  N/R

• Shop tools are equipped with anti-restart devices as appropriate

  3

  2

  1

  N/A

  N/R

• Tool bits, blades, and other attachments are in good condition

  3

  2

  1

  N/A

  N/R

• Shop floors are kept clear of shavings, chips, and other debris and materials

  3

  2

  1

  N/A

  N/R

• Machining of toxic materials (beryllium, lead, asbestos containing materials, etc.) is adequately controlled

  3

  2

  1

  N/A

  N/R

• Welding shields and ventilation systems are in place around welding areas

  3

  2

  1

  N/A

  N/R

• Push blocks are used to feed stock into tools where appropriate

  3

  2

  1

  N/A

  N/R

• Proper techniques are used when operating shop tools and equipment (including the proper method for polishing shaft material on a lathe)

  3

  2

  1

  N/A

  N/R

• Potential chemical hazards in the shop have been identified

  3

  2

  1

  N/A

  N/R

16. Office Work Environment

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Cutting tools are in good condition, appropriate for the task, and equipped with safety devices

  3

  2

  1

  N/A

  N/R

• File cabinets are properly loaded and secured. File and desk drawers are kept closed when not in use

  3

  2

  1

  N/A

  N/R

• Furniture and equipment are in good repair

  3

  2

  1

  N/A

  N/R

• Walking surfaces (carpet, tile, etc.) are in good condition

  3

  2

  1

  N/A

  N/R

• First-aid kits are properly stocked and available for use

  3

  2

  1

  N/A

  N/R

• Employees are trained and qualified in first aid and CPR. AEDs are available and personnel are trained in their use

  3

  2

  1

  N/A

  N/R

• Storage areas are organized and properly utilized (heavy items on bottom shelves)

  3

  2

  1

  N/A

  N/R

• Emergency exits are well marked and clear

  3

  2

  1

  N/A

  N/R

• A facility siting analysis has been performed/reviewed for siting of occupied facilities

  3

  2

  1

  N/A

  N/R

17. Environmental

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Have the potential environmental hazards on the site have been identified and evaluated?

  3

  2

  1

  N/A

  N/R

• The project has coordinated with the client regarding environmental compliance issues

  3

  2

  1

  N/A

  N/R

• Employees are trained and qualified to work with and around hazardous materials

  3

  2

  1

  N/A

  N/R

• Is waste segregated and processed for recycling or disposal?

  3

  2

  1

  N/A

  N/R

• Have the appropriate environmental permits been obtained?

  3

  2

  1

  N/A

  N/R

• Does the site emergency response plan address chemical spills?

  3

  2

  1

  N/A

  N/R

• Have all hazardous wastes have been identified?

  3

  2

  1

  N/A

  N/R

• Is spill containment provided around tank and drum storage?

  3

  2

  1

  N/A

  N/R

• Do employees understand their roles and responsibilities in the environmental program?

  3

  2

  1

  N/A

  N/R

• Are storage containers are properly labelled?

  3

  2

  1

  N/A

  N/R

18. Confined Spaces

• Did you review this section?

  Select Yes No N/A N/R

  • Yes
  • No
  • N/A
  • N/R

• Is a written confined space program required and is it in place?

  3

  2

  1

  N/A

  N/R

• Have confined Space hazard analyses been performed?

  3

  2

  1

  N/A

  N/R

• Has a rescue plan been developed?

  3

  2

  1

  N/A

  N/R

• Are personnel trained?

  3

  2

  1

  N/A

  N/R

19. Emergency Response

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Does a written emergency response plan exist? Are employees aware of the plan?

  3

  2

  1

  N/A

  N/R

• Is the emergency response plan coordinated with the client/site plan?

  3

  2

  1

  N/A

  N/R

• Are emergency response drills performed?

  3

  2

  1

  N/A

  N/R

• Are the site office facilities tied into the client/site emergency alarm/notification system?

  3

  2

  1

  N/A

  N/R

• Is the emergency plan reviewed and updated periodically?

  3

  2

  1

  N/A

  N/R

20. Site Access Control

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Is site access adequately controlled?

  3

  2

  1

  N/A

  N/R

• Is visitor (including client personnel) access controlled?

  3

  2

  1

  N/A

  N/R

• Are the site boundaries adequately marked and controlled?

  3

  2

  1

  N/A

  N/R

• Are there security and/or safety issues that are not addressed by the current program?

  3

  2

  1

  N/A

  N/R

21. Utility Clearance

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Is there a system for identification of underground utilities?

  3

  2

  1

  N/A

  N/R

• Is the utility clearance system integrated with the work permit system?

  3

  2

  1

  N/A

  N/R

• Does the utility clearance system apply to all ground and structure penetration activities?

  3

  2

  1

  N/A

  N/R

• Does the utility clearance system include a formal survey process?

  3

  2

  1

  N/A

  N/R

• Have underground utilities, including utilities embedded in structures, been identified?

  3

  2

  1

  N/A

  N/R

22. Work Permits

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Is there a permit to work system?

  3

  2

  1

  N/A

  N/R

• Does the permit system adequately control hazardous work (hot work, line break, etc.)?

  3

  2

  1

  N/A

  N/R

• Does the permit to work involve a site assessment?

  3

  2

  1

  N/A

  N/R

• Does the permit system require positive verification of the safe condition?

  3

  2

  1

  N/A

  N/R

• Does the permit system include awareness of adjacent work activities and hazards?

  3

  2

  1

  N/A

  N/R

23. Line & Equipment Opening

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Are line and equipment openings performed?

  3

  2

  1

  N/A

  N/R

• Is there a process for identification of hazards and controls?

  3

  2

  1

  N/A

  N/R

• Is there a process for controlling access to the area during the work?

  3

  2

  1

  N/A

  N/R

• Are positive isolation means utilized?

  3

  2

  1

  N/A

  N/R

• Is the Line Breaking and Equipment Opening Checklist used?

  3

  2

  1

  N/A

  N/R

24. Lifting

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Does the site perform critical lifts?

  Yes

  No

  N/A

  N/R

• Is the pre-lift checklist used to ensure appropriate precautions have been taken?

  3

  2

  1

  N/A

  N/R

• Is critical lift planning performed and documented?

  3

  2

  1

  N/A

  N/R

• Are critical lift plans reviewed by a qualified person?

  3

  2

  1

  N/A

  N/R

25. Employee Monitoring

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Have potential exposures been characterized by monitoring?

  3

  2

  1

  N/A

  N/R

• Are the monitoring procedures defined in the site safety plan or site HSE plan?

  3

  2

  1

  N/A

  N/R

• Are monitoring personnel trained and qualified?

  3

  2

  1

  N/A

  N/R

• Are monitoring instruments maintained and calibrated?

  3

  2

  1

  N/A

  N/R

• Are required medical surveillance programs in place? (e.g Drug/ Alcohol - region specific)

  3

  2

  1

  N/A

  N/R

26. Medical Monitoring

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Are required medical surveillance programs in place?

  3

  2

  1

  N/A

  N/R

• Does the client conduct medical surveillance testing on our employees?

  3

  2

  1

  N/A

  N/R

• Is medical surveillance testing conducted by a Jacobs approved third party medical provider?

  3

  2

  1

  N/A

  N/R

• Are copies and/or original medical records and test results maintained at the work site?

  3

  2

  1

  N/A

  N/R

• Are medical records and test results maintained by the client?

  3

  2

  1

  N/A

  N/R

• Are medical records and test results forwarded to the Occupational Health Services Department to be maintained?

  3

  2

  1

  N/A

  N/R

27. COVID -19 Management

• Did you review this section?

  Select Yes No N/A N/R

  • Yes
  • No
  • N/A
  • N/R

• Are there designated, identifiable COVID-19 compliance officers in place?

  3

  2

  1

  N/A

  N/R

• Are adequate COVID- 19 measures in place?

  3

  2

  1

  N/A

  N/R

• Is there adequate signage, information in place?

  3

  2

  1

  N/A

  N/R

28. Temporary Works

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Is there an appointed Temporary Works Co-Ordinator onsite?

  3

  2

  1

  N/A

  N/R

• Are temporary works design calculations, drawings and signed Temporary Works Design Certificates in place for all temporary works installations on site?

  3

  2

  1

  N/A

  N/R

• Are all TWDC reviewed and signed by the Temporary Works Designer, Permanent Works Designer and the Temporary Works Co-Ordinator?

  3

  2

  1

  N/A

  N/R

• Is there an up to date temporary works register in place?

  3

  2

  1

  N/A

  N/R

• Are all temporary works installations walked down prior to and after installation to ensure they have been installed as per design?

  3

  2

  1

  N/A

  N/R

29. Driving for work

• Did you review this section?

  Yes

  No

  N/A

  N/R

• Are there people that ‘drive for work’. i.e. Claim mileage?

  3

  2

  1

  N/A

  N/R

• Is there evidence of Journey Planning for those that do?

  3

  2

  1

  N/A

  N/R

• Have they complete and current Advanced Driver Techniques (ADT) training and do they hold a valid ‘permit to drive’?

  3

  2

  1

  N/A

  N/R

H. Additional Items

• Any other Comments/ Areas of concern?