JP Services Field Safety Daily Site Audit

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

JSA

• Is JSA Complete?

  Yes

  No

  N/A

• Has Onsite Personnel Signed The JSA?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Required PPE

• Hard Hat

  Yes

  No

  N/A

• Safety Glasses

  Yes

  No

  N/A

• Face Shield / Goggles

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Gloves

  Yes

  No

  N/A

• ANSI 107 Class II or III Safety Vest

  Yes

  No

  N/A

• Foot Protection / Safety Toe

  Yes

  No

  N/A

• FRC Clothing

  Yes

  No

  N/A

• Dust Mask

  Yes

  No

  N/A

• Other:

  Yes

  No

  N/A

Material Handling

• Body Mechanics

  Safe

  At Risk

  N/A

• Load Secure, Rigged Properly

  Yes

  No

  N/A

• Tag Lines Used

  Yes

  No

  N/A

• Other:

  Safe

  At Risk

  N/A

Vehicle/Equipment Checks

• Pressure Relief Valve Installed On Pressure Side of Pump

  Yes

  No

  N/A

• Pressure Relief Valve Installed on Test Tree

  Yes

  No

  N/A

• Daily Equipment and Truck Inspection Completed

  Yes

  No

  N/A

• Other:

  Safe

  At Risk

  N/A

Housekeeping

• Trash

  Safe

  At Risk

  N/A

• Trash Receptacles

  Yes

  No

  N/A

• Crew Trucks/Trailers

  Safe

  At Risk

  N/A

• Other

  Safe

  At Risk

  N/A

Material Storage

• Material Stored Properly

  Yes

  No

  N/A

• Flammable/Combustible Storage

  Safe

  At Risk

  N/A

• Other:

  Safe

  At Risk

  N/A

Electrical

• GFCI/Assured Grounding Program

  Yes

  No

  N/A

• Cords/Tools – Inspected

  Yes

  No

  N/A

• Cords Routed Properly

  Yes

  No

  N/A

• Other:

  Safe

  At Risk

  N/A

Fire Protection & Prevention

• Fire Suppression Equipment

  Yes

  No

  N/A

• Fire Extinguisher Inspection

  Yes

  No

  N/A

• Properly Rated/Size (BC versus ABC)

  Yes

  No

  N/A

• Combustible/Flammable Material Away from Hot Work

  Yes

  No

  N/A

• Other:

  Safe

  At Risk

  N/A

Signs/Barricades

• Proper Type

  Yes

  No

  N/A

• Appropriate Location

  Safe

  At Risk

  N/A

• Marking Hazards

  Yes

  No

  N/A

• Other:

  Safe

  At Risk

  N/A

X-Ray

• Signs, Signals & Barricades

  Yes

  No

  N/A

• Other

  Safe

  At Risk

  N/A

Lock-Out/Tag-Out

• Potential Energy Sources Identified

  Yes

  No

  N/A

• Isolated

  Yes

  No

  N/A

• Other

  Safe

  At Risk

  N/A

Miscellaneous

• Restrooms & Potable Water Available

  Yes

  No

  N/A

• First Aid Kit

  Yes

  No

  N/A

• Fall Protection

  Yes

  No

  N/A

Closing Comments