LafargeHolcim - Regional OH&S Inspection Version 1.2

• Site

• Region

  Select North East Region Mid-Atlantic Great Lakes North Central Western West Central Region Mid America South

  • North East Region
  • Mid-Atlantic
  • Great Lakes
  • North Central
  • Western
  • West Central Region
  • Mid America
  • South

• Division

  AGG

  HMA

  RMX

  Contracting

• Conducted on

  Date

• Prepared by

• Personnel Present for Inspection

Level 1 Safety Inspection

Finding

• Image

  Media

• Location

• Observation/Finding

• Reference

  Select Personal Protective Equipment HS.3.1 Machine Guarding HS.3.10 Isolation LOTO HS.3.11 Electrical HS.3.12 Hot Work HS.3.15 Fire Safety HS.3.17 Lifting & Supporting HS.3.18 Working at Heights HS.3.19 Compressed Gas HS.3.20 Confined Space HS.3.8 Contractor Safety Management HS.3.4 Excavation & Digging HS.3.23 Management of Change HS.2.2 Vehicle &Traffic Safety HS.3.9 Hazcom & Chemical Safety HS.3.3 Safe Access First Aid Materials Environmental Housekeeping Bloodborne Pathogens HS.2.01 Site Security

  • Personal Protective Equipment HS.3.1
  • Machine Guarding HS.3.10
  • Isolation LOTO HS.3.11
  • Electrical HS.3.12
  • Hot Work HS.3.15
  • Fire Safety HS.3.17
  • Lifting & Supporting HS.3.18
  • Working at Heights HS.3.19
  • Compressed Gas HS.3.20
  • Confined Space HS.3.8
  • Contractor Safety Management HS.3.4
  • Excavation & Digging HS.3.23
  • Management of Change HS.2.2
  • Vehicle &Traffic Safety HS.3.9
  • Hazcom & Chemical Safety HS.3.3
  • Safe Access
  • First Aid Materials
  • Environmental
  • Housekeeping
  • Bloodborne Pathogens HS.2.01
  • Site Security

• Recommended Action:

• Recommended Action Due Date

  Date

• On Site's SSIP?

  YES

  No- Add To SSIP

  NA

• Potential:

  1- Property Damage (<$10,000

  2- First Aid or Property Damage (>$10,000)

  3 - Medical Treatment

  4 - Loss Time

  5- Fatality

• Likelihood:

  1- Unlikely to Occur

  2 - Possible within a year

  3 - Likely within 6 months

  4- Probable within a month

  5- Almost certain in next week

• Risk:

Good Practice - Good Finding

• Type

  Good Practice

  Good Finding

• Add media

  Media

• Description

Contractor Safety Management

• Add media

  Media

• Contractors Name

• Is Contractor Green In Avetta

  Yes

  No

• Has Contractor Completed Site Induction

  Yes

  No

• Contractor Job Safety Plan Complete

  Yes

  No

• Contractor Pre-Shift Hazard Assessment Complete:

  Yes

  No

• Contractor Competency,<br> i.e. MSHA trained, proper licensed, Documented equipment training, etc.

  Yes

  No

• Compliant with all Site Safety Standards

  Yes

  No

  N/A