Leadership Tour Record

• Conducted For:

• Conducted on

  Date

• Location

• Shell/Contractor Supervisor

• Shell/Contractor OSR

• Person Leading Tour

Leadership Tour

• Is the proper Work Authorization Permit on the job site?

  Yes

  No

  N/A

• Are all work permit provisions satisfied?

  Yes

  No

  N/A

• Fire/Safety Watch/Attendant properly placed and knowledgeable?

  Yes

  No

  N/A

• Lockout/Tagout instructions followed?

  Yes

  No

  N/A

• Appropriate PPE worn properly ( hearing, shoes, glasses, hard hats, gloves, face shield, fall protection, FRC clothing )

  Yes

  No

  N/A

• Tools/Equipment in good repair?

  Yes

  No

  N/A

• Tools/Equipment being used properly?

  Yes

  No

  N/A

• Any potential for employee exposure to air contaminants and if so is there protection given?

  Yes

  No

  N/A

• Spill pans and containment are in place where needed?

  Yes

  No

  N/A

• Ladders being properly used?

  Yes

  No

  N/A

• Proper barricades erected?

  Yes

  No

  N/A

• Fire protection equipment inspections up to date & available for hot work?

  Yes

  No

  N/A

• General housekeeping acceptable?

  Yes

  No

  N/A

• Material Safety Data Sheets for products used on site available?

  Yes

  No

  N/A

• Electrical extension cords in good repair?

  Yes

  No

  N/A

• Contractor Orientation performed and employee interviews indicated a commitment to on the job safety?

  Yes

  No

  N/A

• Emergency evacuation information known to all?

  Yes

  No

  N/A

• Excavation/Trenching properly shored?

  Yes

  No

  N/A

• High-pressure cylinders properly used/stored?

  Yes

  No

  N/A

• Ground Fault (GFCI's) or assured grounding program being utilized?

  Yes

  No

  N/A

• Spills are cleaned up immediately and reported to the Supervisor and documented?

  Yes

  No

  N/A

• Waste materials are appropriately segregated and labeled?

  Yes

  No

  N/A

• Watch ongoing activities: During the initial walk around, observe what activities are going on. Watch an activity for a while, at least several minutes. Document the activities you have observed.

• Talk to the workforce: Speak to some of the site workforce involved in the activity you have been watching before talking to the supervisors.

• Comments/Corrective Action: