LMRP - Smoky Falls

• Audit Title

• Site/project

• Conducted on

  Date

• Prepared by

1. LOTO Electrical and Mechanical

• 1.1 Review of logbooks?

  Yes

  No

  N/A

• 1.2 Energization and testing policy?

  Yes

  No

  N/A

• 1.3 Commissioning procedure?

  Yes

  No

  N/A

2. Housekeeping

• 2.1. Construction debris being removed? (Garbage)

  Yes

  No

  N/A

• 2.2. Cleanliness of work area?

  Safe

  At Risk

  N/A

3. JHA Review

• 3.1. Long Form JHA reviewed?

  Yes

  No

  N/A

• 3.2. Fall Protection Plan reviewed?

  Yes

  No

  N/A

• 3.3. Minor JHA reviewed? (Orange Book)

  Yes

  No

  N/A

4. Electrical

• 4.1. Ground Fault Circuit Interrupter (GFCI)

  Safe

  At Risk

  N/A

• 4.2. Electrical cord?

  Safe

  At Risk

  N/A

• 4.3. Cables?

  Safe

  At Risk

  N/A

• 4.4. Spider-box and C4?

  Safe

  At Risk

  N/A

• 4.5. Assured grounding program?

  Yes

  No

  N/A

5. Personal Protective Equipment (PPE)

• 5.1. Lack of, or inadequate PPE (including sun protection)

  Safe

  At Risk

  N/A

• 5.2. Lack of system to issue, inspect, replace and monitor PPE?

  Safe

  At Risk

  N/A

• 5.3. Lack of training in safe use, clean-up and inspection of PPE?

  Safe

  At Risk

  N/A

6. Walking and Work Surfaces

• 6.1. Tripping hazards?

  Safe

  At Risk

  N/A

• 6.2. Slippery surfaces?

  Safe

  At Risk

  N/A

• 6.3. Floor openings and holes?

  Safe

  At Risk

  N/A

• 6.4. Ladders?

  Safe

  At Risk

  N/A

7. Electrical Tools

• 7.1. Guards in place?

  Yes

  No

  N/A

• 7.2. Good condition?

  Yes

  No

  N/A

• 7.3. Stored properly?

  Yes

  No

  N/A

8. Crane (documentation)

• 8.1. Rigging equipment inspected?

  Yes

  No

  N/A

• Reviewed "On The Spot Lift Plan" (Yellow Book)

  Yes

  No

  N/A

9. Access & Egress

• 9.1. Ladders secured and positioning?

  Safe

  At Risk

  N/A

• 9.2. Ramps?

  Safe

  At Risk

  N/A

10. Hot Work

• 10.1. Task specific PPE?

  Yes

  No

  N/A

• 10.2. Combustibles removed from area?

  Yes

  No

  N/A

• 10.3. Flammables protected fire blankets being used?

  Yes

  No

  N/A

• 10.4. Fire extinguisher excess-able?

  Yes

  No

  N/A

11. WHMIS

• 11.1. MSDS binder on project and accessible to workers?

  Yes

  No

  N/A

• 11.2. Product (Supplier) Labels attached and legible?

  Safe

  At Risk

  N/A

• 11.3. Materials stored correctly?

  Yes

  No

  N/A

12. Scaffold System

• 12.1. Fully assembled?

  Yes

  No

  N/A

• 12.2. Inspection tag attached and dated?

  Yes

  No

  N/A

• 12.3. Fully blanked and cleated?

  Yes

  No

  N/A

• 12.4. Proper guardrail (top, mid and toe board)?

  Yes

  No

  N/A

13. Proper barricades

• 13.1. Yellow or red chain and barricade tag attached?

  Yes

  No

  N/A

• 13.2. Miscellaneous warning signs as per site conditions?

  Safe

  At Risk

  N/A

Comments and corrective actions?

• Comments or action taken?

Sign Off

• On site representative

  Sign

• Safety Coordinator signature

  Sign