Title Page
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Actionable items require follow-up and documentation within 5 days of the inspection, sooner if possible.
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Site:
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Inspection Team:
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Date:
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Client Representatives:
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JHSC Members:
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Frequency:
HSE Inspection
HSE Inspection
1. CHEMICAL/ ENVIRONMENT
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1.1 Pre-Environmental Checklist
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1.2 Proper Storage
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1.3 Filter Fence/Straw Bales
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1.4 Water
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1.5 T.D.G.
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1.6 W.H.M.I.S.
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1.7 S.D.S.
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1.8 Spill Kits/Response
2. ELECTRICAL
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2.1 Correct Limits of Approach
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2.2 Signage Warning of Hazards
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2.3 Protective Barricades
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2.4 Ground Fault Circuit Interrupter
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2.5 Proper Grounding in Place
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2.6 All Panels Locked
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2.7 All Panels Kept Clear
3. WORKSITE DOCUMENTS
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3.1 Emergency Procedure Posted
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3.2 Health & Safety Policy Posted
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3.3 Standards / Procedures Available
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3.4 HSE Manual Available
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3.5 OHS Regulations Available
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3.6 Safe Work Plan Available
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3.7 Safety Meeting Minutes Posted
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3.8 HSE Inspections Posted
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3.9 SWAs in Place
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3.10 LSRs Posted
4. FIRST AID/MEDICAL
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4.1 First Aiders Identified
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4.2 First Aid Supplies Available
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4.3 First Aid Procedures Posted
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4.4 Facilities Sanitary
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4.5 Facility Hours Posted
5. WORKSITE CONDITION
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5.1 Equipment use
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5.2 Material Storage
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5.3 Power Tools
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5.4 Hand tools
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5.5 House Keeping
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5.6 Temporary Lighting
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5.7 Waste/Recycle
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5.8 Cords and Cables
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5.9 Fire Extinguishers
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5.10 Ergonomics
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5.11 Winter Ground Conditions
6. EMERGENCY PLANNING
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6.1 Plan is developed / Sufficient
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6.2 Posted in conspicuous location
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6.3 Contact #s available
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6.4 Plan has been communicated
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6.5 Drills Conducted
7. HAZARD WARNINGS
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7.1 Cones/Barricades
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7.2 Covers marked and secure
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7.3 Guardrails/handrails
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7.4 Signs/Signals
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7.5 Tags
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7.6 Warning flagging
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7.7 Defective tool removal system
8. LOTO
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8.1 Isolation points identified
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8.2 Isolation Verified
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8.3 Valves in correct position
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8.4 Locks / blanks/ blinds installed
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8.5 SWA in place
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8.6 JHA/SOP/SWP Reviewed
9. CONFINED SPACE
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9.1 Air Monitoring
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9.2 Barricades
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9.3 Lighting
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9.4 Ventilation
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9.5 Rescue Plan
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9.6 Safety Attendant/Monitor
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9.7 Workers Trained
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9.8 SWA in place
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9.9 JHA Reviewed
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9.10
10. FLHA
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10.1 Card completed
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10.2 Risk Properly Identified
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10.3 Reviewed by Supervisor
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10.4 All Persons Signed On
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10.5 Muster Area Identified
11. PERSONAL PROTECTIVE EQUIP.
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11.1 Body Protection
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11.2 Hi-Visibility Clothing
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11.3 Eye Protection
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11.4 Face Protection
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11.5 Fall Protection
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11.6 Foot Protection
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11.7 Hand Protection
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11.8 Head Protection
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11.9 Hearing Protection
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11.10 Respiratory Protection
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11.12 Biohazard PPE
12. TRAFFIC CONTROL
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12.1 Proper PPE being used
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12.2 Control plan in place
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12.3 Plan reviewed by workers
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12.4 Workers trained (as per role)
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12.5 Signage
13. TRENCHES & EXCAVATIONS
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13.1 Access and egress
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13.2 Cutbacks/Shoring
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13.3 Permits in place
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13.4 Spoil pile
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13.5 Workers Protected
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13.6 Inspections Performed
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13.7 Utility Locates Available
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13.8 Hand Digging/Vac Truck
14. HOT WORK
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14.1 Spark Containment
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14.2 Fire Extinguishers/Hose
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14.3 Combustibles Protected
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14.4. Ventilation
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14.5 Hot Work Permit
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14.6 Procedures Followed
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14.7
15. LIFTING OPERATIONS
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15.1 Crane Log Book
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15.2 Engineered lift
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15.3 Rigging Inspected
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15.4 Signaler identified
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15.5 Tag line used
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15.6 Procedures Followed
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15.7 Workers competent
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15.8 JHA Reviewed
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15.9 Outrigger Pads in Place
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15.10
16. PORTABLE EQUIPMENT
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16.1 Spill Containment
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16.2 Wheel Chocks
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16.3 Positive Air Shutoff
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16.4 Exhaust Directed Properly
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16.5 OTHER
17. VEHICLES / MOBILE EQUIP.
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17.1 Emergency equipment
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17.2 Equipment certified
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17.3 Log book and Manual
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17.4 Maintenance
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17.5 Operator certified
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17.6 Traffic control used
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17.7 Spotters Utilized
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17.8 Interior Clean
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17.9 Exterior Clean / Damage Free
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17.10 No visible leaks
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17.11
18. HYGIENE
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18.1 Washrooms Available
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18.2 Facilities cleaned
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18.3 Potable water available
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18.4 Waste disposal
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18.5 Toilet Stall Available
19. FALL PROTECTION
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19.1 Correct Equip Selected
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19.2 Condition
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19.3 Worn Correctly
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19.4 Worker trained
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19.5 Adequate anchor points
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19.6 Proper clearance maintained
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19.7 Fall protection plan/rescue in place
20. ELEVATED WORK
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20.1 Materials Stored Properly
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20.2 Open Holes Barricaded
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20.3 Grating Covered
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20.4 Area Below Barricaded
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20.5 Tools / Equipment Tied Off
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20.6 Procedures Followed
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20.7 OTHER
21. RIGGING
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21.1 Anchor Points Adequate
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21.2 Rigging rated for load
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21.3 Condition
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21.4 Used correctly
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21.5 Shackles used
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21.6 Shackle pins fully seated
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21.7 Shackles orientated correctly
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21.8 Lashing tight
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21.9 Correct number cable clips
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21.10 Clip orientation correct
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21.11
22. SCAFFOLDS/PLATFORMS
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22.1 Condition
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22.2 Construction
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22.3 Tagged correctly
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22.4 Correct Use
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22.5 Inspected
23. LADDERS / STAIRWAYS
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23.1 Condition
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23.2 Usage
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23.3 Clear Access / Egress
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23.4 Tied Off & Angle
24. COMPRESSED GASES
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24.1 Stored properly
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24.2 Secured/Upright
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24.3 Flashback/ Check valve
25. Public Safety
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25.1 Perimeter fencing secure/well defined
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25.2 Pedestrian pathway defined/maintained: free of trip hazards
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25.3 Signage directions/hazard awareness clear
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25.4 Disability access is accommodated or restored
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25.5 Tools/equipment secured/protected
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25.6 Excavations/trenches/hazards secure at end of shift
Follow-up
- ITEM REQUIRING FOLLOW-UP or CORRECTIVE ACTION (Act/Regulation/Code; Policy/Procedure)
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No.
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Target Date
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Action By
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Completion Date
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Comments, Commendations and Safety Concerns:
Sign-off
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Lodge Manager's Name and Signature
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HSE Advisor's Name and Signature
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JHSC Name and Signature
