Information
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
BEHAVIOR BASED SAFETY CATEGORIES
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As a Manager or Supervisor you are accountable for the safety performance of every person in your area of responsibility. When you systematically observe people, encourage their safe work practices and address their unsafe behaviors, you help prevent injuries.
As you arrive in a work area pay close attention to how the work is being performed. Make a mental note of both the safe and unsafe behaviors of employees and conditions you see. Now be prepared to talk with employees about your observations.
1.0 PERSONAL PROTECTIVE EQUIPMENT
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~ Head
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~ Eyes & Face
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~ Ears
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~ Respiratory System
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~ Trunk (Body)
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~ Arms & Hands
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~ Legs & Feet
2.0 REACTIONS OF PEOPLE
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~ Adjusting Personal Protective Equipment
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~ Changing Their Position
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~ Rearranging Their Job
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~ Stopping Their Job
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~ Attaching Grounds
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~ Locking or Tagging Out
3.0 POSITIONS OF PEOPLE
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~ Striking Against An Object
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~ Being Struck By An Object
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~ Being Caught In, On, Or Between
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~ Falling
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~ Contact With Temperature Extremes
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~ Contact With Electrical Current
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~ Inhalation of Hazardous Material
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~ Absorption of Hazardous Material
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~ Swallowing A Hazardous Material
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~ Overexertion
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~ Repetitive Motion
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~ Awkward Position
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~ Static Posture
4.0 TOOLS AND EQUIPMENT
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~ That Are Wrong For The Job
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~ That Are Being Used Incorrectly
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~ That Are In An Unsafe Condition
CONDITIONAL BASED SAFETY CATEGORIES
1.0 ENVIRONMENTAL
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Does site have Track Out Prevention in place?
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Have appropriate measures been taken to control dust?
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Have appropriate measures been taken to establish and maintain control over Storm Water?
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Have appropriate measures been taken to establish and maintain control of Concrete Washout Areas?
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Is there an appropriate number and type of Spill Response Kits available?
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The site has appropriate Permits for Portable Equipment
2.0 SUGGESTED CONVERSATION STARTERS FOR SUPERVISORS
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2.1 When/What was your last accident?
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2.2 What do you attribute your success or failure to?
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2.3 When was your last Take-5 Meeting?
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2.4 What was the topic of your your last Take-5 Meeting?
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2.5 What do you see as the greatest hazard on this job?
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2.6 What injury could occur if the unexpected happens?
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2.7 How can this work be done more safely?
3.0 SUGGESTED CONVERSATION STARTERS FOR EMPLOYEES
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3.1 When was your last Take-5 Meeting?
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3.2 What was the topic of your last Take-5 Meeting?
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3.3 What do you see as the greatest hazard on this job?
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3.4 What injury could occur if the unexpected happens?
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3.5 How can your job be done more safely?
4.0 SUGGESTED CONVERSATION STARTERS RED HARD HAT EMPLOYEES
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4.1 How did your operation go?
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4.2 What do you see as the greatest hazard on this job?
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4.3 How can your job be done more safely?
5.0 CORRECTIVE ACTIONS
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Noted below are the actions that I have taken to reinforce the SAFE WORK CONDITIONS and address or correct the UNSAFE WORK CONDITIONS.
Corrections of UNSAFE CONDITIONS should always include a conversation with affected employees!
CORE SAFETY SYSTEMS PARTICIPATION
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While on site I also performed the following functions:
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Reviewed the JOB HAZARD ANALYSIS with the supervisor.
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Reviewed the TAKE-5 MEETING with the supervisor.
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Attended the TAKE-5 MEETING.
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Attended the TAILGATE SAFETY MEETING.
Sign Off
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Auditor's signature
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Granite Management Systems (GMS) Form#: S-F-023
