MD/PA Field Services Safety Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Personal Protective Equipment

Is appropriate Personal Protective Equipment being used?

• Safety Glasses w/ side shields?

  Yes

  No

  N/A

• Glove use appropiate for the task being performed ?

  Yes

  No

  N/A

• Hard Hat being used where appropiate?

  Yes

  No

  N/A

• Hearing Protection being used?

  Yes

  No

  N/A

• Clothing appropiate for task being performed. ( Arc rated clothing for electrical work, leathers for welding, etc.)

  Yes

  No

  N/A

• Footwear appropiate for task being performed? (Safety toe required)

  Yes

  No

  N/A

General Safety Practices?

• Are associates working safely with no unsafe work practices observer? ( Improper lifting, rushing, use of wrong tools, etc.)

  Yes

  No

  N/A

• Has a pre-task JSA or safety check been completed prior to start of work task?

  Yes

  No

  N/A

• Hand and power tools in good working condition?

  Yes

  No

  N/A

• Are associates familiar with emergency procedures?

  Yes

  No

  N/A

• Proper fire extinguishers available?

  Yes

  No

  N/A

• First aid kits available?

  Yes

  No

  N/A

• Do associates know who to contact in the event of an emergency?

  Yes

  No

  N/A

Housekeeping

• Is housekeeping acceptable?

  Yes

  No

  N/A

• Are spills cleaned up immediatly?

  Yes

  No

  N/A

• Walking and working surfaces free of slip and trip hazards?

  Yes

  No

  N/A

• Are walkways kept clear and free of obstructions?

  Yes

  No

  N/A

• Is stored material stable and secure from tipping or fall over?

  Yes

  No

  N/A

• Are tools and toolboxes properly located and stored? Are all stray tools gathered and stored properly at the end of the day?

  Yes

  No

  N/A

• Are emergency egress routes clear and free of obstructions?

  Yes

  No

  N/A

• Is the level of lighting adequate for the safe employee movement and for the work being performed?

  Yes

  No

  N/A

Chemical

• Are chemical containers labeled properly?

  Yes

  No

  N/A

• Are proper containers used and closed when not in use?

  Yes

  No

  N/A

• Are hazardous material supplies kept at a minimum?

  Yes

  No

  N/A

• Are SDS's available and current?

  Yes

  No

  N/A

• Is PPE being used appropiate for the hazards associated with the chemical?

  Yes

  No

  N/A

• Do associates know who to contact in the event of a chemical spill?

  Yes

  No

  N/A

• Are chemicals disposed of properly?

  Yes

  No

  N/A

Electrical

• Are associates wearing electrical PPE when working near (</= 4') live electric ? (electrial gloves, protectors, arc rated clothing, balaclava, faceshield/hardhat, hearing protection & safety glasses)

  Yes

  No

  N/A

• Are barriers in place to prevent unqualified people from approaching exposed electrical components?

  Yes

  No

  N/A

• Are all temporary circuits properly guarded and grounded?

  Yes

  No

  N/A

• Are extension cords in continuous lengths with out splices and free of any damage (plugs etc.)

  Yes

  No

  N/A

• Are GFCI's being utilized?

  Yes

  No

  N/A

• Are working surfaces clear of cords so as not to create a tripping hazard?

  Yes

  No

  N/A

• If temporary lighting is provided, are bulbs protected against accidental breakage?

  Yes

  No

  N/A

• Electrical outlets appear not to be overloaded?

  Yes

  No

  N/A

Ladders

General

• Ladders in good condition?

  Yes

  No

  N/A

• Correct ladder being used?

  Yes

  No

  N/A

• Are all labels and warnings ledgible?

  Yes

  No

  N/A

• Are screws, bolts or other metal parts secure?

  Yes

  No

  N/A

• Are uprights, braces, steps or rungs free of checkering, cracks, splits, slivers or breaks?

  Yes

  No

  N/A

• Are step and rungs tight?

  Yes

  No

  N/A

• Are non-slip bases in place and not damaged or worn?

  Yes

  No

  N/A

Step Ladder

• Is ladder fully opened and spreaders locked when ladder is in use?

  Yes

  No

  N/A

• Is the ladder steady and free of wobble?

  Yes

  No

  N/A

• Are the spreaders tight and not bent or broken?

  Yes

  No

  N/A

Extention ladder

• Is ladder secured from tipping and/or sliding?

  Yes

  No

  N/A

• Are extension locks in place and not broken or loose?

  Yes

  No

  N/A

• Does ladder extend 3 feet above the point of support?

  Yes

  No

  N/A

• Do locks seat properly when the ladder is extended?

  Yes

  No

  N/A

• Is the condition of the rope good and free of deteriation or cuts?

  Yes

  No

  N/A

Scaffold

• Are scaffold components inspected for visible defects by a competent person before each work shift and is this inspection documented?

  Yes

  No

  N/A

• Is scaffolding properly erected with all pins and braces in place and locked?

  Yes

  No

  N/A

• Is scaffolding erected on a firm and substantial surface?

  Yes

  No

  N/A

• Ladder provided for access to scaffold work platform?

  Yes

  No

  N/A

• Is planking of a scaffold grade?

  Yes

  No

  N/A

• Planking in good condition and properly overlapped?

  Yes

  No

  N/A

• Are toe boards and guardrails in place on scaffolding?

  Yes

  No

  N/A

• Are workers on scaffolding protected from falling objects if overhead hazards exist?

  Yes

  No

  N/A

• Are rolling scaffolds equipped with locking wheels?

  Yes

  No

  N/A

• Are wheels locked when scaffolding is in use?

  Yes

  No

  N/A

Welding, Cutting and Brazing

• Are non-combustible enclosures, (screens/shields) provided and used when welding?

  Yes

  No

  N/A

• Welding shield, gloves and protective clothing being used when welder?

  Yes

  No

  N/A

• Tinted eyewear being worn when brazing and cutting?

  Yes

  No

  N/A

• Are gas cylinders, hoses, regulators, torches, torch tips and welding cart in good condition?

  Yes

  No

  N/A

• Are gas cylinders properly secured for tipping and protected from damage?

  Yes

  No

  N/A

• Are valves closed when gas cylinders are not in use?

  Yes

  No

  N/A

• Is a current Hot work Permit posted in the area where welding, cutting, brazing or spark producing operations are being performed?

  Yes

  No

  N/A

• Have all flammable materials been removed from the area? If combustible material cannot be removed are they protected from ignition?

  Yes

  No

  N/A

• Are fire extinguishers readily available in the immediate vicinity of the operation?

  Yes

  No

  N/A

• Is a fire watch being maintained a minimum of 30 minutes after welding, cutting and brazing operations are complete?

  Yes

  No

  N/A

Hoist, Cranes and Rigging

• Has the annual inspection been completed and properly documented?

  Yes

  No

  N/A

• Has the crane been inspected prior to use?

  Yes

  No

  N/A

• Are ropes, slings, chains, hook and chokers in good condition and inspected (below the hook)?

  Yes

  No

  N/A

• Rigging equipment inspected regularly and in good condition (above the hook)?

  Yes

  No

  N/A

• Are cables and sheaves checked?

  Yes

  No

  N/A

• Are the capacities posted on both sides of the bridge/beam?

  Yes

  No

  N/A

• Are power lines at a safe distance from lifting equipment?

  Yes

  No

  N/A

• Are crane inspection logs with crane?

  Yes

  No

  N/A

• Was site survey completed prior to set up of crane?

  Yes

  No

  N/A

• Does crane operator have required training documentation?

  Yes

  No

  N/A

• Does signal person have required training documentation?

  Yes

  No

  N/A

Fall

Personal Fall Arrest

• Are full body harnesses used for fall protection?

  Yes

  No

  N/A

• Are body belts prohibited from being used for fall protection?

  Yes

  No

  N/A

• Are lanyard and tie-off straps protected against cuts and abrasions?

  Yes

  No

  N/A

• Are multiple lanyards prohibited from being attached together?

  Yes

  No

  N/A

• Are lanyards not hooked back on themselves?

  Yes

  No

  N/A

• Are knots prohibited in lanyards and other components of the fall protection system?

  Yes

  No

  N/A

• Is anchor point substancial enough to withstand a fall? (5000#)

  Yes

  No

  N/A

• Are all fall protection equipment inspected prior to each use?

  Yes

  No

  N/A

Guardrail / Warning Line / Parapet Wall

• Are work areas 4' and greater above lower level protected by a guardrail system?

  Yes

  No

  N/A

• Does the guardrail consist of a top rail, intermediate rail, and toe board?

  Yes

  No

  N/A

• Is the top rail 42" from the floor and has a smooth top surface for the full length of the rail?

  Yes

  No

  N/A

• Is the intermediate rail halfway between the top rail and the floor?

  Yes

  No

  N/A

• Are warning lines set back for the leading edge by at least 15' (6' for roofers only)?

  Yes

  No

  N/A

• Is warning line not greater then 39" or less then 34" from the the floor/roof?

  Yes

  No

  N/A

• Are there warning flags at intervals of 6' or less along the entire length of the warning line?

  Yes

  No

  N/A

• Are parapet wall at least 39" tall?

  Yes

  No

  N/A

Confined Space

• Are associates prohibited from working in permit required confined spaces?

  Yes

  No

  N/A

Lock Out/Tag Out

• Were affected persons notified?

  Yes

  No

  N/A

• Is the equipment shut down properly?

  Yes

  No

  N/A

• Are all enegy-isolating devices locked and tagged out properly

  Yes

  No

  N/A

• Has all strored or residual energy been dissipated or restrained?

  Yes

  No

  N/A

• Did authorized worker(s) verify ZERO energy?

  Yes

  No

  N/A

• Does each lock and/or tag indicate the authorized employee's name, company and telephone number?

  Yes

  No

  N/A

• Are there a lock and <br>tag on the equipment for each employee working on the equipment?

  Yes

  No

  N/A

• Electrical locked and tagged out properly?

  Yes

  No

  N/A

• Water locked and tagged out properly

  Yes

  No

  N/A

• Gas locked and tagged out properly?

  Yes

  No

  N/A

• Steam locked and tagged out properly?

  Yes

  No

  N/A

• Refrigerant locked and tagged out properly?

  Yes

  No

  N/A

Mobile Equipment

• Has operator been properly trained and is authorized to operate equipment?

  Yes

  No

  N/A

• Has daily/shift inspection been completed?

  Yes

  No

  N/A

• Is appropiate safety equipment being used (seatbelt, fall protection etc.)?

  Yes

  No

  N/A

Additional EHS Comments - Please use this area to include any additional information pertaining to this audit.