Monthly NGD Construction Safety Q/A QC Checklist

Information

Location
TCC Location
- COH-Springfield (0651)
- COH-Wintersville (0731)
- COH-Bellaire (0732)
- COH-East Liverpool (0733)
- COH-Columbus SE (0822)
- COH-Columbus NE (0823)
- COH-Columbus NW (1324)
- COH-Columbus Central & SW (1325)
- COH-Alliance (0971)
- COH-Findlay (1031)
- COH-Fremont (1053)
- COH-Firelands (1054)
- COH-Toledo (1121)
- COH-Lorain (1222)
- COH-Middleburg HTS (1261)
- COH-New Lexington (1424)
- COH-Zanesville (1441)
- COH-Cambridge (1442)
- COH-Coshocton (1443)
- COH-Newark (1451)
- COH-Athens (1521)
- COH-Chillicothe (1531)
- COH-Jackson (1533)
- COH-Portsmouth (1541)
- COH-Mansfield (1721)
- COH-Marion (1732)
- COH-Mt. Vernon (1743)
- COH-Ironton (1943)
- CMD-Hagerstown (2141)
- CMD-Cumberland (2151)
- CPA-Greencastle (2171)
- CPA-Mt. Lebanon (2221)
- CPA-Rochester (2231)
- CPA-Emleton (2232)
- CPA-New Bethlehem (2234)
- CPA-Warren (2239)
- CPA-Smithfield (2321)
- CPA-Washington (2391)
- CPA-York (2421)
- CPA- New Castle (2231)
- CPA-State College (2451)
- CPA-Bradford (2238)
- CMA-Brockton (8100)
- CMA-Springfield (8200)
- CMA-Ludlow (8710)
- CMA-Brockton-Meadow Ln. (8730)
- CMA-Easton (8720)
- CMA-Northampton (8201)
- CMA-Lawrence (8400)
- CPA- Uniontown/Connellsville
- People's Natural Gas (PNG)
- CPA- Central
Performing Work For:
Prepared by
Contractor Company Name
- Alex E. Paris Contracting Company, Inc.
- Allegheny Contracting, LLC
- Banks Gas Services, Inc.
- Buckeye Utility Services, LLC
- C.J. Hughes Construction Company, Inc.
- Casper Colosimo & Son, Inc.
- Dekatherm, Inc.
- Feeney Brothers Excavation, LLC
- InfraSource Construction Services, LLC
- InfraSource Construction, LLC
- Kinsley Construction, Inc.
- KS Energy Services, LLC
- Lineal Industries, Inc.
- M. O'Herron Company
- Michels Corporation
- Mid-Ohio Pipeline Company, Inc.
- Miller Pipeline Corporation
- Minnesota Limited
- New England Utility Constructors, Inc.
- NPL Construction Company
- R&R Pipeline, Inc.
- R.L. Coolsaet Construction Co.
- RH White Construction Company, Inc.
- Riley Brothers, Inc.
- RLA Investments, Inc.
- Robert J. Devereaux Corporation
- Southeast Connections, LLC
- Stanley Pipeline, Inc.
- The Fishel Company
- Utility Line Services, Inc.
- W.E. Curling, Inc.
- AWP
Contractor Foreman (Last Name, First Name)
Contractor Employee(s) (CREW) (Last Name, First Name)
Company Crew Involved?
Company Crew Leader Name (Last Name, First Name)
Crew Members (Last Name, First Name)
Conducted on
Document No.

Safety and PPE

Work Zone

Work Zone - Traffic Control, Personal and Public Safety Measures
Work Zone Properly Marked/ Posted (MUTCD Guidelines, HSE 4100.020).
Traffic Control Adequate for Work Site (HSE 4100.020).
Workers Protected by Cones, Barricades that meet Pub 213 and MUTCD guidelines (HSE 4100.040)
Vehicle warning lights operating (Best Practice)
Pedestrian traffic addressed (HSE 4100.20)
Flaggers Present if necessary (HSE 4100.020)
Excavation protected by cones and/or barricades (HSE 4100.040)

Housekeeping

Housekeeping
Properly Maintained Work Site (Housekeeping/Cleanup) (OSHA 29 CFR 1910.22 & ANSI A1264.2-2012) (OSHA 29 CFR 1926.25 House Keeping)
Properly Staged and Stored Equipment, Material, Tools (HSE 4100.050)
Work area free of trip, slip, and fall hazards
Extension cords are not draped in walk areas
There is a designated placed for tools and equipment that is marked
Work area is neat and organized

PPE

Personal Protective Equipment
Proper PPE Attire for Task or Site (HSE 4200.050, .040, .030, .020)
Hardhat? (HSE 4200.050)
Safety glasses? (HSE 4200.030)
Foot protection (Steel toed, and metatarsals if applicable) (HSE 4200.020)
High Visibility Vest? (HSE 4100.020)
Gloves worn where applicable to the job task? (HSE 4200.040)
Hearing Protection (HSE 4000.030)
All PPE in Clean and Serviceable Condition (HSE 4200 Series)
Atmospheric Monitoring (CGI, O2 Monitor) Calibrated and Used as Necessary (HSE 4100.010)
Respiration Protection (Air Purifying - Proper Cartridge) (HSE 4200.010)

Fire Protection/ First Aid

Fire Protection/First AId
Fire Extinguisher Inspection Tag Complete and Current (HSE 4000.082)
Fire Extinguisher Properly inspected with no defects to the hose, and safety pin in place
Fire Extinguisher Positioned Properly, within 25 ft. of excavations and placed UPWIND (HSE 4000.082)
First Aid Kit Complete, Inspected and Sanitary (HSE 4200.020)

Excavation

Excavation Safety
Proper One Call and Utilities Marked? (GS 1100.010)
Atmospheric monitoring was conducted prior to work? (CGI was taken) (HSE 4100.010)
Excavation Protected by Cones, Barricades, Etc... (HSE 4100.040)
Proper Techniques Used While Excavating to Prevent Potential Damage (Recognized and Used shovels to dig around buried utilities)(GS 1100.040 MA) (OSHA 1926.651 A)
Demonstrated ability to use excavator safely and correctly. Utilized designated spotters, and inspected equipment prior to digging.
One Designated Competent Person On Site (HSE 4100.040)
Means of Egress Within 25 Feet of Employees (OSHA 1926.651)
Egress Provided For >4 Feet Deep, Ladder Extends 3' Above Excavation (OSHA 1926.651 C)
Shoring Space/Sloping in Greater Than 5 Feet Depth, Shoring Extends 18" Above Excavation (HSE 4100.040)
Spoil Pile, Tools and Equipment Placed 2 Feet From Edge of Excavation (OSHA 1926.651)
Vehicle between site and work area (HSE 4100.020)
Site Inspected for Changing Conditions (OSHA) (HSE 4100.010) (HSE 4100.040)
Hand digging around other buried facilities (GS 1100.040)
After work is completed, employees demonstrated ability to backfill correctly, using proper backfill material, and installed marking ball and warning tape within 6-12 inches from the surface of the buried gas line.

Equipment and Tools

Equipment and Tools
Tools, Equipment and Materials Available and in Safe Working Condition (HSE 4100.050)
Air Hoses and Fittings in Good Condition, Whip Check Safety Cord on Connections (OSHA 1926.302 B)
Employees bleed off lines prior to disconnecting all pneumatic tools
Employees inspected tools and equipment prior to usage. No signs of wear and tear or damages when operating.
Employees chose the correct tool for the job
Employees maintained good grip while operating tools, and kept hands away from pinch point areas.
Employees chose and wore the correct PPE for the selected tool in use
Employees kept guards on all Portable Tools (HSE 4100.050)
Gauges, Instruments and Equipment Calibrated and Current (GS 1754.010)
Power Tools Not Used In a Gaseous Atmosphere (GS 1770.010)
Flashlight Intrinsically Safe (Class 1 DIV 1) (GS 1770.010)
Tools, Pipes and Containers Grounded as Required (GS 1770.010)

Electrical and Generators

Electrical Components and Generators
Electrical Cords on all tools and extension cords in Good Condition (No Cuts, Damage, or Spliced, and Grounding Pin in place) (OSHA 1910.334)
Electrical Tools and Extension Cords Double Insulated and Grounded, Checked for Continuity (HSE 4100.050, OSHA 1910.334)
Outlets Free of Cracks/ Breaks (HSE 4100.050, OSHA 1926.404)
Generator is GFCI protected (if applicable) or GFCI pigtails are used.
GFCI'S Checked, Tested and Used on all Power Supplies (HSE 4100.050)
Generator is positioned so that carbon monoxide and exhaust fume ventilate into the atmosphere.
Generator is at least 5000 watts when plastic fusing

Vehicles

Vehicles
Wheels Chocked (HSE 4100.050)
Engine off When Unattended (HSE 4100.050)
Valid License and Medical Card as Required (HSE 4300.010, .035)
DOT Pre-Inspection Performed (HSE 4300.010)
Vehicles free of clutter? (HSE 4300.010)<br>
Parking brake set? (HSE 4100.50)
All meters secured and capped? (GS 6500.100)
360 walk around conducted?
Vehicles backed into parking spaces where appropriate and employees follow the first move forward policy? (HSE 4300.010)

Material Rigging/ Slings and Chains

Material Rigging, Slings/Chains (OSHA 1910.184) if applicable to site
Spotters were utilized in order to keep others away from swing radius and ensure clearances of power lines and other obstructions.
Employees hands or other body parts are not under the load
Operator demonstrated ability to use rigging equipment safely, effectively, and maintained communication with others at all times.
Proper rigging configuration (hooks, shackles, etc.) (OSHA 1910.184)
Materials inspected prior to rigging
In safe condition (OSHA 1910.184)
Properly rated (OSHA 1910.184)
Powdered fiber between threads, abnormal wear visible, not excessively worn or damaged, not discolored punctured or snagged (OSHA 1910.184)
No signs of heat damage (OSHA 1910.184)
Warning yarns visible if excessively warn (RED CORE) (OSHA 1910.184)
Label is Legible and Properly Rated for Work Being Performed (OSHA 1910.184)
Abnormal Wear Visible (OSHA 1910.184)
In Safe Working Condition (OSHA 1910.184)
Employees performed a load test prior to moving material in place.
Prior to lifting, a rigging plan was established in order to move materials into place.

Hazardous Chemicals and Container Labeling

HAZMAT/Chemicals/Spill Kits
Demonstrates how to Find Chemical MSDS and Information Available (HSE 4000.040)
Chemical Container Quantities Below MOT (HSE 4410.010)
Containers Labeled, Secured, Sealed and in Good Condition (HSE 4410.010)
Flammables in Safety Approved Cans (HSE 4410.010) (OSHA CFR 1910.106)
Spill Kits Available and Stocked (HSE 4440.020)

Ergonomics

Ergonomics (HSE 4100.020)
Employees demonstrate proper body mechanics, proper footing and body positioning when operating tools (OSHA 29 CFR 1926.20)
Employees maintain good grip when operating tools.
Employees recognize hot surfaces and keep hands away.
Employees Positioned Away From Moving Parts or Pinch Points. Employees keep hands away from pinch point areas while operating tools and equipment, while building regulator sets (as applicable), and when fitting or insulating pipe, (HSE 4100.020)
Employees utilize proper lifting techniques, does not bend or twist at the back, and lifts with legs. (OSHA 29 CFR 1926.20)
Employees use assisted lifting practices when lifting heavy equipment over 45 lbs. (Whacker and Generator for example)
Employees utilize worker rotation to reduce excessive exposure to vibration, noise, or any other ergonomic hazards, as required
Employees use Skid Steer or Excavator to move heavy equipment, if applicable

Recognition of Potential Hazards

Recognition of Hazards/Environment (HSE 4440.020)
Employees Can Identify Risks/ Hazards on Site (Pre-Job Briefing Prior to Work) (HSE 4100.020)
Employees maintain constant communication with one another at all times and communicate hazards effectively
Traffic/ Pedestrian Hazards (HSE 4100.020)
Structural Hazards (Floor, Steps, Porch) (HSE 4100.020)
Tripping/ Slipping/ Falling Hazards (HSE 4100.020)
Employees Recognize Low Clearances and Overhead and Power Line Hazards, and keep at least 10 ft. away (HSE 4100.020)
Poison (Ivy, Oak, Etc.) Plant Life Hazards (HSE 4100.020)
Ticks or Insects - Spray? (HSE 4100.020)
Stray Animals/ Dogs (HSE 4100.020)
Environmental Plan Being Followed (HSE 4100.020)

DOT Compliance and Securing Loads

DOT Compliance and Load Securement
360 walk around was conduced
Proper tie down was established
Vehicle has at least 6 flares or 3 flares and 3 triangles in cab.
Fire extinguisher on truck inspected and current
Fire extinguisher is properly supported and mounted in the cab
Proper manufactured ramps were used in order to load equipment
Employee has CDL available if the vehicle has a weight greater than 26,000 lbs. or a combination of weight that is greater than 26,000 lbs.
All chains and hooks are in good condition
All safety pins are in place
Springed hooks are not damaged

OQ Qualification and Overall Appearance

Appearance
ID Badge (Employees and Contractors)
Proper Dress and Attire for Job Task
OQ Cards available
DOT Medical Cards available for all drivers
CDL available if applicable

Task Specific Operations/JHA Evaluation

Shoveling and Raking Soil

Shoveling/raking
Employees properly inspect the shovel/rake and ensure that it is in operative condition (free of cracks and splintered edges, blade in good condition)
Employees use shovel/rake properly following manufacturers recommendations
Employees maintain proper body positioning when shoveling/raking
Employees maintain proper footing
Employee does not jump and stomp on shovel
Employees maintain good grip on shovels/rakes
Employees recognize buried utility lines and use shovel to dig around structures
Employees properly stores shovels/rakes placing the blade downward

Power Tool Usage

Power Tool Usage
Employees inspect power tool prior to usage
Employees follow manufacturers recommendations when operating and servicing equipment.
Employees choose correct tool for the job. If cutting, employees use correct blade, and ensures that saw-zaws are not being used to cut active steel gas lines.
Employees use tools that are intrinsically safe.
Employees ensure that all electrical components are not damaged. Cord is not damaged or frayed, and ground prong is in place.
Employees keep all guards and auxiliary handles on power tools.
While operating, employees maintain good grip.
Employees maintain adequate footing and body positioning when operating.
Employees keep hands away from point of operation while operating.
if cutting or drilling, employees inspect the cutting or drilling edge prior to use.
if binding occurs, employees stop, assess the situation, and corrects the issue.
While operating, employees maintain adequate body pressure on the tool.
Employees don proper PPE for the job. When cutting or drilling, safety glasses are worn at all times.

Hand Tool Usage

Hand Tool Useage
Employees inspect hand tools prior to usage. All tools in safe operative condition.
Employees use the correct tool for the job.
Handles are free of cracks and splintered edges.
Jaws on wrenches are not sprung.
Impact tools (chisels) are not mushroomed.
Screwdrivers are not used as impact tools.
Employees pull wrenches towards the body and does not push.
Employees maintain adequate body positioning and proper footing when operating.
Employees maintain good grip on tools wen operating.
Employees don correct PPE for the job.
Employees keep hands away from pinch point areas when operating.
Employees use caution when operating, keeping hands away from the point of operation.

Vac Truck Air Striking (blasting)

Air Striking Operations
Employees follow manufacture's recommendations when operating
Employees have Whip Check Safety Cords on all air hose connections
Employees maintain good grip on tool when operating
Employees maintain good body positioning and proper footing when operating
Employees wear proper PPE when operating. (Safety vest, hardhat, steel toed boots, ear plugs safety glasses)
Employees bleed all lines prior to disconnecting tool from air hose connections

Vac Truck Vacuum Hose Operation

Vacuum Hose Operations
Operator maintains good body positioning and footing when vacuuming
Operator avoids excessive bending and twisting of the back
Operator wears proper PPE when operating (Safety glasses, safety vest, hardhat, steel toed boots, ear plugs, and face shield as applicable)
If hose becomes clogged, operator assess the situation and properly unclogs the hose by striking the hose with a hammer. Operator uses caution when striking, and keeps hands away from line of fire.

Pogo and Whacker Operations

Pogo/Whacker Operations (Tamping coal patch and soil)
Employees inspect equipment prior to use.
Employees use proper equipment for the job. Pogo is recommended for coal patches, etc.
Employees wear proper PPE while operating. (Safety Vest, hardhat, steel toed boots, safety glasses, ear plugs, metatarsals)
If using the whacker, employees utilize assisted lifting techniques to carry machine.
Safety Whip Check Safety Cords are on all air hose connections.
Employees maintain control over the machine
Employees maintain good body positioning and adequate footing while operating.
Employees keep feet away from tamping baseplate.

Concrete Cutting

Concrete Saw Cutting
Employees inspect equipment prior to usage
Employees do not drop start the machine
Employees follow manufactures recommendations while using equipment, and have all guards on the machine
Employees use wet methods to reduce exposure to Silica Dust while operating machinery
Employees use proper PPE while using machine, including hardhat, ear plugs, dust masks, safety glasses, safety vest, and steel toed boots
Employees identify and react to hazardous situations while operating

Jackhammering

Jackhammering
Employees properly secure jackhammer to vehicle. Chains and locks are used.
Jackhammer chains and locks are inspected for securement on vehicle, if applicable.
Employees properly remove jackhammer from truck and move to desired position, maintaining good body positioning and using assisted lifting techniques.
Employees inspect jackhammer prior to use.
Operates ensure all Whip Check Safety Cords are on all air hose connections.
Operators use machinery according to manufacturers recommendations.
Operators ensure work area is marked and One Call was made.
Operators don proper PPE which include hardhat, safety glasses, high visibility vest, steel toed boots, and metatarsals.
Operator maintains adequate body positioning when operating jackhammer, keeping control over the machine.
Operators does not jackhammer when spotter is in an excavation, or when he/she is in a prone position to get struck by the point of operation of the machine.
Operators react to underground utilities.

Directional Drilling (mainline)

Directional Drilling
Employees demonstrated proper hauling of equipment to jobsite. all chains, spring hooks, in good condition. Proper tie down utilized, and Emergency brake cable used.
Employee safely moves drill off of trailer and into desired position, using spotters, maintaining proper footing, and maintaining 360 degree awareness.
Employee properly grounds the machine
Employee is OQ qualified to operate
Employee demonstrates proper methods to operate machine following the gas standards and manufactures recommendations.
Operators use outriggers while drilling
Drilling area is properly marked and One Call was made.
Operator reacts to underground utilities and does not perform drills if underground structures are within the drilling path.
Operator reacts to landscapes, achieves proper depth, and adjusts depth of the bore as needed.
Operator uses bore gel mix, and demonstrates proper procedures in order to fill bore gel tank with a mixture of water and gel.
All hydraulic hoses in good condition and bled prior to disconnection. Designated person utilized to operate valves.
Spotters are utilized in order to locate the drill at exact depth and location. Spotter demonstrates ability to read and understand electronic readout of the locator, and maintains communication with the drill operator.
Operators back ream as needed, demonstrate proper procedures when back reaming, and react to landscape as applicable.
Operators back ream no larger than 1.5 X the pipe diameter
Employees use weak link on pulls 50 ft. or greater
Employees install tracer wire on pipe. Use safe methods while installing.
Employees handle pipe and materials with caution and use assistive devices as needed
Employees pull pipe through bore hole to minimize pipe deflection and damage.
Spotters are used on pulls and communicate effectively with the drill operator (two way radio used)

Boring (with Pneumatic Piercing Tool/ Mole)

Pneumatic Piercing Tool
Properly mark and measure desired piercing length of hose with electrical tape
Employees inspect equipment prior to usage
Employees ensure correct lubrication is added to oiler
All Whip Check Safety Cords on all hair hose connections
Employees ensure all shut off valves are in operative condition
Employees inspect oiler and other components to ensure safe operative condition
Employees use spotters while operating to prevent potential damages and equipment malfunction
1 Designated employee operates valves
Employees follow manufacturers instructions for maintenance and operations
Employees use proper lifting techniques while moving the tool into desired location for drilling
Employees keep hands away from drilling edge and pinch point areas
Employees use caution when guiding the tool into the ground to start piercing operations
Employees maintain proper body positioning while guiding
Employees recognize and react to underground utilities
Employees properly reverse drill direction using 1 designated person
Employees bleed all valves prior to disconnected air hoses

Excavating and Backfilling Ditch

Excavator Operations
Proper hauling of equipment. Proper tie down methods, and all chains, spring hooks, and cables inspected
Operators load and unload equipment safely off of trailers. Spotters are used, and equipment is moved in a manner that reduces the risk for rollover. Operator avoids situations where center of gravity of machine exceeds the fulcrum point resulting in potential rollovers.
Operator is OQ qualified
Work area is properly marked and One call was made.
Fire extinguisher is present and UPWIND of the excavation.
Employees properly inspect the excavator prior to use and is in operative condition. Performs maintenance on machine as required.
Operator utilizes proper PPE while operating machine, and does NOT wear a safety vest or loose clothing while operating.
Operator unloads equipment off of the trailer and into desired position safely and effectively using designated spotters
Operator inspects work area and identifies and avoids unstable ground when operating to prevent rollover.
Operator maintains adequate communication with spotters at all times during operation, and is aware of blind spots.
Operator reacts to buried utility lines to prevent damages.
Hand tools are used to dig around buried utilities.
Operator demonstrates ability to operate machine effectively and in accordance with manufacturers recommendations.
Operator maintains safe distance away from overhead structures and power lines (minimum of 10 ft.)
Once work is complete, Operator backfills excavation with proper backfill material, and installs caution tape, and marker ball 6-12 inches fro the buried utility line.
After operation, Operator places boom on the ground, and places machine in a stable position.

Bobcat Skid Steer Operations

Skid Steer Operations
Machine properly tied down to trailer. All hooks, chains, and safety pins in place and in good condition.
Machine inspected prior to use and in operative condition. Maintenance of machine is performed as needed.
Operator is OQ qualified
Operator wears proper PPE and does NOT wear Safety Vest or loose clothing
Operator maintains 360 degree awareness when operating and is aware of any blind spots.
Spotters are used during operation
Skid Steer is used to haul heavy equipment to work area. Equipment is properly secured in bucket.
Proper methods of machine operation is utilized and operator follows manufacturer's recommendations.
Once work is complete, operator places bucket on the ground, puts the machine in park, and sets emergency brake.

Storing and Handling Gas Piping

Pipe Handling and Storage
Pipe handled with caution to prevent damages and pipe deflection
Assistive devices used to handle pipe as applicable
Employees demonstrate proper body positioning when handling pipe.
Pipe stored in a safe accessible location
Pipe does not pose tripping hazards
Pipe is properly chocked

Cutting Gas Pipelines

Pipe Cutting
Proper cutting methods are used.
Employees properly support pipe in a vice or clamp.
Employees use intrinsically safe tools and does not cut using a saw-zaw on an active gas line.
Employees use correct cutting tool for the job. Pipe cutters are used for best practice.
Safety glasses used at all times when cutting
Employees demonstrate safe use of tools when cutting.
The cutting tool is properly inspected and in operative condition.
Employees use caution while cutting and keeps hands away from the cutting edge and point of operation.
Employees demonstrate correct body positioning when cutting and maintain good grip on tools.
Correct saw-zaw blade was utilized if applicable, and is in operative condition.
If binding occurs, employees stop operation, assesses the situation, and takes proper corrective actions.

Carving Nipples and Threading Pipe

Nipple Carving
Operator is OQ qualified.
Pipe Vice is used and is in good operative condition.
Generator is GFCI protected or GFCI pigtails are used.
GFCI pigtails are tested and inspected prior to use. Tagged Out Of Service as required.
Minimal trip/fall hazards. Extension cords not draped in walk areas.
Extension cords are inspected and in operative condition. The machine is properly grounded and cords are not frayed and damaged.
All tools and equipment inspected prior to use and in operative condition
Operator maintains control over tools and machine while operating.
Operator uses proper lubrication while carving
Operator uses caution while operating machinery and recognizes and avoids pinch points and areas around the point of operation.
Operator follows manufacturers recommendations while using machinery and performs maintenance on machine as required.
Chains are used to strap pipe to vice.
Catch basins are used to catch metal shavings.

Flagging Operations

Flagging
Flaggers are OQ qualified through PennDOT guidelines
Flaggers properly set up the 5 area's of a work zone which include the advanced warning area, transition area, buffer area, work area, and termination area, in the correct order.
Flaggers maintain 360 degree awareness while setting signs and cones up, and anticipate and react to traffic patterns
Flaggers properly set up road work signs 500 ft. apart following PUB 213 and MUTCD guidelines.
Flaggers properly set up the tapper which incudes a minimum of 6 devices, or cones, and is at least 50 ft. in length.
Flaggers utilize proper equipment to direct traffic. Slow/Stop paddles are used for one or two lane traffic, meeting MUTCD guidelines, and Red Flags are used in intersections and emergencies ONLY.
Flaggers use arrow boards that meet MUTCD guidelines when applicable.
Flaggers demonstrate ability to direct traffic using the proper methods, and following PennDOT guidelines.
Flagger positioning is 40 ft. away from the tapper area.
Flaggers communicate effectively with one another to direct traffic with the use of a 2 way radio, and have no other duties.
Flaggers utilize proper PPE including hardhat, class 2 high visibility safety vest, and steel toed boots.
While directing traffic, flaggers maintain 360 degree awareness, but face on coming traffic at all times.
Flaggers have an escape route
Flaggers do not put slow/stop paddle in a cone for support.
Flaggers are equipped with air horns to alert workers of potential work zone encroachment.
Flaggers are not texting or on the phone while flagging.
Flaggers are relived for bathroom breaks periodically.
Flaggers are the first and last employees on the jobsite
When work is complete, flaggers remove all signs and cones, in the correct sequence.

Restoration

Topsoil and Restoration
All PPE worn including hardhats, safety vests, and boots.
Employees inspect tools and equipment prior to use.
All tools and equipment are in good operative condition.
Employees demonstrate ability to use tools and equipment correctly.
Wheels chocked
Employees properly use spotters when backing if applicable
Employees recognize correct and avoid potential hazards on the job
While shoveling from dump trucks, employees stay clear of line of fire, and are not positioned in a manner that exposes them to get hit with spoil.

Plant and Construction/Gas Compliance

Welding Steel and Cast Iron Pipe

Welding
Welding Certification Card (GS 1210.010)
Welding Voltage/ Amperage
Welding Machine Grounded- Gas Piping not Used as the Ground Unless Tight and No Arc Burns Result From Grounding (GS 1210.010)
Welding Cables Free of Splices Within 10' of Holder (HSE 4120.010)
UT Gauge Calibrated and Used to Take Pipe Wall Thickness (GS 1210.010)
Welding Shield Required (GS 1210.010)
Trench Clean and Dry (GS 1210.010)
Signs of External Undercut, Cracks, Weld Splatter, or Incomplete Fusion (GS 1210.010)
Followed Applicable Welding Procedures (GS 1210.010)

Fusing Gas Pipelines

Plastic Fusion
Butt Fusion
OQ Valid/Fusion Certification Card (GS 1301.010)
Employee Name/Date/Cool Time Written on Fusion
Properly Inspected, Protected, Prepared and Aligned Pipe Surfaces (GS 1302.010)
Equipment in Good Condition (GS 1316.010)
Verified Proper Heater Plate Temperature (400-450 Degrees F) (GS 1302.010)
Fusion Machine Operated Properly (GS 1302.010)
Employees use caution while fusing and keep hands away from heater plate
Employees keep iron in proper heater cover, and handle with care.
Employees allow for proper cooling time.
Inspected Joint for Quality; Removed if Unacceptable (GS 1302.010)
Electrofusion
OQ Valid/Fusion Certification Card (GS 1301.010)
Employee Name/Date/Cool Time Written on Fusion
Properly Inspected, Protected, Prepared and Aligned Pipe Surfaces (GS 1304.010)
Proper markings prior to scraping (GS 1304.010)
Scraping satisfactory (GS 1304.010)
Fitting positioned and clamped correctly (GS 1304.010)
Verified That the Control Box Functioned Properly (Prior to an During Fusion) (GS 1304.010)
Used proper extension cord (GS 1304.010)
Conditioned fittings and control box to worksite temperature (GS 1304.010)
Control box has correct connected fitting (GS 1304.010)
Employees out of excavation before starting the fusion process (GS 1304.010)
Allowed Joint to Cool for Specified Time Before Removing Clamp (GS 1304.010)
Inspected Joint for Quality; Removed if Unacceptable (GS 1304.010)
Socket Fusion
OQ Valid/Fusion Certification Card (GS 1301.010)
Employee Name/Date/Cool Time Written on Fusion
Properly Inspected, Protected, Prepared and Aligned Pipe Surfaces (GS 1308.010)
Properly Positioned Cold Ring Clamp (GS 1308.010)
Verified Proper Heater Plate Temperature (500 Degrees +/- 10 Degrees) (GS 1308.010)
Machine operated properly
Employees use caution when fusing and keep hands away from heater plate.
Employees keep iron in proper heater cover and handle with care.
Employees allow for proper cooling time.
Inspected Joint for Quality; Removed if Unacceptable (GS 1308.010)

Joining Gas Piping

Joining by Mechanical Fittings
Compression/ Bolted Type Fittings
OQ Valid (GS 1301.010)
Followed Manufactures Instructions (GS 1320.010)
Properly Inspected, Protected, Prepared and Aligned Pipe Surfaces (GS 1320.010)
Inspected Joint for Quality; Removed if Unacceptable (GS 1320.010)
Stab Style Fittings
OQ Valid (GS 1301.010)
Followed Manufactures Instructions (GS 1300.010 , GS 1320.010)
Properly Inspected, Protected, Prepared and Aligned Pipe Surfaces (GS 1300.010 , GS 1320.010)
Followed the Manufacturer's installation Instructions (GS 1300.010 , GS 1320.010)
Inspected Joint for Quality; Removed if Unacceptable (GS 1300.010 , GS 1320.010)

Meter/ Regulator Set Constructing

Install/Replace/Repair Meter & Regulator Sets
OQ Valid (CFR 192.805)
Checked meter set for stray voltage (GS 6500.100)
Installed Meter and Regulator Set to Minimize Anticipated Stress on Connecting Piping and Meter (192.357-A)
All tools inspected and in operative condition
Employees use the right tool for the job.
Employees use caution while building meter sets and fitting joints on pipe.
While building sets, employees keep hands away from pinch point areas.
Employees maintain good body position when building and have good grip on tools
Employees pull wrenches toward the body and does not push
Ensure that materials meet pressure rating standards (GS 3000.030)
Located regulator Vent Away From any Opening Into the Building (GS 6500.100)
Located Meter Set in a Position to Minimize Exposure to Hazards From Traffic (GS 6400.030)
Installed the Meter Set in an Easily Accessible Location (GS 6400.030)
Output pressure correct (GS 6500.100)
Meter set properly insulated (GS 6500.100)
Checked for Leakage (GS 6500.100)

Service Line Installation/Repair

Install/Replace/Repair Gas Service Lines
OQ Valid (CFR 192.805)
Valid one call?
Materials inspected (GS 3000.020)
Followed manufacturers installation instructions (GS 1300.010)
Installed Service Line at the Proper Depth on Undisturbed or well Compacted Soil (GS 3020.010)
Avoid excessive bending and pipe deflection (GS 3010.060)
Adequate Clearance From Other Underground Facilities (GS 3010.080)
Installed Service Line Piping in a Continuous Straight Line With Proper Valve or EFV (GS GS 3020.010)
Grounded Plastic Service Lines and Tools (as Applicable) Whenever Cutting or Squeezing-off Plastic Lines Containing Gas (GS 1770.010)
Tap fitting positioned properly (GS 3020.030)
Plastic pipe was not inserted in above ground casing except for company approved risers (GS 3010.060)
Installed warning tape in upper 6"-12" of trench (GS 3020.010)
Turned gas off at the meter valve or curb valve (GS 6500.130)
Installed Tracer Wire/ Warning Tape/ Electronic Marker Verifying Continuity (as Applicable) (GS 3010.050, GS 3010.060)
Followed boring procedures (GS 1100.050)

Corrosion Control

Apply & Monitoring Corrosion Control
OQ Valid (CFR 192.805)
External Condition
Installed an Anode When Required According to Gas Standards (GS 1714.020, 1460.010)
CGI taken prior to burning anode. Atmosphere is not in hazardous state prior to burning.
Employees use caution when burning anode onto pipe, and keeps hands away from hot surfaces.
Properly Cleaned Area on Piping to Ensure a Good Connection (GS 1420.580)
Installed Protective Coatings Following the Manufacturer's Instructions (GS 1420.580)
Test Station Installation
Thermite Welds Properly Placed (GS 1420.580)
Proper Box and or Cover (GS 1420.580)

Pipeline Tapping

Tapping Pipelines
OQ Valid (CFR 192.805)
Tie-in Plan Reviewed and Signed (GS 1680.010)
Tap Pipelines Under Pressure Using a Self-Tapping Tee
Proper Tapping Tool (OQ L1c) (GS 1680.010)
Replaced the Cap, Tightened According to the Manufacturer's Instructions (OQL1c) (GS 1680.010)
Tap Pipelines Under Pressure Using a Drilling Machine
Verified That the Equipment Being Used was Within the Proper Pressure Design Range (GS 1680.010)
Monitored Pressure as Applicable (GS1680.010)
Used Correct Tapping Speed (Manufactures Instructions) (GS 1680.010)
Depressurized Before Equipment Removal (Manufactures Instructions) (GS 1680.010)
Verified Coupon Retained (Manufactures Instructions) (GS 1680.010)
Stop Pipelines Under Pressure (1PSIG and Less) Using an Inflatable Bag/Diaphragm Stopper (GS 1680.010)
Followed the Equipment Manufacturer's Installation Instructions (GS 1680.010)
Visually Examined Equipment and Tested for Defects Prior to use (GS 1680.010)
Monitored Line and Bag Pressure (GS 1680.010)
Cleaned the Interior of the Pipe After Tapping and Before Inserting Bag into the Main (GS 1680.010)
"Double Bagged Line" (GS 1680.010)
Stop Pipelines Under Pressure Using a Plug Type Stopping Device (GS 1680.010)
Cleaned the Interior of the Pipe After Tapping and Before Inserting Stopper Into the Main (GS 1680.010)
Verified Proper Plug Position/Effectiveness (GS 1680.010)
Monitored Line Pressure (GS 1680.010)

Pipeline Purging

Purging Pipeline (GS 1690.010)
OQ Valid (CFR 192.805)
Capitol Design Job Orders had a Purging Plan Attached and Employee Followed the Plan (GS 1690.010)
Properly Installed and Grounded Purging Stack (GS 1690.010)
Provided Fire Extinguisher at Each Activated Vent Point (GS 1690.010)
Purged Mains/ Services Until a Sustained Reading of 95% Gas or 0% Gas as Applicable was Obtained (GS 1690.010)
Notified Dispatcher for Pressure for Pressure Control Issues; Involved Pressure Control Personal When Adjustments in the System or Monitoring at Regulator Stations was Required (GS 1690.010)
Abandoned Piping Sealed Upon Completion of Purging (GS 1690.010)

Locating Underground Facilities

Locate and Mark Underground Facilities (811) (GS 1100.010)
OQ Valid (CFR 192.805)
Ability to read and interpret pipeline maps and other records
Valid One Call (811) Excavation Area Clearly Marked (GS 1100.010 State Specific)
One Call Ticket Number (811)
Checked equipment for proper operation
Followed Established Locating Practices and the Manufacturer's Operating Instructions (GS 1100.010)
Demonstrated the Ability to use Pipeline Locating Equipment to Find Buried Metal or Plastic Piping (GS 1100.010)
Recognized locate request time frame
Recognized and Reacted to Unmarked Facilities (GS 1100.010)
Recognized whether temporary or permanent markings were required
Locate all mains and services within the locate ticket boundaries
Documented locate results
Verified that all Line Markers Examined in the Field were Properly Identified and Included Emergency Telephone Number (GS 1100.010)
Selected appropriate marking materials

Pressure Testing Pipelines

Pressure Testing Pipelines
OQ Valid (GS 1500.010) (CFR 192.805)
Backfilled Ditch (if Practical) (GS 1500.010)
Determined the Safety Procedures to be Used Prior to Testing (GS 1500.010)
Used an Appropriate test Gauge and Fitting(s) (GS 1500.010)
Test tree in correct configuration
All Whip Check Safety Cords on all air hose connections
Gauges Calibrated (as Applicable) (GS 1500.010)
Tested Mains and Services at the Appropriate Pressure and Duration (GS 1500.010)
Documented Test Results (GS 1500.010)
Bled all valves, and shut air compressor off prior to disconnecting air hoses.

Gas Mainline Installation/ Repair

Install/Replace Main Lines
OQ Valid (CFR 192.805)
Pipe Protected from damage: Properly Handled, Stored and Inspected Prior to Installation (GS 3000.020, .010)
Located all Underground Facilities Prior to Excavating/Boring (GS 1100.050)
Installed Pipe With the Proper Cover (GS 3010.090)
Followed Proper Excavation Methods (OQ M8)
Maintained Proper Clearance with Other Underground Structures (GS 3010.080)
Pipe Properly Installed (GS 3010.050)
Trench Bottom Properly Prepared (Smooth Surface, Padded as Required) (GS 3010.050)
Bore Method
Proper Boring Methods Used (GS1100.050)
Located all Underground Facilities Prior to Excavating/Boring (GS 1100.050)
Used a "Weak Link" on Pulls 100' or Greater (GS 3010.060)
Pipe Examined for Damage (GS 3010.100)
Casing
Properly Inserted Main in Casing (GS 3010.070)
At Least 5' of Leading End of Carrier Pipe Inspected After Insertion (GS 3010.060)
Plastic Pipe Continuously Supported Where it Enters and Leaves the Casing (GS 3010.070)
End Seals Insulated on Steel Carrier Pipe Following the Manufacturer's Installation Instructions (GS 3010.070)
Insertion
Maintained Approved "Pipe Cover" Requirements (GS 3010.060)
Leading End of Carrier Pipe Closed Prior to Insertion (GS 3010.060)
At Least 5' of Leading End of Carrier Pipe Inspected After Insertion (GS 3010.060)
Pipe Continuously Supported Where it Enters and Leaves the Casing (GS 3060.060)
Steel Pipe Bending
Used Proper Bending Methods (GS 3010.030)
Followed the Maximum Deflection Guidelines (Per Procedure) (GS 3010.030)
Recognized That Wrinkle Bends are Prohibited (GS 3010.030)
Properly Placed Pipe Seam Prior to Bending (GS 3010.030)
Tracer Wire Installation
Made Accessible for Above-Ground Connection (Free Ends Coated) (GS 3010.060)
Properly Placed Line Markers (GS 1720.010)
Temporary Bonding
Used Correct Size Bonding Cable #8 Minimum (GS 1770.010)
Properly Grounded Squeeze-Off Tools With a #12 AWG Wire (GS 1680.040)
Backfilling
Excavated Rocks Removed or Proper Padding Used (GS 3010.050)
Proper Compaction was Used (GS 3010.050)
Excavators Were Not Used For Tamping (GS 3010.050)
Anchors and Supports
Short Sections Viewed for Obstruction, or Longer Sections Pigged (GS 3000.500)
Pipe Bends Anchored as Directed (GS 3000.500)

Repair and Protecting Cast Iron Pipe

Repair/Protect Cast Iron Pipe
OQ Valid (CFR 192.805)
Recognized That Any Bell and Spigot Joint That Has Been Exposed Must be Sealed (GS 1780.010)
Properly Supported Exposed Cast Iron Piping (GS 1780.010)
Insulated Steel Pipe From Cast Iron Pipe (GS 1420.530)

Abandon/Deactivate Gas Piping

Abandon/Deactivate Gas Piping
OQ Valid (CFR 192.805)
Abandon/Deactivate Mains and Service Lines
Disconnected All Source of Gas Supply as Close to That Supply Source as Practical (GS 1740.010)
Used Static Control Measures When Working on Plastic Pipe (GS 1770.010)
Removed Line Markers That Were No Longer Needed (GS 1740.010)
Discontinue Service to the Customer/New Service Line Not in Use (GS 1740.010)
Insured the Flow of Gas had Been Stopped (GS 1740.010)
Removed the Meter and Installed Plugs in the Inlet and Outlet Swivels, or Discontinued Service by Physically Disconnecting the Customers Piping From the Gas Supply and Sealing the Open Pipe Ends (GS 1740.010)
Sealed the Outlet Piping of the Meter Valve and the Inlet Piping of the House Line When the Meter was Removed (GS 1740.010)

Final Page

Further Action Required
General comments
Number of Unsafe acts observed
Number of Employees performing unsafe acts:
Overall Safety Awareness On Site
Safety Coordinator Signature

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Work Zone

Housekeeping

PPE

Fire Protection/ First Aid

Excavation

Equipment and Tools

Electrical and Generators

Vehicles

Material Rigging/ Slings and Chains

Hazardous Chemicals and Container Labeling

Ergonomics

Recognition of Potential Hazards

DOT Compliance and Securing Loads

OQ Qualification and Overall Appearance

Shoveling and Raking Soil

Power Tool Usage

Hand Tool Usage

Vac Truck Air Striking (blasting)

Vac Truck Vacuum Hose Operation

Pogo and Whacker Operations

Concrete Cutting

Jackhammering

Directional Drilling (mainline)

Boring (with Pneumatic Piercing Tool/ Mole)

Excavating and Backfilling Ditch

Bobcat Skid Steer Operations

Storing and Handling Gas Piping

Cutting Gas Pipelines

Carving Nipples and Threading Pipe

Flagging Operations

Restoration

Welding Steel and Cast Iron Pipe

Fusing Gas Pipelines

Joining Gas Piping

Meter/ Regulator Set Constructing

Service Line Installation/Repair

Corrosion Control

Pipeline Tapping

Pipeline Purging

Locating Underground Facilities

Pressure Testing Pipelines

Gas Mainline Installation/ Repair

Repair and Protecting Cast Iron Pipe

Abandon/Deactivate Gas Piping

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