MPW Wet / Dry Vacuum Checklist

• Client / Customer Site

• Conducted on

  Date

• Prepared by

• Personnel On-site

Wet / Dry Vacuum Checklist

• Is the vacuum area properly barricaded and posted with signs?

  Yes

  No

  N/A

• Have all the fittings, clamps, connections, setups and other equipment been inspected for good working condition?

  Yes

  No

  N/A

• Have the bolts on the hard pipe been inspected to ensure that they are intact? (look for telltale dust)

  Yes

  No

  N/A

• Are all the cam-lock fittings "dogs" secured?

  Yes

  No

  N/A

• Are the vertical runs of pipe / hose properly secured and supported from falling?

  Yes

  No

  N/A

• Are the vacuum pipe / hose routed around doorways and walkways whenever possible?

  Yes

  No

  N/A

• Is vacuum pipe / hose that poses a trip hazard marked with "CAUTION" tape and signage posted?

  Yes

  No

  N/A

• Has all moving equipment and other hazardous sources of energy been locked out, LO/TO? (hydraulic, mechanical, steam, electric, pneumatic,chemical, hazardous materials)

  Yes

  No

  N/A

• Is the work area a confined space?

  Yes

  No

  N/A

• Has a MPW Confined Space Permit been completed?

  Yes

  No

  N/A

• What safety guards are required for the job? (check all that apply)

  Yes

  No

  N/A

• Stationary Hose (wet vac)

• Safety Tee

• Remote Handle

• Remote Stick

• Pendant Valve

• Other (specify)

• Is vacuum hose bonded to the truck? (combustible dust)

  Yes

  No

  N/A

• Is vacuum truck grounded to permanent bare metal structure / ground rod to reduce static charge?

  Yes

  No

  N/A

• What Personal Protective Equipment (PPE) will be used for this job? (check all that apply)

  Yes

  No

  N/A

• Safety Glasses with side shields

• Goggles

• Face Shield

• Hard Hat

• Rain Suit (yellow)

• Chemical Suit (green)

• Chemical Gloves

• Steel Toe Work Boots

• Hearing Protection

• Respirator

• Chemical Overboots

• Full Body Coverals

• Leather Gloves

• Flame Retardant Clothing

• Tyvek Suit

• Other (specify)

• Have Emergency Showers and Eye Wash Stations been identified and checked for operability?

  Yes

  No

  N/A

• Have in-plant emergency phone numbers been identified?

  Yes

  No

  N/A

• Have on-site first aid and off-site emergency medical facilities been identified?

  Yes

  No

  N/A

• Have emergency exits and evacuation routes been identified?

  Yes

  No

  N/A

• Have emergency notification procedures been established?

  Yes

  No

  N/A

• Has the crew been informed of the emergency procedures?

  Yes

  No

  N/A

• Is the truck operator stationed at the controls? (operator their only duty)

  Yes

  No

  N/A

• What method of communication between the truck operator and hose operator is being used? (check all that apply)

  Yes

  No

  N/A

• Voice

• Visual

• Radio

• Are all Vacuum truck operators properly trained? (MPW or other acceptable source)

  Yes

  No

  N/A

• Is lighting in the work and support areas adequate?

  Yes

  No

  N/A

• Are footing conditions firm?

  Yes

  No

  N/A

• Is the Safety Tee accessible and within easy reach of the technicians operating the end of the vacuum hose?

  Yes

  No

  N/A

• Have MSDS's or SDS's for the hazardous materials in the work area been reviewed with the crew?

  Yes

  No

  N/A

• Has a Job safety Analysis (JSA) or Work Task Safety Requirements (WTSR) been prepared for this work?

  Yes

  No

  N/A

• Has the JSA or WTSR been reviewed with the crew?

  Yes

  No

  N/A

• Have the contents of this checklist been reviewed with the crew?

  Yes

  No

  N/A

• Is a variance required for any deviation from safety requirements?

  Yes

  No

  N/A

• Date: Time:

  Date

• Supervisor's Signature:

  Sign