Information

  • Project

  • Quarter

  • Contract Number

  • Contractor

  • Location
  • Attendees

  • Additional Attendees

  • Conducted on

  • Prepared by

  • Project Description

1.0 Air Quality

  • Are dust control methods bring used, such as misting systems, dust boss, and ventilation to minimize dust being generated?

  • Is equipment >50 hp fitted with a DPF or other emission control device, or use a tier4 engine?

  • Are Camp meters in place upwind and downwind of where the work is happening?

  • Are all pieces of equipment inventoried with a MTACC sticker?

2.0 Noise and Vibration

  • Are noise readings being taken for all pieces of equipment?

  • Are noise blankets, mufflers being used in loud areas?

  • Are backup alarms community sensitive?

3.0 Stormwater/ Erosion and Sediment Control/ Dewatering

  • Are all equipment washing operations performed in a manner so as to minimize any adverse impact on storm water catchbasins?

  • Are access streets free of soil carryover or sediment runoff?

  • Are all catch basins protected with filter fabric or other device? Are the inserts being maintained?<br>

  • Are catchbasins adjacent to chemical and waste storage areas free of signs of contaminated runoff?

  • Is ground water being collected and managed with a NYC deposit permit? <br>

  • Are daily flows and pH being recorded?

  • Are stockpiles covered to minimize Sediment from leaving the work site?

4.0 Chemical Product and Waste Management

  • Are chemical and waste areas kept segregated and appropriately labeled?

  • Are paint and solvent containers stored in fire safety cabinets

  • Are product containers completely emptied (<1” product left) before discarding as trash?

  • Are mobile oil/diesel containers provided with containment and labeled with product name and container capacity? Is secondary containment free of accumulated product?

  • Are spill/drip pans used under equipment such as cranes and pipe threaders?

  • Are raw materials stored on pallets and open materials stored on spill pallets?

  • Are all containers labeled with contents and waste drums/containers labeled properly?

  • Are roll off containers covered at the end of the shift?

  • Is used oil being generated?

  • Is the storage tank registered with the DEC and comply with DEC PBS requirements?

  • Is used oil stored in drums?

  • Is the oil drum in secondary containment?

5.0 Spill Prevention and Response

  • Are all stationary product tanks registered with DEC?

  • If yes, are the registration accurate and current. Do the tanks comply with applicable DEC requirements (label, color code, containment, gauge)?

  • Are spill kits available and accessible? Are spill kits at chemical/waste storage areas inspected weekly and replenished?

6.0 General Site Conditions

  • Is housekeeping being performed and site generally clean?

  • Is vector control in place?

Conclusion and auditor's comments

  • Are boxes being labeled and maintained?

  • Date of audit completed

  • Signature of auditor

  • Date of auditor's signature

  • Signature of auditee

  • Date of auditee's signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.