NADC Safety Inspection - GFS Texas

GFS Texas Job-Site Safety Inspection

• Audit Title

• SAFETY INSPECTION

• Job Number / Name

• Location
  Address

• Conducted on

  Date

• Conducted by

• Document No.

• How many field employees are on the the job-site?

• How many crews are running on the job-site?

Job-Site Documents

• Has a JHA been filled out for the day?

  Yes

  No

  N/A

• Ask some employees random question about the JHA (EX: What is one of the hazards associated with "hanging pipe"?)

• Can field employees answer questions about JSA?

  Yes

  No

  N/A

• Is there a MSDS Book on the job-site?

  Yes

  No

  N/A

• Is the MSDS current and have all job site chemicals listed on it?

  Yes

  No

  N/A

• Do the employees know where MSDS is located?

  Yes

  No

  N/A

• Is there a Company Safety Manual on the job-site?

  Yes

  No

  N/A

• Do the employees know of the company safety manual and where it is located?

  Yes

  No

  N/A

• Is there a ToolBox Talk Booklet on the job-site?

  Yes

  No

  N/A

• Has it been filled out and up to date?

  Yes

  No

  N/A

• Is there an Emergency Contact list?

  Yes

  No

  N/A

• Is the emergency contact list easy to get to?

  Yes

  No

  N/A

• Do all employees know where the emergency contact list is?

  Yes

  No

  N/A

• Does the foremen know the location of the nearest hospital?

  Yes

  No

  N/A

• Do the employees know the location of the nearest hospital?

  Yes

  No

  N/A

• Do the employees know about Stop Work Authority (SWA) Program?

  Yes

  No

  N/A

• Did the user perform a inspection of fall arrest system prior to use?

  Safe

  At Risk

  N/A

• Can they explain how the Stop Work Authority (SWA) program works?

  Yes

  No

  N/A

PPE (Personal Protective Equipment)

• Are all employees wearing safety glasses?

  Safe

  At Risk

  N/A

• Are all employees wearing hard hats?

  Safe

  At Risk

  N/A

• Are all employees wearing (safety toe or steel toe) boots?

  Safe

  At Risk

  N/A

• Are all employees wearing safety vest?

  Safe

  At Risk

  N/A

• All employees are wearing proper gloves while working

  Safe

  At Risk

  N/A

• Are all employees wearing the proper clothing for work depends on weather at minimum long pants (no sweat pants or athletic pants) and a shirt with at least 4" sleeves?

  Safe

  At Risk

  N/A

• If weather is cold are employees wearing appropriate external wear (coat or jacket)?

  Safe

  At Risk

  N/A

• If a tool or equipment requires additional PPE (Face Shield, Welding helmet, etc..) is the employee wearing the required PPE?

  Safe

  At Risk

  N/A

• The number of employees on the job-site

• The number of employees that failed to be wearing proper PPE

• The number of works having to be sent home

• Additional comments

• Additional Pictures

  Media

Scissor Lifts

• Has the operator completed scissor lift inspection form?

  Safe

  At Risk

  N/A

• Is the safety chain on scissor lift in place and being used properly?

  Safe

  At Risk

  N/A

• Operator tied off to scissor lifts?

  Safe

  At Risk

  N/A

• Does the operator have a valid license to operate scissor lifts

  Yes

  No

  N/A

• Does operator have license on person?

  Yes

  No

  N/A

• Is the operator staying within the confines of the scissor lift? (Not climbing the hand rails)

  Safe

  At Risk

  N/A

• Is the operator using the scissor lift in a matter that the manufacturer intended?

  Safe

  At Risk

  N/A

• The number of scissor lifts on the job-site

• The number of scissor lifts with safety issues

• The number of scissor lifts that had to be removed from service

• Additional comments

• Additional Pictures

  Media

Fall Arrest System

• Did the user perform a inspection of fall arrest system prior to use?

  Safe

  At Risk

  N/A

• Is the body harness being worn properly?

  Safe

  At Risk

  N/A

• Does the fall arrest system have any damage?

  Safe

  At Risk

  N/A

• Does the fall arrest system have any third party writing on the webbing?

  Safe

  At Risk

  N/A

• Are all labels clear and visible on fall protection equation?

  Safe

  At Risk

  N/A

• Has the inspection label on body harness, lanyard been filled out?

  Safe

  At Risk

  N/A

• Is the user tied off to a proper anchor point?

  Safe

  At Risk

  N/A

• Will the fall arrest system that is in place prevent the user from hitting the floor

  Safe

  At Risk

  N/A

• How many fall arrest system are being used?

• How many fall arrest system have problems or issues?

• How many fall arrest systems had to be removed from service

• Additional Comments

• Additional Pictures

  Media

Forklifts

• Does the forklift pass a spot inspection

  Safe

  At Risk

  N/A

• Did the operator perform inspection prior to use?

  Safe

  At Risk

  N/A

• Is the seatbelt being used?

  Safe

  At Risk

  N/A

• Does the operator have a license to operate the forklift

  Safe

  At Risk

  N/A

• Does the operator have license on their person?

  Safe

  At Risk

  N/A

• Is the load secure and unable to fall off forks?

  Safe

  At Risk

  N/A

• If the operator view is obstructed, does the operator have a flagger directing him?

  Safe

  At Risk

  N/A

• Is the operator following all the manufacturer's rules and operation guidelines?

  Safe

  At Risk

  N/A

• Number of forklifts on the job-site

• Number of forklifts that had issues

• Additional Comments

• Additional pictures

  Media

Ladders

• Did the user perform an inspection prior to use?

  Safe

  At Risk

  N/A

• Does ladder pass inspection?

  Safe

  At Risk

  N/A

• Does the ladder have an ID number?

  Yes

  No

  N/A

• Are labels on the ladder clear and visible?

  Safe

  At Risk

  N/A

• Is the user using the ladder as the manufacturer intended it to be used?

  Safe

  At Risk

  N/A

• Number of ladders on the job site?

• Number of ladder with issues

• Number of ladders that had to be removed from service

• Additional Comments

• Additional Picture

  Media

Hand / Power Tools

• Are hand tools in good working condition?

  Safe

  At Risk

  N/A

• Did the operator inspect the hand tool(s)?

  Safe

  At Risk

  N/A

• Are the hand tools used in the manner the manufacturer intended them to be used

  Safe

  At Risk

  N/A

• Are any cheaters being used

  Safe

  At Risk

  N/A

• Are the power tools is good working condition

  Safe

  At Risk

  N/A

• Does the power cord have any damage

  Safe

  At Risk

  N/A

• Are all manufacturer guards in place

  Safe

  At Risk

  N/A

• Was the power tool inspected prior to use

  Safe

  At Risk

  N/A

• Has the electrical cord inspected prior to use

  Safe

  At Risk

  N/A

• Are the power tools being used in a manner the manufacturer intended them to be used

  Safe

  At Risk

  N/A

• The number of tools that are damaged

• The number of tools missing guard

• The number of tools that were not used in the correct manner

• The number of tools that had to removed from service

• Additional Comments

• Additional Pictures

  Media

Electrical cords

• Have all extension cords been inspected?

  Safe

  At Risk

  N/A

• Are all electrical cord free from damage

  Safe

  At Risk

  N/A

• Are there any missing prongs on the electrical cords

  Safe

  At Risk

  N/A

• Are all the electrical cords of the proper gauge size

  Safe

  At Risk

  N/A

• Are GFCI in place and working properly

  Safe

  At Risk

  N/A

• Are all the electrical cords out of the path of traffic as much as possible

  Safe

  At Risk

  N/A

• The number of electrical cords that had to be removed from service

• Additional Comments

• Additional Pictures

  Media

Lock-out/Tag-out

• Is the a Lock-out/Tag-out (LOTO) being used?

LOTO

• LOTO is being used in Zone

• What state is the system in?

  Energized

  Deenergized

• Are sign in place to warn people of the LOTO

  Yes

  No

  N/A

• Is the system LOTO properly

  Yes

  No

  N/A

• Who has a lock on the system?

Hot Work Permit

• Is there a Hot Work Permit (HWP) in use?

HWP

• Hot work is being performed in what zone?

• What kind of Hot Work task is being performed?

• Does (Holder) know of the Hot Work

  Yes

  No

  N/A

• Has the Hot Work Permit been filled out properly

  Yes

  No

  N/A

• Does it show a valid day of work

  Yes

  No

  N/A

• Are all safe work practices associated with Hot Work Permits being performed? ( Check below all that apply)

• Trained Fire Watch

• Emergency Action Plan

• Notification of all control rooms with fire and gas detection systems in service?

Fire extinguishers

• Are the fire extinguisher full?

  Yes

  No

  N/A

• Do the fire extinguisher have proper tags?

  Yes

  No

  N/A

• Is the fire extinguisher in good condition?

  Yes

  No

  N/A

• How many fire extinguisher were inspected?

• How many fire extinguisher has to be removed from service

• Picture of fire extinguishers

  Media

Emergency Plan / Weather Condition

• Do employees know the mustard point location

  Safe

  At Risk

  N/A

• Do employees know where to go during tornados

  Safe

  At Risk

  N/A

• (Summer time) Are employees drinking plenty of water

  Safe

  At Risk

  N/A

• (Summer time) Are employees taking break to prevent heat illness

  Safe

  At Risk

  N/A

• Do employees know how to sign of heat illness and how to treat it

  Safe

  At Risk

  N/A

• (Winter time) Are employees wearing proper clothes and staying warm

  Safe

  At Risk

  N/A

General

• Work areas are clean and free of debris

  Safe

  At Risk

  N/A

• Pipe is stacked in a way to prevent a trip hazard

  Safe

  At Risk

  N/A

• All containers are labeled as per HAZCOM requirements

  Safe

  At Risk

  N/A

• All containers are properly stored as per OHSA

  Safe

  At Risk

  N/A

• All holes are covered properly

  Safe

  At Risk

  N/A

Overview

• Comments

• Corrective Actions

• Areas or people that succeed at safety

• Areas that need work or attention

• Sketch of Hazardous Situation

  Drawing

• Overall assessment of the job-site

  Safe

  At Risk

  N/A

• Additional pictures

  Media

• Safety Inspector

  Sign

• Sign below to indicate that the findings of this safety inspection have been reviewed with you by the safety inspector and all question, concerns and comment have been address

• Job-Site Formen

  Sign

• Job-Site Foremen Additional comments