New Site HSE Assessment

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Training Requirements and Documentation

• Is RTC training required?

  Yes

  No

  N/A

• Is OSHA 10/30 training required?

  Yes

  No

  N/A

• How will STARCON Orientation be administered?

• Is First Aid or CPR training required?

  Yes

  No

  N/A

• Will respiratory protection be a project/site requirement?

  Yes

  No

  N/A

• Does the client prefer a brand or type of respirator?

  Yes

  No

  N/A

• Does job scope include crane or rigging activity?

  Yes

  No

  N/A

• Are there special client, local or state requirements regarding cranes or rigging qualifications?

  Yes

  No

  N/A

• Will the project scope require the employment of scaffold builders?

  Yes

  No

  N/A

• Has a fall protection plan been developed?

  Yes

  No

  N/A

• Is there other special requirements such as lead or asbestos for the project/site job scope?

  Yes

  No

  N/A

• Are there chemicals or processes present that require special medical surveillance?

  Yes

  No

  N/A

• Will equipment such as aerial and forklifts be purchased or leased?

  Purchased

  Leased

  Client Provided

  Not Applicable

• Fork Lift Make and Model

• Aerial Lift Make and Model

• Crane Make and Model

• List any other specialized equipment needed to execute job scope.

• Are there non-routine EPA, OSHA, client, local or federal laws or regulations applicable to this project/site.

  Yes

  No

  N/A

Safety Equipment

• Are local vendors available to supply safety supplies? If yes, list company name and contact information.

  Yes

  No

  N/A

• Is there suitable space to maintain a on-site inventory of safety supplies?

  Yes

  No

  N/A

• Are their contract specifications for safety consumables (I.e. specific type, brand, or cost figures)?

  Yes

  No

  N/A

• What type of eye protection is required for the project/site work scope?

• What type of hand protection is required for the project/site work scope?

• What type of respiratory protection is required for the project/site work scope?

• Are suitable facilities available to clean personal protection equipment?

  Yes

  No

  N/A

• Will a Team Member need to be qualified to clean respirators?

  Yes

  No

  N/A

• Is Fire Retardant Clothing required?

  Yes

  No

  N/A

• Will uniforms be furnished for the project/site?

  Yes

  No

  N/A

• Is atmospheric monitoring equipment required to execute the project/site work scope?

  Yes

  No

  N/A

• What type of hearing protection is required?

• What type of fall protection is required?

• Has a list of required fall protection equipment been compiled and a request sent to Logistic's?

  Yes

  No

  N/A

• Are fire extinguishers required for the project/site work scope?

  Yes

  No

  N/A

• If yes, has type, size, quantity and a suitable vendor for inspection and refilling been identified?

  Yes

  No

  N/A

• What LOTO supplies are necessary for the project?

• Will a scaffold tagging system, and tags, be provided by the client?

  Yes

  No

  N/A

• Will a barricade tagging system, and tags, be provided by the client?

  Yes

  No

  N/A

• Are tool holders required for project/site work scope?

  Yes

  No

  N/A

On-Site Material's

• Is access to client Internet available?

  Yes

  No

  N/A

• Has a written copy of the client's Emergency Response Plan been received?

  Yes

  No

  N/A

• Are there specific area hazard warning systems (I.e color coding of caustics/acids, etc.)?

  Yes

  No

  N/A

• Have plot plans for the site/project been received?

  Yes

  No

  N/A

• Do plot plans include the location of safety showers and eye wash stations?

  Yes

  No

  N/A

• Has a facility organization chart been received?

  Yes

  No

  N/A

• Has a facility phone list been received?

  Yes

  No

  N/A

• Have plant radio channel list been received?

  Yes

  No

  N/A

• Are client provided MSDS's available for Team Member access?

  Yes

  No

  N/A

• Has a client safety policy and procedure manual been received?

  Yes

  No

  N/A

• Has a client PSM manual been received?

  Yes

  No

  N/A

• Does the client have a process for preventative work orders that requires contractor involvement?

  Yes

  No

  N/A

• Has a copy of the client's Hazardous Waste Disposal Plan been received?

  Yes

  No

  N/A

• Has a copy of the clients EPA Risk Management Plan been received?

  Yes

  No

  N/A

• Does the client have specific material acquisition procedures?

  Yes

  No

  N/A

• Will access to the clients work order system be necessary to successfully complete project/site scope?

  Yes

  No

  N/A

• Has a copy of the clients Title 5 Air Permit been received?

  Yes

  No

  N/A

On-Site Facilities

• Will a janitorial service be provided?

  Yes

  No

  N/A

• Are First Aid Facilities provided?

  Yes

  No

  N/A

• Are adequate lunch/break areas provided?

  Yes

  No

  N/A

• Are food vending machines available?

  Yes

  No

  N/A

• Is there a cafeteria available?

  Yes

  No

  N/A

• Is there a OT meal program?

  Yes

  No

  N/A

• Are adequate restroom facilities available for male and female usage?

  Yes

  No

  N/A

• Are change facilities available for contractor use?

  Yes

  No

  N/A

• Are decontamination facilities available and adequate?

  Yes

  No

  N/A

• Is there a suitable place to provide on site training and safety meetings?

  Yes

  No

  N/A

• Is space available for a STARCON bulletin board and required governmental postings?

  Yes

  No

  N/A

• Is there suitable office space to lodge personnel?

  Yes

  No

  N/A

• Will office equipment (I.e. chairs, desk, etc.) be provided by the client?

  Yes

  No

  N/A

Site Forms

• Does the client require a specific HSE audit format?

  Yes

  No

  N/A

• Does the client require a specific safety report form?

  Yes

  No

  N/A

• Have sample work order forms been received?

  Yes

  No

  N/A

• Have sample LOTO, Hot Work, Confined Space Entry and Safe Work Permit forms been received?

  Yes

  No

  N/A

• Does the client require specific documentation for safety meeting sign in or training?

  Yes

  No

  N/A

• Does the client use a Root Cause Analysis process?

  Yes

  No

  N/A

STARCON Material

• Is a current HR manual on site?

  Yes

  No

  N/A

• Is a current QA manual on site?

  Yes

  No

  N/A

• Is a current IIPP manual on site?

  Yes

  No

  N/A

• Are current OSHA regulations available?

  Yes

  No

  N/A

• Are JSA and SLA cards available?

  Yes

  No

  N/A

• Is STARCON and client orientation material available on site?

  Yes

  No

  N/A

• Is safety meeting material on site?

  Yes

  No

  N/A

Questions to Ask

• What is the facility recordable incident rate?

• Are dedicated utility systems available and do they require the use of special hoses or fittings?

  Yes

  No

  N/A

• What type of electrical connections are required?

  Yes

  No

  N/A

• Yes

  No

  N/A