NGD Capital Construction (V 1.6)

Required Training Completed

OQ Valid

Company Crew Involved?

Work Zone Properly Marked/ Posted (MUTCD Guidelines, HSE 4100.020)

Traffic Control Adequate for Work Site (HSE 4100.020)

Workers Protected by Cones, Barricades, Etc... (HSE 4100.040)

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)

Proper PPE Attire for Task or Site (HSE 4200.050, .040, .030, .020)

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 Extinguisher Inspection Tag Complete and Current (HSE 4000.082)

Fire Extinguisher Positioned Properly (HSE 4000.082)

First Aid Kit Complete, Inspected and Sanitary (HSE 4200.020)

Excavation Protected by Cones, Barricades, Etc... (HSE 4100.040)

Proper Techniques Used While Excavating to Prevent Potential Damage (GS 1100.040 MA) (OSHA 1926.651 A)

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)

Site Inspected for Changing Conditions (OSHA) (HSE 4100.010) (HSE 4100.040)

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)

Gauges, Instruments and Equipment Calibrated and Current (GS 1754.010)

Guards on all Portable Tools (HSE 4100.050)

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 Cords in Good Condition (Cuts, Damage, Splice, Grounding Pin) (OSHA 1910.334)

Electrical Tools Double Insulated and Grounded, Checked for Continuity (HSE 4100.050, OSHA 1910.334)

Outlets Free of Cracks/ Breaks (HSE 4100.050, OSHA 1926.404)

GFCI'S Checked, Tested and Used on all Power Supplies (HSE 4100.050)

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)

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)

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)

Employees Can Identify Risks/ Hazards on Site (Pre-Job Briefing Prior to Work) (HSE 4100.020)

Employees Positioned Away From Moving Parts or Pinch Points (HSE 4100.020)

Tripping/ Slipping/ Falling Hazards (HSE 4100.020)

Traffic/ Pedestrian Hazards (HSE 4100.020)

Structural Hazards (Floor, Steps, Porch) (HSE 4100.020)

Low Clearance/ Over Head Hazards (HSE 4100.020)

Exposed, Low Hanging Electrical Hazards (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)

ID Badge (Employees and Contractors)

Uniform

Welding Certification Card (GS 1210.010)

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)

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)

Inspected Joint for Quality; Removed if Unacceptable (GS 1302.010)

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)

Verified That the Control Box Functioned Properly (Prior to an During Fusion) (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)

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)

Inspected Joint for Quality; Removed if Unacceptable (GS 1308.010)

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)

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)

OQ Valid (CFR 192.805)

Installed Meter and Regulator Set to Minimize Anticipated Stress on Connecting Piping and Meter (192.357-A)

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)

Checked for Leakage (GS 6500.100)

OQ Valid (CFR 192.805)

Installed Service Line at the Proper Depth on Undisturbed or well Compacted Soil (GS 3020.010)

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)

Installed Tracer Wire/ Warning Tape/ Electronic Marker Verifying Continuity (as Applicable) (GS 3010.050, GS 3010.060)

OQ Valid (CFR 192.805)

Installed an Anode When Required According to Gas Standards (GS 1714.020, 1460.010)

Properly Cleaned Area on Piping to Ensure a Good Connection (GS 1420.580)

Installed Protective Coatings Following the Manufacturer's Instructions (GS 1420.580)

Thermite Welds Properly Placed (GS 1420.580)

Proper Box and or Cover (GS 1420.580)

OQ Valid (CFR 192.805)

Tie-in Plan Reviewed and Signed (GS 1680.010)

Proper Tapping Tool (OQ L1c) (GS 1680.010)

Replaced the Cap, Tightened According to the Manufacturer's Instructions (OQL1c) (GS 1680.010)

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)

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)

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)

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)

OQ Valid (CFR 192.805)

Valid One Call (811) Excavation Area Clearly Marked (GS 1100.010 State Specific)

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 and Reacted to Unmarked Facilities (GS 1100.010)

Verified that all Line Markers Examined in the Field were Properly Identified and Included Emergency Telephone Number (GS 1100.010)

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)

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)

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)

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)

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)

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)

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)

Made Accessible for Above-Ground Connection (Free Ends Coated) (GS 3010.060)

Properly Placed Line Markers (GS 1720.010)

Used Correct Size Bonding Cable #8 Minimum (GS 1770.010)

Properly Grounded Squeeze-Off Tools With a #12 AWG Wire (GS 1680.040)

Excavated Rocks Removed or Proper Padding Used (GS 3010.050)

Proper Compaction was Used (GS 3010.050)

Backhoes Were Not Used For Tamping (GS 3010.050)

Short Sections Viewed for Obstruction, or Longer Sections Pigged (GS 3000.500)

Pipe Bends Anchored as Directed (GS 3000.500)

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)

OQ Valid (CFR 192.805)

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)

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)

Further Action Required