NHPL Distribution Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General

• JHA/Job Briefing Complete?

  Yes

  No

  N/A

• Competent Person on Site?

  Yes

  No

  N/A

• Qualified Workers?

  Yes

  No

  N/A

• Personal Protective Equipment Properly Used?

  Yes

  No

  N/A

• Are Rubber goods properly stored?

  Yes

  No

  N/A

• Are there any Falling Hazards?

  Yes

  No

  N/A

• Harness/Lanyard being properly used?

  Yes

  No

  N/A

• 100%Fall Arrest Utilized?

  Yes

  No

  N/A

• Is rescue equipment available and ready? (Rescue Blocks/Handline)

  Yes

  No

  N/A

• Does the crew have an AED?

  Yes

  No

  N/A

• Enter Test Date.

  Media

• Are there any AC Tools being used?

  Yes

  No

  N/A

• GFCI Protected?

  Yes

  No

  N/A

• Cords in Good Shape?

  Yes

  No

  N/A

• Guards in Place?

  Yes

  No

  N/A

• Electrical Hazards Present?

  Yes

  No

  N/A

• Is Minimum Approach Distance Maintained?

  Yes

  No

  N/A

• Is FR Clothing being worn?

  Yes

  No

  N/A

• Protective Cover-Up Installed?

  Yes

  No

  N/A

• Rubber Gloves/Sleeves required?

  Yes

  No

  N/A

• Enter Test Date.

• Are Hot Sticks Being Used?

  Yes

  No

  N/A

• Enter Test Date.

• Is The Crew working behind protection? (One shot, fuse)

  Yes

  No

  N/A

• Are Grounds being used?

  Yes

  No

  N/A

• Enter Test Date.

• At least 2 employees certified in First Aid/CPR?

  Yes

  No

  N/A

• First Aid Kit Fully Stocked?

  Yes

  No

  N/A

• Drinking Water and Ice on site?

  Yes

  No

  N/A

• House Keeping?

  Yes

  No

  N/A

• Seat belts?

  Yes

  No

  N/A

• Safety Cans Utilized/Labeled?

  Yes

  No

  N/A

• Is Traffic Control Equipment in Place?

  Yes

  No

  N/A

• Safe Temp Monitor?

  Yes

  No

  N/A

• Fire extinguisher inspected?

  Yes

  No

  N/A

System De-Energized.

• Has the system been de-energized, tested, and grounded?

  Yes

  No

  N/A

• Has an EPZ been established?

  Yes

  No

  N/A

• Are the ground locations recorded?

  Yes

  No

  N/A

Lifting/Rigging

• Lifting/Rigging?

  Yes

  No

  N/A

• Lift Plan?

  Yes

  No

  N/A

• Boom Visual Appearance OK?

  Yes

  No

  N/A

• Load Charts?

  Yes

  No

  N/A

• Signal Charts?

  Yes

  No

  N/A

• Load Line/Hook Condition?

  Yes

  No

  N/A

• Winch Rope/Line Condition?

  Yes

  No

  N/A

• Sheave Condition?

  Yes

  No

  N/A

• Turn Table Condition?

  Yes

  No

  N/A

• Tag Line Used?

  Yes

  No

  N/A

• Rope/Hand Line Used?

  Yes

  No

  N/A

• Sling/Shackle Condition?

  Yes

  No

  N/A

• Control Labeling?

  Yes

  No

  N/A

• Bucket Liner/Insert Condition?

  Yes

  No

  N/A

• Bucket Jib Rope Condition?

  Yes

  No

  N/A

Excavation/Trenching/Shoring

• Are there any underground operations on site?

  Yes

  No

  N/A

• Soil Classification?

  Yes

  No

  N/A

• Trench Inspected?

  Yes

  No

  N/A

• Ladder(s)/Ramp in Place?

  Yes

  No

  N/A

• Trench box?

  Yes

  No

  N/A

• Sloping/Benching/Shoring Adequate?

  Yes

  No

  N/A

• Spoil Piles Two Feet Back from edge?

  Yes

  No

  N/A

• Underground Facilities Marked?

  Yes

  No

  N/A

VEHICLE/DOT

• Are vehicles/equipment properly set up?

  Yes

  No

  N/A

• Drivers log complete?

  Yes

  No

  N/A

• DVIR complete?

  Yes

  No

  N/A

• Proper load securement?

  Yes

  No

  N/A

• DOT Inspection Current?

  Yes

  No

  N/A

• Body Components Damaged?

  Yes

  No

  N/A

Signatures

• Foreman

  Sign

• Auditor

  Sign