Information

  • Audit Title

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Add location
  • Select date

RISK ASSESSMENT

  • Documted Risk Assessment in Place

  • Risk Assesment Policy clearly communicated to locations.

  • Risk Assessment Policy specifically addressed: A.) Non-rountine tasks B.) Work carried out by subcontractors

MOBILE PLANT SAFETY

  • Documeted site transported rules in place, based on a site transport assessment

  • Add media

  • Site transport rules adequately addressed:<br>A.) Vehicle-pedestrain segretation

  • Add media

  • b) Edge protection for slopes/benches.<br>

  • Add media

  • c) Driver training .

  • d) Driver assessment.<br>

  • Evidence that drivers are trained. <br><br>

  • Evidence that drivers are regularly assessed. <br>

  • Evidence of documented daily pre-use inspections in place for company on-site vehicles.<br>

  • Evidence that seat belts or other equivalent protective device are in use by all drivers.<br>

  • Evidence that loads are being secured. (refers to CRH operated vehicles) <br>

  • Evidence that loads are within vehicle weight limits. (refers to CRH operated vehicles)<br>

  • e) Vehicle rules including: <br>

  • e.1) speed,<br>

  • Add media

  • e.2) alarms,<br>

  • e.3) reversing systems, <br>

  • e.4) testing <br>

  • e.5) use of mobile phones. <br>

  • Inspect at least one vehicle to ascertain if the following are in place:<br>

  • a) alarms, <br>

  • b) reversing systems, <br>

  • c) testing <br>

  • Observe at least one vehicle to ascertain if the site transport rules are being implemented on site.<br>

Isolation of Operating Machinery

  • Documented lock-out/tag-out or isolation policy in place. <br>

  • Documented lock-out/tag-out or isolation policy incorporates machine specific lock-out/tag-out or isolation rules. <br>

  • Evidence that all employees have been trained in the lock-out/tag-out or isolation policy. <br>

  • Evidence that relevant employees have been trained in machinery specific lock-out/tag-out or isolation policy.<br>

  • Evidence that regular checks of the integrity of the company's lock-out/tag-out or isolation systems are being completed.<br>

  • Examine at least one task involving lock-out/tag-out or isolation to ensure that the system is operated as per rules. <br>

Machinery Guarding

  • Documented system for regular checking of machinery guarding in place.<br><br>

  • Evidence that machines are not operated without the exposed moving parts being appropriately guarded. <br>

  • Add media

  • Examine procedure/s in place to prevent machinery being put into service without authorisation.<br>

  • Carry out an inspection on a number of machines to ensure that:<br>

  • d) Other moving parts are securely guarded as required.<br>

  • a) tail pulley guards are securely in place <br>

  • b) pinch point guards are securely in place. <br>

  • c) exposed shaft guards are securely in place. <br>

Confined Space Entry

  • Documented confined space entry policy for confined spaces on site are in place. <br>

  • Documented c<br>onfined space entry rules for each confined space identified on site are in place.

  • Add media

  • Evidence that employees seek prior authorisation before entering a confined space. <br>

  • Documented authorisation procedures for entry into a confined space forms part of the location's confined space entry policy. <br>

  • Evidence that all excavations over 1.5m (5ft) in depth have shoring or appropriately designed sloping in place. <br>

  • Inspect employees training records to ensure that they have received training in confined space entry rules.<br><br>

  • Examine at least one task involving entry into a confined space to ensure that the system is operated as per rules and includes the completion of the following: <br>

  • a) Process Isolation <br>

  • b) Electical Isolation<br>

  • c) Atmospheric testing as required<br>

  • d) Communications in place<br>

  • e) Emergency rescue adequate<br>

Working at Heights

  • Documented risk assessmen<br>ts for working at heights in place

  • Evidence that locations have location-specific operating rules for working at heights in place<br>

  • Evidence that locations have task-specific operating rules for working at heights in place.<br>

  • Evidence that when working at heights collective measures and/or personal protective equipment are provided in all cases as set out in the risk assessments<br>

  • Evidence that specific training is provided for all relevant personnel working at a height<br>

  • Examine at least one task involving Working at Heights to ensure that: <br>

  • Add media

  • a) Risk assessment completed <br>

  • b) Fall protection measures are in place before work commences<br>

Lifting Operations

  • Inspect training records to see evidence that the relevant personnel using lifting equipment have training in the use of the equipment.<br>

  • Inspect training records to see evidence that the relevant personnel using lifting equipment are competent in the use of the equipment.<br>

  • Examine specific areas around lifting operations to ensure that the area is designated as "out of bounds" to personnel.<br>

  • Evidence that site specific policies are in place to:<br>

  • a) Lifting equipment certification is in place. (Examine the lifting equipment register).<br>

  • b) Lifting equipment loading rates in place.<br>

  • Inspect at<br> least one piece of lifting equipment to ensure the following:

  • a) ensure that the lifting equipment is safe to use<br>

  • Add media

  • b) ensure the safe working load is indicated on the lifting device.<br>

  • Where mobile lifting equipment is used on/off site inspect the Lift Plan to ensure the following:<br>

  • a) weight of the item being lifted is assessed.

  • b) The reach of the lifting equipment is adequate <br>

  • c) The height of the lift is acurately assessed <br>

  • d) Assess the ground conditions to ensure that it is stable and has the capacity to support the dead weight of the crane, load, rigging and any dynamic conditions<br>

  • e) over/under ground utilities are identified and isolated, protected or marked <br>

  • f) access to the lift area is restricted<br>

  • g) wind speed is assessed before the lift commences<br>

  • h) account is taken of the load surface area before the lift commences <br>

Underground and Overhead Utility Dangers

  • Documented risk assessment for underground work in place. <br>

  • Evidence where underground works have been carried out on-site that the site survey for utility lines is in place. <br>

  • Documented risk assessment in place for the use of mobile cranes & excavators taking account of overhead/underground utility lines.<br>

  • Examine at least one task involving the use of mobile cranes, excavators or other equipment with lifting devices e.g. dump truck to ensure the following:<br>

  • a) That all underground or overhead utility dangers are adequately assessed <br>

Use of Personal Protective Equipment (PPE)

  • Documented Personal Protective Equipment (PPE) Policy in place for specific tasks where relevant. <br>

  • Evidence that no employee is permitted to work without the required PPE.<br>

  • Evidence that daily visual inspections are carried out at each location.<br>

  • When carrying out the site inspection, visually check that personnel are wearing the required PPE as per company policy. <br>

  • Add media

Conveyance and Storage of Materials under Pressure

  • Documented pressure relief systems in place on all pressurised conveying systems<br>

  • Evidence of regular checks on pressurised conveying systems. <br>

  • Inspect the maintenance schedules of pressure relief systems to ensure that they are maintained on a regular basis. <br>

  • Inspect the maintenance schedules of pressure relief systems to ensure that they are checked on a regular basis. <br>

  • Evidence that pressurised conveying systems containing a defective pressure relief system are not operated.<br>

  • Inspect a pressurised conveying system to assess if it looks in good condition<br>

  • Add media

  • Evidence that all employees who work with pressurized systems have been trained in proper usage. <br>

Work Zone Safety

  • Are all work zone personnel properly trained for their roles?<br>

  • Are supervisory personnel familiar with the OMG Work Zone Safety Best Practice Manual?<br>

  • Inspect a typical work zone to determine compliance and best practices.<br>

Employee Involvement in Safety Process

  • Is SLT an ongoing process for this company?<br>

  • Are there SLT trained facilitators available within the company?<br>

  • Is there a process for reporting Near Misses at this company?<br>

  • Are there weekly tool box talks conducted and documented at all sites?<br>

  • Are there safety committee's or equivalent in place that engage employees across all levels of the organization?<br>

  • Interview employees about SLT process, Near Miss, Tool Box Talks and Safety Committee's.<br>

  • Review documentation for the above referenced programs.<br>

  • Other Safety Related

  • Add media

  • Other Safety Related

  • Add media

  • Other Safety Related

  • Add media

Environmental - Stormwater

  • Is a copy of the storm water permit located on-site?

  • Is a copy of the Storm Water Pollution Prevention Plan (SWPPP) located on-site?

  • Is the SWPPP up-to-date? Note areas which need to be updated.

  • Has employee training been conducted and documented?

  • Are inspections being performed and documented according to SWPPP frequency?

  • Does the site discharge stormwater?

  • Have appropriate stormwater samples been collected?

  • Is the chemical analysis available on-site?

  • Have chemical analysis results been submitted to the appropriate regulatory office?

  • Are BMP's noted in the SWPPP being followed?

  • Is rainfall information being recorded?

  • Are buckets used to catch oil or other open containers covered and/or not exposed to the weather?

  • Are stormwater discharge locations free of visible silt or other contaminants?

  • Is there visible trackout from the facility?

  • Is the property and surrounding ditches free of trash and litter?

  • Additional comments:

Environmental - Waste Water

  • Is a copy of the NPDES permit on-site?

  • Has appropriate sampling been completed?

  • Are chemical analysis results within permit allowance?

  • Are all controls being properly utilized and not bypassed?

  • At sites that do not discharge, are there any areas of concern with the settling ponds?

  • Additional comments:

Environmental - Air

  • Is a copy of the air permit on-site?

  • Is the facility in compliance with permit conditions? (production limits, hourly limits, temperature readings, etc.)

  • If no permit is required, is appropriate documentation kept on-site? (calculations, rule references, etc.)

  • Are sulfur content of fuel records available?

  • Is dust controlled on-site? (haul roads, crushers, conveyors, maintenance of other controls, etc.)

  • Are Maintenance, Startup, and Shutdown (MSS) Emissions being documented?

  • Does facility equipment list match what is being utilized on-site? (crushers, engines, conveyors, etc.)

  • Are maintenance records for equipment or control equipment available?

  • Have all appropriate emission tests (including NSPS "OOO") been performed and documented?

  • Are required mix type records maintained on-site?

  • Additional comments:

Environmental - Spill Prevention, Control, and Countermeasure Plan (SPCC)

  • If required, is a SPCC maintained on-site?

  • Is the information provided in the SPCC current and has it been reviewed in proper intervals (every 5 years)?

  • Has annual employee training been conducted and documented?

  • Are monthly inspections conducted and documented on-site?

  • Is secondary containment drainage log on-site and current?

  • Are containment drainage valves closed at the time of inspection?

  • Is appropriate secondary containment in place?

  • If present on site, are fuel transport tanks emptied or parked in areas that can provide containment?

  • Are tanks and drums properly labeled?

  • If tanks are not being used, are the tanks empty and marked "Out of Service"?

  • Are adequate materials, equipment, and other resources readily available to effectively control a spill?

  • Additional comments:

Environmental - Mining & Dredging

  • Is a copy of mining permit or mining authorization on-site?

  • Are mining practices following applicable mining regulations?

  • Are appropriate signs, berm, and fences in place?

  • If reclamation has started, is the reclamation plan being followed?

  • Is the site mining in a navigable water, flood plain, or flood way and are all state and federal requirements (404 permits) being met?

Environmental - Good Housekeeping

  • Are oil stains from leaks, drips, or small spills present?

  • Is used oil managed correctly? (burning, labeling, approved haulers, manifests, etc.)

  • Is universal waste handled properly? (batteries, light bulbs, etc.)

  • Is parts washer solvent, antifreeze, and other waste materials properly segregated and disposed of?

  • Does site appear clean and orderly? (5S, trash/garbage, metal storage, etc.)

  • Do floor drains and outfalls have appropriate controls?

  • Are SDS available on-site?

  • Additional comments:

Signatures

  • Signature of Personnel Interviewed

  • Signature of Auditor

  • Signature of Supervisor

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.