Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Store Number
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Store Personnel on site
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Contractor
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Work/Job performed
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Contractor Competent Person:
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Audit Date and Time:
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Tesoro Inspecting Representative:
Background Purpose of checklist: This checklist to be used to document compliance to Federal/State/Local EH&S requirements. Tesoro Retail Operations and contractors own Safety Plan. The procedure is to first check in with the Store personnel, then introduce self to on-site competent person or crew foreman. Without impeding contractors work, conduct audit. If possible perform audit with Contractors submitted Safety Plan for any discrepancies. If element is N/A (not applicable)-write in comments.
Job Site Compliance/Conditions/Behaviors
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MSDS available for review
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Work area is appropriately coned/taped/barricaded
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Work area is clean of debris, trash, oily rags<br>
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All personnel in high visibility wear.<br>
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Work conditions (lighting, weather, available space) adequate and do not create any unsafe conditions.<br>
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Competent Person on-site.<br>
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OtherPPE in use where appropriate (eye protection, fall protection, gloves, respirators, hearing protection, hard hats etc).<br>
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Safety signage in place for site requirements (eye protection, hard hats) and conditions (danger, warning, and caution).<br>
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Safety equipment in obvious locations and well marked (eye wash, fire extinguishers, hazmat disposal, and chemical storage).<br>
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Safety documentation available and accurate ( site safety plan with evacuation and emergency procedures, site safety training, hot work permits, MSDS sheets, confined space entry permits, lock-out tags, fall protection work plans).<br>
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Briefly review area for any unsafe conditions (open manholes, unprotected work at elevation, unprotected energized systems in work).<br>
Safety Processes
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Proper lockout-tag out process followed.<br>
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If there is is work over 6'-fall protection system in place.<br>
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Applicable permits adhered to (confined space, hot work).<br>
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Chemical labeling appropriate.<br>
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Site Safety Plan is specific to site and adhered to.<br>
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Overhead work safety plan utilized where appropriate (spotter, hard hats, barricaded).<br>
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Workers have had safety briefing on site specific issues.<br>
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Workers know procedures for reporting accidents and injuries.<br>
Safety Equipment
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Appropriate guarding on any rotating/reciprocating equipment/machinery.<br>
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Minimum of 1-20lb or 2-10lb Fire extinguishers.<br>
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Fall protection equipment and system in good condition and appropriate for elevated work.<br>
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Lock-out/tag-out devices in good repair and in use.<br>
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Chemical storage and HazMat storage containers labeled and closed (self locking lids).<br>
Work Equipment
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Contractor equipment/trucks have back up beepers where required, safety belts and other safety equipment.<br>
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Ladders are clean and in good repair.<br>
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Ladders appropriate for work, correct ladder for job.<br>
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Scaffolding ridged, on secure footing, capable of supporting 4X loads, with safe means to gain access.<br>
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Scaffolding with platforms at 10' or greater utilize guard railing, toe boards, and/or wire mesh to protect all open sides and ends.<br>
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Electrical equipment is grounded.<br>
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Extension cords used with electrical quip meant are in good repair with ground fault interrupt capability.<br>
General Observations:
Signatures
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