Information
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Audit Title
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Document No.
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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
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This checklist is to be used to document contractor compliance to Federal/State/Local EH&S requirements, Tesoro Retail Operations Safety and contractors own Safety Plan. The procedure is to first check in with Store personnel, and 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.
1.0 Job Site Compliance/Conditions/Behaviors
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1.1 Work area is appropriately coned/taped/barricaded
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1.2 Work area is clean of debris, trash, oily rags<br>
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1.3 All personnel in high visibility wear.<br>
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1.4 Work conditions (lighting, weather, available space) adequate and do not create any unsafe conditions.<br>
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1.5 Competent Person on-site.<br>
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1.6 Other PPE in use where appropriate (eye protection, fall protection, gloves, respirators, hearing protection, hard hats etc).<br>
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1.7 Safety signage in place for site requirements (eye protection, hard hats) and conditions (danger, warning, and caution).<br>
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1.8 Safety equipment in obvious locations and well marked (eye wash, fire extinguishers, hazmat disposal, and chemical storage).<br>
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1.9 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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1.10 Briefly review area for any unsafe conditions (open manholes, unprotected work at elevation, unprotected energized systems in work).<br>
2.0 Safety Processes
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2.1 Proper lockout-tag out process followed.<br>
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2.2 If there is is work over 6'-fall protection system in place.<br>
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2.3 Applicable permits adhered to (confined space, hot work).<br>
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2.4 Chemical labeling appropriate.<br>
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2.5 Site Safety Plan is specific to site and adhered to.<br>
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2.6 Overhead work safety plan utilized where appropriate (spotter, hard hats, barricaded).<br>
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2.7 Workers have had safety briefing on site specific issues.<br>
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2.8 Workers know procedures for reporting accidents and injuries.<br>
3.0 Safety Equipment
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3.1 Appropriate guarding on any rotating/reciprocating equipment/machinery.<br>
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3.2 Minimum 2, 25 lb ABC Fire extinguishers.<br>
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3.3 Fall protection equipment and system in good condition and appropriate for elevated work.<br>
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3.4 Lock-out/tag-out devices in good repair and in use.<br>
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3.5 Chemical storage and HazMat storage containers labeled and closed (self locking lids).<br>
4.0 Work Equipment
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4.1 Contractor equipment/trucks have back up beepers where required, safety belts and other safety equipment.<br>
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4.2 Ladders are clean and in good repair.<br>
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4.3 Ladders appropriate for work, correct ladder for job.<br>
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4.4 Scaffolding ridged, on secure footing, capable of supporting 4X loads, with safe means to gain access.<br>
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4.5 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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4.6 Electrical equipment is grounded.<br>
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4.7 Extension cords used with electrical quip meant are in good repair with ground fault interrupt capability.<br>
5.0 General Observations:
6.0 Signatures
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