Information

  • Document No.

  • ONEOK Business Segment

  • ONEOK Operation Site (i.e. OK Gathering, Medford Plant, etc.)

  • Site Location

  • Conducted on

  • Prepared by

  • Location
  • Prime Contractor on site (if applicable)

1. Work Areas

  • C1:1 - General Housekeeping?

  • C1:2 - Walking - Working Surfaces?

  • C1:3 - Unprotected Sides or Holes?

  • C1:4 - Sanitary Facilities Acceptable?

  • C1:5 - Water - Trash Receptacles?

  • C1:6 Is the site location free from significant erosion and/ or soil channeling?

  • C1:7 is the site location clear of vegetation?

  • C 1.8 Is there active construction on-site?

  • C1:9 - Impalement Hazards?

  • C1:10 - Material Storage/Lay Down?

  • C1:11 - Conex, Box 4 U, Gang Box, Roll Offs?

  • Is the security of the site acceptable? (Fence in good condition, gates locked, lighting in working condition, building in good condition and locked)

  • Other:

2. Job Site Posters/Signage

  • C2:1 - Are job-site required posters posted? (i.e. DOL posters, OSHA 300 Log)

  • C2:2 - Emergency Evacuations Plan including; GPS site location and Nearest Hospital Location?(if required)

  • C2:3 - Emergency Contacts List?

  • C2.4 - Is all DOT signage is place (Company Name, Phone number, PPE requirements, Authorized Personnel, No open flame/smoking, ESD, Exit signs)

  • Other:

3. Heath/First Aid

  • C3:1 - CPR/First Aid Training?

  • C3:2 - First Aid Kit (No expired items)?

  • C3:3 - Eye Wash Facilities in Field?

  • C3:4 - Access to Eye Wash?

  • C3:5 - Is AED functioning? (if on-site)

  • C3:6 - Are AED pads expired? (if on-site)

  • Other:

4. PPE

  • Is there any personnel on-site?

  • C4:1 - Hard Hats?

  • C4:2 - Safety glasses with Side Shields?

  • C4:3 - Face Shield/Goggles (if required)?

  • C4:4 - Respiratory Protection (If required)?

  • C4:5 - Hearing Protection (If required)?

  • C4:6 - Clothing (FRC etc. if required)?

  • C4:7 - Gloves on person?

  • C4:8 - Foot Protection?

5. Fall Protection

  • Is there any elevated work being performed?

  • C5:1 - Trained Personnel (Competent Person)?

  • C5:2 - Worn Properly?

  • C5:3 - Suitable Anchorage Points?

  • C5:4 - Inspected per manufacturer recommendation?

  • C5:5 - Stored Properly?

  • C5:6 - Emergency Rescue Plan?

6. Ladders

  • Are there any ladders on-site?

  • C6:1 - Base/Footing/Set Up/Proper secured?(i.e. proper tied off , 36 inches above landing surface)

  • C6:2 - Inspections/Color Coded?

  • C6:3 - Proper Type for Task?

  • C6:4 - Are label attached and legible?

  • C6:5 - Does ladder show any signs of UV damage?

7. Tools and Equipment

  • Are tools on-site?

  • C7:1 - In Good Condition?

  • C7:2 - Inspected?

  • C7:3 - Whip-Checks?

  • C7.4 - Are all tools equipped with guards as required?

  • Other

8. Excavations

  • Are there any excavation on-site?

  • C8:1 - Trained Personnel (Competent Person)?

  • C8:2 - Access/Egress?(within 25 feet of working area)

  • C8:3 - Soil Condition?

  • C8:4 - Water Accumulating?

  • C8:5 - Shoring/Shielding/Sloping?

  • C8:6 - Barricades?

  • C8:7 - Spoil Pile?(2 beyond the edge of the excavation)

  • C8:8 - Air Monitoring?

  • C8:9 - Emergency Rescue Plan?

  • C8.10 - Has one-call been cleared?

  • C8.11- Have utilities been marked?

9. Confined Space

  • Are there any permit required confined spaces on-site?

  • C9:1 - Trained Personnel (Competent Person)?

  • C9:2 - Attendant Trained?

  • C9:3 - Entrants Trained?

  • C9:4 - Attendant Wearing Monitor?

  • C9:5 - Attendant Sign In Sheet?

  • C9:6 - Permit Required?

  • C9:7 - Permit Followed?

  • C9:8 - Air Monitoring?

  • C9:9 - Emergency Rescue Plan?

  • Are there any reclassified confined spaces?

  • Have all the hazard been eliminated and properly documented on the permit?

10. Electrical

  • C10:1 - GFCI's?

  • C10:2 - Extension Cords?

  • C10.3 - Any exposed electrical wiring?

  • C10.4 - Are ARC Flash labels in place?

  • C10.5 - Are electrical breakers and disconnects labeled?

  • C10.6 - Are combustible materials stored 4 feet away from electrical equipment?

  • C10.7 - Is equipment bonded or grounded adequately?

  • Are any fire extinguishers used for electrical equipment CO2 extinguishers?

  • Is Arc Flash Protection and signage a scope of this audit?

  • Is the Arc Flash PPE in good condition?

  • Is the inspection of the Arc Flash PPE up to date?

  • Is the signs for proper use of Arc Flash PPE satisfactory?

11. Fire Safety

  • Is Hot Work being performed?

  • C11:1 - Hot Work Permit?

  • C11:2 - Fire Watch Assigned (Competent Person)?

  • C11:3 - Hot Work Barricade (if required)?

  • C11:4 - Fire Extinguisher current with monthly and annual inspection?

  • C11:5 - Combustibles Removed/Isolated?

  • C11:6 - Is appropriate Flammable Gas Cans? (No plastic can)

  • C11.7 - Are flammable properly stored? (in flammable cabinet)

  • C11.8 - Is flammable cabinet in good condition? (if on-site)

12. Rigging and Hoisting

  • Are there any Rigging and Hoisting equipment on-site?

  • C12:1 - Capacity Tags attached and legible?

  • C12:2 - Hooks and Latches?

  • C12:3 - Chain Falls/Come-a-Longs?

  • C12:4 - Tag Lines?

  • C12:5 - Has the rigging equipment been inspected prior to use?

  • C12.6 - Stored Properly?

  • C12:7 - Designated Rigger?

13. Scaffold

  • Is any scaffolding on-site?

  • C13:1 - Trained Personnel (Competent Person)?

  • C13:2 - Hand and Mid-Rails, Toeboards?

  • C13:3 - Platform Decked/Secured?

  • C13:4 - Level Footing/Set Up?

  • C13:5 - Access/Egress?

  • C13:6 - Away from Power lines?

  • C13:7 - Barricades?(Fall Zone)

  • C13:8 - Inspection/Tagged Correctly?

14. Crane Equipment

  • Is a crane on-site?

  • C14:1 - Crane Inspection?

  • C14:2 - Operator Manual?

  • C14:3 - Crane Setup?

  • C14:4 - Crane Swing Radius?

  • C14:5 - Flagman with Vest?

  • C14:6 - Operator Qualified and Certified?

  • C14:7 - Designated Qualified Signaler?

  • C14:8 - Fall Zone Procedures?

  • C14.9 - Critical Lift Plan?

15. Mobile Equipment

  • Is there mobile equipment on-site?

  • C15:1 - Equipment Inspections?

  • C15:2 - Operator Qualified and Certified?

  • C15:3 - Operator Manual?

  • C15:4 - Flagman/Spotter?

  • C15:5 - Proper Setup and Use?

16. Hazcom

  • C16:1 - SDS For All Chemicals Onsite?

  • C16:2 - Proper Storage of Chemicals?

  • C16:3 - Proper PPE for Handling Chemicals?

17. Energy Control

  • Is there an energy control in place?

  • Energy Control Number:

  • C17.1 - Has personnel verified all isolation of stored energy?

  • C17.2 - Are all affected personnel on the lockbox? (if on-site including group lock)

  • C17.3 - Does authorized employee demonstrate specific knowledge of the energy control procedure?

18. Process Equipment

  • Is process equipment in the scope of this audit?

  • C18.1 - Are valve indicators in place and functioning?

  • C18.2 - Are all flange bolts flush with the nut or extend past the nut?

  • C18.3 - Are all valves and pipe opening plugged?

  • C18.4 - Does isolated piping, equipment and instruments in traffic areas have barricades and/or visible indicators?

  • C18.5 - Does piping or equipment free from any signs of weak points or leaks?

  • Are DOT regulated valves in the scope of this audit?

  • C18.6 - Is explosion proof equipment properly sealed and all bolts in place?

  • C18.7 - Are DOT valves marked with the valve ID number?

  • C18.8 - Are over-pressure devices isolation sealed in open position (include thermal relief and isolation valves)?

  • Are DOT regulated piping in the scope of this audit?

  • C18.9 - Is conduit and small diameter pipe visibly stress-free?

  • C18.10 - Is piping atmosphere-to-ground interface properly coated?

  • Are DOT regulated Pig Launcher/Receiver in the scope of this audit?

  • C18.11 - Do pig traps have containers for sediments?

  • C18.12 - Are jumpers and bonding wires and grounding rods in place?

  • C18.13 - Do all containers have lids to prevent rain collections and are secured from the wind?

  • C18.14 - Are mainline valves on pig traps locked in normal position?

  • C18.15 - Do trap and vessel enclosure have tattle-tail with chain connected to enclosure?

19. Inspection Conclusion

  • C19.1 - Inspection Notes:

  • C19.2 - Positive Observation:

  • Prepared By:

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.