Outage Safety Plan Audit Form

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1.0 - Safety Files

• 1.1 - Is the safety on file and accessible across the site ?

  Yes

  No

  N/A

• 1.2 - Are weekly safety meetings held and are documented notes and attendance rosters available ?

  Yes

  No

  N/A

• 1.3 - Are weekly site inspections being performed and documented?

  Yes

  No

  N/A

• 1.4 - Are JSA/SRA risk assessments complete and up to date ?

  Yes

  No

  N/A

• 1.5 - Are EHS policies and procedures, including customer requirements, effectively communicated to contractors and subcontractors?

  Yes

  No

  N/A

• 1.6 - is there a means of assigning responsibility for tracking closure of open compliance items?

  Yes

  No

  N/A

• 1.7 - Are GE safety orientation talks being performed and documented?

  Yes

  No

  N/A

• 1.8 - Are toolbox talks being performed and documented?

  Yes

  No

  N/A

• 1.9 - Has the initial site inspection been performed?

  Yes

  No

  N/A

• 1 10 - Has a contractor EHS review been completed for any subcontractors and contractor?

  Yes

  No

  N/A

2.0 - Health and Welfare

• 2.1 - Are there an adequate number of toilets supplied to the site? (>20 employees => 1 toilet per 40 workers; >200 employees => 1 toilet per 50)?

  Yes

  No

  N/A

• 2.2 - Are hand washing stations available on site?

  Yes

  No

  N/A

• 2.3 - Is drinking water available on site and distributed properly? (note: container must be labeled, secured, and cups provided.)

  Yes

  No

  N/A

• 2.4 - Is there adequate lighting for non daylight operations?

  Yes

  No

  N/A

• 2.5 - Are all industrial hygiene hazards identified in the JSA/SRA risk assessments for the task performed? i.e. asbestos and lead abatement

  Yes

  No

  N/A

• 2.6 - Are activities identified in question 2.5 above done by trained, qualified and/or licensed contractors?

  Yes

  No

  N/A

• 2.7 - Are only qualified and trained employees allowed to install, adjust, and operate laser equipment?

  Yes

  No

  N/A

• 2.8 - Does the site have security plan available?

  Yes

  No

  N/A

• 2.9 - Does the site have a emergency data sheet maintained and posted and where applicable an expat roster?

  Yes

  No

  N/A

• 2.10 - Where required are work hours being tracked?

  Yes

  No

  N/A

• 2.11 - If he site is located on a refinery or chemical plant was the trailer sitting risk assessment completed?

  Yes

  No

  N/A

3.0 - Emergency Preparedness and Prevention

• 3.1 - Is there a site specific Emergency Response Plan (evacuation plan, etc.) and is it posted?

  Yes

  No

  N/A

• 3.2 - Are emergency contact numbers posted and verified?

  Yes

  No

  N/A

• 3.3 - Have on-site/off-site medical service providers been identified?

  Yes

  No

  N/A

• 3.4 - Have site personnel been trained in emergency procedures including reporting and evacuation?

  Yes

  No

  N/A

• 3.5 - Are accident investigations conducted including near misses?

  Yes

  No

  N/A

• 3.6 - Have on-site trained first aiders been identified?

  Yes

  No

  N/A

• 3.7 - Is there a fire protection system or fire extinguishers posted on site and offices and other buildings?

  Yes

  No

  N/A

4.0 - Housekeeping and Waste Management

• 4.1 - Are work areas clear of tripping hazards and debris?

  Yes

  No

  N/A

• 4.2 - Are there designated disposal areas?

  Yes

  No

  N/A

• 4.3 - Have recycling provisions been taken?

  Yes

  No

  N/A

• 4.4 - Have approved waste vendors been identified?

  Yes

  No

  N/A

• 4.5 - Are regulated wastes ( hazardous wastes and oils) shipped off site using an approved licensed transporter to an approved licensed facility?

  Yes

  No

  N/A

• 4.6 - Are there adequate measures to prevent dirt from being transferred to public roads from the site?

  Yes

  No

  N/A

• 4.7 - Are overall site conditions acceptable?

  Yes

  No

  N/A

5.0 - PPE USE

• 5.1 - Hardhats

  Yes

  No

  N/A

• 5.2 - Safety glasses and side shields?

  Yes

  No

  N/A

• 5.3 - Boots and safety shoes

  Yes

  No

  N/A

• 5.4 - Respiratory protection

  Yes

  No

  N/A

• 5.5 - Hearing protection

  Yes

  No

  N/A

• 5.6 - Is all other PPE identified by the outage safety plan available and being used where required? (examples safety vests, fall protection, specialized)

  Yes

  No

  N/A

6.0 - Work at Heights

• 6.1 - Are guardrails placed where necessary? (Note! tape with minimal 2 meters (6.6 ft) clearance or ridged barricade with handrail and mid rail)?

  Yes

  No

  N/A

• 6.2 - Are stairways with over 3 risers or ramps over 1.2 meters (4ft) high supplied with handrails?

  Yes

  No

  N/A

• 6.3 - Are ladders used the way are designed? (Note! bifold fully extended, extension ladders extended 36" over the landing and tied off?)

  Yes

  No

  N/A

• 6.4 - Scaffolds inspected and tagged accordingly?

  Yes

  No

  N/A

• 6.5 -Scaffolds work platforms fully decked with scaffold grade boards in good condition?

  Yes

  No

  N/A

• 6.6 - Scaffolds erected on secure base and mud-sills used on all surfaces?

  Yes

  No

  N/A

• 6.7 - Scaffold provided with handrail, mid-rail, and toe boards when men are exposed underneath?

  Yes

  No

  N/A

• 6.8 - Scaffolds tied off when height exceeds four times the base?

  Yes

  No

  N/A

• 6.9 - Suspended scaffold equipped with independent lifelines, all systems including scaffold, cables, outriggers, counterweights designed set up and inspected by a competent person?

  Yes

  No

  N/A

• 6.10 - Is fall protection being used when exposed to heights over 1.8 meters ( ft) and there are no stationary fall protection systems?

  Yes

  No

  N/A

• 6.11 -Personal platforms (man baskets) used correctly, lift permits, inspection reports, and pre-lift meetings?

  Yes

  No

  N/A

• 6.12 - Is all personal fall protection inspected and in good shape?

  Yes

  No

  N/A

• 6.13 - Are all hole coverings marked, secured, and built correctly?

  Yes

  No

  N/A

7.0 - Electrical Safety

• 7.1 - Have measures been taken to prevent the following from being within 3 meters (9.8ft) ( or 5 if voltage >50kv) of energized lines: scaffolding, cranes, and other mechanized equipment?

  Yes

  No

  N/A

• 7.2 - Is all PPE compliant with NFPA 70E, inspected and where required tested prior to used?

  Yes

  No

  N/A

• 7.3 - When grounding de-energized systems, are grounds placed as close as possible to the work and is the following order followed when attaching grounds: ground end shall be attached first, then the other end shall be attached and removed by means of insulated?

  Yes

  No

  N/A

• 7.4 - Are GFCI's used (or an assured equipment grounding program) for all tools and equipment?

  Yes

  No

  N/A

• 7.5 - Is temporary wiring either enclosed or in locations where they are not subject to physical damage?

  Yes

  No

  N/A

• 7.6 - Are flexible cords and cables used in a manner which prevents trip hazards and are protected from damage including pinch points, sharp edges, and vechiles?

  Yes

  No

  N/A

• 7.7 - Are cords and cables in good condition (not worn or frayed, grounding plug)

  Yes

  No

  N/A

• 7.8 - Are electrical cords of the heavy duty grounding type with the three prong plugs in place?

  Yes

  No

  N/A

• 7.9 - Are lights protected from breakage and nit hung by there cords unless so designed?

  Yes

  No

  N/A

• 7.10 - Are electrical disconnects identified and in a readily accessible location?

  Yes

  No

  N/A

• 7.11 - Are electrical installations in areas where there is a potential flammable atmosphere approved as intrinsically safe?

  Yes

  No

  N/A

• 7.12 - Are battery and battery charging installations located in a ventilated area and provided containment?

  Yes

  No

  N/A

• 7.13 - If batteries require require handling and refilling is proper PPE (aprons, goggles) and eyewash provided?

  Yes

  No

  N/A

• 7.14 - Are means of over current protection (circuit breakers) readily accessible, clearly marked, and covered to prevent injury during their operation?

  Yes

  No

  N/A

• 7.15 - Are electrical cabinets, boxes, and fittings provided with covers, with unused openings closed and protected from elements?

  Yes

  No

  N/A

• 7.16 - Are the requirements of NFPA 70E fully implemented, and all work in compliance with this standard?

  Yes

  No

  N/A

8.0 - Hand Tools and Electric Power Tools

• 8.1 - Are all hand and power tools maintained in a safe condition and no cracks, intact electrical cords/plugs, and operating switches?

  Yes

  No

  N/A

• 8.2 - Are electrical power tools double insulated?

  Yes

  No

  N/A

• 8.3 - Are all power operated tools equipped with guards if so designed?

  Yes

  No

  N/A

• 8.4 - Are all points of operation of machines, abrasive wheels, bench/cylindrical grinders gaurded?

  Yes

  No

  N/A

• 8.5 - Are hand tools free of damage i.e. mushroomed heads, cracked/splintered handles?

  Yes

  No

  N/A

• 8.6 - Is proper PPE being used with hand power tools?

  Yes

  No

  N/A

9.0 - Safety - Welding and Burning

• 9.1 - I s all welding and cutting done with proper PPE? (Notes: shaded glasses are not considered adquate protection)

  Yes

  No

  N/A

• 9.2 - Are compressed gases stored correctly in work areas/points of use?

  Yes

  No

  N/A

• 9.3 - Are hot work permits being issued according to site specific rules?

  Yes

  No

  N/A

• 9.4 - Is a fire watch provided when burning or welding around flammables, combustibles, or when such materials maybe impacted?

  Yes

  No

  N/A

• 9.5 - Is each welding cart or welding area unit provided with an approved fire extinguisher?

  Yes

  No

  N/A

• 9.6 - Have measures been taken to protect personnel from arch flashes?

  Yes

  No

  N/A

• 9.7 - Are all welding machines grounded properly?

  Yes

  No

  N/A

• 9.8 - during use are cylinders secured in an upright position and placed far enough away from cutting and welding activates that the flame, slag, and sparks will not reach the cylinders?

  Yes

  No

  N/A

• 9.9 - Are cylinder valves shut off when not in use? If cylinders are not used for 24 hours are regulators removed and the caps secured?

  Yes

  No

  N/A

• 9.10 - In transport ar cylinders turned off and secured with caps on?

  Yes

  No

  N/A

• 9.11 - Are O2 and acetylene regulators and fittings stored away from grease and oil and in good working condition?

  Yes

  No

  N/A

10.0 - Chemical Storage and Handling

• 10.1 - Are MSDSs available on site? Are they accessible to employees?

  Yes

  No

  N/A

• 10.2 - Is a completed chemical inventory available?

  Yes

  No

  N/A

• 10.3 - Is poper labeling provided on all chemical containers?

  Yes

  No

  N/A

• 10.4 - Is there adequate storage provided for flammable solids and lquids?

  Yes

  No

  N/A

• 10.5 - Are preventative measures being taken to keep fuels from being spilt during refueling?

  Yes

  No

  N/A

• 10.6 - Are controls in place to prevent hazardous chemicals being disposed of in dumpsters or other unauthorized areas?

  Yes

  No

  N/A

11.0 Excavation

• 11.1 - is there a qualified excavation competent person on site?

  Yes

  No

  N/A

• 11.2 - Are excavations inspected daily by a competent person?

  Yes

  No

  N/A

• 11.3 - Is there egress and access provided every 7.5 meters (24.6 ft)?

  Yes

  No

  N/A

• 11.4 - Is there adequate barricading provided around all sides of excavations and trenches?

  Yes

  No

  N/A

• 11.5 - Are all heavey equipment prevented from traveling to near the edge of trenches?

  Yes

  No

  N/A

• 11.6 - Are excavations >1.30 meters (4.2 ft) deep monitored for hazardous atmosphere when suspect?

  Yes

  No

  N/A

12.0 - Motorized Equipment

• 12.1 - Reverse alarms audible on all bi-directional and obstructed view?

  Yes

  No

  N/A

• 12.2 - Barricading provided for all swing radius's of operational equipment?

  Yes

  No

  N/A

• 12.3 - No equipment left running while unattended?

  Yes

  No

  N/A

• 12.4 - Are inspections conducted on aerial platforms and forktrucks?

  Yes

  No

  N/A

13.0 - Cranes and Rigging

• 13.1 - are inspection records for lifting and hauling equipment available and up to date?

  Yes

  No

  N/A

• 13.2 - is all rigging stored in safe manner so that it does not pose a tripping hazard or can be damaged by the elements?

  Yes

  No

  N/A

• 13.3 - All rigging in good condition and found without damage?

  Yes

  No

  N/A

• 13.4 - Is a signal man available?

  Yes

  No

  N/A

• 13.5 - Safety latches provided and in good repair on hooks designed to use them?

  Yes

  No

  N/A

• 13.6 - Are loads left attended while hoisted?

  Yes

  No

  N/A

• 13.7 - Personnel not allowed under a load?

  Yes

  No

  N/A

• 13.8 - Are all crane operators trained and qualified?

  Yes

  No

  N/A

• 13.9 - Are lift Plans completed as required?

  Yes

  No

  N/A

• 13.10 -Are forklift and other industrial truck operators trained?

  Yes

  No

  N/A

14.0 - Concrete and Masonary

• 14.1 - Are power trowels equipped with automatic shutoff devices?

  Yes

  No

  N/A

• 14.2 - Masonry saws, bushing, and chipping operation done with proper PPE. (Note! Gloves,ear protection,safety glasses, and face shield required)?

  Yes

  No

  N/A

• 14.3 - Reinforcing steel protected against impalement hazards? ( note! Mushroom caps not effective protection against impalement hazards)

  Yes

  No

  N/A

• 14.4 - Limited access zone established during masonary wall construction?

  Yes

  No

  N/A

• 14.5 - Bracing adequate during wall construction?

  Yes

  No

  N/A

• 14.6 - Concrete buckets used in a safe manor?

  Yes

  No

  N/A

• 14.7 - All sanding or finishing practices that produce concrete dust are done while using respiratory protection?

  Yes

  No

  N/A

15.0 -Confined Space

• 15.1 - Are all confined spaces posted as such throughout the site?

  Yes

  No

  N/A

• 15.2 - Are permits for permitted confined and non-permitted confided spaces completed and posted at space?

  Yes

  No

  N/A

• 15.3 - Hole watch provided for permitted confined spaces?

  Yes

  No

  N/A

• 15.4 - Is craft knowledgable of the sites confined space procedures?

  Yes

  No

  N/A

• 15.5 - Are air samples documented and posted prior to entry into confined space?

  Yes

  No

  N/A

16.0 - LOTO

• 16.1 - Are contractors and employees knowledgeable in LOTO plan and procedures?

  Yes

  No

  N/A

• 16.2 - Isthere a designated LOTO representative available at site?

  Yes

  No

  N/A

• 16.3 - Have all system authorized employees/LOTO Admin been reviewed to ensure understanding of LOTO including verification

  Yes

  No

  N/A

• 16.4 - Do system authorized employees/ LOTOAdmin have access to locks and tags? Do system authorized employees/LOTO admin hace access to multiple lock adapters (hasps) and other specialized LOTO devices?

  Yes

  No

  N/A

• 16.5 - Do all LOTO locks meet the following requirements: unique and distinct from other locks used at site; used exclusively for LOTO, only one available key?

  Yes

  No

  N/A

• 16.6 - Is the verification step completed for each LOTO?

  Yes

  No

  N/A

• 16.7 - Are equipment specific LOTO procedures provided in the local language?

  Yes

  No

  N/A

• 16.8 - If testing is done are correct procedures followed?

  Yes

  No

  N/A

• 16.9 - Are equipment disconnects identified for each piece of equipment under a LOTO?

  Yes

  No

  N/A

• 16.10 - Are power panels and other energy control devices located at the floor level or otherwise accessible for LOTO?

  Yes

  No

  N/A

• 16.11 - Are LOTO clearances accessible?

  Yes

  No

  N/A

• 16.12 - Are keys controlled?

  Yes

  No

  N/A

• 16.13 - Are tags completed properly (LOTO no. tag no., equipment description, name, date)

  Yes

  No

  N/A

• 16.14 - Are tags used unique to LOTO and some combination of red, white, and black?

  Yes

  No

  N/A

• 16.15 - Have all system authorized employees/LOTO admin received LOTO training and refresher training which includes "try out" (verification step)?

  Yes

  No

  N/A

• 16.16 - Have all affected employees received LOTO awareness training?

  Yes

  No

  N/A

• 16.17 - Has contractor training been reviewed and documented?

  Yes

  No

  N/A

• 16.18 - Are weekly LOTO inspections conducted?

  Yes

  No

  N/A

• 16.19 - Is there a major commissioning activity underway in which a commissioning procedure has been developed?

  Yes

  No

  N/A

17.0 -EHS Programs

• 17.1 - Are all persons on site trained for the tasks they are assigned?

  Yes

  No

  N/A

• 17.2 - Are training records maintained?

  Yes

  No

  N/A

• 17.3 - Describe and rate the cooperation between contractor(s) and the GE project team.

  Safe

  At Risk

  N/A

• 17.4 - Describe the effectiveness of GE project EHS.

  Safe

  At Risk

  N/A

• 17.5 - Discuss the relative number of safety problems on the project.

  Safe

  At Risk

  N/A

• 17.6 - Discuss the resolution of the safety problems on site.

  Safe

  At Risk

  N/A

• 17.7 - Discuss the auditor's overall estimation of the safety of this project.

  Safe

  At Risk

  N/A

Sign Off

• On site representative

  Sign

• Auditor's signature

  Sign