Peterson SMAT Model 2014 - English

• SMAT date

  Date

• Location

  Select WNZ area den helder Peterson Paleiskade BD Cuti DH Peterson Chemicals Peterson HUB Peterson DH Airport Peterson planning & decl. & SSC Peterson Supply Peterson technical service Peterson IJmuiden (Peterson & Cuti) MLC (supply) Other

  • WNZ area den helder
  • Peterson Paleiskade BD
  • Cuti DH
  • Peterson Chemicals
  • Peterson HUB
  • Peterson DH Airport
  • Peterson planning & decl. & SSC
  • Peterson Supply
  • Peterson technical service
  • Peterson IJmuiden (Peterson & Cuti)
  • MLC (supply)
  • Other

• If selected location is 'other', please specify:

• SMAT Team

• Spoken with:

The first part is a (safety related) open conversation with an employee. The following questions could be used as guidance:

• 1. What are your day-to-day work activities?
  
  2. Are you satisfied with the setup of the workplace / working area?
  
  3. What kind of tools do you use for work?
  
  4. Could your work activities lead to (health / environmental) risks?
  
  5. If any, do you take any measures to reduce these risks?
  
  6. In general, do you feel safe during work?
  
  7. Did you ever intervene during an unsafe situation?
  
  8. Are you confident with the training / instructions you received to perform your work activities in the correct and safe manner?
  
  9. Are you familiar with the procedures and work instructions regarding your activities?
  

• Notes / remarks / issues:

1. House rules:

• Are there house rules applicable?

  Yes

  No

  N/A

• Were these rules explained to the members of the SMAT team?

  Yes

  No

  N/A

• Pictures (optional)

  Media

2. HSEQ notice boards:

• Is there an HSEQ notice board present?

  Yes

  No

  N/A

• If so, is the information on it up to date?

  Yes

  No

  N/A

• Is the most recent safety (FOS) journal placed on the notice board?

  Yes

  No

  N/A

• Is the emergency response (E.R.) chart placed on the notice board?

  Yes

  No

  N/A

• Picture notice board (if present)

  Media

3. Toolbox meetings

• Are toolbox meetings held on a regular basis?

  Yes

  No

  N/A

• If so, are toolbox reports filed and visible?

  Yes

  No

  N/A

4. E.R. bullet points:

• Is the evacuation floorplan clearly visible?

  Yes

  No

  N/A

• Is the staff familiar with relevant information of the emergency response plan?

  Yes

  No

  N/A

• Is there a first aid kit present and sealed?

  Yes

  No

  N/A

• Are the fire extinguishers placed in a logical position and within reach?

  Yes

  No

  N/A

• Are the fire extinguishers sealed?

  Yes

  No

  N/A

• Are the fire extinguishers recently serviced?

  Yes

  No

  N/A

• Pictures (optional)

  Media

5. Condition of the workplace (general):

• Is there a sufficient number of bins present?

  Yes

  No

  N/A

• Is the electrical equipment tested (including test label) and in good condition?

  Yes

  No

  N/A

• Is the temperature acceptable?

  Yes

  No

  N/A

• Is the ventilation adequate?

  Yes

  No

  N/A

• Are the lights in good condition?

  Yes

  No

  N/A

• Is the noise level acceptable?

  Yes

  No

  N/A

• Is housekeeping adequate?

  Yes

  No

  N/A

• Pictures (optional)

  Media

5.A. Condition of the workplace (quayside / yard / warehouse) - if applicable:

• Are the spill kits in place and clearly visible?

  Yes

  No

  N/A

• Are the spill kits in good condition?

  Yes

  No

  N/A

• Are the walkways clearly indicated?

  Yes

  No

  N/A

• Are the walkways in good condition and free of trash / obstacles?

  Yes

  No

  N/A

• Is housekeeping adequate?

  Yes

  No

  N/A

• Pictures (optional)

  Media

5.B. Condition of the workplace (office) - if applicable:

• Is the furniture height adjustable and in good condition?

  Yes

  No

  N/A

• Are the stair treads and handrails in good condition?

  Yes

  No

  N/A

• Is housekeeping adequate?

  Yes

  No

  N/A

• Pictures (optional)

  Media

5.C. Condition of the kitchen - if applicable:

• Is the kitchen equipment (microwave, sandwich toaster, oven) clean?

  Yes

  No

  N/A

• Is the odor acceptable?

  Yes

  No

  N/A

• If refrigerators are present, are they clean?

  Yes

  No

  N/A

• Is content of refrigerator found to be still in date?

  Yes

  No

  N/A

• Is housekeeping adequate?

  Yes

  No

  N/A

• Pictures (optional)

  Media

6. Smoking areas - if applicable:

• Is the ventilation adequate?

  Yes

  No

  N/A

• Is there a sufficient number of ashtrays present?

  Yes

  No

  N/A

• Is there a fire extinguisher available that meets the requirements as pointed out in chapter 4 of this SMAT model?

  Yes

  No

  N/A

• Is housekeeping adequate?

  Yes

  No

  N/A

• Pictures (optional)

  Media

7. Miscellaneous

• Is the correct branding (logos) used?

  Yes

  No

  N/A

• Additional issues:

• Additional pictures:

  Media

• Initials SMAT Team leader

  Sign