Information
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Pipeline Construction Audit
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Joint Venture/ Spread
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Conducted on
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Prepared by
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Location
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Safety Inspector
Work Permit/ JSA
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Appropriate for Task/Task Covered
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Performed
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Reviewed
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Signed
Environmental/Emergency Response
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Emergency Action Plan
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Spill Response Kit
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Certified Responders
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First-Aid Kit
Hazardous Communication
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Safety Data Sheet Available
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Safety Data Sheet Reviewed
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Containers Labeled Properly
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Handling Procedures Followed
PPE
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Hard Hat
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Hard Hat worn correctly
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Eye/Face
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Hand
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Hearing
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Footwear
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Hi-Vis Vest
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FRC
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Monitors Available, In Use, Calibrated (4-Gas, H2S or Other)
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Other:
Material Handling
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Body Mechanics
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Manual Lifting Devices (Come-a-Longs, Chain falls, etc) )
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Safety Latch
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Slings
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Hooks & Shackles
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Wire Rope
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Lifting Chains
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Load Secure, Rigged Properly
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Tag Lines Used
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Other:
Worksite Protection
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Signs and crosswalks available for pedestrians
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Adequate cushion/warning for drivers
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Flagger present if necessary
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Flagger is wearing/using proper PPE/Equipment-hard Hat, Vest, Paddle
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Flagger positioning visible to drivers
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Signage is properly placed
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Cones are properly placed
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Retro reflective equipment and flashers in use at night
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Adequate clearance from overhead and other hazards
Vehicle/Equipment/Crane
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Authorized/Qualified Operator
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Designated Signal Person
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Seatbelt Used
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Backup Alarm
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Daily/Weekly/Annual Inspection
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Inspection Completed Properly
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Other:
Material Storage
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Material Stored Properly
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Flammable/Combustible Storage
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Pipe Chocked
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Other:
Fall Prevention/Protection
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Access/Egress
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Fall Protection
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Fall Protection Inspected
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Scaffolds/Ladders - Proper Type
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Scaffolds/Ladders - Inspected
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Scaffolds/Ladders - Use
Hand Tools
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Condition
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Guards/Handles
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Proper for Job/Use
Electrical
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GFCI/Assured Grounding Program
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Cords/Tools Inspected
Hot Work
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Permit
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Permit Conditions Followed
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Fire Watch
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Gas Cylinder Management
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Leads/Hoses/Gauges
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Other:
Fire Protection & Prevention
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Extinguisher inspection tag present and current
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Properly Rated/Size (BC versus ABC)
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Combustible/Flammable Material Away from Hot Work
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Fire Extinguishers at least 25ft away but no further than 75ft away from Fuel Cells
Excavation
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Hand digging used when approaching/crossing buried facilities
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Spill kits on board and stocked
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Sloped Properly
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Benched Properly
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Trench Box/Shoring Proper
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Trench Box Certifications
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Access/Egress Points
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Spoil Pile Minimum 2-Feet From Excavation
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Signs, Signals & Barricades
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One Call Made
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Utilities Identified
Signs/Barricades
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Condition
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Proper Type
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Marking Hazards
Housekeeping
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Worksite free of clutter
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Equipment, machines/tools do not block pathway
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Tripping and slipping hazards
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Tools properly stored/staged
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Crew Trucks/Trailers clean and free of clutter
Ergonomics/ Jobsite
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Proper lifting techniques used
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Employees positioned away from hazards, moving parts and equipment
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Pinch points
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Proper body positioning
Walking Surfaces
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Pathways
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Trip Hazards
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Holes Guarded
Overhead Power Lines
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Power Lines Marked with Goal Post and Signs
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Designated Spotter
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Proper Equipment for Spotter (Air Horn, Vest, etc )
Radiation Sources
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Signs, Signals & Barricades
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Film Badges for X-Ray Crew
Pressure Testing
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Equipment Integrity
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Whip Checks/Connections Pinned
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Signs, Signals & Barricades
Confined Space
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Permitted
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Personnel Trained
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Emergency Rescue Plan
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Rescue/Retrieval Equipment (Anklets, Harness, Life Line, etc...) )
Equipment/ Tools
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Availability and condition of tools
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Adequate lighting/visibility
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Grounding of tools/pipe/containers
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Air tools/hose connections/pins in place
Inspection Conclusion
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Inspection Notes
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Inspection Photos
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HSE Specialist
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Safety Inspector
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Date & Time
