Information

  • Pipeline Construction Audit

  • Joint Venture/ Spread

  • Conducted on

  • Prepared by

  • Location
  • Safety Inspector

Work Permit/ JSA

  • Appropriate for Task/Task Covered

  • Performed

  • Reviewed

  • Signed

Environmental/Emergency Response

  • Emergency Action Plan

  • Spill Response Kit

  • Certified Responders

  • First-Aid Kit

Hazardous Communication

  • Safety Data Sheet Available

  • Safety Data Sheet Reviewed

  • Containers Labeled Properly

  • Handling Procedures Followed

PPE

  • Hard Hat

  • Hard Hat worn correctly

  • Eye/Face

  • Hand

  • Hearing

  • Footwear

  • Hi-Vis Vest

  • FRC

  • Monitors Available, In Use, Calibrated (4-Gas, H2S or Other)

  • Other:

Material Handling

  • Body Mechanics

  • Manual Lifting Devices (Come-a-Longs, Chain falls, etc)…)

  • Safety Latch

  • Slings

  • Hooks & Shackles

  • Wire Rope

  • Lifting Chains

  • Load Secure, Rigged Properly

  • Tag Lines Used

  • Other:

Worksite Protection

  • Signs and crosswalks available for pedestrians

  • Adequate cushion/warning for drivers

  • Flagger present if necessary

  • Flagger is wearing/using proper PPE/Equipment-hard Hat, Vest, Paddle

  • Flagger positioning visible to drivers

  • Signage is properly placed

  • Cones are properly placed

  • Retro reflective equipment and flashers in use at night

  • Adequate clearance from overhead and other hazards

Vehicle/Equipment/Crane

  • Authorized/Qualified Operator

  • Designated Signal Person

  • Seatbelt Used

  • Backup Alarm

  • Daily/Weekly/Annual Inspection

  • Inspection Completed Properly

  • Other:

Material Storage

  • Material Stored Properly

  • Flammable/Combustible Storage

  • Pipe Chocked

  • Other:

Fall Prevention/Protection

  • Access/Egress

  • Fall Protection

  • Fall Protection Inspected

  • Scaffolds/Ladders - Proper Type

  • Scaffolds/Ladders - Inspected

  • Scaffolds/Ladders - Use

Hand Tools

  • Condition

  • Guards/Handles

  • Proper for Job/Use

Electrical

  • GFCI/Assured Grounding Program

  • Cords/Tools – Inspected

Hot Work

  • Permit

  • Permit Conditions Followed

  • Fire Watch

  • Gas Cylinder Management

  • Leads/Hoses/Gauges

  • Other:

Fire Protection & Prevention

  • Extinguisher inspection tag present and current

  • Properly Rated/Size (BC versus ABC)

  • Combustible/Flammable Material Away from Hot Work

  • Fire Extinguishers at least 25ft away but no further than 75ft away from Fuel Cells

Excavation

  • Hand digging used when approaching/crossing buried facilities

  • Spill kits on board and stocked

  • Sloped Properly

  • Benched Properly

  • Trench Box/Shoring Proper

  • Trench Box Certifications

  • Access/Egress Points

  • Spoil Pile Minimum 2-Feet From Excavation

  • Signs, Signals & Barricades

  • One Call Made

  • Utilities Identified

Signs/Barricades

  • Condition

  • Proper Type

  • Marking Hazards

Housekeeping

  • Worksite free of clutter

  • Equipment, machines/tools do not block pathway

  • Tripping and slipping hazards

  • Tools properly stored/staged

  • Crew Trucks/Trailers clean and free of clutter

Ergonomics/ Jobsite

  • Proper lifting techniques used

  • Employees positioned away from hazards, moving parts and equipment

  • Pinch points

  • Proper body positioning

Walking Surfaces

  • Pathways

  • Trip Hazards

  • Holes Guarded

Overhead Power Lines

  • Power Lines Marked with Goal Post and Signs

  • Designated Spotter

  • Proper Equipment for Spotter (Air Horn, Vest, etc…)

Radiation Sources

  • Signs, Signals & Barricades

  • Film Badges for X-Ray Crew

Pressure Testing

  • Equipment Integrity

  • Whip Checks/Connections Pinned

  • Signs, Signals & Barricades

Confined Space

  • Permitted

  • Personnel Trained

  • Emergency Rescue Plan

  • Rescue/Retrieval Equipment (Anklets, Harness, Life Line, etc...)…)

Equipment/ Tools

  • Availability and condition of tools

  • Adequate lighting/visibility

  • Grounding of tools/pipe/containers

  • Air tools/hose connections/pins in place

Inspection Conclusion

  • Inspection Notes

  • Inspection Photos

  • HSE Specialist

  • Safety Inspector

  • Date & Time

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.