Title Page
Location Information
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Site conducted
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Operating Division
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Areas Inspected
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Areas Inspected
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Areas Inspected
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What Areas Were Inspected?
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Date Of Audit
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Lead Auditor
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Audit Participants
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Event Number
Field Observations
- Observation
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Hazard Type
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What Policy Was Violated?
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Hazard Group
- Housekeeping
- Ground Control
- Fire Prevention
- Air Quality
- Explosives
- Ventilation
- Loading, Hauling, Dumping
- Travel & Escapeways
- Electricity
- Compressed Air
- Machinery, Equipment, Tools
- Illumination
- Personal Protection
- Materials & Chemical Storage
- Miscellaneous
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Hazard Category
- Loose Ground
- Damaged Ground Support
- Improperly Installed Ground Support
- Working Under Unsupported Ground
- Other
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Hazard Category
- Inadequate Warning Signage
- Accumulation Of Combustible Materials
- Damaged Or Defective Firefighting Equipment
- Inadequate Or Damaged Evacuation Warning Systems
- Improper Storage Of Flammable Or Combustible Products
- Damaged Or Defective Fire Control Devices
- Other
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Hazard Category
- Observed Airborne Contaminates
- Improper Respirator Use Or Care
- Air Quality Readings Outside Established Limits
- Damaged Or Inadequate Controls
- Other
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Hazard Category
- Improper Separation Of Explosives Materials
- Accumulation Near Storage Facilities
- Improper Storage Of Explosives Materials
- Inadequate Or Damaged Storage Facilities
- Inadequate Or Damaged Delivery Vehicles
- Inadequate Control Of Blasting Operations
- Damaged Or Outdated Explosives Materials
- Improper Use Of Detonating Systems
- Use Of Improper Tools
- Other
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Hazard Category
- Air Not Sweeping Working Places
- Damaged Air Delivery Systems
- Areas Lacking Ventilation Not Barricaded
- Air Recirculating
- Damaged Or Defective Ventilation Controls
- Other
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Hazard Category
- Lack Of Traffic Control Devices
- Hazardous Transportation Of Materials
- Spillage Of Materials During Transportation
- Inadequate Berms
- Inadequate Dump Area Portections
- Inadequate Roadway Maintenance
- Insufficient Dust Control At Dumps or Muckpiles
- Other
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Hazard Category
- Unsafe Access To Working Places
- Damaged Ladders, Stairs, Or Handrails
- Improper Ladder Placement Or Securement
- Unmarked Area Of Restricted Clearance
- Snow, Ice, Or Mud Accumulation On Walkways
- Improper Ladder Construction
- Inadequate Escapeways From Working Places
- Insufficient Or Damaged Refuge Areas
- Other
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Hazard Category
- Damaged Electrical Conductors
- Unlabeled Power Switches
- Inadequate Switchgear Protection
- Inadequate Danger & Warning Signage
- Inadequate Infrastructure Grounding
- Untested Or Outdated Ground Continuity Test
- Damaged Or Dislodged Cover Plates
- Unguarded Lighting Fixtures
- Other
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Hazard Category
- Missing Or Outdated Certification Stamp/Tag
- Damaged Or Missing Tank Pressure Gage
- Insufficient Or Missing Hose Locking Device
- Other
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Mobile Equipment?
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Was A Preoperation Inspection Completed By The Operator?
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Is The Operator Properly Trained To Use The Equipment
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Hazard Category
- Improper Parking Procedures
- Operator's Station Free Of Debris
- Damaged Steps, Handles ,Climbing Points
- Damaged Tires Or Wheels
- Leaks Or Accumulation
- Damaged Windshield, Windows, Mirrors
- Damaged Or Outdated Fire Suppression
- Damaged Seatbelts Or Seats
- Damaged Or Unavailable Wheel Chocks
- Insufficient Or Missing Placards Or Signs
- Insufficient Lighting
- Horn Insufficient Volume Or Non-Functional
- Backup Alarm Insufficient Volume Or Non-Functional
- Damaged Steering And Control Systems
- Inadequate Service Or Emergency Brake Tests
- Other
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Hazard Category
- Safety Defects Or Equipment Damage
- Insufficiently Or Unguarded Moving Parts
- Insufficient Falling Material Overhead Protection
- Stationary Grinding Machines
- Damaged Tools
- Tools Used Beyond Designed Capacity
- Hazardous Towing Or Moving of Equipment
- Welding Or Hot Work Areas Not Shielded
- Other
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Hazard Category
- Inadequate Illumination At Loading Or Dumping Areas
- Office Buildings >30fc
- Plant Areas & Shops >10fc
- Warehouses, Walkways, Exits >5fc
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- Inadequate First Aid Materials
- Damaged Or Outdated Hard Hat
- Damaged Or Inadequate Foot Protection
- Damaged or Inadequate Eye/Face Protection
- Improperly Worn Or Damaged Fall protection
- Inadequate High Visibility/Reflective Clothing
- Damaged Or Unavailable Life Jackets Or PFD
- W65 Not Inspected Or Not Within 25 FT
- Other
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- Unlabeled Chemical Containers
- Hazardous Stacking Or Storage of Materials
- Incorrect Storage Container For Material
- Unsecured Or Unprotected Gas Cylinders
- Failure To Use Taglines While Lifting
- Storage of Incompatible Substances
- Improper Hoisting Or Rigging
- Other
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- Potable Water Not Available Or Posted
- Inadequate Or Missing Barricades And Signage
- Food Being Consumed Or Stored In Prohibited Areas
- Other
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Hazard Category
- Trash & Refuse Improper Disposal
- Floors And Travelways Not In Clean/Passable Condition
- Toilet Facilities Not Clean Or Adequately Stocked
- Waste Receptacles Overflowing Or Uncovered
- Work Areas Cluttered & Disorganized
- Tools & Equipment Not Properly Stored
- Other
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Priority
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Hazard Description
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Critical Risk Prevention Violation?
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Which CRP was violated?
- #1-Fitness For Duty
- #2-Confined Space Entry
- #3-Working At Heights
- #4-Hazard & Risk Assessment
- #5-Lifting & Hoisting
- #6-Mobile Equipment Operations
- #7-Chemicals & Hazardous Materials
- #8-Equipment Safeguards & Protective Devices
- #9-Hazardous Energy Control
- #10-Ground Control & Slope Stability
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Has The Hazard Been Corrected
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Photographs
