PMI Cross Assessment V2

• Conducted on

  Date

• Prepared by

• Location
  Address

1) Safety Communication

• A. Weekly Safety Topics

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. T5 Subject

  Developing

  Implementing

  Practicing

  Excelling

  N/A

2) Posted Documents

• A. Emergency Guidelines

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. Permits

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. SDS

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• D. Ethics Hotline

  Developing

  Implementing

  Practicing

  Excelling

  N/A

3) Signage

• A. Entry

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. Confined Space

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. Arc Flash Labels

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• D. H2S - Hydrogen Sulfide (Asphalt Plants)

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• E. Overhead Powerlines

  Developing

  Implementing

  Practicing

  Excelling

  N/A

4) Slip, Trip, Falls

• A. Walking Surfaces

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. Ladders

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. Steps

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• D. Ground Hazards

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• E. Handrails

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• F. Grip Tape

  Developing

  Implementing

  Practicing

  Excelling

  N/A

5) Guarding

• A. Guards

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. Emergency Stops

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. Proximity Cables

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• D. Bench/Hand Grinders

  Developing

  Implementing

  Practicing

  Excelling

  N/A

6) VPS

• A. Crosswalks

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. Barriers

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. Signage

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• D. Designated Parking

  Developing

  Implementing

  Practicing

  Excelling

  N/A

7) PPE

• A. PPE

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. AC Cabinet (Asphalt Plant)

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. Arc Flash

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• D. Hot Work

  Developing

  Implementing

  Practicing

  Excelling

  N/A

8) Mobile Equipment

• A. 3 Point Stickers

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. Pre-Trip Inspection

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. Flex Step

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• D. Housekeeping

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• E. Seatbelt Compliance

  Developing

  Implementing

  Practicing

  Excelling

  N/A

9) LOTO

• A. Locks, Keys

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. Annual Proficiencies

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. CPM - Close Proximity Maintenance

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• D. Site Specific LOTO

  Developing

  Implementing

  Practicing

  Excelling

  N/A

10) Working from Heights

• A. Harnesses

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. Lanyards

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. Storage

  Developing

  Implementing

  Practicing

  Excelling

  N/A

11) Man Lifts

• A. Training

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. Secured Materials

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. Operators Manual

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• D. Inspection

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• E. Tie Off points

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• F. Housekeeping

  Developing

  Implementing

  Practicing

  Excelling

  N/A

12) Electrical Safety

• A. Temp cords

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. GFCI

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. Disconnects

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• D. Panels

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• E. Tools

  Developing

  Implementing

  Practicing

  Excelling

  N/A

13) Fire Protection

• A. Inspection - Annual/Monthly

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. Proper Class

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. Clearance

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• D. Signage

  Developing

  Implementing

  Practicing

  Excelling

  N/A

14) Containments

• A. Drum Covers

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. Fire Cabinets

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. Gasses Separation

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• D. Containment Tanks/Drums

  Developing

  Implementing

  Practicing

  Excelling

  N/A

15) Air Compressors

• A. Clamps

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. Hoses

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. Keepers

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• D. Whip Checks

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• E. Air Nozzles

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• F. Pop Up Relief Valves - Monthly Test

  Developing

  Implementing

  Practicing

  Excelling

  N/A

16) Lifting Devices

• A. Tags

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. Capacities

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• C. Condition

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• D. Safety Latches

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• E. Storage

  Developing

  Implementing

  Practicing

  Excelling

  N/A

17) Structural Integrity

• A. Rusting Supports

  Developing

  Implementing

  Practicing

  Excelling

  N/A

• B. Loose panels (side walls/roofing)

  Developing

  Implementing

  Practicing

  Excelling

  N/A

18) Best Practices

• A. Best Practices Not Mentioned Above (share with other lines of business)

  Yes

  No

  N/A