Information
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Client, Site and/ or Location:
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Conducted on:
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Evaluated by:
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Supervisor:
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Location:
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Personnel Affiliated; if Applicable:
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In support of a sustainable culture with a focus on Safety and Environmental Adherence, Quality, Communication and Customer Service we have developed this Project Packet Auditing Tool. The purpose of this tool is to provide management and/or designated competent personnel a guide for reference when reviewing project affiliated documentation.
The titled sections below are intended to evaluate by scoring, the quality of documentation that is of representation for each section. Select all applicable section(s) from (1) through (9) and appropriately provide an answer that best supports the question for each based on your review of the supporting documentation. Each tilted section offers an input of “Coaching Comments and/or Recognition”. Please use such to provide directional guidance or positive acknowledgement supportive of the review. At time of completion the evaluation and results shall be reviewed with the supervisor. Evaluation closure is subject to the completion of any action items deemed required by the evaluator.
The quality of your feedback is essential to the success of this program and development of our personnel and safety culture. -
1.0 PROJECT MANAGEMENT TOOL - SECTION 0.16
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Review includes documents supportive of the titled section:
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1.1 Is the current version of the Company's Project Management Tool form being utilized
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1.2 On page (1), Expectation Orientation - is the form complete and signed by all crew members
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1.3 On page (2), Observation Checklist - is the form complete with information that would reflect usage for observance guidance and notations throughout the shift of work
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1.4 On page (2), Observation Checklist - does the form have a beginning and ending time complete
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1.5 On page (3), Post-Shift Evaluation - is the form complete with all selections filled in or marked non-applicable
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1.6 On page (3), Post-Shift Evaluation - is the form completed with writings that promote positive development by reviewing such in the following day's safety meeting
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1.7 On page (3), Post-Shift Evaluation - does the form have a beginning and ending time complete
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Coaching Comments and/or Category Recognition:
2.0 SAFETY MEETING - SECTION 0.17
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Review includes documents supportive of the titled section:
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2.1 Is the current version of the Company's Safety Meeting form being utilized
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2.2 Are the topic(s) relevant to the job task, related equipment, work environment or exposures of risk
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2.3 Is the form complete with information in all of the required fields; legible and accurate
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2.4 Does the information reflect or reference any items captured in the previous days Post-Shift Evaluation
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Coaching Comments and/or Category Recognition:
3.0 JSEA - SECTION 37.12
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Review includes documents supportive of the titled section:
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3.1 Is the current version of the Company's JSEA being utilized
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3.2 On page (1), is all the required header information legible, complete, and accurate
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3.3 On all pages, is the main work activity and traceability data identified and accurate
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3.4 If applicable; does the JSEA identify SSE(s) and are mentor(s) assigned
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3.5 Are the environmental concerns relative to the task been identified and mitigation(s) acknowledged
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3.6 Has (SWA) Stop-Work-Authority on the JSEA been checked as to identify such was reviewed
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3.7 On page (1); have all the affiliated PPE requirements, safety systems, work permits, equipment and pre-use inspections data been checked
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3.8 Have all the personnel involved in the JSEA process “PRINTED” and provided their “SIGNATURE” within the lines provided on page (1)
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3.9 On page (2), have all the P.A.L.S. rules and hazard identification tools been selected accurate to the JSEA task
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3.10 On page (3), has a sequence of job/ task steps, the associated hazards and precautionary safeguards for each step been written in a descriptive manner
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3.11 Have personnel been assigned as appropriate for each task step of the JSEA; initials or present in the column
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3.12 Does the JSEA identify the most serious potential injury for the task being performed and is the identification accurate to task and/or work environment
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3.13 For review/ authorization purposes, has the JSEA been acknowledged by signature of the Ultimate-Work- Authority (UWA) or Person-In-Charge (PIC)
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3.14 Is there evidence that the JSEA was available at the vicinity of work following the morning review; i.e. for reference and/ or revision opportunities? Does it offer task writings beyond those written and reviewed pre-task commencement.
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3.15 If applicable; were there references identifying procedures, SOP(s), SWP(s), SIM-OPS, etc.) - if so are the reference documents attached to the JSEA and/or work folder
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3.16 If applicable, was any recognition made that required changes to an existing work procedure or practice; i.e. (MOC) Management-of-Change process
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Was a MOC properly documented and processed for adequate approval
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Coaching Comments and/or Category Recognition:
4.0 PERMIT TO WORK or HOT-WORK PERMIT - SECTION 33.1 or 33.2
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Review includes documents supportive of the titled section:
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4.1 Is the current version of the Company's Permit-To-Work or Hot-Work Permit being utilized
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4.2 Is all the form's required information legible, complete, and accurate
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4.3 Was an adequate hazard assessment identifying the work and PPE performed prior to commencement of the permit
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4.4 If applicable, is an SDS (Safety Data Sheet) and/ or MOC (Management of Change) referenced for support and attached to the work folder
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4.5 Is the "Items to be Completed" section complete with initials <br>
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4.6 Are there any "Special Limitations" written supportive of the permit and are the writings sufficient
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4.7 Are the required signatures complete? (supervisor, involved personnel, and UWA or PIC)
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4.8 Do the forms acknowledge times of the Permit(s) being "Opened" and then "Closed"
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Coaching Comments and/or Category Recognition:
5.0 CONFINED SPACE ENTRY - SECTION 7.2 AND 7.3
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Review includes documents supportive of the titled section:
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5.1 Is the current version of the Company's Confined Space Entry Form being utilized
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5.2 Is all of the required information for the "Scope" section complete, legible and accurate
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5.3 Is the "Preparation" (Prep.) section complete and accurate supportive of the entry
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5.4 Is the "Atmospheric Testing" section complete, supportive of (30) minute logging for continuous monitoring and are the writings legible
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5.5 Is the "Protective Equipment" section complete and accurate supportive of the entry
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5.6 Is the "Communication and Emergency Action" section complete, accurate supportive of the entry and are the writings legible
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5.7 Is the "Signatures" section complete with signatures of responsibility
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5.8 Are the "Additional Emergency Procedures" specified, are they accurate supportive of the environment and is the writings legible
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5.9 Is the "Authorized Entrant(s) Roster" accurately complete; i.e. supervisor's signature with documented entry and exit times for entrant personnel
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5.10 Is the "Permit Cancellation" section complete and the writings legible
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5.11 Is the "Additional Atmospheric Tests" section complete, supportive of (30) minute logging for continuous monitoring and are the writings legible
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Coaching Comments and/or Category Recognition:
CONFINED SPACE RESCUE PLAN
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5.12 Is the current version of the Company's "Confined Space Rescue Action Plan" being utilized
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5.13 Is all of the required information complete, written legible and accurate supportive of the entry permit
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5.14 Is the "Means to Summon Rescue" section complete and has response personnel been noted
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5.15 Is the "Method of Rescue" section complete and accurately supportive of the entry
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5.16 Is the "Equipment Required" for rescue completely identified; i.e. pre-rigging, equipment, rope and medical supplies sections
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5.17 Is the "Designation of Rescue Personnel" section complete properly identifying all parties involved; supportive of their roles
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5.18 Is the "Space Description" diagram section complete with drawing(s) accurate to entry and legible for rescue planning
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5.19 Is the "CSR" Action Plan/ Planning referenced in the JSEA supportive of the activity
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5.20 Is the steps of the rescue plan sufficient and/or specific to an overview of the entry; i.e. tank, vessel, barge, cutting box, marine portable tank (MPT), etc.
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5.21 Has the plan been completed and signed for acknowledgement by the Entry Supervisor
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Coaching Comments and/or Category Recognition:
6.0 ATMOSPHERIC MONITORING/ CALIBRATION LOG - SECTION 25.2 AND 25.3
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Review includes documents supportive of the titled section:
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6.1 Is the current version of the Company's Daily Bump Test form (Section 25.2) being utilized
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6.2 Is a bump test being performed daily and is the required information complete; i.e. date, tester's name and signature, calibration gas lot # and "PASS" being acknowledged by way of the tester's initials
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6.3 Is the current version of the Company's Air Monitoring Results form (Section 25.3) being utilized
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6.4 Has the generator/client name and location along with the manifest number been filled out
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6.5 Are the readings supportive of monitoring results written legible and the section of the form fully complete
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Coaching Comments and/or Category Recognition:
7.0 EQUIPMENT INSPECTION
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Review includes documents supportive of the titled section:
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7.1 Select the type of inspection(s) applicable and supportive of this evaluation
- Crane
- Fork-Lift
- Skid-Steer/ Loader
- Cleaning Equipment
- Transfer Equipment
- Fall Protection
- Confined Space Rescue
- Respiratory
- Vehicle
- Other
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7.2 Have the applicable and current versions of the Company's pre-use inspection forms been filled out adequate to the equipment involved with the task
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Coaching Comments and/or Category Recognition:
8.0 LIFT PLAN PERMIT - SECTION 10.14
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Review includes documents supportive of the titled section:
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8.1 Is the current version of the Company's Lift Plan Permit being utilized
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8.2 Is all the form's required information written legible, complete, and accurate
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Coaching Comments and/or Category Recognition:
9.0 BEHAVIOR BASED SAFETY (BBS) - SECTION 4.1
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Review includes documents supportive of the titled section:
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9.1 Is the current version of the Company's BBS card being utilized
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9.2 Is a selection indicating the type of observation checked; i.e. Safe, Unsafe or Stop-Work-Authority
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9.3 Are the applicable observation "Categories" marked; i.e. Body Positioning, Work conditions/ Housekeeping, etc.
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9.4 Is the card written with a quality description of the Observation, Intervention Conversation and Actions Taken
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9.5 Was the card signed and dated by the observer
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Coaching Comments and/or Category Recognition:
10.0 EVALUATOR ACKNOWLEDGMENT
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Name of Reviewer/ Evaluator:
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Add signature
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Select date
