Audit

Work order

Tailgate safety topic is specific to the job performed

JHSA signed by all crew members

Pre job inspection done on equipment/vehicles

Safety controls

Crew is aware of all hazards and how to avoid them

LOTO done correctly

MSDS SHEETS CORRECT

All permits filled out correctly (Confined Space etc)

Barricade and tags properly placed

All PPE present and properly used

Is working area clean and free of hazards

Are ladders, scaffold, fall protection in use

Are the ladders, scaffolds, man lifts and fall protection being properly used

Hydroblasting

Whip checks in place

Blast hose inspected

Blast hose in good repair

10k

20k

40k

Lancing

Job on elevated floor.

Is blast hose properly tied off

Anti withdrawal device in place

Is anti-withdrawal device properly mounted

Is stinger and nozzle 1.5X the diameter of the pipe being cleaned?

Is lance in good repair

Is employee operating his own foot pedal

Is foot pedal in proper working order

Shotgun

Shotgun appropriate length

Does shot gun have a hose shroud

Vacuuming

Is job on an elevated floor

Is vac hose properly tied off

Is there a hose break in use

If necessary, is vac truck properly bonded

Vehicle/equipment

Is fire extinguisher in place and inspected

Is vehicle/equipment clean

Comments and corrections

Observations

Corrective Action

Auditor
Crew Leader/Supervisor
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.