Information
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Location Name:
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Client / Site
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Conducted on
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Prepared by
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On Site Representative or Person In Charge
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Supervisor or Forman on site
HOUSEKEEPING/ENVIRONMENTAL
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Are all pathways clear of rubbish or obstructions and slip free?
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Are all stairs and steps in good/safe condition and have suitable non-slip surfaces?
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Are hand rails secure and in good condition?
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Are emergency contact numbers posted and readily available?
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Are spills reported promptly?
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Is spill clean-up materials readily available ? (Absorbent pads, spill booms, etc.)
LIGHTING
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Is there adequate lighting in the area?
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Are all lights functional and in good working order?
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Where needed are explosions proof lights available ?
ELECTRICAL
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Are all electrical cords in good repair with no broken or damaged plugs or sockets?
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Are quarterly electrical tool and cord inspection being completed and visibly marked with the proper color for the quarter?
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Are breakers properly labeled and kept closed?
EQUIPMENT
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Does heavy equipment such as track cranes, forklifts, dozers, etc. have back-up alarms that are functional?
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Are crane and heavy equipment inspections up to date?
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Are guards in place on all machinery?
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Is there evidence of spills or discharges from the crane, spud unit, or other heavy equipment?
PPE
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Are employees wearing secondary eye protection when grinding/chipping?
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Are employees wearing the appropriate PPE for the job task at hand? ( Hard Hat, Hearing Protection, Chain Saw Chaps, PFD, Gloves, Etc.)
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Is the correct PPE available?
FIRST AID
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Does the First Aid Kit appear to be fully stocked?
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Is the Gurney in place and accessible?
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Is there someone on site that is First Aid/CPR trained?
GENERAL SAFETY
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Are compressed cylinders secured with a chain and caps on?
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Are ladders in good condition with no apparent damage?
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Are lockout/tagout materials readily available on site if needed?
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Are surface openings properly guarded?
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Are Lift Slings in good condition and stored properly? (Random Checks)
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Is a tag line used when a load could swing or needs guidance?
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Are hand tools in good condition?
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Are guards in place on shafts, pinch points, power tools, etc?
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Are storage areas properly secured?
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Are any containers (Drums, Pails, Etc.) damaged?
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Are all containers labeled with its proper contents?
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Are fire extinguishers properly mounted and present?
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Are man-hole covers/hatches marked confined space?
DOCUMENTATION
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Are safety training and meetings being held and documented?
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Are monthly fire extinguisher inspections being documented?
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Are employees completing the monthly BBS observation cards?
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Are JSEA's being completed daily or before each new job task?
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Do employees have a current safety training card (PEC, Safe Gulf, Safe Land, EnCosha, Etc.)?
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Are material safety data sheets available on all substances on site?
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Are evacuation procedures displayed or available for employees/visitors to review?
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Are evacuation drills/fire practiced and date of last drill?
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Are new employees given a site specific orientation?
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Are visitors to job sites or vessels given an orientation of safety rules and informed of current work hazards?
Comments and Signatures
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SITE SUPERVISOR'S COMMENTS
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SITE SUPERVISOR'S SIGNATURE
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CORRECTIVE ACTION TAKEN OR NEEDED
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COMPLETION DATE AND RESPONSIBILTY
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CLOSING COMMENTS
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PERSON COMPLETING THE AUDIT