Safety Inspection DRAFT

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

Documentation

• A current written program is in place for this topic.

  Yes

  No

  N/A

• All employees have been trained on this topic (New Hire and Refresher every 12 months).

  Yes

  No

  N/A

Inspection

• Emergency Action Plan (MAP) is posted, exit routes, location of portable fire extinguishers, and AT LEAST two (2) rally points identified.

  Yes

  No

  N/A

• Exits are clearly marked with signage and illuminated as required.

  Yes

  No

  N/A

• Exit doors are accessible and functioning as required.

  Yes

  No

  N/A

• Incident Reporting Procedures posted near each phone and common areas.

  Yes

  No

  N/A

• First Aid Kits clean and properly stocked with no out-of-date items. Bloodborne pathogens kit available (gloves, glasses, bio-hazard bags)

  Yes

  No

  N/A

• Eye Wash Stations installed correctly where required and functioning.

  Yes

  No

  N/A

Documentation

• A current written program is in place for this topic.

  Yes

  No

  N/A

• All Affected Employees have been trained on this topic (New Hire and Refresher every 12 months).

  Yes

  No

  N/A

• All Authorized Employees have been trained on this topic (Initial and Refresher every 12 months).

  Yes

  No

  N/A

Inspection

• It is clear to all employees who has been trained as and is authorized to be Entrants, Attendants and Entry Supervisors.

  Yes

  No

  N/A

• A Master List and procedures are available for each Confined Space.

  Yes

  No

  N/A

• All Confined Spaces numbered and identified with signage.

  Yes

  No

  N/A

• Confined Space entry permits are available and, if used, were completed correctly and are kept on file.

  Yes

  No

  N/A

• Yes

  No

  N/A

Documentation

• A current written program is in place for this topic.

  Yes

  No

  N/A

• All employees have been trained on General Safety and Housekeeping requirements.

  Yes

  No

  N/A

• Yes

  No

  N/A

Inspection

• Entry sign, traffic plan, and other safety signage in place at entrance to facility.

  Yes

  No

  N/A

• Grounds free of trash and debris, trash cans on site, dumpsters have lids & plugs. No empty drums, totes or tanks.

  Yes

  No

  N/A

• Hoses stored properly and are not a tripping hazard.

  Yes

  No

  N/A

• Lighting is adequate and operational.

  Yes

  No

  N/A

• Housekeeping acceptable - OFFICE (counters, floor, storage, bathroom).

  Yes

  No

  N/A

• Housekeeping acceptable - YARD (entrance, parking areas, roadways, etc.).

  Yes

  No

  N/A

• Housekeeping acceptable - SHOP / OTHER BUILDING (floor, parts room, etc.).

  Yes

  No

  N/A

Documentation

• A current written program is in place for this topic.

  Yes

  No

  N/A

• All employees have been trained on HAZCOM requirements.

  Yes

  No

  N/A

• SDS updated and available for all applicable materials used on site. List of chemicals on site.

  Yes

  No

  N/A

Inspection

• All containers labeled correctly.

  Yes

  No

  N/A

• Flammable liquids stored in metal cans with self-closing lids.

  Yes

  No

  N/A

Documentation

• A current written program is in place for this topic.

  Yes

  No

  N/A

• All employees are trained and aware of the policy forbidding exposing themselves to live electrical and protections / procedures are in place to safely resolve issues.

  Yes

  No

  N/A

Inspection

• Electrical room is labeled, is clean, has clear access and can be closed. High voltage signs posted. Not used for storage.

  Yes

  No

  N/A

• Panels, breakers and switches are properly identified and labeled.

  Yes

  No

  N/A

• GFI's used for all outdoor or wet areas.

  Yes

  No

  N/A

• All conduit and wiring free from damage.

  Yes

  No

  N/A

• All extension power cords and plugs free from damage and NOT used for permanent applications (3+ days is considered permanent).

  Yes

  No

  N/A

• All panels, switches, receptacles, junction boxes are provided with appropriate covers (i.e. there is no exposure to live electrical parts).

  Yes

  No

  N/A

Documentation

• A current written program is in place for this topic.

  Yes

  No

  N/A

• It is clear who is trained as an Authorized and Affected Individual.

  Yes

  No

  N/A

• LOTOTO procedures available for each piece of equipment.

  Yes

  No

  N/A

Inspection

• LOTOTO station mounted with standardized RED locks and tags and only ONE (1) unique key per lock.

  Yes

  No

  N/A

• LOTOTO devices are used properly and ONLY for Energy Isolation processes.

  Yes

  No

  N/A

• A Continuous Log and Periodic Inspection is completed for procedures executed.

  Yes

  No

  N/A

Documentation

• A current written program is in place for this topic.

  Yes

  No

  N/A

• All employees are appropriately trained on this topic and the training is documented.

  Yes

  No

  N/A

• Current PPE Selection sheets are available describing the requirements by job title.

  Yes

  No

  N/A

• Task specific PPE identified and available (hearing protection, full face shields and rubber gloves for truck wash area, leather gloves, Arc Flash kit, etc).

  Yes

  No

  N/A

Inspection

• PPE requirements posted.

  Yes

  No

  N/A

• "Basic 5" available and observed being worn (Hard Hats, Glasses, Hi-Viz, Safety Boots, Gloves ready for use).

  Yes

  No

  N/A

• Extra PPE available for employees as needed and for visitors.

  Yes

  No

  N/A

Documentation

• A current written program is in place for this topic.

  Yes

  No

  N/A

• All employees are appropriately trained on this topic and the training is documented.

  Yes

  No

  N/A

Documentation

• A current written program is in place for this topic.

  Yes

  No

  N/A

• All employees are appropriately trained on this topic and the training is documented.

  Yes

  No

  N/A

• WAH procedures, risk assessments, and permits implemented, used, and filed.

  Yes

  No

  N/A

• Personal Fall Protection Systems are inspected before use and an annual inspection is documented as required.

  Yes

  No

  N/A

Inspection

• Elevated work platforms and cat walks clear of trip hazards and debris.

  Yes

  No

  N/A

• All work platforms that are elevated four (4) feet or more have handrail (42"), midrail (21"), and toe board (4" tall).

  Yes

  No

  N/A

• All stairs with four (4) or more steps have standard hand rails.

  Yes

  No

  N/A

• There are NO aluminum ladders on site. Portable ladders and scaffolding in good condition, labeled, properly used, secured and stored when not in use.

  Yes

  No

  N/A

• Fixed ladders in good condition, secure, and cages on ladders over 20' starting at 7' and provided with cages/wells or landing platforms.

  Yes

  No

  N/A

• Beginning Nov. 2018, any NEW fixed ladder installations over 20' equiped with safety cable and connecting device.

  Yes

  No

  N/A

• Swing Gates are installed according to OSHA requirements (see guide).

  Yes

  No

  N/A

• Personal Fall Protection Systems are appropriate and being used properly by trained employees (full body harness and lanyard, connecting devices, etc.).

  Yes

  No

  N/A

• A current written program is in place for this topic.

  Yes

  No

  N/A

• All employees are appropriately trained on this topic and the training is documented.

  Yes

  No

  N/A

Documentation

• A current written program is in place for this topic.

  Yes

  No

  N/A

• All employees are appropriately trained on this topic and the training is documented.

  Yes

  No

  N/A

Inspection

• Fire Extinguishers mounted as required and checked every month for service life, pin secured, & mounted and accessible.

  Yes

  No

  N/A

• Oxygen / acetylene tanks in compliance (all gauges working properly, chained in proper manner to carts or walls, capped and stored at least 20 feet apart or from other combustibles when not in use, valves closed while not in use, equipped with a safety cap over the valves when in use)

  Yes

  No

  N/A

• All welding equipment is in good working order.

  Yes

  No

  N/A

• All portable welding equipment trailers equipped with fire extinguishers.

  Yes

  No

  N/A

• All torch hoses are in good condition with no unauthorized repairs and torch heads equipped with back-flow preventers.

  Yes

  No

  N/A

• All fuel storage containers have labels and required placards (Diesel Fuel, LP Gas, etc.).

  Yes

  No

  N/A

• Fuel storage emergency shutoff is marked, spill kit is on site, & fire extinguisher in operating condition & accessible.

  Yes

  No

  N/A

• No leaks in Fuel plumbing system, or outside containment area, fill pipes are capped, spill bucket has lid, tank monitoring system is operable.

  Yes

  No

  N/A

• Flammable and No Smoking signs present in all required areas (fueling area, etc.)

  Yes

  No

  N/A

• If amounts of flammable products exceed 25 gallons, they are stored in fire proof cabinets.

  Yes

  No

  N/A

Documentation

• A current written program is in place for this topic.

  Yes

  No

  N/A

• All employees are appropriately trained on this topic and the training is documented.

  Yes

  No

  N/A

• Operator trained (documentation available including annual observation) and is observed operating safely (seat belt, speed, looks before backing, etc.) during this inspection.

  Yes

  No

  N/A

Inspection

• There is designated parking for Front-End Loader, Powered Industrial Trucks (PIT), Forklifts, etc.

  Yes

  No

  N/A

• Pre-use inspections are completed.

  Yes

  No

  N/A

• INTERIOR inspected and compliant (Operator's Manual available, Fire Extinguisher, Seatbelt, Cab free of debris, etc.).

  Yes

  No

  N/A

• EXTERIOR inspected and compliant (Backup alarm working, All lights working, Tire/Wheel condition, Ladder, Hand-holds, Steps, Frame/Structural, etc.).

  Yes

  No

  N/A

• Site hazards for equipment are controlled (blind corners, slopes/drop-offs with proper berm, protocol in place for other vehicles, etc.).

  Yes

  No

  N/A

• If a PIT / Forklift / Moffett is on site, the Site-Specific Hazard Identification Forms are completed as required.

  Yes

  No

  N/A

• Yes

  No

  N/A

• A current written program is in place for this topic.

  Yes

  No

  N/A

• All employees are appropriately trained on this topic and the training is documented.

  Yes

  No

  N/A

• Lifting / Rigging Devices are compliant (tagged, safety latches, in good working order, stored properly, etc.)

  Yes

  No

  N/A