Information
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Document No.
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Conducted on
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Auditors Name
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Client / Customer Name
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Customer Address
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Name & SESA Number of first (Lead) person audited:
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Audit Title
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Name & SESA Number of second person audited:
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SE Business
- Buildings
- Energy
- Industry
- IT
- Partner
- Smart Infrastructure
- Solar
- All Business (Execution Centre)
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Type of Auditors
- Field Employee Supervisor
- Service Manager
- Business Leader
- Country President/SVP
- Customer
- Safety Department
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Describe the work being completed:
At the vehicle
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1. 2. Is the vehicle content secure and barriers in place?
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1. 3. Identify any other vehicle safety equipment (high-vis vests, accident triangle, first aid etc.)
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1. 1. Is the vehicle documentation, and required markings present and valid?
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1. 4. Is the vehicle content organized?
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1. 5. Identify the general PPE available to the Auditee:
- Helmet
- Eye protection
- Hearing protection
- Respiratory protection
- Mechanical gloves
- Chemical gloves
- High visibility clothing
- Safety footwear
- Cold weather protection
- Other.
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1. 6. Identify the electrical PPE available to the Auditee:
- Electrical insulated gloves less 1000V
- Electrical insulated gloves greater 1000V
- Arc flash clothing Cat 0
- Arc flash face shield Cat 2
- Balaclava Cat 2
- Arc flash gloves Cat 2
- Arc flash clothing Cat 2
- Arc flash hood Cat 4
- Arc flash clothing Cat 4
- Other. Please give details below in 1.7
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1. 7. Details of other PPE available:
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1. 8. Is all conductive objects (jewellery, belt buckle, glasses) removed or protected?
BEFORE STARTING WORK- PLANNING FOR EMERGENCIES
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2. 1. Is the Auditee aware of the Fire & Medical emergency procedures?
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2. 2. Has the Auditee confirmed with the customer the location of all devices that will isolate the electrical energy in the event of an emergency?
DOCUMENTATION & TRAINING
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3. 1. Has the Auditee completed a Hazard Assessment & Written Work Plan?
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3. 2. Has the Auditee completed a point of work risk assessment (Pre-job safety plan) every day?
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3. 3. Has the Auditee received training on the product they are working on?
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3. 4. Has the Auditee received safety training in the previous 12 months?
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3. 5. (If more than one person are carrying out work) Has the person in charge been identified on the documentation?
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3. 6. Explain the tasks being performed detailing key hazards and voltages?
INSPECT EQUIPMENT
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4. 1. Has the FE inspected his/her tools & equipment?
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4. 2. Are the tools in good working order (Insulation not damaged)
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4. 3. Specific Tools - Leads have only 4mm exposed / Box cutters have auto retractable blades
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5. 1. Is the environment safe? Lighting adequate, guards in place, overhead hazards controlled, chemicals controlled, slip trip fall hazards removed?
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5. 2. Is the employee wearing appropriate PPE for the hazards identified? (i.e. Mechanical gloves, hearing protection, etc.)
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5. 3. Are adequate measures in place to prevent unauthorized access to the work area?
WORKING AT HEIGHTS
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6. Working at heights<br><br>6. 1. Does the access equipment used comply with GSD 10-Guidance-Document-Ladders? <br>
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6. 2. Is a safety harness used if required when working at height?
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6. 3. Are people working below protected?
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6. 4. Has scaffolding been inspected & tagged by a competent person?
GENERAL WORK
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5. 1. Is the environment safe? Lighting adequate, guards in place, overhead hazards controlled, chemicals controlled, slip trip fall hazards removed?<br><br>
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5. 2. Is the employee wearing appropriate PPE for the hazards identified? (i.e. Mechanical gloves, hearing protection, etc.)
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5. 3. Are adequate measures in place to prevent unauthorized access to the work area?
ELECTRICAL DE-ENERGIZED WORK (CONSIDERED ENERGIZED UNTIL ALL STEPS OF LOTO ARE COMPLETE)
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7. 2. Is the LOTO checklist completed correctly?
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7. 3. Are all isolation devices locked out?
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7. 4. When there is more than one worker, does every worker have their locks in place?
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7. 5. Has the Auditee verified absence of voltage on all conductors, load and line side in every cabinet as they are opened? YES / NO / N/A
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7. 6. Is the appropriate meter for measuring less and more than 1000 volt used?
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7. 7. Is a Hot Stick used for applying grounds and voltage measurement above 1000 volt?
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7. 8. Is the meter calibrated annually if periodic calibration is required by the manufacturer?
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7. 9. Is the Hot Stick (Fiberglass rod) certified?
ENERGIZED TESTING
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8. 1. Has the Auditee a safety watch person available in case of emergency (Mandatory >1000V)?
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8. 2. Is the Auditee wearing the correct arc flash PPE that is equal to or exceeds the hazard level?
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8. 3. Are unprotected persons outside the limited approach and arc flash boundary?
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8. 4. Is there an Electrical Rescue hook (Shepherd's hook) available if required?
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8. 5. Are insulated tools used?
OTHER ENERGY SOURCES & HAZARDOUS SUBSTANCES (GAS, CHILLED WATER ETC.)
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9. 1. Are all other sources of energy & hazardous substances identified
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9. 2. Are all the steps of the LOTO procedure for other energy sources followed?
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9. 3. Is the appropriate PPE worn to protect against the hazards present from hazardous substances & other energy sources?
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9. 4. Is a safety Data Sheet (SDS) available for any Hazardous Substances used?
SAFETY MANAGEMENT & COMMUNICATION
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10. 1. When was the last safety audit by the Auditee's manager or delegate?
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10. 2. Describe the actions taken following the last audit:
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10. 3. How many times did the Auditee receive safety communication in the previous 12 months?
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10. 4. How does the Auditee access safety information?
- Safety Meetings
- E-mail from my Manager
- E-mail from others
- SERE Intranet
- Local Intranet
- Newsletter
- Safety on SPICE
- Other
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10. 5. Has the Auditee reported any near misses and safety improvement suggestions in the previous year?
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10. 6. If a near miss has been reported, is the Auditee satisfied with the preventative action taken?
CONCLUSIONS
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Record any non-compliances to procedures here:
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Record any good behaviours or practices observed here:
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Signed by
