Information

  • Document No.

  • Conducted on

  • Auditors Name

  • Client / Customer Name

  • Customer Address
  • Name & SESA Number of first (Lead) person audited:

  • Audit Title

  • Name & SESA Number of second person audited:

  • Name & SESA Number of third person audited:

  • Name & SESA Number of fourth person audited:

  • Name & SESA Number of fifth person audited:

  • Name of Contractor or Partner Company:

  • SE Business

  • Type of Auditors

  • Describe the work being completed:

At the vehicle

  • 1. 2. Is the vehicle content secure and barriers in place?

  • 1. 3. Identify any other vehicle safety equipment (high-vis vests, accident triangle, first aid etc.)

  • 1. 1. Is the vehicle documentation, and required markings present and valid?

  • 1. 4. Is the vehicle content organized?

  • 1. 5. Identify the general PPE available to the Auditee:

  • 1. 6. Identify the electrical PPE available to the Auditee:

  • 1. 7. Details of other PPE available:

  • 1. 8. Is all conductive objects (jewellery, belt buckle, glasses) removed or protected?

BEFORE STARTING WORK- PLANNING FOR EMERGENCIES

  • 2. 1. Is the Auditee aware of the Fire & Medical emergency procedures?

  • 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

  • 3. 1. Has the Auditee completed a Hazard Assessment & Written Work Plan?

  • 3. 2. Has the Auditee completed a point of work risk assessment (Pre-job safety plan) every day?

  • 3. 3. Has the Auditee received training on the product they are working on?

  • 3. 4. Has the Auditee received safety training in the previous 12 months?

  • 3. 5. (If more than one person are carrying out work) Has the person in charge been identified on the documentation?

  • 3. 6. Explain the tasks being performed detailing key hazards and voltages?

INSPECT EQUIPMENT

  • 4. 1. Has the FE inspected his/her tools & equipment?

  • 4. 2. Are the tools in good working order (Insulation not damaged)

  • 4. 3. Specific Tools - Leads have only 4mm exposed / Box cutters have auto retractable blades

  • 5. 1. Is the environment safe? Lighting adequate, guards in place, overhead hazards controlled, chemicals controlled, slip trip fall hazards removed?

  • 5. 2. Is the employee wearing appropriate PPE for the hazards identified? (i.e. Mechanical gloves, hearing protection, etc.)

  • 5. 3. Are adequate measures in place to prevent unauthorized access to the work area?

WORKING AT HEIGHTS

  • 6. Working at heights<br><br>6. 1. Does the access equipment used comply with GSD 10-Guidance-Document-Ladders? <br>

  • 6. 2. Is a safety harness used if required when working at height?

  • 6. 3. Are people working below protected?

  • 6. 4. Has scaffolding been inspected & tagged by a competent person?

GENERAL WORK

  • 5. 1. Is the environment safe? Lighting adequate, guards in place, overhead hazards controlled, chemicals controlled, slip trip fall hazards removed?<br><br>

  • 5. 2. Is the employee wearing appropriate PPE for the hazards identified? (i.e. Mechanical gloves, hearing protection, etc.)

  • 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)

  • 7. 1. Is the presence of SF6 considered?

  • 7. 2. Is the LOTO checklist completed correctly?

  • 7. 3. Are all isolation devices locked out?

  • 7. 4. When there is more than one worker, does every worker have their locks in place?

  • 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

  • 7. 6. Is the appropriate meter for measuring less and more than 1000 volt used?

  • 7. 7. Is a Hot Stick used for applying grounds and voltage measurement above 1000 volt?

  • 7. 8. Is the meter calibrated annually if periodic calibration is required by the manufacturer?

  • 7. 9. Is the Hot Stick (Fiberglass rod) certified?

ENERGIZED TESTING

  • 8. 1. Has the Auditee a safety watch person available in case of emergency (Mandatory >1000V)?

  • 8. 2. Is the Auditee wearing the correct arc flash PPE that is equal to or exceeds the hazard level?

  • 8. 3. Are unprotected persons outside the limited approach and arc flash boundary?

  • 8. 4. Is there an Electrical Rescue hook (Shepherd's hook) available if required?

  • 8. 5. Are insulated tools used?

OTHER ENERGY SOURCES & HAZARDOUS SUBSTANCES (GAS, CHILLED WATER ETC.)

  • 9. 1. Are all other sources of energy & hazardous substances identified

  • 9. 2. Are all the steps of the LOTO procedure for other energy sources followed?

  • 9. 3. Is the appropriate PPE worn to protect against the hazards present from hazardous substances & other energy sources?

  • 9. 4. Is a safety Data Sheet (SDS) available for any Hazardous Substances used?

SAFETY MANAGEMENT & COMMUNICATION

  • 10. 1. When was the last safety audit by the Auditee's manager or delegate?

  • 10. 2. Describe the actions taken following the last audit:

  • 10. 3. How many times did the Auditee receive safety communication in the previous 12 months?

  • 10. 4. How does the Auditee access safety information?

  • 10. 5. Has the Auditee reported any near misses and safety improvement suggestions in the previous year?

  • 10. 6. If a near miss has been reported, is the Auditee satisfied with the preventative action taken?

  • 10. 7. What has prevented the Auditee from being fully compliant?

CONCLUSIONS

  • Record any non-compliances to procedures here:

  • Record any good behaviours or practices observed here:

  • Signed by

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