Serious Seven - S11 – Mobile Equipment

• PREPARED BY:

• Date

  Date

• MANUFACTURING LINE

  Select Line 1 Line 2 Common System

  • Line 1
  • Line 2
  • Common System

• LOCATION / AREA

• NAME OF EQUIPMENT

• JOB DESCRIPTION (DESCRIBE SPECIFIC TASK)

• NAME OF ADDITIONAL OBSERVERS

• NUMBER OF IMERYS EMPLOYEES OBSERVED

• NUMBER OF CONTRACTORS OBSERVED

• Additional comments

• PICTURE OF THE SYSTEM / EQUIPMENT DURING THE INSPECTION

  Media

• Is there a completed vehicle inspection record for the mobile equipment observed?

  Yes

  No

  N/A

• Is the traffic plan currently used by all trucks delivering crude, supplies, chemicals or waste hauling?

  Yes

  No

  N/A

• Is traffic signage in place and in good condition?

  Yes

  No

  N/A

• All devices (i.e. brakes, horn, back-up alarm, etc) which may effect safe mobile equipment operation were functional and properly used.

  Yes

  No

  N/A

• Do forklift operators contact the FEL operator prior to entering the crude shed area?

  Yes

  No

  N/A

• Seat belts were worn as required for the mobile equipment operation.

  Yes

  No

  N/A

• Safe operational practices were observed with loading and unloading operations?

  Yes

  No

  N/A

• Are Pedestrian walkways marked?

  Yes

  No

  N/A

• All individuals observed remained clear of suspended loads

  Yes

  No

  N/A

• Does the list include all equipment safety issues identified this observation?

  Yes

  No

  N/A

SAFETY VISIT CARD

• CHECKLIST # 1 - MARK ALL BEHAVIOURS THAT APPLY

  Select Climbing or Standing on Equipment Climbing through Equipment (Awkward Position) Ascending/Descending (Stairs, Ladders, Platforms) Ergonomics (Position/Posture) (Pushing & Pulling) Eyes on Task Line of Fire (Being Struck By Something) Electrical Hazards (Following Safe Work Practices) Isolation (Installation of Lockout/Tagout / Try) Ergonomics (Lifting/Carrying) Line of Fire (Caught Between Something)

  • Climbing or Standing on Equipment
  • Climbing through Equipment (Awkward Position)
  • Ascending/Descending (Stairs, Ladders, Platforms)
  • Ergonomics (Position/Posture) (Pushing & Pulling)
  • Eyes on Task
  • Line of Fire (Being Struck By Something)
  • Electrical Hazards (Following Safe Work Practices)
  • Isolation (Installation of Lockout/Tagout / Try)
  • Ergonomics (Lifting/Carrying)
  • Line of Fire (Caught Between Something)

• CHECKLIST # 2 - MARK ALL BEHAVIOURS THAT APPLY

  Select Stepping Over or Under Equipment (Awkward Position) Climbing Over Handrails Isolation (Securing or Bleeding Off Stored Energy) Personnel Protective Equipment (All Needed for Job) Vehicles & Driving (Securing Parked Vehicles) Vehicles & Driving (Maintaining an appropriate Speed) Proper Chemical Handling (Labeling, Storage, Use) Tools/Equipment (Correct For Job & Proper Use) Tools/Equipment (Good Condition or Properly Stored) Are Hazards Controlled (Eliminated/Barricading)

  • Stepping Over or Under Equipment (Awkward Position)
  • Climbing Over Handrails
  • Isolation (Securing or Bleeding Off Stored Energy)
  • Personnel Protective Equipment (All Needed for Job)
  • Vehicles & Driving (Securing Parked Vehicles)
  • Vehicles & Driving (Maintaining an appropriate Speed)
  • Proper Chemical Handling (Labeling, Storage, Use)
  • Tools/Equipment (Correct For Job & Proper Use)
  • Tools/Equipment (Good Condition or Properly Stored)
  • Are Hazards Controlled (Eliminated/Barricading)

• CHECKLIST # 3 - MARK ALL BEHAVIOURS THAT APPLY

  Select Reaching through Handrails Interaction with Vehicles Have Hazards/Risks been Communicated with Others Are there any Balance Traction Grip Issues Pre Job Safety Assessment Used Work at Heights (Protecting from Fall Hazards) Confined Spaces (Following Safe Work Practices) Work Environment (Hot, Cold, Wet, Etc.) Are Safe Work Practices being used?

  • Reaching through Handrails
  • Interaction with Vehicles
  • Have Hazards/Risks been Communicated with Others
  • Are there any Balance Traction Grip Issues
  • Pre Job Safety Assessment Used
  • Work at Heights (Protecting from Fall Hazards)
  • Confined Spaces (Following Safe Work Practices)
  • Work Environment (Hot, Cold, Wet, Etc.)
  • Are Safe Work Practices being used?

HAZARDS & RISK ASSESMENT

ASSESMENT

• Select the level of risk: Low, Medium, High

  Low

  Medium

  High

• Is there a way to do the job/task "Better" and/or "Safer"?

• Feedback Given:

• Follow Up Action required ? (if any, submit action plan)

  Yes

  No

  N/A

ENDING TIME

• ENDING TIME

  Date