SH EMEA FBA BEL QT - CS (2021/02)

• Conducted on

  Date

• Prepared by

• Location
  Address

• This inspection is to enhance safety awareness amongst the employees and must be conducted in a dialogue with the affected employees, thus to drive continuous improvement by active leadership in EHS.

• Site Name:
  Address

• Section "5. Car Audit" may also be performed as a separate inspection, i.e. during a regional CS meeting. In this case, please mark all other questions as N/A and enter 'Car Audit only' in the box below (Description of the works - intervention:)

• Description of the works - intervention:

• Present subcontractor(s); company name(s): (enter "None" if no subcontractors are present)

• In case questions can't be verified or checked; than please select N/A

1. Organization, environment and execution of the works

• 1.4. Is a work permit for hazardous activities (i.e. work at heights) and/or a hot work permit available and followed through?

  Yes

  No

  N/A

• 1.5. Is the work area properly demarcated and/or indicated with safety signage?

  Yes

  No

  N/A

• 1.7. Are the works conducted safely?

  Yes

  No

  N/A

• 1.8. Is an access procedure followed (through Technical/Facilities Department or Reception)?

  Yes

  No

  N/A

• 1.9. Is the technical documentation available?

  Yes

  No

  N/A

• 1.10. Is the work area arranged neatly and in order?

  Yes

  No

  N/A

• 1.11. Is generated waste removed and properly segregated?

  Yes

  No

  N/A

• 1.12. Can the works be conducted ergonomically?

  Yes

  No

  N/A

• 1.13. Can the works be conducted without risk for cut injuries, needle stick injuries, or entrapment of the limbs (hand/arm - foot/leg)?

  Yes

  No

  N/A

2. Protective equipment

• 2.2. Is lead protective equipment available and used when required?

  Yes

  No

  N/A

• 2.4. Have the workers safety shoes and do they wear them when required?

  Yes

  No

  N/A

• 2.5. Have the workers a safety helmet and do they wear it when required?

  Yes

  No

  N/A

• 2.6. Have the workers suitable safety gloves and do they wear them when required?

  Yes

  No

  N/A

• 2.7. Have the workers a dosimeter and do they use it correctly when required?

  Yes

  No

  N/A

• 2.8. Have the workers suitable working clothes (i.e. lab, surgery room)?

  Yes

  No

  N/A

3. Work tools

• 3.2. Is the (step)ladder properly set up, inspected (label) and suitable for the job?

  Yes

  No

  N/A

• 3.3. Are the used lifting devices and lifting equipment (i.e. pallet/material lifts, hoists, slings) properly set up, inspected (label) and suitable for the job (not exceeding their maximum load capacity)?

  Yes

  No

  N/A

• A hoist is a device used for lifting or lowering a load. Our hoists are manually operated and use chain as its lifting medium. The hoists couple to their loads using a lifting hook.

• A sling is a flexible strap or belt used in the form of a loop to support or raise a hanging weight, it is used in a rigging system for lifting. Our slings are made of synthetic fiber.

• 3.4. Are hazardous substances (chemicals), incl. spray cans, equipped with the correct safety signage?

  Yes

  No

  N/A

• 3.5. Have the employees a safety data sheet for the used hazardous substances (chemicals) or can they show where to find this information quickly?

  Yes

  No

  N/A

Are the tools listed below in good shape, inspected (label), calibrated and suitable for the job?

• 3.6. mAs meter / Multi meter

  Yes

  No

  N/A

• 3.7. Soldering iron

  Yes

  No

  N/A

• 3.8. Oscilloscope

  Yes

  No

  N/A

• 3.9. Dosimeter(s)

  Yes

  No

  N/A

• 3.10. Temperature probe

  Yes

  No

  N/A

• 3.11. Newton meter

  Yes

  No

  N/A

4. Knowledge and qualification

• 4.1. Do the workers understand the risks they are exposed to and the risks they are generating by their tasks?

  Yes

  No

  N/A

• 4.2. Do the workers know the assembly point in case of evacuation or can they show where to find this information quickly?

  Yes

  No

  N/A

• 4.3. Do the workers know the emergency number(s) or can they show where to find this information quickly?

  Yes

  No

  N/A

• 4.4. Do the workers know what to do when they are involved in a work-related accident or incident?

  Yes

  No

  N/A

• 4.5. Do the workers know the safety procedures and requirements imposed by the customer?

  Yes

  No

  N/A

• 4.6. Do the workers know the process to handle incidents with an instrument or device?

  Yes

  No

  N/A

• 4.7. Do the workers know the principle of LMRA (Last minute risk-assessment)?

  Yes

  No

  N/A

• 4.8. Are the workers that work with electricity certified for the job?

  Yes

  No

  N/A

5. Car Audit

• 5.1. Is a high visibility vest available?

  Yes

  No

  N/A

• 5.2. Is a first aid box available and is it still valid (items within expiration date)?

  Yes

  No

  N/A

• 5.3. Is a warning triangle available?

  Yes

  No

  N/A

• 5.4. Is a fire extinguisher available and is it still valid (within expiration date)?

  Yes

  No

  N/A

• 5.5. Are the tires in good shape, incl. tire pressure?

  Yes

  No

  N/A

• 5.6. Are the car lights in good working order?

  Yes

  No

  N/A

• 5.7. Is the windscreen in good shape (no cracks or other damages)?

  Yes

  No

  N/A

• 5.8. Are the work tools safely stored in the vehicle (i.e. check if they are exceeding the height of the backseats without safety net)?

  Yes

  No

  N/A

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