SM Contractor Field Audit

SM Energy Contractor Field Audit

• Conducted on

  Date
• Location
  Address

• Prepared by

• Team Member Conducting Audit:

• Contractor Being Observed:

• Location:

• Area Being Observed:

• Summery of job Task:

Section to Identify that all PPE, Equipment, and conditions are safe:

• Are eye and or face protection being used?

  Yes

  No

  N/A

• Is appropriate respiratory protection used?

  Yes

  No

  N/A

• Is appropriate hand protection being used?

  Yes

  No

  N/A

• Is appropriate foot protection being used?

  Yes

  No

  N/A

• Is appropriate Hearing protection being used?

  Yes

  No

  N/A

• Are all Employees wearing FRC's?

  Yes

  No

  N/A

• Is fall protection being used?

  Yes

  No

  N/A

• Are H2S monitors or 4 gas monitors being used?

  Yes

  No

  N/A

• Are JSEA's/SOP's available for reference?

  Yes

  No

  N/A

• Are safety meeting/tailgate meetings being held?

  Yes

  No

  N/A

• Are required permits available? (LOTO, Hotwork, Hazardous Work Permit, Etc.)

  Yes

  No

  N/A

• Is good housekeeping in place?

  Yes

  No

  N/A

• Have any spills been identified?

  No

  Yes

  N/A

• Are there any slip trip and falls?

  No

  Yes

  N/A

• Are machine guards in place?

  Yes

  No

  N/A

• Are cords/hoses in good condition?

  Yes

  No

  N/A

• Are slings/chains/ropes in good condition?

  Yes

  No

  N/A

• Is there an emergency management plan in place?

  Yes

  No

  N/A

• Are lifting devices in good condition?

  Yes

  No

  N/A

• Have tools been inspected and are being used properly?

  Yes

  No

  N/A

• Are fire extinguishers available and inspected?

  Yes

  No

  N/A

• Are bonding cables and grounding equipment in place?

  Yes

  No

  N/A

• Are workers aware of Stop Work Authority?

  Yes

  No

  N/A

• Is a Hazard Communication system in place along with SDS for chemicals on location?

  Yes

  No

  N/A

Positive Observations

• Observation No. 1

• Observation No. 2

• Observation No. 3

• Additional comments:

• Additional Pictures

  Media

• Contractor Signature

  Sign

• Observer Signature

  Sign