Solid Platforms Site HSSE Audit - Local

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1. Work Permits - Are the Following Procedures Understood/Followed

• 1.1 Hot Work

  Yes

  No

  N/A

• 1.2 Lockout / Tag out

  Yes

  No

  N/A

• 1.3 Confined Space

  Yes

  No

  N/A

• 1.4 Excavation

  Yes

  No

  N/A

• 1.5 Lead

  Yes

  No

  N/A

• 1.6 Is proper permit on site?

  Yes

  No

  N/A

• 1.7 Proper ventilation, proper respirators?

  Yes

  No

  N/A

• 1.8 Attendant properly positioned/equipped for rescue if necessary?

  Yes

  No

  N/A

• 1.9 Special warning posted (lead, trenching, personnel working overhead) if necessary?

  Yes

  No

  N/A

2. Emergency Response

• 2.1 Do employees know the evacuation alarm?

  Yes

  No

  N/A

• 2.2 Do employees know emergency telephone numbers?

  Yes

  No

  N/A

• 2.3 Has Midwest PRCS Emergency Action Plan been completed?

  Yes

  No

  N/A

• 2.4 Has MITTAL (site specific) Emergency Action Plan been completed?

  Yes

  No

  N/A

• 2.5 Has the U.S. Steel PRCS Emergency Action Plan been completed?

  Yes

  No

  N/A

• 2.6 Has the U.S. Steel (site specific) Emergency Action Plan been completed?

  Yes

  No

  N/A

• 2.7 Has BP (site specific) Emergency action plan been completed?

  Yes

  No

  N/A

• 2.8 Has NI-Source (site specific) Emergency action plan been completed?

  Yes

  No

  N/A

• 2.9 Have all employees been trained in (site-specific) evacuation procedures?

  Yes

  No

  N/A

3. Orderliness and Material Storage

• 3.1 Are work areas neat and orderly (including break/office trailer)?

  Yes

  No

  N/A

• 3.2 Is lay down yard material properly stored?

  Yes

  No

  N/A

• 3.3 Are containers provided for trash, waste, or other garbage?

  Yes

  No

  N/A

• 3.4 Are passageways and walkway clean?

  Yes

  No

  N/A

• 3.5 Are nails removed or bent down?

  Yes

  No

  N/A

• 3.6 Are spills cleaned up promptly?

  Yes

  No

  N/A

• 3.7 Proper lifting methods/materials handling?

  Yes

  No

  N/A

• 3.8 Proper/Approved lifting in use?

  Yes

  No

  N/A

• 3.9 Are solvents properly stored?

  Yes

  No

  N/A

• 3.10 Are flammables properly stored?

  Yes

  No

  N/A

• 3.11 First Aid Kit inspected and complete with required supplies?

  Yes

  No

  N/A

4. Hand and Power Tools

• 4.1 Tools and cords in good condition/inspected and quarterly color coated?

  Yes

  No

  N/A

• 4.2 Tool guards in place?

  Yes

  No

  N/A

• 4.3 Are ground fault circuit interrupters (GFCI) used for temporary cords?

  Yes

  No

  N/A

• 4.4 Are tools properly stored?

  Yes

  No

  N/A

• 4.5 Proper eye and face protection worn?

  Yes

  No

  N/A

• 4.6 Are surge protectors on compressors?

  Yes

  No

  N/A

• 4.7 Are hoses properly secured?

  Yes

  No

  N/A

• 4.8 Are hoses properly used?

  Yes

  No

  N/A

• 4.9 Are hose restraints used?

  Yes

  No

  N/A

5. Personal Protective Equipment

• 5.1 Equipment properly used and maintained/inspected and quarterly color coded?

  Yes

  No

  N/A

• 5.2 Sufficient equipment provided?

  Yes

  No

  N/A

• 5.3 Hard hats worn by everyone, OSHA foam lined safety glasses?

  Yes

  No

  N/A

• 5.4 Proper eye and face protection used?

  Yes

  No

  N/A

• 5.5 Protective clothing worn as required?

  Yes

  No

  N/A

• 5.6 Ear protection provided and worn where required (I.e. sandblasting, near compressor)?

  Yes

  No

  N/A

• 5.7 Proper respirators worn for paint, fumes, gasses or dust hazards?

  Yes

  No

  N/A

• 5.8 CO monitor or Oil Free Air (Grade D breathing air)?

  Yes

  No

  N/A

• 5.9 Approved clothing?

  Yes

  No

  N/A

• 5.10 Respirators properly cleaned ad stored and in good condition?

  Yes

  No

  N/A

• 5.11 Are employees respirator medically qualified?

  Yes

  No

  N/A

• 5.12 Are employee clean-shaven?

  Yes

  No

  N/A

• 5.13 Are employees respirator Fit tested and trained?

  Yes

  No

  N/A

• 5.14 Nomex (FRC's) required?

  Yes

  No

  N/A

• 5.15 All PPE being worn correctly according to SITE/MANUFACTURER'S REQUIREMENTS?

  Yes

  No

  N/A

6. Flammable and Combustable Liquids

• 6.1 Containers clearly marked to show contents?

  Yes

  No

  N/A

• 6.2 Drums/tanks used for outdoor dispensing and fueling purposes are located at least 25 feet from any building?

  Yes

  No

  N/A

• 6.3 Drums/tanks used for outdoor dispensing and fueling purposes are grounded and bonded?

  Yes

  No

  N/A

• 6.4 "No Smoking" signs posted?

  Yes

  No

  N/A

• 6.5 Fuel properly stored including secondary containment?

  Yes

  No

  N/A

7. Welding and Cutting

• 7.1 Is fuel gas and oxygen separated in storage?

  Yes

  No

  N/A

• 7.2 Are compressed bottles upright and secured?

  Yes

  No

  N/A

• 7.3 Power cables and hoses protected and in good repair?

  Yes

  No

  N/A

• 7.4 Flow gauges and regulators maintained?

  Yes

  No

  N/A

• 7.4.1 Removed when not in use?

  Yes

  No

  N/A

• 7.5 Back-flow check valves in oxy-acetylene?

  Yes

  No

  N/A

• 7.6 Are welders and helpers using PPE and protection against sparks?

  Yes

  No

  N/A

• 7.6.1 Welding and cutting?

  Yes

  No

  N/A

• 7.6.2 Ultraviolet radiation?

  Yes

  No

  N/A

• 7.7 Proper fire protection?

  Yes

  No

  N/A

8. Fall Protection

• 8.1 Safety harnesses/lanyard inspected and quarterly color coded?

  Yes

  No

  N/A

• 8.2 SPI 100% tie-off policy followed using steel rebar hooks?

  Yes

  No

  N/A

• 8.3 Lifelines a minimum of 5/8" Polyester polypropylene rope?

  Yes

  No

  N/A

• 8.4 Lifelines secured to an anchorage/structural member above point of operation?

  Yes

  No

  N/A

• 8.5 Lifelines used when working in suspended scaffold or lifts?

  Yes

  No

  N/A

• 8.6 Safety nets used where other fall protection is not feasible?

  Yes

  No

  N/A

• 8.7 Is all fall protection stored properly?

  Yes

  No

  N/A

• 8.8 Swing stage qualified?

  Yes

  No

  N/A

9. Laddered and Scaffolds

• 9.1 Erected, tagged,and inspected under supervision of competent person?

  Yes

  No

  N/A

• 9.2 Proper footings - sound, rigid, secured?

  Yes

  No

  N/A

• 9.3 Scaffold has required vertical and horizontal bracing?

  Yes

  No

  N/A

• 9.4 Proper access; ladder/stair tower or direct access provided?

  Yes

  No

  N/A

• 9.5 Defective and damaged parts, planks, etc. removed from service and stored secured from usable material?

  Yes

  No

  N/A

• 9.6 Guardrails, midrails & toe boards installed on all open sides of platform?

  Yes

  No

  N/A

• 9.7 Complete platforms, planks, close together, and overlapped by at least 12" or secured by wire or proper cleating ?

  Yes

  No

  N/A

• 9.8 Inspected and in good condition?

  Yes

  No

  N/A

• 9.9 Scaffold is properly secured from tipping over (tie-points)?

  Yes

  No

  N/A

• 9.10 All straight & extension ladders equipped with safety shoes and/or blocked off in use?

  Yes

  No

  N/A

• 9.11 Rails extended at least 36" above landing or work platform?

  Yes

  No

  N/A

• 9.12 Defective ladders tagged and removed from work area?

  Yes

  No

  N/A

• 9.13 Ladder areas barricaded where required?

  Yes

  No

  N/A

10. Equipment

• 10.1 Safety devices operational on equipment (I.e. airless spray guns, Hilti guns, compressors, etc.?

  Yes

  No

  N/A

• 10.2 Cables free from excessive wear?

  Yes

  No

  N/A

• 10.3 All equipment properly lubricated and maintained?

  Yes

  No

  N/A

• 10.4 Tools and cords in good condition?

  Yes

  No

  N/A

• 10.5 Explosion proof lighting in areas with limited ventilation?

  Yes

  No

  N/A

• 10.6 Daily Vehicle Safety Inspection Form being completed for all Company Owned/Leased vehicles in use at this job site? (Forklifts Include)

  Yes

  No

  N/A

• 10.7 Seat belts used?

  Yes

  No

  N/A

• 10.8 Dead-man in use?

  Yes

  No

  N/A

11 Job Site Specific Paperwork

• 11.1 Solid Platforms, Inc. Job Hazard Analysis (JHA) completed?

  Yes

  No

  N/A

• 11.2 Solid Platforms, Inc. Daily Task Planner completed?

  Yes

  No

  N/A

• 11.3 MITTAL Steel (All) PRE-JOB Safety, health, and environmental Checklist completed?

  Yes

  No

  N/A

• 11.4 MITTAL Steel (All) Daily Work Authorization form completed?

  Yes

  No

  N/A

• 11.5 BP Site Specific paperwork completed?

  Yes

  No

  N/A

• 11.6 U.S. STEEL / SAFETY LINE-UP Completed? Midwest /Safety Work?

  Yes

  No

  N/A

• 11.7 DUKE ENERGY SITE SPECIFIC PAPERWORK?

  Yes

  No

  N/A

• 11.8 NI-Source Site Specific paper work completed?

  Yes

  No

  N/A

• 11.9 Other - SPI Supervisor's Daily Job Site Safety Observation?

  Yes

  No

  N/A

12 SUSPENDED SCAFFOLD

• 12.1 Will the structure support the necessary loads imposed on it by the suspended scaffold?

  Yes

  No

  N/A

• 12.2 Does the outrigger beam(s) rest on wood blocks which are perpendicular to the outrigger beams?

  Yes

  No

  N/A

• 12.3 Are tie-backs installed at right angles to the face of the building and if not, have opposing tie-backs (2) been installed?

  Yes

  No

  N/A

• 12.4 Is the number of counterweights being used sufficient, are they properly installed and properly secured?

  Yes

  No

  N/A

• 12.5 Are the FISTGRIPS tightened to the manufacture's required torque: (5/16th cable:35 foot pounds)?

  Yes

  No

  N/A

• 12.6 Is each hoist motor properly secured to the stirrup and are hoisting cables secured and cables free of any burrs or kinks?

  Yes

  No

  N/A

• 12.7 Are independent lifelines secured to an anchorage point that is not part of scaffold or the scaffold's sport system?

  Yes

  No

  N/A

• 12.8 If welding from suspended scaffold, have exposed cable(s) and hoist motor(s) been covered and protected?

  Yes

  No

  N/A

• 12.9 Are all required handrails and toe boards installed on the scaffold?

  Yes

  No

  N/A

• 12.10 Do all power cords being used have strain relief at their connection point?

  Yes

  No

  N/A

• 12.11 Has the area below the suspended scaffold been barricaded with proper signage attached?

  Yes

  No

  N/A

Corrective Action

• Enter any corrective actions taken.

Auditor's Signature

• Auditor's Name

  Sign

Foreman's Signature

• Foreman's Name

  Sign

General Foreman's Signature

• General Foreman's Name

  Sign