SunGrid Project Execution HSE Governance Checklist US

• Jicarilla - 021579 - 0372

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Instructions : SunGrid supervisor complete this checklist every work day at each project site (Tier 1). They are consolidated weekly to SunGrid leadership (Tier 2) and a summary of compliance and corrective actions to close gaps escalated to the Honeywell project leaders (Tier 3)

Signature Section

• Monday

  Sign

• Tuesday

  Sign

• Wednesday

  Sign

• Thursday

  Sign

• Friday

  Sign

Task Risk Assessment or JSA

• Was a JSA completed?

  Yes

  No

  N/A

• Have all job steps been listed

  Yes

  No

  N/A

• Have all hazards been identified?

  Yes

  No

  N/A

• Have all hazards that have been identified been mitigated with control measures?

  Yes

  No

  N/A

• Have all PPE been identified and used

  Yes

  No

  N/A

• Have SIMOPS been identified

  Yes

  No

  N/A

• Have all workers for task signed the JSA

  Yes

  No

  N/A

Review of: expectation around Life Saving Commitments

• Is Stop Work used when unsafe?

  Yes

  No

  N/A

• Say no to drugs and alcohol?

  Yes

  No

  N/A

• Follow Safety Controls?

  Yes

  No

  N/A

• Practice Safe Mechanical lifting?

  Yes

  No

  N/A

• Follow Driving and Traffic Rules?

  Yes

  No

  N/A

• Verify Isolation before work begins?

  Yes

  No

  N/A

• Is Hot Work safely performed?

  Yes

  No

  N/A

• Only enter confined space with authorization

  Yes

  No

  N/A

• Stay away from line of fire hazards

  Yes

  No

  N/A

• Careful when working at height?

  Yes

  No

  N/A

Daily / weekly equipment checks

• Specify the weekday of the review

  Date

Weekly facility checks (e.g. fuel tanks, other support equipment on site)

• Specify the weekday of the check

  Date

Weekly job audits of site – completion and findings

• Weekly job audit completed?

  Yes

  No

  N/A

• Pictures of findings

  Media

• Specify the weekday of the audit

  Date

• Incidents reported / near misses encountered

  Yes

  No

  N/A

General Safety

• First Aid kit onsite

  Yes

  No

  N/A

• Eye wash stations onsite and full

  Yes

  No

  N/A

• Job site orientations completed

• Spill kits onsite and full

• Supervisor onsite

  Yes

  No

  N/A

Other Media

• Attach all other media

  Media

Signature

• Type name

• Sign name

  Sign