tke Repair Audit-06/15/18

• Conducted on

  Date

• Prepared by

• Branch Location/Job Name/Employee
  Address

• Client / Site

• Mechanics Name

Safety Documentation:

• Does Employee have a safety manual?

  Yes

  No

  N/A

• Has a Job Hazard Analysis been completed and discussed with all Employees on site?

  Yes

  No

  N/A

• Are the applicable F.P.P.checked off and incorporated into the JHA<br> Personal Protective Equipment<br> Lock-Out/Tag-Out/Try-Out<br> Jumpers<br> Live Electrical Troubleshooting<br> Mechanical Stored Energy<br> Cartop and Pit Access<br> Barricades<br> Fall Protection<br> False Cars and Running Platforms<br> Hoisting and Rigging<br>

  Yes

  No

  N/A

• Are the applicable 5 Behavioral Safety Traps checked off and incorporated into the JHA<br> Lack of Awareness<br> Diminishing the Risk<br> Lack of Concentration<br> Unintentional Pressure<br> Fear Factor<br>

  Yes

  No

  N/A

Clothing & Personnel Equipment:

• Are Employees wearing proper footwear?

  Yes

  No

  N/A

• Are safety glasses being worn?

  Yes

  No

  N/A

• Is the Proper PPE being used as required for work being performed?

  Yes

  No

  N/A

• Does employee have Arc rated gloves and sleeves available for immediate use?

  Yes

  No

  N/A

Electrical Safety:

• Are all power cords in use plugged into GFCI?

  Yes

  No

  N/A

• Are all cords serviceable and grounded?

  Yes

  No

  N/A

• Is TKE jumper policy being followed completely including only authorized & registered jumper use?

  Yes

  No

  N/A

• Are meter and leads properly rated per TKE Policy (Category III, 1000V)?

  Yes

  No

  N/A

JUMPER KIT SERIAL # QTY:

• JUMPER KIT SERIAL # QTY:

  Yes

  No

  N/A

Lockout/Tagout:

• Are energy sources locked & tagged out as required by TKE lockout policy?

  Yes

  No

  N/A

• Does employee have personal lock, hasp & tag available?

  Yes

  No

  N/A

• Are all damaged & defective tools, power cords, ladders & hoisting equipment tagged "Out of Service"?

  Yes

  No

  N/A

Fall Protection:

• Are employees tied off when required by TKE policy?

  Yes

  No

  N/A

• Have employees discussed the fall protection plan for the jobsite?

  Yes

  No

  N/A

• In the event of an employee falling into their PFAS, has a rescue plan been discussed?

  Yes

  No

  N/A

Barricades:

• Are proper barricades being used per TKE policy?

  Yes

  No

  N/A

Fire Protection:

• Could employee find their way out safely if they could not see?

  Yes

  No

  N/A

• Is employee following fire regulations regarding storage of flammables & combustibles?

  Yes

  No

  N/A

First Aid:

• Are adequate first aid supplies on hand?

  Yes

  No

  N/A

Hand & Power Tools:

• Are all tools in good condition?

  Yes

  No

  N/A

Hazard Communication:

• Are SDS's available on site for all chemicals and cleaners?

  Yes

  No

  N/A

• Are all containers and chemicals clearly marked with contents?

  Yes

  No

  N/A

Housekeeping:

• Are work areas kept free of slip and trip hazards?

  Yes

  No

  N/A

• Are work areas free of puncture and laceration hazards?

  Yes

  No

  N/A

Illumination:

• Are work areas illuminated enough to work safely?

  Yes

  No

  N/A

Ladders:

• Are portable ladders in good condition & with non-metal side rails?

  Yes

  No

  N/A

• Are ladders being used properly & for all access over 19" when stairs or ramp are not provided?

  Yes

  No

  N/A

Hoisting Equipment:

• Are all hoisting devices on site marked with rated capacity?

  Yes

  No

  N/A

• Have all employees on site received proper training for the equipment to be used?

  Yes

  No

  N/A

• Do we know the capacities of any building components used for hoisting?

  Yes

  No

  N/A

• Is all hoisting equipment & rigging in good condition? (hoists, hooks, clamps, shackles & slings)

  Yes

  No

  N/A

• Have all chain falls & chain hoists been certified within the last year?

  Yes

  No

  N/A

• Is the weight of the material to be lifted been verified?

  Yes

  No

  N/A

Material Handling:

• Are proper lifting techniques being followed? (back vertical / lifting with legs)

  Yes

  No

  N/A

• Are material handling dollies and hand trucks in good condition? (wheels, handles, etc.)

  Yes

  No

  N/A

• Is the path of travel free of obstructions?

  Yes

  No

  N/A

• Is the weight of the material to be moved been verified?

  Yes

  No

  N/A

Are there any OTHER UNSAFE CONDITIONS, equipment or actions? If yes, explain below. N/A if there are none

• Comment:

  Yes

  No

  N/A