tke Service 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 documented as required?

  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

• Are proper gloves being worn?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

Machine Room:

• Is there safe access to the machine room?

  Yes

  No

  N/A

• Is the work area clear and clean of debris?

  Yes

  No

  N/A

• Is the area properly illuminated?

  Yes

  No

  N/A

• Are all guards in place, holes properly covered?

  Yes

  No

  N/A

• Does the Machine Room have a properly sized and rated fire extinguisher certified within 12 months?

  Yes

  No

  N/A

Electrical Safety:

• Are all power cords in use plugged into GFCI?

  Yes

  No

  N/A

• Are extension cords & drop light cords in good condition including ground prong?

  Yes

  No

  N/A

• Are drop lights properly guarded and are flashlights non-conductive?

  Yes

  No

  N/A

• Are all power tools and chargers either double insulated or with a ground prong?

  Yes

  No

  N/A

• Is employee following proper live electrical and troubleshooting procedures?

  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

• JUMER 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 tagged "Out of Service"?

  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

Hoistway Procedures:

• Can employee demonstrate proper hoistway access procedures?

  Yes

  No

  N/A

• Are all pit ladders accessible without putting TKE employee at risk?

  Yes

  No

  N/A

• Is proper Hoistway illumination available and functioning?

  Yes

  No

  N/A

• Is there a functioning car top inspection station?

  Yes

  No

  N/A

• Are pipe stands available on site?

  Yes

  No

  N/A

• Are proper barricades in place as required?

  Yes

  No

  N/A

• Prior to entering, did employee confirm car top / pit clear of oil and debris?

  Yes

  No

  N/A

• Upon exit, are all covers and guards returned to proper position?

  Yes

  No

  N/A

Fall Protection:

• Are employees tied off when required by TKE policy?

  Yes

  No

  N/A

First Aid:

• Are adequate first aid supplies on hand?

  Yes

  No

  N/A

• Does employee know how to identify blood borne pathogens and where they might be found?

  Yes

  No

  N/A

• Does employee know how to protect themselves from contaminated sources?

  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

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

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

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

• Comment:

  Yes

  No

  N/A