Traverse City - GRMI Safety Audits

• Audit Title

Audit Information

• Select date

  Date

• Supervisor/Observer

  Mike Kocis

  Bill Dyette

• Employees 1

  Select E. Christunas P. Ehle R. Elliott M. Frasier J. Haines F. Hart K. LaHaye M. Leigeb M. O'Leary R. Perez J. Ruthkowski S. Seitz R. Stewart T. Stiglich C. Usiondek G. Vogel D. Warner D. Willman A. Wodehouse T. Wozny

  • E. Christunas
  • P. Ehle
  • R. Elliott
  • M. Frasier
  • J. Haines
  • F. Hart
  • K. LaHaye
  • M. Leigeb
  • M. O'Leary
  • R. Perez
  • J. Ruthkowski
  • S. Seitz
  • R. Stewart
  • T. Stiglich
  • C. Usiondek
  • G. Vogel
  • D. Warner
  • D. Willman
  • A. Wodehouse
  • T. Wozny

• Employees 2

  Select E. Christunas P. Ehle R. Elliott M. Frasier J. Haines F. Hart K. LaHaye M. Leigeb M. O'Leary R. Perez J. Ruthkowski S. Seitz R. Stewart T. Stiglich C. Usiondek G. Vogel D. Warner D. Willman A. Wodehouse T. Wozny

  • E. Christunas
  • P. Ehle
  • R. Elliott
  • M. Frasier
  • J. Haines
  • F. Hart
  • K. LaHaye
  • M. Leigeb
  • M. O'Leary
  • R. Perez
  • J. Ruthkowski
  • S. Seitz
  • R. Stewart
  • T. Stiglich
  • C. Usiondek
  • G. Vogel
  • D. Warner
  • D. Willman
  • A. Wodehouse
  • T. Wozny

• Employee (type if not listed above)

• Location

• Add location
  Address

• Job Type

  Select Service Work Leak Miss Digs AMR Mobile Collector Set Meter RAVE Rotary Meter Inspections Chart Calibrations Pressure Williamson Tapping Mueller Tapping C&C Construction Fire Service Repair Main Repair Main Renewal New Service Service Alteration Service Renewal Meter Reading

  • Service Work
  • Leak
  • Miss Digs
  • AMR
  • Mobile Collector
  • Set Meter
  • RAVE
  • Rotary Meter Inspections
  • Chart Calibrations
  • Pressure
  • Williamson Tapping
  • Mueller Tapping
  • C&C
  • Construction
  • Fire
  • Service Repair
  • Main Repair
  • Main Renewal
  • New Service
  • Service Alteration
  • Service Renewal
  • Meter Reading

• Job Type

Pre-Job Briefs

• Were the potential job hazards reviewed?

  Yes

  No

  N/A

• Were the Distribution & FSO Procedures available for review?

  Yes

  No

  N/A

• Does the employee(s) have a full understanding / knowledge of the job task?

  Yes

  No

  N/A

Personal Protective Equipment (PPE)

• Does the employee(s) have the required PPE for the job task?

  Yes

  No

  N/A

Tools/Equipment

• Are the proper tools/equipment in use or available when needed?

  Yes

  No

  N/A

• Are all tools/equipment in good working condition?

  Yes

  No

  N/A

• Is work area in a safe condition?

  Yes

  No

  N/A

• Is the vehicle(s) and/or equipment parked properly on site?

  Yes

  No

  N/A

• If an excavation, are proper sloping, shoring, ingress and egress methods being utilized?

  Yes

  No

  N/A

• Is proper signage and barricading being used as necessary?

  Yes

  No

  N/A

• Were any safety defects observed in building / parking lot / stock room / yard area?

  Yes

  No

  N/A

Human Performance

• Was employee(s) using 3 points of contact and observing potential slip, trip, and fall hazards?

  Yes

  No

  N/A

• Is vehicle(s) in good operating condition and are all DOT pre/post inspections completed where required?

  Yes

  No

  N/A

• Is vehicle(s) housekeeping in good shape or is a 5S needed?

  Yes

  No

  N/A

• Are there other safety defects observed, corrected and/or being entered on a countermeasure worksheet?

  Yes

  No

  N/A

Corrective Actions

• Discussed with Employee

• Enter any corrective actions that will be undertaken

Sign Off

• Supervisor's Signature

  Sign

• Drawing / Notes

  Drawing

• Pictures

  Media