Voith Field Service Monthly Inspection

• Conducted on

  Date

• Prepared by

• Location
  Address

Monthly Site Inspection Checklist

• Location:

• Conducted by:

• Date:

  Date

• Follow-up inspection required:

  Yes

  No

  N/A

• Item #

I - Work Practices

• Daily Toolbox talks (Tailboards) properly documented

  Yes

  No

  N/A

• Field Level Risk Assessment properly documented

  Yes

  No

  N/A

• Signage (Barriers / Warnings) in place

  Yes

  No

  N/A

• Emergency Numbers displayed

  Yes

  No

  N/A

• Safety Concerns / Issues addressed

  Yes

  No

  N/A

• Emergency exits clearly marked & easily accessible

  Yes

  No

  N/A

• Item #

• II - WHMIS / TDG / Flammable Cabinet

  Yes

  No

  N/A

• All containers having controlled products (WHMIS) label

  Yes

  No

  N/A

• Safety Data Sheet (SDS) available for each hazardouschemical

  Yes

  No

  N/A

• Safety Data Sheet easily accessible by employees

  Yes

  No

  N/A

• All SDS kept up-to-date (3 years old)

  Yes

  No

  N/A

• Employees trained /informed about hazards related to chemicals

  Yes

  No

  N/A

• Appropriate PPE used while using chemicals

  Yes

  No

  N/A

• Flammables / Corrosives separate-stored in the applicable cabinet

  Yes

  No

  N/A

• Flammable / Corrosive cabinets are grounded properly

  Yes

  No

  N/A

• Nothing is stored over the flammable cabinets

  Yes

  No

  N/A

• Solid waste containers labelled

  Yes

  No

  N/A

• Hazardous waste containers labelled

  Yes

  No

  N/A

• Item #

III - Personal Protective Equipments (PPE)

• CSA approved footwear worn as required

  Yes

  No

  N/A

• CSA / Client approved class hardhats used as required

  Yes

  No

  N/A

• PPE fitted and worn properly ie: fall protection

  Yes

  No

  N/A

• CSA approved Safety Glasses/Goggles worn as required

  Yes

  No

  N/A

• Suitable gloves for the activity

  Yes

  No

  N/A

• High visibility vests / coveralls used as required

  Yes

  No

  N/A

• Respirator: Fit Tested, users trained and stored properly

  Yes

  No

  N/A

• Face shields worn appropriate to the task ie: Grinding / Welding

  Yes

  No

  N/A

• Hearing protection worn as required

  Yes

  No

  N/A

• Other PPE worn as required ie barrier cream, leathers, etc

  Yes

  No

  N/A

• Signs posted at locations where protection is required

  Yes

  No

  N/A

• Item #

IV - Forklift and Crane Operation

• Only trained & certified Froklift operators are operating the forklift

  Yes

  No

  N/A

• Forklift inspection logbook filled as required

  Yes

  No

  N/A

• Crane inspection logbook filled as required

  Yes

  No

  N/A

• Crane lift plan prepared for lifting > 15 000 lbs

  Yes

  No

  N/A

• Crane is operated by only trained crane operator

  Yes

  No

  N/A

• Rigging only done by qualified person

  Yes

  No

  N/A

• Slings and Rigging (Labelled, Secured and Inspected)

  Yes

  No

  N/A

• V - Housekeeping

  Yes

  No

  N/A

• Walkways free of tripping hazards ie: extension cords, welding cables

  Yes

  No

  N/A

• Accumulation of combustile materials (boxes, paper, etc.)kept to a minimum in inappropriate areas

  Yes

  No

  N/A

• Walkways free of chemicals, oils or water

  Yes

  No

  N/A

• Garbage bins are cleaned at the end of the day

  Yes

  No

  N/A

• Lunch room clean and tidy

  Yes

  No

  N/A

• Areas free of nails and protruding objects

  Yes

  No

  N/A

• Exactos kept in down and locked position when not in use

  Yes

  No

  N/A

• All openings properly covered and protected

  Yes

  No

  N/A

• Storage/metal shelves bolted down and properly secured to prevent them from falling over

  Yes

  No

  N/A

VI - Material Handling

• Materials stacked / stored to prevent sliding or collapsing

  Yes

  No

  N/A

• Equipment available to assist in moving materials (ex.dolly)

  Yes

  No

  N/A

• All employees using an electric pallet lift or a lift truck certified

  Yes

  No

  N/A

• Employees received Safe Lifting/Back Safety Training

  Yes

  No

  N/A

VII - Equipment / Tools

• All grinder, saw, drill gruards in place and stored properly

  Yes

  No

  N/A

• Disc / Stone size is correct for the grinder

  Yes

  No

  N/A

• Powe, hydraulic, pneumatic tools used in a safe manner

  Yes

  No

  N/A

• Whip checks in place for pneumatic tools

  Yes

  No

  N/A

• Item #

VIII - Machine Guarding

• Machines/equipment/hand tool with exposed moving parts have appropriate guardings

  Yes

  No

  N/A

• Indication of what PPE to use and warning signs on machine

  Yes

  No

  N/A

• Operational emergency stop well identified on the machine

  Yes

  No

  N/A

• Shield or guards in place to prevent and protect the employees from flying debris from machine

  Yes

  No

  N/A

• Welders are using double protection (safety glasses and face shield)

  Yes

  No

  N/A

• Item #

IX - Accidents: Medical Aid

• Lost Time

  Date

First Aid

• Nearmiss

  Yes

  No

  N/A

• Weekly first aid inspection is in place & complete

  Yes

  No

  N/A

• Emergency equipment readily available

  Yes

  No

  N/A

• All accidents & incidents are reported

  Yes

  No

  N/A

• Item #

X - Emergency Preparedness and Response

• First aid kit seal is intact. Inventory contents if broken

  Yes

  No

  N/A

• First aid / RTW report forms available in the first aid room

  Yes

  No

  N/A

• List of the first aiders posted in the first aid room / job board

  Yes

  No

  N/A

• Date of first aiders' certification is adequate

  Date

• A first aider is available at all times

  Yes

  No

  N/A

• First aid room / kit is tidy and organized

  Yes

  No

  N/A

• First aid kits accessible and clearly identified

  Yes

  No

  N/A

• First aid register available

  Yes

  No

  N/A

• Spill kits available near the chemicals use

  Yes

  No

  N/A

• Eye wash bottles / station is located near the chemical use

  Yes

  No

  N/A

• Eye wash station(s) available and inspected

  Yes

  No

  N/A

• If eye wash station is not connected to the municipal water system, expiration date on the equipment or the date of the last liquid change adequate

  Yes

  No

  N/A

• Fire extinguishers are in working order and inspected

  Yes

  No

  N/A

• Fire extinguishers clearly identified (sign)

  Yes

  No

  N/A

• Employees trained in the use of fire extinguishers

  Yes

  No

  N/A

• Fire safety / evacuation plan established

  Yes

  No

  N/A

• Operating fire/smoke detection system functionnal

  Yes

  No

  N/A

• Written emergency preparedness / medical emergency plan in place

  Yes

  No

  N/A

• Item #

XI - Electrical

• GFCI's in place when required

  Yes

  No

  N/A

• Circuit breakers or fuse panels properly labeled, kept closed and accessible

  Yes

  No

  N/A

• Extension cords kept out of wet areas

  Yes

  No

  N/A

• Certified electricians used for electrical work

  Yes

  No

  N/A

• Appropriate permanent wiring preventing the excessive use of extension cords

  Yes

  No

  N/A

• Switches, circuit breakers and switchboards installed in wet locations enclosed in weatherproof enclosures

  Yes

  No

  N/A

• Cords, panels, receptacles and plugs in good condition

  Yes

  No

  N/A

• Item #

XII - Compressed Gas Cylinders

• Oxy & Acet are stored separately from each other

  Yes

  No

  N/A

• Bottles are properly secured

  Yes

  No

  N/A

• Item #

XIII - Welding / Hot Work / Fire Protection

• Fire station / extinguishers clear of clutter

  Yes

  No

  N/A

• Inspection and tags up to date

  Yes

  No

  N/A

• Welding screens used

  Yes

  No

  N/A

• Hot work permits in place for the activity / current

  Yes

  No

  N/A

• Flash arrestors in place

  Yes

  No

  N/A

• Equipment available ie fire blankets, metal bucket, fire extinguishers, etc

  Yes

  No

  N/A

• Item #

XIV - Confined Space and Rescue

• Entry permit, filled out properly by competently trained person

  Yes

  No

  N/A

• Rescue plan available

  Yes

  No

  N/A

• Entry permit posted outside the confined space

  Yes

  No

  N/A

• Item #

XV - Fall Protection

• Fall protection used above 3m (10 feet)

  Yes

  No

  N/A

• All openings are covered with a guardrail

  Yes

  No

  N/A

• Written fall protection plan in place for work with no permanent guardrails

  Yes

  No

  N/A

• Handrails / Guardrails installed properly

  Yes

  No

  N/A

• Proper anchor points having capacity of 5000 lbs

  Yes

  No

  N/A

• Fall protection equipment inspected / maintained properly

  Yes

  No

  N/A

• Plywood covered openings appropriately marked

  Yes

  No

  N/A

• Item #

XVI - HSE Documentation / Work Practices

• Tailboards properly documented

  Yes

  No

  N/A

• FLRA filled out / applicable for the task

  Yes

  No

  N/A

• Emergency numbers posted at conspicuous locations

  Yes

  No

  N/A

• Emergency escape routes designated and posted

  Yes

  No

  N/A

• Last version of the HSE policy posted at the site

  Yes

  No

  N/A

• Safety prevention program posted and available for consultation by employees and staff

  Yes

  No

  N/A

• Item #

• XVII - Other

  Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

• If any of the above items were checked as "No". A follow-up plan must be set up for it

  Yes

  No

  N/A

• Correctives actions (CA): CA to be SMART (Specific, Measurable, Achivable, Realistic, Time sensitive)Each cause has to be link to a corrective action identified in the analysis table

• Item #

Corrective / Preventive Measures

• Responsible

• Time Frame

  Yes

  No

  N/A

Identification # (Information to be transferred in the Corrective Action Tracking Spreadsheet

Starting

• Ending

• - CA -

  Yes

  No

  N/A

• - CA -

  Yes

  No

  N/A

• - CA -

  Yes

  No

  N/A

• - CA -

  Yes

  No

  N/A