Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Housekeeping
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Project work areas are clean, free of excess trash/debris
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Project materials have been stored / stacked safely
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Project materials stored with clear aisles for travel
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Trash receptacles are provided for work areas
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Portable water containers on site with adequate amount for crews
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Portable water containers clean / sealed with cups properly contained
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Are jobsite port-a-lets clean and properly placed
Personal Protective Equipment
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Hard hats worn / maintained as required by PPE pgm/mgf recommendations
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Safety glasses in use
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Hearing protection is worn where required
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Face shield or googles worn as required
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High visibility garments worn where required
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Safety toe footwear being worn
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Correct gloves being utilized for task being conducted
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Respirators utilized as required
Fall Protection
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Body harness worn properly
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Lanyards are adequately secured to suitable anchorage
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Perimeter guarding in place
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Man-Lift tie off points are in good condition
Excavations
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Sloped, shielded or shored properly based on soil classification
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Spoil set back 2' from excavation
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Access and Egress is provided every 25 feet
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Daily / periodic documented inspections conducted by competent person and posted at excavation
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Propane bottles removed prior to start of welding
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Ladders secured at top and extend 3' above
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Ladder users facing ladders ascending and descending and not carrying a load
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No work performed on slope above workers in the bottom of excavation
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No workers in excavation during overhead lifts
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Trench box certification paperwork on site
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Water pumps utilized as necessary to reduce water accumulation and competent person monitoring pump
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Ventilation adequate for any hazards that may exist
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Barricades / Barriers installed for traffic control ( within 25' of roadway) pedestrian warning as needed
Scaffolds and Ladders
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Scaffold built per specification
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Scaffolding is inspected/tagged daily per requirements by competent person
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Proper access and egress ladders provided, secured, and extends beyond the landing by 3'
Hoisting and Lifting Equipment
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Proper rigging equipment utilized and in good condition
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Proper rigging techniques used
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Proper signaling used during lifts
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Tag lines utilized during lifts
Seat belts used by all occupants
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Stickers installed on vehicles (360 Walk a round, Don't start up til you buckle up)
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Seat belts used by all occupants
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All lights working properly
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License plate(s) securely attached
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Observed damage has been reported
Tools and equipment
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Proper tools used for the job being performed
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Guards on all hand grinders/circular saws (w/o modifications made)
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Tools being carried correctly
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Electrical cords free of visible damage
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Tools are maintained in a safe condition
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Tools are stored properly
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Pneumatic / hydraulic hose connections properly secured (crows feet pins, whip checks)
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Rebar caps installed on exposed rebar
Fire Protection
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Flammables stored properly (bulk, portable in vehicles, proper distance, etc)
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Oxygen and combustible cylinders separated
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Containers labeled as to content
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Fire extinguishers properly located and has current inspection tag
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Compressed gas cylinders properly maintained
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Containment of hot work and welding screens as required
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Regulator gauges properly attached and maintained. Flash arrestors installed
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Bulk fuel tanks grounded and electrical classification maintained
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Portable equipment allowed to cool prior to refueling
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Spout / funnel used during portable container refueling
JSA
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Daily JSA available for review
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Safety tailgate meeting content confirmed by worker interview(s)
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JSA job steps described task being performed
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JSA addresses specific hazards at the task location
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JSA indicates utilization of Foreman/Employee handbooks for job discussions
Responsibilities
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MSDS's are readily available
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Supervisor observed making safe behavior interventions
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Employees observed making safe behavior interventions
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Stop work authority observed being used by supervisor or employee(s)
Power Line Crossings
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Overhead power lines have been identified
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Proper signage posted, legible, visible to approaching equipment
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Goal posts and flagging are in place
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Power line spotter is present during work near / under power lines and when passing equipment under lines
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Spotter has proper PPE and horn while performing spotter duties
Confined Space Entry
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CSE properly identified as permit / non-permit required
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CSE properly cleared, cleaned and isolated
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CSE respiratory protection adequate for the task (ventilation / air supply)
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CSE checklist and procedures on site with the attendant
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Permitted CSE rescue equipment on site with trained personnel on hand
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CSE lighting is 32v or less and all electrical shock concerns eliminated / mitigated
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CSE external / introduced air contaminate concerns have been eliminated
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Environmental hazardous monitoring is adequate for the task performed
Welding / Cutting
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Hard hats/Safety glasses worn outside the immediate welding zone
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Welding leads are positioned to prevent tripping hazards
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Spent rods are properly disposed of in a bucket
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Fully operational/inspected fire extinguishers are present at "hot work" location
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Flash arrestors in place on gauges
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Proper cribbing support supplied for bottom welding to prevent subsidence
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Proper excavation floor to prevent laying in mud/water to weld
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No loose clothing worn during grinding / buffing operations
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Thermal burn protection being worn
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Double eye protection used during buffing / grinding
Abrasive Blasting and Coating
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Hoods with proper air supply being used
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CO monitors installed (inside hood/inline or both when applicable)
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Unnecessary personnel are cleared crosswind / upwind of the abrasive blast
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Proper respiratory protection being worn during coating (wet & dry powder)
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Remote switches are protected from inadvertent operations
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Abrasive media pot work area clear of trip hazards, empty bags, pallets, etc.
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Environmental requirements are being met where applicable
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Hoses, hose connections are in proper working order, cotter pins in place, whip checks on all connections
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Personnel fit tested when applicable and medical questionnaires completed
Environmental
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Silt fences and/or environmental logs installed and maintained
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Wetland signage properly installed and maintained
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Equipment is supplied with spill kits
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No re-fueling within 100' of a wetland area
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ROW boundary markers properly installed and being maintained
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SPCC plan on site and requirements being met
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Secondary containment in place for equipment / portable fuel storage etc.
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Oil and fuel storage areas bermed and maintained dry
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Proper ROW berming erosion control and flow water correctly directed to drainage area
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Waste petroleum containers properly labeled and in secondary containment
Flagging
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DOT (Federal, local) temporary traffic control plan, specific to the site, exists
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Traffic control signage properly stored when flaggers not in attendance
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Flaggers wearing proper PPE
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Flaggers properly trained
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Flaggers properly using hand and sign communications with traffic
Body Position
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Workers not observed in pinch point / caught between line of fire
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Workers not observed in falling object line of fire
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Workers not observed in a struck by line of fire
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Workers observed using control to prevent strike against / strain line of fire
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Workers observed using proper lifting techniques or helping each other
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Workers observed ascending / descending in a safe manner
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Workers observed properly using push / pull for the task to be done
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Workers observed properly maintaining focus (eyes) on the task being done
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Workers observed using proper center of balance / walking technique to prevent falls
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Workers are not under suspended loads
DOT
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All documents in cab of trucks secured in a binder
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Crew truck checklist available / completed correctly
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All lights, all lighting, windshield washer and wipers operational
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Fire extinguisher secured and charged
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Driver documentation in order (DL, CDL, medical card current)
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Windshields free of cracks
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Willbros logo and USDOT number on both sides of vehicles
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Set of 3 emergency triangles in vehicle
Inspection / Documentations
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Electrical cords inspected (Color coded)
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Ladders inspected (color coded)
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Rigging tackle inspected / documented
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Fall protection maintained and has current inspection documented
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Forklift operator has certification
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Personnel lifts inspected and documented
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Daily equipment checklists available for review / completed for the day's operations
Lock - Out / Tag-Out Review
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Is a review conducted at least once a year
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Procedures properly followed during LOTO operations
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Employees involved understand procedure
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Proper documentation present
Other Site Specific
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Other
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