Administrative

Site specific emergency procedures reviewed?

All personnel possess OSHA 10 hour card?

Do boom lift and forklift operators have their qualification cards?

Is scaffold in good condition and GREEN TAGGED?

Any Confined Space entry to be coordinated?

Has Gas Free Work Scope been submitted?

Has superintendent been advised to submit Daily Tank Lists to BAE?

Is PAI required for this job?

Paint sample results reviewed?

Do paint samples contain toxic metals?

Has Toxic Metal Abatement SOP been reviewed with crew?

Are any containment inspections required? (Usually for over water projects such as catwalks)

Are LOTO procedures required?

Are PFD's required?

Are personnel wearing PFD's properly?

Are harness' required?

Are harness on site and properly worn?

Are POC signs on Job box, trailer, compressors, blast pots and any other equipment?

Is the first aid kit on site and fully stocked?

Is eye wash station or eye wash bottles on site?

Hand Tools & Equipment

Visually check hand tools and confirm with users that all tools and equipment on site are in good condition?

Review the hazards caused by faulty or improperly used hand tools and identify and eliminate any instances on site.

Are all employees wearing appropriate safety glasses, face shields, gloves, etc. while using hand tools or equipment that might produce flying materials or be subject to breakage?

Personal Protective Equipment & Clothing

Are all employees clean shaven?

Are all employees wearing their eye protection and hard hats now?

Names of employees who are not a below;

Has follow up safety violation report been generated?

What is the reading on the sound pressure decibel level meter?

Are all employees wearing their hearing protection now?

Names of employees who are not a below;

Has follow up safety violation report been generated?

Are protective gloves, shields, or other means provided against cuts, or abrasions in use now?

Is all protective equipment maintained in a sanitary condition and ready for use?

Do you have eye washing facilities within the work area?

Has this job foreman been directed to ensure and ENFORCE proper use of PPE?

Name or initials of foreman are:

Electrical

Are portable electrical tools and equipment grounded or of the double insulated type?

Check for exposed wiring and cords with frayed or deteriorated insulation.

Do extension cords being used have a grounding conductor?

In wet or damp locations, are electrical tools and equipment clear of puddles or otherwise protected?

Are electrical appliances such as industrial vacuums and blowers grounded?

Ensure no metal ladders are in use with any electrical activity.

Are all disconnecting switches and circuit breakers labeled to indicate their use or equipment served?

Are all energized parts of electrical circuits and equipment guarded against accidental contact by approved cabinets or enclosures?

Is sufficient access and working space provided and maintained about all electrical equipment to permit ready and safe operations and maintenance?

Are all unused openings (including conduit knockouts) in electrical enclosures and fittings closed with appropriate covers, plugs or plates?

Walking, Tripping & Falling

Is this work in a bilge?

Has crew been briefed by safety department on dangers in bilge?

Is 'Bilge Injury" photo warning sign posted?

Are "RESTRICTED ACCESS YYK PERSONNEL ONLY" signs posted?

Are "DECK PLATES REMOVED" signs posted?

Are "Caution Hot Steam Pipe" signs required?

Is there sufficient lighting?

Are materials/equipment stored so that sharp projectiles will not interfere with the walkway?

Are aisles or walkways that pass near moving or operating machinery, welding operations or similar operations arranged so employees will not be subjected to potential hazards?

Are changes of direction or elevations readily identifiable with orange tape or otherwise?

Are bridges provided over pipes and similar hazards?

Is a spill kit necessary for this project, if so, is it in place now?

Are holes in the deck or other walking surface covered or otherwise made safe?

Are aisles and passageways kept clear?

Portable Ladders

Are portable ladders being used on this project?

When ladders are used to gain access to elevated platforms, ensure the ladder extends at least 3 feet above the elevated surface?

Confirm that ladders are not placed on boxes, or other unstable bases to obtain additional height?

Are hardware and fittings securely attached, and movable parts operating freely?

Is ladder used with the base in place so that slipping will not occur, or it is lashed in place?

Are ladder rungs and steps free of grease and oil?

Compressors & Compressed Air

Is this a diesel compressor?

Is the permit posted?

What is the APCD Permit Number?

For reporting requirements what is serial # of compressor?

Is compressor being used to provide Grade "D" breathing air?

Has Grade "D" air analysis been performed?

Is Grade "D" air analysis certificate posted on compressor?

Are supplied air lines for breathing YELLOW only throughout length of hose?

Are YYK ID tags in place at manifolds and other key points?

Are compressed air hose Chicago fittings connected with safety pins?

Does compressor have POC signage?

Are safety collars in place at all connectors?

Are quick disconnects in place, identified and marked with orange tape at fire boundaries?

Are drums in place for condensate water collection?

Does water condensate drum have proper label?

Is water condensate drum in secondary containment?

Hazardous Chemical Exposures

Who is responsible for HAZMAT disposal?

Is the HAZMAT locker labeled with POC's?

Is facility authorization to use paint permit posted in locker or job box?

Are there any open containers in the paint locker?

Are MSDS's on site?

Are secondary containments in place?

Are secondary labels available and being properly used?

Are site specific HAZMAT labels available for containers?

Are metal flammable storage drums grounded properly to prevent sparks and fire?

Which type of respirator cartridge is required for this job?

Are those respirator cartridges on site in sufficient quantity?

Are compressed gas cylinders in use at job site?
If YES utilize YYK COMPRESSED GAS CHECKLIST

Use YYK compressed gas check list

Flammable & Combustible Materials

Are combustible scrap, debris and waste materials being removed from the worksite promptly?

Is vacuuming used whenever possible rather than blowing or sweeping combustible dust?

Are employees trained in the use of fire extinguishers?

Are employees aware of the site specific fire extinguisher location?

Ventilation

Is ducting Fire Retardant?

Is ducting run with minimal bends?

Is proper filtration installed and properly secured?

What type of filtration is in use

Is Negative Exhaust Ventilation in place?

Is there sufficient draw at the exhaust inlet(s)?

Is ducting free of rips, tears, holes etc.?

Can holes and tears be repaired now?

Were/are the duct ends capped during transport?

Is anemometer reading available?

Spraying Operations

Are spraying operations currently in progress?

Is confined space permit valid?

Is containment inspection required? (Usually on over water jobs such as a catwalk)

Confirm no welding or cutting or any hot work operations being conducted in vicinity of spray operations.

Are paint mixing and staging areas in a secondary containment?

Is the spray area at least 35 feet from flames, and other ignition sources?

Is the spray area kept clean of combustible residue?

Is the spray area free of hot surfaces?

Is adequate ventilation in place now, before this spray operations begins?

If lay flat is in use is it setup for exhaust only?

If lay flat is in use inspect run for punctures/rips/tears and repair.

Is ventilation arranged to provide fresh air in and exhaust vapors?

Are portable lamps used to illuminate spray areas explosive proof and suitable for use in a hazardous location?

Are PFD's available for use on over water operations?

Is foreman actively enforcing PPE policy particularly in regards to eye protection?

Blasting Operations

Blast Equipment Setup

Are blasting operations in progress?

Is containment satisfactory?

Are all services run in an organized low travel area and marked off with caution tape as necessary?

Is blast pot production area clean and has vacuum and brooms for cleanup?

Is poly wrapped around dust collector chute to minimize dust and debris?

Is all equipment properly grounded and guarded?

Are spotters being used during moving and transport of equipment?

Is hearing protection being used at all times in production area?

Do all compressed air hoses have safety chokers installed?

Are vacuum lines that run over water of one continuous segment .

Are blast hose couplings wrapped in rubber if there is danger of contaminating the water?

Are dust collector chute ends capped and sealed tightly during transportation.

Are there requirements to access area in excess of 5 feet in the blast area?

Are harness available and on site?

Air Compressor

Are secondary containment and berms setup around compressor.

Are drums in place for water collection.

Are drums properly labeled.

Blast Pot and Hopper

Are guillotine hoses maintained and inspected for wear at contact points?

Is the blast pot SOP for refilling posted?

Are APCD PERMITS POSTED?

Are "DANGER CONFINED SPACE "signs,posted legible and in good condition?

Is crew minimizing buildup of used blast media in consideration of supporting structure overloads, blockage of egress routes and engulfment hazards?

Auditor Notes and Signature

Auditor notes and comments:

WHAT IF ANY POTENTIAL HAZARDS HAVE BEEN IDENTIFIED NOT COVERED BY THIS JSA?

Auditor
Signature
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.