Information
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Ship
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Conducted on
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Job number
Administrative
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Site specific emergency procedures reviewed?
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All personnel possess OSHA 10 hour card?
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Do boom lift and forklift operators have their qualification cards?
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Is scaffold in good condition and GREEN TAGGED?
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Any Confined Space entry to be coordinated?
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Has Gas Free Work Scope been submitted?
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Has superintendent been advised to submit Daily Tank Lists to BAE?
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Is PAI required for this job?
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Paint sample results reviewed?
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Do paint samples contain toxic metals?
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Has Toxic Metal Abatement SOP been reviewed with crew?
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Are any containment inspections required? (Usually for over water projects such as catwalks)
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Are LOTO procedures required?
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Are PFD's required?
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Are personnel wearing PFD's properly?
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Are harness' required?
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Are harness on site and properly worn?
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Are POC signs on Job box, trailer, compressors, blast pots and any other equipment?
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Is the first aid kit on site and fully stocked?
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Is eye wash station or eye wash bottles on site?
Hand Tools & Equipment
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Visually check hand tools and confirm with users that all tools and equipment on site are in good condition?
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Review the hazards caused by faulty or improperly used hand tools and identify and eliminate any instances on site.
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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
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Are all employees clean shaven?
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Are all employees wearing their eye protection and hard hats now?
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Names of employees who are not a below;
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Has follow up safety violation report been generated?
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What is the reading on the sound pressure decibel level meter?
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Are all employees wearing their hearing protection now?
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Names of employees who are not a below;
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Has follow up safety violation report been generated?
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Are protective gloves, shields, or other means provided against cuts, or abrasions in use now?
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Is all protective equipment maintained in a sanitary condition and ready for use?
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Do you have eye washing facilities within the work area?
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Has this job foreman been directed to ensure and ENFORCE proper use of PPE?
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Name or initials of foreman are:
Electrical
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Are portable electrical tools and equipment grounded or of the double insulated type?
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Check for exposed wiring and cords with frayed or deteriorated insulation.
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Do extension cords being used have a grounding conductor?
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In wet or damp locations, are electrical tools and equipment clear of puddles or otherwise protected?
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Are electrical appliances such as industrial vacuums and blowers grounded?
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Ensure no metal ladders are in use with any electrical activity.
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Are all disconnecting switches and circuit breakers labeled to indicate their use or equipment served?
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Are all energized parts of electrical circuits and equipment guarded against accidental contact by approved cabinets or enclosures?
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Is sufficient access and working space provided and maintained about all electrical equipment to permit ready and safe operations and maintenance?
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Are all unused openings (including conduit knockouts) in electrical enclosures and fittings closed with appropriate covers, plugs or plates?
Walking, Tripping & Falling
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Is this work in a bilge?
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Has crew been briefed by safety department on dangers in bilge?
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Is 'Bilge Injury" photo warning sign posted?
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Are "RESTRICTED ACCESS YYK PERSONNEL ONLY" signs posted?
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Are "DECK PLATES REMOVED" signs posted?
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Are "Caution Hot Steam Pipe" signs required?
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Is there sufficient lighting?
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Are materials/equipment stored so that sharp projectiles will not interfere with the walkway?
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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?
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Are changes of direction or elevations readily identifiable with orange tape or otherwise?
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Are bridges provided over pipes and similar hazards?
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Is a spill kit necessary for this project, if so, is it in place now?
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Are holes in the deck or other walking surface covered or otherwise made safe?
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Are aisles and passageways kept clear?
Portable Ladders
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Are portable ladders being used on this project?
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When ladders are used to gain access to elevated platforms, ensure the ladder extends at least 3 feet above the elevated surface?
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Confirm that ladders are not placed on boxes, or other unstable bases to obtain additional height?
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Are hardware and fittings securely attached, and movable parts operating freely?
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Is ladder used with the base in place so that slipping will not occur, or it is lashed in place?
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Are ladder rungs and steps free of grease and oil?
Compressors & Compressed Air
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Is this a diesel compressor?
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Is the permit posted?
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What is the APCD Permit Number?
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For reporting requirements what is serial # of compressor?
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Is compressor being used to provide Grade "D" breathing air?
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Has Grade "D" air analysis been performed?
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Is Grade "D" air analysis certificate posted on compressor?
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Are supplied air lines for breathing YELLOW only throughout length of hose?
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Are YYK ID tags in place at manifolds and other key points?
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Are compressed air hose Chicago fittings connected with safety pins?
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Does compressor have POC signage?
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Are safety collars in place at all connectors?
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Are quick disconnects in place, identified and marked with orange tape at fire boundaries?
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Are drums in place for condensate water collection?
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Does water condensate drum have proper label?
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Is water condensate drum in secondary containment?
Hazardous Chemical Exposures
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Who is responsible for HAZMAT disposal?
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Is the HAZMAT locker labeled with POC's?
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Is facility authorization to use paint permit posted in locker or job box?
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Are there any open containers in the paint locker?
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Are MSDS's on site?
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Are secondary containments in place?
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Are secondary labels available and being properly used?
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Are site specific HAZMAT labels available for containers?
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Are metal flammable storage drums grounded properly to prevent sparks and fire?
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Which type of respirator cartridge is required for this job?
- Particulate
- Vapor
- Both
- NONE
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Are those respirator cartridges on site in sufficient quantity?
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Are compressed gas cylinders in use at job site?<br>If YES utilize YYK COMPRESSED GAS CHECKLIST
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Use YYK compressed gas check list
Flammable & Combustible Materials
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Are combustible scrap, debris and waste materials being removed from the worksite promptly?
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Is vacuuming used whenever possible rather than blowing or sweeping combustible dust?
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Are employees trained in the use of fire extinguishers?
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Are employees aware of the site specific fire extinguisher location?
Ventilation
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Is ducting Fire Retardant?
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Is ducting run with minimal bends?
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Is proper filtration installed and properly secured?
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What type of filtration is in use
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Is Negative Exhaust Ventilation in place?
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Is there sufficient draw at the exhaust inlet(s)?
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Is ducting free of rips, tears, holes etc.?
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Can holes and tears be repaired now?
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Were/are the duct ends capped during transport?
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Is anemometer reading available?
Spraying Operations
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Are spraying operations currently in progress?
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Is confined space permit valid?
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Is containment inspection required? (Usually on over water jobs such as a catwalk)
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Confirm no welding or cutting or any hot work operations being conducted in vicinity of spray operations.
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Are paint mixing and staging areas in a secondary containment?
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Is the spray area at least 35 feet from flames, and other ignition sources?
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Is the spray area kept clean of combustible residue?
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Is the spray area free of hot surfaces?
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Is adequate ventilation in place now, before this spray operations begins?
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If lay flat is in use is it setup for exhaust only?
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If lay flat is in use inspect run for punctures/rips/tears and repair.
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Is ventilation arranged to provide fresh air in and exhaust vapors?
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Are portable lamps used to illuminate spray areas explosive proof and suitable for use in a hazardous location?
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Are PFD's available for use on over water operations?
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Is foreman actively enforcing PPE policy particularly in regards to eye protection?
Blasting Operations
Blast Equipment Setup
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Are blasting operations in progress?
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Is containment satisfactory?
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Are all services run in an organized low travel area and marked off with caution tape as necessary?
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Is blast pot production area clean and has vacuum and brooms for cleanup?
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Is poly wrapped around dust collector chute to minimize dust and debris?
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Is all equipment properly grounded and guarded?
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Are spotters being used during moving and transport of equipment?
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Is hearing protection being used at all times in production area?
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Do all compressed air hoses have safety chokers installed?
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Are vacuum lines that run over water of one continuous segment .
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Are blast hose couplings wrapped in rubber if there is danger of contaminating the water?
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Are dust collector chute ends capped and sealed tightly during transportation.
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Are there requirements to access area in excess of 5 feet in the blast area?
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Are harness available and on site?
Air Compressor
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Are secondary containment and berms setup around compressor.
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Are drums in place for water collection.
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Are drums properly labeled.
Blast Pot and Hopper
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Are guillotine hoses maintained and inspected for wear at contact points?
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Is the blast pot SOP for refilling posted?
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Are APCD PERMITS POSTED?
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Are "DANGER CONFINED SPACE "signs,posted legible and in good condition?
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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
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Auditor notes and comments:
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WHAT IF ANY POTENTIAL HAZARDS HAVE BEEN IDENTIFIED NOT COVERED BY THIS JSA?
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Auditor
- Ron Pivaro
- Carlos Sosa
- Juan Saludes
- Henry Huffman
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Signature