Information

  • Ship

  • Conducted on

  • Job number

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?

  • Select from range

  • 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?<br>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?

  • Select from range

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

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