Vgs worksite safety audit
Utility - natural gas
What does this form include?
This form contains 15 sections:
Add media
Documentation & Qualification
- Pre-Job Observation (Safety Tailboard) Completed? If yes, attach photo of completed form below.
- Employees performing pipeline functions wearing hard hat sticker verifying OQ/D&A status?
Other Comments
Document(s) Photos
Traffic Control & Worksite Setup
- Signage, cones and barricades are utilized and adequate?
- Traffic control personnel are appropriately equipped and performing well?
- Pedestrian & vehicular traffic monitored for safe passage?
- Police utilized to direct traffic at traffic lights and busy intersections?
Other Comments:
Noteworthy photos:
Personal Protective Equipment
- Hard hats worn at all times?
- Proper footwear worn?
- Appropriate high visibility apparel worn?
- Eye and face protection worn or readily available?
- Hearing protection used when noise exposure exist?
Excavations & Trenching
- Utilities located before excavating begins?
- Trench box, sloping and/or benching utilized if excavation is 5 or more feet deep?
- Spoil pile is at least 2 feet from the edge of the excavation?
- Ladder used if the trench is deeper than 4 feet deep?
- Water within excavation monitored and controlled?
- Surface encumbrances identified and secured?
- A competent person is on scene monitoring trench conditions?
- Atmosphere monitored for O2 and flammability when a potentially hazardous atmosphere is likely to exist?
Tools & Equipment
- Chains and slings used for lifting have safe working load tags on them?
- Air tools and hoses are secured with clips?
- Ground fault circuit interrupters are available and/or in use?
- Extension cords are in good shape and without taped splices, etc.?
- Hand tools are in good condition (pipe wrench teeth, etc.)?
- Guards on power tools are being used as required by the manufacturer?
- Ladders in good shape and non-conductive?
- Welding leads are in good shape and undamaged?
Fire Protection & First Aid
- A charged and functional dry chemical extinguisher is readily available ?
- Flammable liquids are stored in approved containers?
- CGI's are utilized to monitor the atmosphere when performing live gas operations?
Hazardous Materials
- Containers are labeled?
- SDS (Safety Data Sheets) on site or readily accessible?
- Compressed gas cylinders are appropriately secured during storage and transport?
Housekeeping & General Site Safety
- Jobsite is maintained in a neat and orderly fashion?
- Pipe is chocked or otherwise secured to prevent accidental movement?
- Tag lines used whenever pipe is being moved above shoulder height?
Motor Vehicles & Mechanized Equipment
- Seat belts, where provided, are being utilized?
- Back up alarms are functional?
- Vehicle wheels are chocked as required?
- Employees remain clear of the backhoe boom swing radius while it is operating?
NOTES:
Use this template