SMR STP Project

Compliance Inspections
Last Updated
Project
Package
Compliance 79%
Number ofNumber of Observations 47

1 Priority 1 Spills 67%

2 Priority 2 Waste 70%
3 Priority 3 Waste Water 80%
Safe At Risk Total Compliance
6 Vehicle Safety 0 0 0 - ###
6 Traffic Control 0 0 0 - ###
6 PPE 0 0 0 - ###
6 Ladders 0 0 0 - ###
6 Warning Barriers 0 0 0 - ###
6 Housekeeping 0 0 0 - ###
6 Mobile Plant 0 0 0 - ###
6 Hoisting & Lifting Equipment 0 0 0 - ###
6 Lifting (Rigging) 0 0 0 - ###
6 JSA & STA 0 0 0 - ###
6 Oxy Fuel Gas 0 0 0 - ###
6 Hot Work Permits 0 0 0 - ###
6 EWP 0 0 0 - ###
6 Power Tools 0 0 0 - ###
6 Manbasket 0 0 0 - ###
6 Scaffolding 0 0 0 - ###
6 Confined Space 0 0 0 - ###
6 SDS 0 0 0 - ###
6 Electrical 0 0 0 - ###
6 Emergency Equipment 0 0 0 - ###
6 Excavations 0 0 0 - ###
6 Eyewash Stations 0 0 0 - ###
6 Fall Prevention 0 0 0 - ###
6 Working at Heights 0 0 0 - ###
6 Fire Prevention 0 0 0 - ###
6 Forklifts 0 0 0 - ###
6 Safe Work Practices 0 0 0 - ###
6 Hand Injury 0 0 0 - ###
6 Heat Stress 0 0 0 - ###
6 Lock Out/Tag Out 0 0 0 - ###
6 Material Handling & Storage 0 0 0 - ###
6 Pipe Stands 0 0 0 - ###
6 Respirators 0 0 0 - ###
6 Steel Erection 0 0 0 - ###
6 Tools & Equipment 0 0 0 - ###
6 Vehicles & Equipment 0 0 0 - ###
6 Work Access & Egress 0 0 0 - ###
6 Flammable Cabinets 0 0 0 - ###
4 Secondary Containment 4 1 5 80% ###
1 Spills 6 3 9 67% ###
2 Waste 7 3 10 70% ###
5 Stormwater 3 0 3 100% ###
3 Waste Water 16 4 20 80% ###
Potable Water 0 0 0 -
(Camp) Diner Mess Hall 0 0 0 -
(Camp) Laundry 0 0 0 -
(Camp) Environmental & Waste 0 0 0 -
6 (Camp) Fire Prevention 0 0 0 - ###
Extended Hours-Night Work 0 0 0 -
Total 36 11 47 79%
 Safe At Risk Total Compliance
E PPE 0 0 0 0%
E Housekeeping 0 0 0 -
E SDS 0 0 0 -
E Eyewash Stations 0 0 0 -
E Material Handling & Storage 0 0 0 -
E Flammable Cabinets 0 0 0 -
E Secondary Containment 4 1 5 80%
E Spills 6 3 9 67%
E Waste 7 3 10 70%
E Stormwater 0 0 0 0%
E Waste Water 16 4 20 80%
E Potable Water 0 0 0 -
Total 33 11 44 75%

Environmental Compliance Inspection Observations

25

20

15
Number of Observations

10
At Risk
5 Safe

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 COMPLIANCE INSPECTION SHEET - VEHICLE SAFETY

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Seat Belts worn by ALL occupants 0 0 -
Eye protection worn by occupants where windows
0 0 -
are down in travelling vehicles
Stop signs adhered to with vehicles coming to a
0 0 -
complete stop
Vehicles giving way where required 0 0 -
Appropriate speed being observed 0 0 -

Over size vehicle escorts provided where required 0 0 -

Loaded crane and EWP's being escorted along

0 0 -
roadways
Warning devices operable where required 0 0 -
Mobile phone not being used by driver 0 0 -
Is the driver looking in the direction of travel? 0 0 -
Does the driver allow pedestrians to have the
0 0 -
right-of way?
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - TRAFFIC CONTROL

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Traffic Control signage in place and followed 0 0 -

Signs maintained in a legible condition 0 0 -

Reverse parking requirements observed 0 0 -
Vehicles removed from the workface following
0 0 -
delivery of tools and materials
Stop signs adhered too with vehicles coming to a
0 0 -
complete stop
Vehicles giving way where required 0 0 -
Appropriate speed being observed 0 0 -
Road Closure Permits in place 0 0 -
Detour signage erected in the areas of road
0 0 -
closures
Over size vehicle escorts provided where required 0 0 -
Hazard lights not utilized during the course of
0 0 -
escorting (rotating beacons are used)
Do STA (Hazard Assessment) address traffic
0 0 -
hazards when applicable?
Are equipment spotters being used when backing
0 0 -
equipment or in congested work tasks?
Unloading Checklists being performed 0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - PPE

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Head Protection worn correctly and where
0 0 -
required
Correct form of eye protection worn for the area 0 0 -
Double Eye Protection worn where required 0 0 -
Hearing Protection worn in designated areas 0 0 -
Correct form of hand protection worn for manual
tasks 0 0 -
Respiratory protection worn where dust, mist or
fumes are present 0 0 -
Footwear in good condition/correct type 0 0 -
Hi-vis vest worn around mobile equipment and
0 0 -
escort duties
Safety Harness appropriately worn at height 0 0 -
Correct lanyard selected for application and
0 0 -
attached for 100% hook up
Additional Protective clothing used where required
0 0 -

Are employees wearing hard-toe(steel or

0 0 -
composite) sturdy work shoes?
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - LADDERS

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Ladder positioned 1:4 and appropriately secured
0 0 -
top and bottom
Ladder positioned to facilitate ease of access /
egress without obstruction. 0 0 -

Access / egress points clear of trip hazards at

step of points 0 0 -
Ladder extends a minimum of 1M beyond the step
off point. 0 0 -

Visible identification available that ladder has

been inspected for current 3 monthly period. 0 0 -
Rungs not broken, decayed, split, cracked, worn
0 0 -
or missing
Stiles not split, broken or damaged 0 0 -
Ladder footings in place and in good condition 0 0 -
Ladder being used for access and not as a work
0 0 -
platform
Portable ladders have a work platform and
0 0 -
handrails if they are used to work from
Is the base of the ladder clear of material and
0 0 -
hoses?
Are employees using non conductive ladders for
0 0 -
electrical work?
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - WARNING SIGNS & BARRICADES

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are appropriate warning signs and barricading
displayed where hazards are evident 0 0 -

Do barricades have 4 sides or adequately protect

0 0 -
personnel from walking into the hazard?
Are information tags being used and are legible 0 0 -
Are there any signs or bunting that no longer
apply and which should be removed 0 0 -

Is the correct barrier tape or flagging being used

to identify the hazard 0 0 -

Is the intent of the barricading / warning signs

being adhered too. 0 0 -

Are penetrations appropriately covered,

barricaded and sign posted 0 0 -
Is temporary construction signage removed when no
longer required 0 0 -

Are hard barricades made of wooden 2"x4"

material, tube-loc scaffold material, or 1/2" cable
stretched tight between steel or stanchions with 0 0 -
turnbuckles or appropriate number of cable
clamps?

Are barricades used for fall protection/prevention

and equipment protection adequately illuminated
0 0 -
for dark condition if near roadways or travel
paths?
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - HOUSEKEEPING

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Is the work area clean & free of excess trash &
0 0 -
debris?
Construction materials laid out safely and
0 0 -
accessible
Material / equipment laid out on gluts / dunnage
for ease of access 0 0 -

Waste materials cleaned up and disposed of on a

0 0 -
regular basis
Gang boxes / containers maintained in orderly
0 0 -
fashion
Clear access to fire and emergency equipment /
0 0 -
exits maintained
Base of ladders clear of lose material or
0 0 -
obstructions
No evidence of spilled material or slippery
0 0 -
surfaces
Work area clear of general and domestic rubbish 0 0 -
Are electrical cords, leads, and hoses protected
0 0 -
from damage and positioned to minimize tripping?

Are electrical cords, hoses, welding leads, etc.

0 0 -
rolled up when not in use?
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - MOBILE PLANT

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Has the plant log book been completed by the
0 0 -
operator as part of the pre-start check
Are guards in position and in good condition 0 0 -
Has a spotter been provided where required 0 0 -
Have adequate precautions such as flagging,
cones or warning signs been erected to warn of 0 0 -
hazards.
Are flashing lights or reverse warning alarms
operable where fitted 0 0 -

Is the item of plant / equipment being operated in

0 0 -
a safe manner
In the case of load shifting equipment are loads
0 0 -
appropriately secured
Are operators wearing the correct PPE for the
task (i.e. safety harnesses for boom hoists. 0 0 -

Other 0 0 -
0 0 -
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Hoisting and Lifting Equipment(Chain falls and Come-a-longs)

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Is equipment properly inspected?
0 0 -

Are manufacturer's labels/tags/ markings legible?

0 0 -

Are chainfalls used properly(vertical lifts)?

0 0 -

Is lashing in place where needed?

0 0 -

Are softeners used appropriately?

0 0 -

Do employees understand various load limitations

based on sling configuration-for example-Choke, 0 0 -
basket or hitch?
Are come-a-long or chainfall hooks NOT hooked
back to the load chain? 0 0 -

Is the weight of the load known by employees?

0 0 -

Is the anchor point, rigging and equipment rated

for the load? 0 0 -

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - LIFTING / RIGGING

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are the cranes inspected on a daily basis or before use? 0 0 -

Lifting gear is appropriately stored when not in use 0 0 -

Are lights, brakes, horn, and anti-two block working
properly?
0 0 -

Are outriggers properly used/mats in place where

needed?
0 0 -

Are applicable lifting plans (lifts over 20 tons) available

at the work area?
0 0 -

Permit in place for use of synthetic slings 0 0 -

Is lifting equipment double wrap on steel components 0 0 -

WLL/Capacity tags/info on lift equipment-legible 0 0 -

Are sharp edges protected 0 0 -
Is the correct equipment being utilized for the task 0 0 -
Are operators performing works in such a manner as to
minimize Line of Fire events
0 0 -

16mm Tag lines used to control inadvertent load shift 0 0 -

Barricading / cones in place to define lift and slew radius 0 0 -

Are secondary slings being utilized to support
unattended suspended loads 0 0 -

Are portable lifting devices (hoist, come-a-longs,

etc) inspected daily or before use? 0 0 -

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET -STA

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Has a STA been developed for the task and
readily accessible at the workface
0 0 -

Have all personnel engaged in the task signed

onto the STA 0 0 -
Has the STA been reviewed and signed by the job
0 0 -
Supervisor
In the case of a lower tier subcontractor has the
STA been authorized by the principle contractor 0 0 -
Does the STA identify Permit To Work
0 0 -
requirements associated with the task
Does the STA adequately reflect the task being
0 0 -
performed
Does the STA have an overriding Hazard
Assessment 0 0 -

Are the STA task steps being followed 0 0 -

Have all potential hazards been identified (detail
major hazards that have not been accounted for) 0 0 -

Does the STA reflect any field modifications 0 0 -

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - OXY / FUEL GAS

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are cylinders secured in the upright position and
separation distances maintained for bulk fuels 0 0 -

Are cylinders transported by appropriate means in

the up right position 0 0 -

Are fuel hoses maintained in a good state of

repair 0 0 -

Are flash back arrestors fitted at both hand piece

and gauges 0 0 -

Is an appropriate fire extinguisher in

0 0 -
place/charged/inspected for current period
Is a Fire Watch in place 0 0 -
Have combustibles / flammables been removed
0 0 -
from the immediate work area
Have precautions been taken to protect adjacent
0 0 -
services from sparks etc
For hot work at height have the appropriate
controls been implemented to prevent inadvertent 0 0 -
entry to the area
Other 0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - HOT WORK PERMITS

Date:

Inspection Team:

Area:

Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment

Is there a Hot Work Permit approved by a
Responsible Officer for the work to be carried out 0 0 -

Is the Permit the correct type for the area of work

0 0 -

Has a gas test been performed where required 0 0 -

Have potential fire hazards within 15m been
removed or adequately controlled 0 0 -

Is an appropriate fire extinguisher in

0 0 -
place/charged/inspected for current period
Is the Fire Watch wearing appropriate Hi-vis
0 0 -
clothing
Does the fire watch have a suitable means of
0 0 -
reporting an emergency
Is the Fire Watch attentive to the task 0 0 -
Has the equipment being worked on been
0 0 -
isolated, purged and tagged out where required
Have controls been put into place to prevent
sparks, slag, off cuts, hot metal or electrode stubs
0 0 -
lodging in places likely to cause a fire or fall to a
lower level
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - EWP

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Has the plant log book been completed 0 0 -
Is a copy of the operator’s manual maintained with the machine
0 0 -
Is the EWP free from defect likely to affect the integrity of the
machines operation 0 0 -
Are operating controls legible and safety devices in an operable
condition 0 0 -
Is the self closing mechanism on the gate in a functional
condition 0 0 -
Is the EWP being operated in a safe manner i.e. proximity to
adjacent services, pipe racks, line of fire 0 0 -
Are harnesses worn and tied off inside of the platform?
0 0 -
Has a spotter / escort been provided and is within sight of the
operation of the machine 0 0 -
Is the spotter competent in the operation of the machine and
familiar with the emergency ground controls 0 0 -
Have adequate precautions such as flagging, cones or warning
signs been erected to warn of hazards 0 0 -
Is a Permit displayed on the machine for exiting the platform in
an elevated position 0 0 -
Is there a fire extinguisher in the platform and is it in working
order? 0 0 -
Is equipment staged in non-congested/obstructed fashion?
0 0 -

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - POWER TOOLS

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are the correct guards fitted to portable
0 0 -
power tools
Handles fitted where required 0 0 -
Leads free from defect indicating, employee
inspected prior to use 0 0 -

Cords elevated where possible 0 0 -

Cables and leads supported on insulated
0 0 -
hanger/hooks
Plug terminations in good order 0 0 -
Leads appropriately tagged for the current
0 0 -
period
Use of GFCI (RCD) with all portable electrical
0 0 -
equipment
Correct power tool being used for the task 0 0 -
Other 0 0 -
0 0 -
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - MANBASKET

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Is basket equipped with a guardrail system (top
and mid rail and toe board) and enclosed 0 0 -
construction between the toe board and the mid
rail (solid or expanded 1/2" metal)?
Is access gates provided with restraining device to
prevent accidental opening? 0 0 -

Is platform weight and maximum load capacity

posted permanently on the platform? 0 0 -

Has a trial lift of an unoccupied personnel platform

that is 125 percent of platform capacity been 0 0 -
made?
Is grab rail been provided inside the entire
perimeter? 0 0 -

Is the manbasket being utilized if wind speeds

exceed 15 mph (Shut down)? 0 0 -

If welding is performed by employees occupying

the platform, is the electrode protected from 0 0 -
touching the metal components of the platform?
Is manbasket permit filled out, signed and
reviewed with all employees? 0 0 -

0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - SCAFFOLDING

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Is the scaff-tag appropriately displayed at the entry point
to the scaffold indicating its status for use
0 0 -

Has the scaffold been inspected for the current period,

monthly as a minimum
0 0 -

Are cables and leads suspended from the scaffold

supported on insulated hanger/hooks
0 0 -

Is the loading on the scaffold in conformance to the

scaffold rating (light, medium or heavy) duty stage
0 0 -

Is the Scaffold appropriately tied in 0 0 -

Is the scaffold appropriately supported on sole boards
0 0 -
Ladders secured, 1.4 meter lean, project 1m above
platform
0 0 -

Clear access egress points to scaffolds, 0 0 -

Sharp edges and scaffold clips covered on walkways 0 0 -

0 0 -
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - CONFINED SPACE

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Is the Permit currently valid for the Confined Space. 0 0 -
Permit requirements complied with - access, gas monitoring,
isolation, housekeeping, ventilation etc. 0 0 -
Confined space entry procedure is attached to permit with any
additional JSA's (STA). MSDS's attached to permit and 0 0 -
complied with.
Communications in place, suitable and understood by
employees. 0 0 -
JSA accounts for daily conditions and change management
processes 0 0 -
Access - internal & external conducive to safe entry. 0 0 -
Pre-entry briefing was conducted and sign off completed 0 0 -
Emergency evacuation plan in place and understood by
employees. 0 0 -
Stand-by person identified, in position, understands his
responsibilities. 0 0 -

Entry Leader identified and understands responsibilities. 0 0 -

Is there a method to summon emergency services? 0 0 -

Correct signage in place "No Unauthorized Access", "Confined

Space No Unauthorized entry". 0 0 -

Personal locks and Danger tags attached to hasp at permit. 0 0 -

Emergency lighting installed & functional 0 0 -

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - SDS

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Contractors MSDS Register is maintained at an
accessible location known to employees.
0 0 -

MSDS are available for all products stored or in use by

the contractor
0 0 -

Product storage areas are provided with adequate

segregation between products and other materials, 0 0 -
warning signs displayed as per regulations.

Product usage is seen to be covered in the daily JSA

(STA) / Safe Work Instruction.
0 0 -

A copy of the MSDS is provided in the work pack as

part of the work instruction for high risk classification 0 0 -
products

Containers are appropriately labeled, particularly where

decanting has occurred.
0 0 -

Daily use products are appropriately transported to /

stored at the workface with precautions clearly 0 0 -
identified.
Waste containers are appropriately disposed of after
use 0 0 -

Employee's observed to be wearing the appropriate

form of PPE in accordance with the requirements of the 0 0 -
manufacturer

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - ELECTRICAL 1

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are Ground Fault Circuit Interrupters (GFCI's)
utilized while operating power tools? 0 0 -

Are Motor Control Centers and Switch Gear

Rooms clean and free of storage or debris? 0 0 -

Are High Voltage panels or equipment (temporary

or permanent) labeled and adequately protected 0 0 -
from damage?
Are temporary construction power panels or
distribution panels designed and maintained by 0 0 -
qualified personnel?
Are temporary construction power panels or
distribution panels labeled adequately? 0 0 -

Are underground electrical utilities (temporary or

permanent) marked or located before excavation 0 0 -
begins?
Are Lockout/Tagout requirements being properly
implemented per procedures? 0 0 -

Are all employees given Lock-out/Tag-out

Awareness training in New Hire Orientation? 0 0 -

Are temporary power cords suitable for their use

and protected from mechanical damage? 0 0 -

Is access readily available to electrical panels and

disconnect switches? 0 0 -

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - ELECTRICAL 2

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Is equipment properly grounded? 0 0 -
Do GFCI's have proper color code? 0 0 -
Are GFCI's inspected and logged properly by
Competent Person? 0 0 -

Are employees carrying electrical power tools

properly? 0 0 -

Are ground wires on plugs intact? 0 0 -

Are extension cords in good condition? 0 0 -
Are welding ground leads properly connected? 0 0 -
Area welding leads in good condition? 0 0 -

0 0 -

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Emergency Equipment/Emergency Preparedness

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Do employees know where assembly points are?*
0 0 -
Do employees know how to report an emergency?
0 0 -
*
Do employees know what to do if they hear
0 0 -
evacuation alarm?*
Is fire extinguishing equipment (hoses,
connections, nozzles) and the water truck readily 0 0 -
available if required on permit or STA?
Do employees know what to do in the event of
0 0 -
severe weather?*
Do employee(s) know the location of the nearest
0 0 -
eyewash station?*
Do employee(s) know the location of the nearest
0 0 -
fire extinguisher?*
Are emergency telephone numbers posted inside
0 0 -
all field offices?
Has the Emergency Response Team been
notified of existing hazardous tasks (confined
space entry, work at heights, unique tasks, etc.) 0 0 -
that may require a response in the event of an
incident? (see permit)

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - EXCAVATIONS

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are daily pre-entry excavation inspections
completed by an Excavation Competent Person
when excavations over 1 meter in depth? 0 0 -

Is the Competent Person inspection documented

and communicated to the workers entering the 0 0 -
excavation?
In trench excavations, are there designated
means of access/egress within 7 meters of work 0 0 -
task?
Are workers using the designated access routes?
0 0 -
Are spoils a minimum of 1 meter from the edge of
0 0 -
the excavation?
Are excavation slopes adequate? 0 0 -
Are traffic controls and/or stops in place for traffic
or equipment in use within 1.8 meters of the 0 0 -
excavation?
Are barricades properly erected (soft-2 meters
0 0 -
from edge, hard-capable of 90 kg force)?
Are barricades properly erected for visibility during
dark conditions (lights, reflectors, etc.) when
trenches or excavations near roadways or travel 0 0 -
paths?

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - PORTABLE EYEWASH STATIONS

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Is this eye wash station designed to wash the
eyes with copious quantities of water for at least
15 minutes? 1 liter rinse bottles or similar 0 0 -
containers are not emergency eyewash stations.

Is the eyewash station positioned so that it is

readily visible and accessible? Travel should be
not more than 7 meters. Eyewash must be 0 0 -
moved to the location where corrosive materials
are used.
Are the eyewash heads covered to prevent the
0 0 -
intrusion of airborne contaminates?
Is the eyewash unit kept clean and sanitary? 0 0 -
Is the water being replaced immediately if the
inspection gives any evidence of particulates or 0 0 -
discoloration?
Is the eye wash station cleaned using hot water?
(50°c or hotter is recommended) do you know 0 0 -
who does the cleaning?
Do discharge nozzles discharge evenly and
0 0 -
provide water to adequately wash the eyes?
Is the water replaced as per the manufacturer’s
directions? Usually every six months or more 0 0 -
frequently.
Is the inspection tag visible, legible and up to
0 0 -
date?
Is a new bottle of bacteriostatic additive added
every time the eyewash tank is serviced and 0 0 -
refilled (prevents bacteria growth)
Is the eyewash station inspected weekly for
inadequate water level and topped off as 0 0 -
necessary? (recommended)
For pressure eyewash stations – Is the proper
pressure maintained? 0 0 -

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - FALL PREVENTION AND PROTECTION

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are guard rail systems in place where required to
0 0 -
prevent fall exposure?
Are Employees connecting to the required
anchorage points within the aerial lifting devices 0 0 -
(JLGs)?
Are employees working on scaffold where fall
protection is required using personal fall arrest 0 0 -
systems?
Are employees working above 1.8 meters using
personal fall arrest systems to achieve 100% fall 0 0 -
protection?
Are employees fall arrest lanyards connected
(above the harness D ring) to limit free fall 0 0 -
distance?
Are inspections of personal fall arrest system
components (harness, lanyards, rope grabs, etc.)
conducted as required and color coded for current 0 0 -
quarter?
Are employees aware of the proper anchorages?*
0 0 -
Are hole covers secure and properly labeled? 0 0 -
Where barricades are used to prevent access to
fall hazards, are they located at least 2 meters
away from the fall hazard? Are they visible during 0 0 -
darkness(if applicable)?
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - FALL PREVENTION - WORKING AT HEIGHTS

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Does STA address hazards and mitigation for
0 0 -
employees working at heights?
Is there appropriate signage on ladders and/or
platforms to indicate fall protection requirements? 0 0 -

Are decks/platform kept clean and orderly? 0 0 -

Do employees have bolt bags or skip pans to
0 0 -
keep loose materials secure?
Do employees have tools secured using tool
0 0 -
lanyards when feasible?
Is area below adequately barricaded with proper
0 0 -
tags/signals?
Are employees lifting materials properly(bolt bags)
0 0 -
with proper knots?
Are personnel wearing appropriate fall protection
0 0 -
and tied off properly?
Are adequate toilets and drinking water available?
0 0 -
Are adequate fire extinguishers and/or eye wash
stations readily available? 0 0 -

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - FIRE PREVENTION/PROTECTION

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are applicable Work Permits completed and a
0 0 -
copy at the area/unit?
Is fire protection equipment outlined in the
permit/STA card at the work area (within 0 0 -
7meters)?
Is fire protection equipment inspection completed
before work begins and are inspection tags/color 0 0 -
code current? *
Is work area where welding, cutting or burning is
occurring free of flammable and combustible
materials within 10 meters or physically 0 0 -
protected?
Are appropriate personnel trained in fire watch
duties(designated fire watches or area fire 0 0 -
monitors)?
Are employees assigned to operate fire protection
equipment trained to use the applicable 0 0 -
equipment? *
Are oxygen/fuel gas systems equipped with
approved backflow prevention valves, flash 0 0 -
arresters, and pressure relief device(s)?
Are compressed gas cylinders stored upright and
0 0 -
secured?
Are compressed gas cylinders capped securely
0 0 -
when not in use?
Are the applicable flammable materials (greater
than 50 liters) stored in an approved and labeled 0 0 -
flammable liquid cabinet?
Are offices equipped with the proper number of
0 0 -
fire extinguishers?
Are the areas (with in1 meter) around mounted
0 0 -
fire extinguishers clear of obstructions?
Are smoking areas kept clean and are butt cans
0 0 -
available?
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Forklifts/Front End Loaders/Dirt & Equipment

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are daily inspections complete? 0 0 -
Are there NO signs of fluid leaks? 0 0 -
Are operators trained and authorized by their
0 0 -
supervisor to operate the equipment?
Are forks/buckets lowered as much as possible
0 0 -
(visibility) when traveling?
Are items being transported secured on pallets or
0 0 -
secured from falling/spilling?
Are spotters used when backing or operating in
0 0 -
congested areas?
Are operators obeying posted speed limits and
0 0 -
traveling in a safe manner?
Is equipment being operated only on stable
0 0 -
surfaces?
Are operators paying full attention to the task (For
0 0 -
example: not on cell phone)?
Are operators using seat belts? 0 0 -
Are lights operational on equipment used during
0 0 -
periods of low light?
Are back ups alarms, lights and horn operational?
0 0 -

0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - General Safe Work Practices-I

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are employees following site smoking policies and
disposing of smoking materials in the proper 0 0 -
receptacles?
Are eye wash stations located in appropriate
0 0 -
areas and maintained?
Are employees wearing long sleeve shirts and
0 0 -
long pants? Or are FRC's required?
Are defective tools removed from the work area
0 0 -
and tagged?
Do tools have required guards in place? 0 0 -
Are GFCIs in use? 0 0 -
Are cords and hoses kept out of the walkway and
0 0 -
off of the working surface?
Are excess flow valves in use on air-supplying
0 0 -
hoses exceeding 1/2"?
Is the work area adequately illuminated? 0 0 -
Are all protruding reinforcement steel guarded to
0 0 -
eliminate the hazard of impalement?
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - General Safe Work Practices-II

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are employees aware of MSDS "book" location?
0 0 -
Are containers properly labeled? 0 0 -
Does the STA address chemical hazards? 0 0 -
Has the supervisor discussed the chemical
0 0 -
hazards with the employees?
Are employees aware of location of area Work
0 0 -
Permit?
Have the employees identified the nearest eye
0 0 -
wash and/or safety shower on the STA card?
Have the employees identified the proper
0 0 -
assembly point on the STA?
Have the employees identified the nearest fire
0 0 -
extinguisher on the STA?
Have employee identified the proper emergency
0 0 -
contact numbers on the STA?
0 0 -
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - HAND INJURY PREVENTION

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are employee keeping hands and arms away from
pinch points when performing their task(s)? 0 0 -

Are employee keeping legs and feet away from

0 0 -
pinch points when performing their task(s)?
Are employees operating power tools with the
0 0 -
appropriate guards?
Are employees wearing the appropriate gloves
0 0 -
while performing their task(s)?
Are rebar tie-wires in the appropriate position
0 0 -
(bent down and away from employee contact?)
Is housekeeping in the work area free from
0 0 -
laceration or puncture hazards?
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Heat Stress Prevention

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are discussions concerning Heat Stress
Prevention performed in morning safety meetings 0 0 -
and documented on the STA?
Do employees know the signs of Heat Cramps?*
0 0 -
Do employees know the signs of Heat
0 0 -
Exhaustion?*
Do employees know the signs of Heat Stroke?*
0 0 -
Do Supervisors plan work if feasible to make use
0 0 -
of shaded areas?
Are fans, tarps, or cool down stations available?
0 0 -
If swamp coolers are in use, are they maintained
0 0 -
properly?
Do employees have unobstructed access to water
0 0 -
coolers?
Is cool / fresh water available throughout the work
0 0 -
day?
Are water coolers sealed and dated properly? 0 0 -
If work/rest periods are implemented, are they
being followed? 0 0 -

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - LOCK OUT/TAG OUT

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are all employees given Lock-out/Tag-out
0 0 -
Awareness training in New Hire Orientation?
Are all authorized employees and supervisor
0 0 -
trained in the Lock Out/Tag Out procedure?*
Is LOTO permit filled out correctly? 0 0 -
Is group lock out implemented correctly? 0 0 -
Are blinds properly tagged and identified? 0 0 -
Are locks identifiable as "lockout" locks and not
0 0 -
used for other purposes?
Was isolation verified --"test"? 0 0 -
Are vents or bleeds in the appropriate position?
0 0 -

0 0 -
0 0 -
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Material Handling & Storage

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are manual handling tasks discussed on the
0 0 -
STA?
Do project personnel participate in stretching? 0 0 -
Are mechanical methods used when needed? 0 0 -
Are employees wearing the appropriate gloves
0 0 -
when handling materials?
Are employees using proper lifting techniques? 0 0 -
Are incompatible materials segregated and stored
separately? (example: oxidizers and petroleum 0 0 -
based products)
Are hazardous materials stored separately and
0 0 -
protected from the elements?
Are storage areas orderly and is there an walkway
0 0 -
for access?
Are stored materials/pallets securely stacked at a
0 0 -
safe height?
0 0 -
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Pipe Stands 3 and 4 Legged

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Is equipment properly inspected before
0 0 -
use(ask employee(s))?
Are manufacturer's labels/tags/ markings
0 0 -
legible?
Do employees understand various load
limitations based on 3 legged and 4 0 0 -
legged pipe stands?
Is pipe stand locking ring in place and
0 0 -
holding?
Is stand on firm, level surface? 0 0 -
Are supports or legs free from damage or
0 0 -
bent legs?
Is the yoke free from grease? 0 0 -
Are 3 legged stands being used to
0 0 -
support pipe 8 inches or smaller?
When using pipe stands on scaffolding
are scaffold(s) designed for the load(see 0 0 -
scaffold request)?
0 0 -
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - RESPIRATORS

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are respirators being used proper for the
0 0 -
hazard(see JSA or STA)?
Are respirators stored properly when not in use?
0 0 -
Are respirators being worn properly? 0 0 -
Is employee knowledgeable of field fit test?* 0 0 -
Does employee have proper medical clearance to
0 0 -
wear a respirator?*
Does employee have training on respiratory
0 0 -
hazards?*
Is respirator clean? 0 0 -
Does STA address respiratory hazards? 0 0 -
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Steel Erection

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are employees 100% tied-off when elevated 1.8
meters off the ground and/or leading edge that 0 0 -
has a fall greater than 1.8 meters?
Is the area barricaded properly with the
0 0 -
appropriate barricade tape when making lift?
Has all rigging equipment/material properly
0 0 -
inspected?
Are employees watching pinch point hazards
0 0 -
when connecting/setting steel?
Is crane cab and rigger sounding horns and
0 0 -
whistles when a lift is being made?
Do nylon chokers have softeners in place to
0 0 -
prevent cuts and frays on rigging?
Is structural steel being hot bolted properly? 0 0 -
When exiting a manlift- has it been noted on STA
and signed by safety/site 0 0 -
superintendent/Construction Manager?
Do personnel have tool secured
0 0 -
properly(lanyards/bolt bag/tool pouch)?
Do personnel have bolts and nuts secured
0 0 -
properly(bolt bag)?
0 0 -
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - TOOLS & EQUIPMENT

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are hand tools in good condition? 0 0 -
Are power(electric, air, fuel) tools in good
0 0 -
condition?
Are electrical tools inspected per the Project
0 0 -
Procedures (color coding or GFCI inspection)?
Are employees carrying and hoisting tools
0 0 -
properly?
Are tools/equipment guards and handles in place?
0 0 -
Are hoses, cords, and leads in good condition:
0 0 -
free of cuts, melting or abrasion?
Are proper securing methods used on material to
be cut, drilled, welded, etc.? (For example: 0 0 -
sawhorses, clamps, jack stands)
Are the correct tools used for the job task(s)? 0 0 -
Are pneumatic tools properly connected and
sized: hoses, whip checks, locking pins, excess 0 0 -
flow valves?
Are persons NOT cleaning themselves with
0 0 -
pneumatic tools?
Are pneumatic cleaning devices proper- 30 psi
0 0 -
max (not homemade)?
Are damaged or worn tools and equipment tagged
and removed from service? 0 0 -

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - VEHICLES AND EQUIPMENT

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are daily inspections complete and does audit of
0 0 -
equipment match daily inspection?
If items are noted as non-functioning, has
0 0 -
supervisor been informed?
Are there NO signs of fluid leaks? 0 0 -
Are operators trained and authorized by their
supervisor(or third party) to operate the 0 0 -
equipment?
Is the driver obeying traffic signs? 0 0 -
Does the driver allow pedestrians to have the
0 0 -
right-of way?
Are forks/buckets lowered as much as possible
0 0 -
(visibility) when traveling?
Are items being transported secured on pallets or
0 0 -
secured from falling/spilling?
Are spotters/flaggers used when backing or
0 0 -
operating in congested areas?
If a manlift or crane, are areas properly
0 0 -
barricaded?
Is equipment being operated only on stable
0 0 -
surfaces?
Are operators paying full attention to the task (For
0 0 -
example: not on cell phone)?
Are operators using seat belts? 0 0 -
Are employees operating vehicles and equipment
0 0 -
NOT passing on roadways?
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - WORK ACCESS AND EGRESS

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Is emergency equipment NOT blocked (Fire
Extinguishers, Eye Washes or Other 0 0 -
_____________________)?
Does walking or working path have minimal or
0 0 -
free of materials ?
Are ladders clear of obstructions at top and
0 0 -
bottom?
Are materials stacked/stored to prevent tipping?
0 0 -
Is there minimal excess materials in work area
0 0 -
(scrap or new materials)?
Are cords, hoses, leads arranged out of
0 0 -
walking/working path?
Are people standing on appropriate work surfaces
(for example, no buckets, no beams, scaffold rails, 0 0 -
etc.)?
Are Laminated Crane mats free of loops or
0 0 -
protected/secured?
Are Hard Wood Crane mats' lifting openings
0 0 -
covered or filled with rock/dirt?
0 0 -
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Flammable Cabinets (ENVIRO)

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are flammable cabinets free of trash and debris?
0 0 -
Is there any standing water/spills at the bottom of
0 0 -
the flammable cabinets?
Is the flammable cabinet properly ventilated? 0 0 -
Are there any containers in the flammable cabinet
that can be taken to disposal? (i.e. empty 0 0 -
containers, out-of-date chemicals)
Is there easy access to flammable cabinets? 0 0 -
Are all containers in the flammable cabinets
0 0 -
properly labeled?
Is excess liquid in containers less than 50 liters?
0 0 -
(excluding aerosol cans)
Are flammable cabinets grounded? 0 0 -
Is there a fire extinguisher within 10 meters of
0 0 -
flammable cabinet?
Is flammable cabinet secured? 0 0 -
Are proper fire symbols or signage on flammable
0 0 -
cabinet?
Are hazard materials stored away from other
0 0 -
incompatible hazardous materials?
0 0 -
0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Secondary Containments (ENVIRO)

Date:

Inspection Team:

Area:

Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment

Does portable (compressors, generators, light
plants) equipment have adequate spill 0 0 - No portable equipment at site yet.
containment beneath (or internal to) it?
Does secondary containment contain all L-
0 0 -
Brackets and is containment properly erected?
Are any holes located inside the secondary
0 0 -
containment? Is equipment running?
Are chemical mixing areas performed inside
0 0 - n/a (no other chemicals yet in the area except for diesel)
containments?
Is equipment properly positioned in containment
and are containments able to hold 20% more than
the fuel tank? (i.e. Is the body of equipment and 0 0 -
fueling spout properly located inside the
secondary containment?)
Are pipe threading operations done within a
0 0 - n/a
containment?
Are all containers of liquid hazardous/non-
hazardous materials located inside proper 1 0 100% diesel storage drum located inside the containment.
secondary containment?
Are secondary containments free of debris/trash?
1 0 100% regularly cleaned
Are secondary containments properly cleaned
1 0 100%
after spill has occurred?
After rain event, are containments being emptied
of water? (i.e. Evaluated for sheen and either 1 0 100% rain water discharged immediately
vacuumed or released)
Is there adequate spill response equipment
0 1 0% no available spill kit
located nearby to secondary containment?
Are the bunded areas lined with low-permeability
materials (such as concrete or high density n/a (they use drip tray, while waiting for construction of
0 0 -
polyethylene)? bunded wall)

Total 4 1 80%
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Environmental/Spill Prevention (ENVIRO)

Date:

Inspection Team:

Area:

Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment

Does portable (compressors, generators, light
plants) equipment have adequate spill 0 0 - No generators or compressors yet at site.
containment beneath (or internal to) it?
Is equipment inspected before use for leaking
1 0 100%
fluids?
Is leaking equipment taken out of service? 2 0 100% 1 dump truck and backhoe out of service
Are chemical mixing areas performed inside
0 0 - No chemicals at site
containments?
Are fueling operations performed using spill
0 1 0% No
containment?
Are pipe threading operations done within a
0 0 -
containment?
Are hoses used to transfer combustible,
flammable, or toxic liquids flushed, emptied or 0 0 -
plugged prior to storage?
Is there secondary containment for open
containers of liquid hazardous/non-hazardous 1 0 100% provided but need to improve already damaged.
materials?
Are spill kits properly stocked and free of
0 1 0% no available spill kit at site
debris/trash?
Have all spills/leaks been properly contained and
cleaned up? Has Environmental been notified of 1 0 100% contaminated soil removed from site
the spill/leak?
Are areosol cans returned to flammable cabinets
1 0 100%
or put in Protherm disposal drums?
Is equipment properly positioned in containment
and are containments able to hold 20% more than Some secondary containment not able to hold the required
0 1 0%
the fuel tank? percentage of fuel tank

Total 6 3 67%
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Environmental - Waste (ENVIRO)

Date:

Inspection Team:

Area:

Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment

Is there adequate number of general trash
2 1 67% site office adequated trash bins, STP site need more
containers placed throughout the site?
Are trash containers overflowing? 1 0 100% regularly remove
Are all roll-off/trash containers properly labeled
0 1 0% Some trash container not labeled properly
and have an adequate stand sign in front of it?
Is there any aerosol cans located in the general
1 0 100%
trash containers?
Is there any oily waste located in the general trash
1 0 100%
containers?
Do the metal roll-off box or metal hoppers contain
0 0 -
general trash inside it?
Is there any treated wood or lumber located in the
0 0 -
general trash containers?
Is housekeeping performed around all trash
1 1 50% site office need to assigned wast bins
containers? Are they easily accessible?
Does the Protherm Aerosol Can Drum have
1 0 100%
general trash inside it?
Do metal roll-off trash contained trash as labelled?
0 0 -

-
-
Total 7 3 70%
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.

The Column OBSERVATION refers to the number of situations observed with the same characteristic at the same work area.
The column NON COMPLIANT refers to the number of non compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Stormwater

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Does portable (compressors, generators, light
plants) equipment have adequate spill 1 0 100%
containment beneath (or internal to) it?
Does secondary containment contain all supports
and filling points and is containment properly 1 0 100%
erected?
Are any holes located inside the secondary
1 0 100%
containment? Is equipment running?
Are chemical mixing areas performed inside
0 0 -
containments?
Is equipment properly positioned in containment
and are containments able to hold 20% more than
the capacity of the tank/drums? 0 0 -

Are pipe threading operations done within a

0 0 -
containment?
Are all containers of liquid hazardous/non-
hazardous materials located inside proper 0 0 -
secondary containment?
Are secondary containments free of debris/trash?
0 0 -
Are secondary containments properly cleaned
0 0 -
after spill has occurred?
After rain event, are containments being emptied
of water? (i.e. Evaluated for sheen and either 0 0 -
vacuumed or released)
Is there adequate spill response equipment
0 0 -
located nearby to secondary containment?
Are the bunded areas lined with low-permeability
materials (such as concrete or high density 0 0 -
polyethylene)?
Total 3 0 100%
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Waste Water

1
Date: Nov. 12, 2024
2
Inspection Team: 3 Company: ARCC
4
Area: TSF Sanitary Tanks Area
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Is sanitary wastewater collected on a regular
2 0 100% collected regularly
basis?
Is there any level indication for sanitary waste
2 0 100% installed level measurement equipment for 2 tanks
tanks?
Are sanitary waste tanks located in any secondary
0 2 0% no secondary containment or bundwall around the tanks
containment?
Are sanitary waste tanks easily accessible for
2 1 67% only 1 access door, need to provide a 2nd access/egress
emptying purposes?
Is sanitary waste infrastructure (pipes, tanks etc)
regularly inspected for condition and leaks? 2 0 100% checklist provided

Are sanitary wastes transported and disposed of

2 1 67% no document submitted relating to service provider
in accordance with RCER 2010
Are sanitary waste manifests kept that are
2 0 100% waste manifest provided
appropriately signed
Is portable toilet/pre-fabricated toilet been clean
2 0 100% clean regularly
and sanitized regularly?
Is portable toilet/pre-fabricated toilet been open
2 0 100% open all the time
and usable all the time?
0 0 -
0 0 -
0 0 -
Total 16 4 80%
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Potable Water

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Are water storage tanks easily inspected 0 0 -
Are water storage tanks regularly cleaned 0 0 -
Are piping, valves and connections easily
0 0 -
accessible for cleaning
Are piping, valves and connections regularly
0 0 -
inspected and cleaned
Are all inlets and openings to tanks constructed so
that no foreign material may enter & contaminate 0 0 -
water?
Are transfer hoses constructed of safe & easily
0 0 -
cleaned materials
Are transfer hoses clearly identified as to their use
0 0 -
Are caps and keeper chains fitted to all water
0 0 -
inlet, water outlet and hoses?
Are all hoses stored off the ground so there is no
0 0 -
contamination?
Are all water delivery trucks solely used for the
0 0 -
delivery of potable water?
Are all water dispensers inspected & cleaned
0 0 -
regularly
Are all water storage igloos sealed, time & date
0 0 -
marked
Is all potable water checked for quality in
0 0 -
accordance with RCER
Are all water storage tank are clearly mark of what
0 0 -
type of water filled?
Are water filters been inspected and changed 0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Camp - Kitchen & Mess hall

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Cleanliness and Hygiene of all areas shall be
adequately maintained. Checklist and system for
monitoring are developed and used. 0 0 -

Electrical Panels should be secured, Outlets must

be safe to use and meet NEC regulations. 0 0 -

Illuminations should be evenly distributed and

Ventilations should be appropriately screened,
0 0 -
cleaned and in good repair.

Fire Extinguishers available and inspected/sufficient

type. Appropriate tagging systems implemented.
Clear access to it. 0 0 -

All areas shall shall be free from insects and pests.

Effective Pest Control program should be in place,
Signing log used to record pest control activity. 0 0 -

Mess hall facility should have confidential feedback

mechanism by which workers can report concerns
with food quality and or services. 0 0 -

All staffs working with food are to maintain a high

degree of personal hygiene as well as wear
appropriate clean protective clothing. 0 0 -

Grills and Ovens including Grease Hoods and Filters

should be regularly cleaned, free of grease,
inspected and in good condition. 0 0 -

Food should be stored in such a way as to ensure

good stock rotation using FIFO(first in, first
out)practice. All Food labelled, dated and within use 0 0 -
by dates

Shelving's and racks should be free of dust, dirt and

webs. Food stored off the floor and correctly
segregated. 0 0 -

Cleaning chemicals, detergents, mops and brushes

must not be kept in food stores.
0 0 -

In the Freezer all items should be on shelves and

properly wrapped. Meat Types Stored Separately
0 0 -

Temperature check completed daily. Temperatures

are within requirement.(-30˚C to 0˚)
0 0 -

Total 0 0 -

INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The column “Non Compliant” refers to the
number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Camp - Laundry

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant% Compliant Observation Comment
Cleanliness and Hygiene of the area shall be
adequately maintained. Checklist and system for
monitoring are developed and used. 0 0 -

Illuminations should be evenly distributed and

Ventilations should be appropriately screened,
cleaned and in good repair. 0 0 -

Electrical Panels should be secured, Outlets

must be safe to use and meet NEC regulations.
0 0 -

Workers should wear suitable Personal

Protective Equipment when handling dirty clothes
and other cleaning chemicals such as
detergents. 0 0 -

All laundry equipments should be well maintained

and in good condition. Equipment maintenance
system should be in place. 0 0 -

Cleaning chemicals should be stored in a

appropriate location with available SDS(Safety
Data Sheet) 0 0 -

Suitable Shelves should be available for cleaned

clothes. 0 0 -
Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The column “Non
Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Camp - Environmental

1
Date:
2
Inspection Team: 3
4
Area:
5
Observation Criteria: Satisfactory Non Compliant % Compliant Observation Comment
Potable water testing and analysis records
available for review. Potable water tanks
and hoses protected from contamination. 0 0 -

Secondary containment for fuel storage

shall be in compliance with the local
regulatory requirement, regularly 0 0 -
inspected and maintained.
LPG shall be safely stored and well
ventilated, adequate fire extinguishers
provided. Appropriate multilingual signs 0 0 -
posted.
Noise levels at closest cabin perimeter
<45dB 0 0 -

Spill kits available and regular inventories

taken 0 0 -

SDS(Safety Data Sheet) for all products

available(e.g. detergents, water treatment
products, pesticides, oils, greases, etc) 0 0 -

Treated wastewater testing and analysis

records available for review 0 0 -

Pest control must be provided by a

contractor licensed by relevant municipal 0 0 -
authority.
The grounds and open areas surrounding
the camps should be maintained in a clean
and sanitary condition free from rubbish, 0 0 -
debris, waste paper, garbage, or other
refuse.

Sufficient signed & labelled trash bins

available 0 0 -

Waste management signs in appropriate

language for residents 0 0 -

Waste collected on a regular basis 0 0 -

Records of waste transportation 0 0 -
Records of waste disposal within 30 days
of transportation 0 0 -

Waste disposal records stamped by RC 0 0 -

Total 0 0 -

INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - Camp - Fire Prevention

Date:
Inspection Team:
Area:
Observation Criteria: SatisfactorNon Compli% Compli Observation Comment
Fire management plan in place and posted
-
Emergency evacuation routes & muster points easily identifiable
-
Means of Egress_ Are signs conspicuously posted and well lit. -
Are exit doors clear of combustible or other hazardous material. Corridors and exits
unobstructed (no storage of files, furniture, etc.). Adequate lighting in corridors, exits -
and stairwells.
Emergency Contact Numbers are conspicuously posted.
-
Regular and routine inspection and maintenance of fire extinguishers. Appropriate
inspection tagging system shall be visible. -

Adequate clearance (3 feet) for all fire extinguisher and hoses. Fire equipment in
proper locations and undamaged. -

Is the hose in cabinet properly racked and in good condition? Is the fire water storage
tank to proper level? -

Regular, routine inspection, maintenance and testing of smoke detection systems and
-
smoke alarms.
Fire detection and alarm systems tested regularly
-

Regular Fire Drills Conducted

-
"No Smoking" signs posted & "No Smoking" regulation observed
-

Trash/rubbish removal done on a regular basis

-
All electrical plugs, switches and cords legal and in good repair & No extensive use of
cords from outlets (octopus) -

Heat-producing appliances well ventilated. Electrical equipment turned off when not in
use. Malfunctioning electrical equipment immediately reported or taken out service. -

Areas kept as clean and neat as possible

-

Materials stacked so as not to tip or fall

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Project Requirements at the same work area. The column “Non Compliant” refers to the
number of non-compliances found with the same characteristic at the same work area.
 COMPLIANCE INSPECTION SHEET - EXTENDED HOURS-NIGHT W

1
2
Inspection Team: 3
4
5
Observation Criteria: Satisfactory Non Compliant % Compliant Obse
Has Permit to Work been signed and readily
accessible at the workface 0 0 -

Have all personnel engaged in the task signed

onto the STA 0 0 -

Are Emergency Phone Numbers on STA or

readily visible on site 0 0 -

Are Lux Level Readings minimum 107.64 and are

there no shadows in work area 0 0 -

Is Access/Egress to workplace including welfare

facilities illuminated 0 0 -

Is there HSE Officer coverage at a ratio of 1:40, or

for High Risk works 1:15 0 0 -

Are there nominated First Aiders at a ratio of 1:15

0 0 -

Is there an Ambulance on standby and is it

contactable 0 0 -

Is there an Electrician/Mechanic on site in case of

lighting failure 0 0 -

Are all personnel wearing Clear Safety Glasses

0 0 -

Total 0 0 -
INSTRUCTIONS: The Column “SATISFACTORY” refers to the number of observations where the activity or condition was deemed to be in compliance with Pro
column “Non Compliant” refers to the number of non-compliances found with the same characteristic at the same work
 HOURS-NIGHT WORK

Date:

Area:

Observation Comment

med to be in compliance with Project Requirements at the same work area. The
characteristic at the same work area.