TSTI Quality Evaluation Form

Activity 1 2 3 4 5 Rating Weight Score

Crew Assigned to a Vague, difficult to Clear, but not Clear review with all
Task Clear review with
location without pre- clearly identify task reviewed with all crew members, tested 1 0
Assignment all crew members
discussion on task or exact location crew members for understanding
Conducted or started
Information All required info avail.
without all required 1 0
Availability - Permit, dwgs., etc.
information
Discussion outside of Discussion outside of Discussion at the
Location work location without work location with work location with 1 0
pre inspection pre inspection pre inspection of area
Discussion without all
All crew members
crew members present All crew members Most crew members
Interactive Discussion with most present, with a good,
- One person writing, present, no group present, with group 2 0
Discussion crew members present interactive group
others missing or discussion discussion
discussion
engaged elsewhere
Excellent hazard ID w/
Generic items only: Good hazard ID with interactive discussion
- PPE interactive discussion - What could go wrong
Hazard Generalized discussion
- Slips & falls - What could go wrong related to work steps 5 0
Identification related to work activities
- Weather related to work steps - Other trade impacts
- Pinch points - Operations impacts
- Worse case scenario
Specific hazards
Mostly generic:
clearly identified and
- H2S/Toxics Somewhat generic but
Documented documented.
- PPE some distinct hazards 5 0
Risks - Slips & Falls included
- "What if"
- "Worst case"
- Pinch points
- "If this happens"
Some attempt to
document risk control. Clear "instructional"
Somewhat generic but
Documented - Wear H2S monitor controls documented
some distinct controls 5 0
Controls - Watch footing which could include
documented
- Watch pinch points "stop and reevaluate"
- Wear PPE
Score: 0
Evaluator: Don Coop Date:

Team Evaluated: Company: Brieser Construction Company

Comments:

Work Area:
Exelon-Dresden
Midwest Generation
Caterpillar-Joliet
Exxon Pipeline

Stepan Chemical
Lyondell Chemical
Aux Sable
BP Pipeline
Other _______________________