Safety Inspection Checklist With OSHA References 2011 Updated

Observations
Inspection Element Location 1 Location 2 Location 3 Location 4 Location 5 Wamsutter Jayhawk San Juan San Juan East Texas OGC STX Field OGC South F&H CCDF Totals
South North Field Louisiana
Electrical 19 0 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
Emergency Mgmt. 23 0 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
Energy Isolation 4 0 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
Fire Protection 4 0 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
Hazcom 10 0 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
Housekeeping 35 0 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
IH/PPE 9 0 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
Lifting 4 0 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
Machine Guards 15 0 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
Mechanical Integrity 14 0 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
#REF!
Stairways, 18 0 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
Walkways, Ladders #REF!
Training and Written 4 0 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
Programs #REF!
Totals 159 0 0 0 0 #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF! #REF!
Inspection Element Totals

Electrical 0
Emergency Mgmt. 0
Energy Isolation 0
Fire Protection 0 Electrical
Hazcom 0
Housekeeping 0 Emergency Mgmt.
IH/PPE 0
Lifting 0 Energy Isolation
Machine Guards 0
Mechanical Integrity
Fire Protection
0
Stairways,
Hazcom
Walkways, Ladders 0
Training and Written
Housekeeping
Programs 0
Totals 0
IH/PPE
Lifting
Machine Guards
Mechanical Integrity
Stairways, Walkways, Ladders
Training and Written Programs
Location Category Best Practice Description
Electrical Monthly, Documented Electrical cord
inspections with date and inspector
name printed on tape & placed on the
cord.
Housekeeping Housekeeping and organization in the
Sunray Gas Plant Warehouse is
exemplary.
Lifting Lifting chains and straps inspected
monthly
Housekeeping Housekeeping in Welding shop excellent
Housekeeping Housekeeping in Warehouse excellent

Hazcom Excellent labelling of tanks and
containers
Contact/ Owner
Date:
Facility:
Location:
Participants:
NA = Not Applicable, N = Needs Attention, CDW= Corrected During Walkthrough, BP=Beat Practice
Area Element : Training and Written Programs
OSHA 300, 300A logs & OSHA 301, past three years,
Workers Comp First report of injury
Document Link Site Specific Orientation
Document Link Contractor Orientation/ SafeLandUSA
Document Link Incident Investigation Reports (Tr@ction)
Document Link Contractor Incident Reports (Tr@ction)
BP's SOC Page SOC
SOC for LeadersBehavior Based/ Stop the Job Observations
Tr@ction Incident Investigation Reports

Document Link LOTO Annual Reviews and training
LOTO Tier Three, tier 4 documents (local policy)

Reference Document
Document Link LOTO permits reviewed for accuracy
Document Link Work permits review
Document Link PPE Hazard Asessment
PPE Training
Fall Protection/ PPE selection and inspections
Lifting Equipment Inspections ( slings, chains, clevices, etc..)
Ladder inspections
Gaurding Floor and Wall Openings
Electrical equipment inspections cords and tools
Drill documentation (internal)
Drill documentation: comprehensive, including emergency services such as
ambulance, air ambulance, fire & law enforcement officials as applicable
Means of Egress (Exit Signs)

Fire Protection
Portable Fire Extinguishers
Incident Management Plans and training (IMP):
EPA Risk Management Plan (RMP): Operators aware of worst case and actions
Validate IMP/RMP with control room operators

Chemical inventory and MSDS
OSHA Required Training
CoW training, competent person and risk registers
Federal, State, Local and company required posters and information posted in
easily accessable areas, up to date
Accurate Reporting, Observations: SOC: first aid, near miss
Contractor MSDS and JSEA
Fire and first aid equipment inspections
Written Procedures for equipment specific PM or energy isolation on file
Contractor Assessment
Contractor Oversight
- Eric shared three areas of interest from OSHA that he and Dustin will incorporate into the
o Are employees provided specific guidance and instruction on the reporting of work
o Is the company aware of the requirements for reporting to OSHA workplace fataliti
o Are emergency response services, specific to the location, equipped and suitable fo
NA, N, Comments / Action Resp. Party Work Order
CDW, BP
Dustin will incorporate into the check list:
uction on the reporting of workplace injuries or illnesses?

rting to OSHA workplace fatalities/catastrophes?
ation, equipped and suitable for the performed operations?
Date:
Facility:
Location:
Participants:
NA = Not Applicable, N = Needs Attention, CDW= Corrected During
Walkthrough, BP=Beat Practice
Area Element : Training and Written Programs
OSHA 300, 300A logs & OSHA 301, past three
years,
1904.32(a)(2) Create an annual summary of injuries and

illnesses recorded on the OSHA 300 Log;
1904.32(a)(3) Certify the summary; and 1904.32(a)(4)
Post the annual summary.
1904.32(b) Implementation.
1904.32(b)(1) How extensively do I have to review the
OSHA 300 Log entries at the end of the year? You must
review the entries as extensively as necessary to make
sure that they are complete and correct.
Comments / Action Resp. Party Work Order
o Are employees provided specific guidance and

instruction on the reporting of workplace injuries or
illnesses?
o Is the company aware of the requirements for
reporting to OSHA workplace fatalities/catastrophes?
Emergency Action Plans
Letter of Interpretation OSHA

Drill documentation: comprehensive, including emergency
services such as ambulance, air ambulance, fire & law
enforcement officials as applicable
Means of Egress (Exit Signs)

Fire Protection
Portable Fire Extinguishers
Incident Management Plans and training (IMP):
EPA Risk Management Plan (RMP): Operators aware of
worst case and actions
Validate IMP/RMP with control room operators
Chemical inventory and MSDS
OSHA Required Training
CoW training, competent person and risk registers
Federal, State, Local and company required posters and
information posted in easily accessable areas, up to date
Accurate Reporting, Observations: SOC: first aid, near

miss
Contractor MSDS and JSEA
Fire and first aid equipment inspections
Written Procedures for equipment specific PM or energy
isolation on file
Contractor Assessment
Contractor Oversight
Comments / Action
Are emergency response services, specific to the location,

equipped and suitable for the performed operations?
Date
Facility
Location
Participants
NA = Not Applicable, NC =Not Checked, OK, N = Needs Attention,CDW= Corrected During Walkthrough,
BP=Best Practice
Area Element: LOTO, The Control of Hazardous Energy
Is there an equipment specific procedure for isolation Have all employees involved been
trained on those procedures?
Have all employees involved been trained on applicable LOTO procedures?
Is required re-training complete and up to date?
Have all energy sources and isolation points been identified and recorded on the Isolation
Log?
Has the Issuing Authority determined the monitoring requirements and have those
requirements and results been documented on the Isolation Log? Are the monitoring
points free of obstruction?
Does this isolation have an established procedure for normal shut down and start up of
equipment and/or process?
Have all Authorized Employees involved in this isolation reviewed the isolation?
If single block isolation is involved in this isolation, has the Single Block Isolation Hazard
Assessment and Form been completed?
Permit
Do you have an Isolation Permit for this isolation and is it filled out completely?
Does the scope of this isolation match the work being performed and are the conditions of
the Isolation Permit being met?
Has the Isolation Permit been signed by the Issuing Authority and all Performing
Authorities and a copy of both documents at the work site?
Execution
Have all Affected Employees been identified and notified of the isolation?
Do all Authorized Employees involved in this isolation have a personal lock applied?
Have all lockout/tagout points been locked and tagged out and blinds been tagged if
blinding is part of this isolation?
Has the isolation been verified (e.g. bump test)?
If this is a confined space, has positive isolation been achieved?
If this is an electrical isolation has a visual (physical break in the circuit) or metered
verification for the absence of voltage been completed?
Return to Service
Upon completion of the work and prior to the removal of the isolation has the area been
surveyed to make sure tools and individuals are no longer on the site?
Upon completion of the isolation has the Isolation Log been reviewed and a determination
all isolations have been removed?
Upon completion of the isolation has the Isolation Permit been reviewed and closed and
all Affected Employees notified?
Periodic Review of LOTO
Has a documented periodic review of the LOTO program been conducted?
LOTO Materials and Hardware
Standardized locks
Lock-out Devices are Durable

Lock-out devices are Substantial
Tag-out Devices
Tags completed and affixed properly
Group LOTO
LOTO locks and tags separate from Out of Service designation

NA,NC, OK, Comments / Action Resp. Party Work Order
N, CDW, BP
Portable Ladder Ratings and Types:
Manufactured ladders are rated to the duty or service to which they will be put and the working load under
will be used in a standard inclined position. The following table provides the different grades of ladders an
are rated for:
Table 2. In-Line Load Ratings & Duty Type
(Wooden and Metal Ladders)
Duty Rating & Type Working Load (pounds)
Extra Heavy Duty – Type IA 300 lb
Heavy Duty – Type I 250 lb
Medium Duty – Type II 225lb
Light Duty – Type III 200lb
See OSHA Reference 29 CFR 1910 Subpart D - Walking-Working Surfaces

Ladder Inspection and Use - Recommended Practice
Electrical Work
• Metal ladders (e.g. aluminium) should NEVER be used for electrical work, or in close proximity to overhe
lines and/or electrical circuits;
• Wooden ladders with metal reinforcing rods shall NOT be used for electrical work, due to the danger of i
electrical contact;
• Wooden ladders or fibreglass ladders are acceptable for using near or during electrical work, however th
completely dry;
• Wooden ladders that are damp or wet can conduct electricity and should NOT be used when working on
around electrical equipment or electrical power sources
Ladder Inspections
• Ladders should be inspected before each use for loose or damaged rungs, steps, rails or braces and to
obvious signs of damage or deterioration. If they can be moved by hand, they are too loose;
• Check the ladder rungs to be sure that they are free of any slippery material;
Suggested Inspection Criteria
• Ensure that stepladder spreaders are sturdy, tight and can be properly locked in place;
• Check all ladder hardware, nuts, bolts, spreaders, etc. for tightness and good repair with particular atten
mechanisms;
• Check pulleys on extension ladders for good condition and proper lubrication. If pulleys are damaged, th
replaced;
• Check ropes on extension ladders and replace any frayed or worn ropes;
• Check for damaged or excessive wear on the non-slip feet;
• Check ladders for twisted or distorted rails. Do not attempt to straighten, or allow to remain in use, any b
metal ladder;
• In wooden ladders, check for rot, decay, or warped rails;
• Check for missing identification and/or warning labels; (minimum labels: load rating and manufacturer, a
extention ladder)
• Where damage to or deterioration of any ladder is encountered, a qualified person must determine whet
ladder can still be used;
• Ladders cannot be safely repaired. If the damage is significant enough to affect the safety of the unit, the
be immediately removed from service, destroyed, and replaced as soon as possible;
• Ladders should also be thoroughly examined/inspected once every three (3) months and a record of tho
should be kept on file for future reference
Ladder Maintenance
• The feet of ladders, especially straight or extension ladders, should be equipped with slip-resistant surfa
• Untreated wooden ladders should be stored in dry areas to prevent moisture or water absorption;
• Wooden ladders must not be painted, since this may hide serious defects that may develop. A wood pre
clear finish coating (e.g. varnish) should be used to protect the ladder;
• Avoid painting the rungs/steps with anything, even clear coatings, unless a non-slip material has been a
prevent slipping;
• Ladders constructed from fibreglass should be cleaned and sprayed lightly with a clear or pigmented lac
wax once every three (3) months to reduce deterioration (weathering);
• When transported on a vehicle, ladders should be properly supported and secured using proper “tie dow
Avoid using rubber “bungy cords” unless the travel distance is short;
Scaffolding Inspections and Fall Protection
Construction
1. Does each scaffold and scaffold component Y N N/A ?
?
support (without failure) its own weight and
at least 4 times the maximum intended load?
[29 CFR 1926.451(a)(1)]
Note: The stall load of any scaffold hoist

must not exceed 3 times its rated load
[29 CFR 1926.451(a)(5)]. Appendix A of
the OSHA regulations gives directions for
constructing scaffolds.
2. Are all working levels on scaffolds fully Y N N/A ?

planked or decked between the front uprights ?
and the guardrail supports?
[29 CFR 1926.451(b)(1)]
3. Are scaffold platform spaces 1inch or less Y N N/A ?

between adjacent units and the uprights? ?
[29 CFR 1926.451(b)(1)(i)]
Note: Spaces up to 9 1/2 inches wide are

permitted around uprights. If platforms are
used only as walkways or during erecting or
dismantling, the employer may establish
the space between planking as necessary to
provide safe working conditions.
4. Are all scaffold platforms at least Y N N/A ?

18 inches wide? ?
[29 CFR 1926.451(b)(2)]
Note: Scaffold platforms less than

18 inches wide are permitted if wider
platforms are not possible. However,
students and employees who use these
platforms must be protected by
guardrails or personal fall arrest

systems.
5. Is the distance between the front edge of Y N N/A ?

the scaffold platform and the face of the ?
work 14 inches or less, unless guardrail

systems are put along the front edge, or
personal fall arrest systems are used?
[29 CFR 1926.451(b)(3)]
Note: Exceptions are permitted under

special situations. Consult the OSHA
regulations for details. The maximum
distance from the face for plastering and
lathing operations is 18 inches.
6. Does the end of each scaffold platform Y N N/A ?

extend over the centerline of its support at ?
least 6 inches unless cleated or otherwise
restrained by hooks or equivalent means?
[29 CFR 1926.451(b)(4)]
7. If the scaffold platform is 10 feet or less in Y N N/A ?

length, does the end of the scaffold platform ?
extend 12 inches or less over its support?
[29 CFR 1926.451(b)(5)(i)]
Note: The end of the scaffold platform may

extend more than 12 inches over its support
if the platform is designed and installed so
that the cantilevered portion of the platform
can support workers or materials without
tipping, or a guardrail blocks worker access
to the cantilevered end.
8. On scaffolds where planks are abutted to form Y N N/A ?

?
Y N N/A ?
a long platform, does each plank end rest on ?
a separate support surface?
[29 CFR 1926.451(b)(6)]
Note: Common support members, such as

"T" sections, may be used to support abutting
planks. Hook-on platforms designed to rest
on common supports may also be used.
9. On scaffolds where platforms overlap to Y N N/A ?

form a long platform, does the overlap ?
occur over supports? Is the overlap at
least 12 inches unless the platform is
nailed together or otherwise restrained
to prevent movement?
[29 CFR 1926.451(b)(7)]
10. At points of a scaffold where the platform Y N N/A ?

changes direction, is this procedure followed? ?
[29 CFR 1926.451(b)(8)]
Step 1: Lay the platform that rests on a

bearer at an angle other than a right angle.
Step 2: Lay the platform that rests at

right angles over the same bearer, on
top of the first platform.
11. Is it prohibited to cover wood platforms Y N N/A ?

on scaffolds with opaque finishes? ?
[29 CFR 1926.451(b)(9)]
Note: Platform edges may be covered or

marked for identification. Wood platforms
may be coated periodically with wood
preservatives, fire-retardant finishes,
and slip-resistant finishes; however, the
coating may not obscure the top or
bottom wood surfaces.
12. Do scaffold components from different Y N N/A ?
manufacturers fit together without force and ?
maintain the scaffold's structural integrity?
[29 CFR 1926.451(b)(10)]
13. Are scaffold components from different Y N N/A ?

manufacturers modified ONLY if a ?
competent person determines that the
scaffold made of the 'mixed' parts is
structurally sound?
[29 CFR 1926.451(b)(10)]
14. Are scaffold components made of dissimilar Y N N/A ?

metals used together ONLY if a competent ?
person has determined that galvanic action
will not reduce the strength of any
component to an unacceptable level?
[29 CFR 1926.451(b)(11)]
Criteria for Supported Scaffolds

15. Are supported scaffolds with a height to Y N N/A ?
base width ratio of more than 4 to 1 ?
restrained from tipping by guying, tying,
bracing, or equivalents?
[29 CFR 1926.451(c)(1)]
Note: Install guys, ties, and braces at

locations where horizontal members
support both inner and outer legs. Install
Guys, ties, and braces according to the
scaffold manufacturer's recommendations
or at the closest horizontal member to
the 4 to 1 height. Repeat vertically at
locations of horizontal members every
20 feet or less thereafter for scaffolds
3 feet wide or less, and every 26 feet or
less thereafter for scaffolds greater than
3 feet wide. Place the top guy, tie, or
brace of completed scaffolds no further
than the 4 to 1 height from the top. Install
guys, ties, and braces at each end of
the scaffold and at horizontal intervals
30 feet or less (measured from one end
[not both] towards the other). Use ties,
guys, braces, or outriggers to prevent
tipping when there is an eccentric load,
such as a cantilevered work platform.
16. Are supported scaffold poles, legs, posts, Y N N/A ?

frames, and uprights placed on base plates ?
and mud sills or other firm foundation?
[29 CFR 1926.451(c)(2)]
17. Are footings level, sound, and rigid? Can they Y N N/A ?
support the loaded scaffold without settling or ?
displacement?
[29 CFR 1926.451(c)(2)(i)]
18. Is it prohibited to use unstable objects for Y N N/A ?

supporting scaffolds and platform units? ?
[29 CFR 1926.451(c)(2)(ii)]
19. Is it prohibited to use unstable objects as Y N N/A ?

working platforms? ?
[29 CFR 1926.451(c)(2)(iii)]
20. Is it prohibited to use front-end loaders and Y N N/A ?

similar pieces of equipment to support scaffold ?
platforms, unless they were designed by the
manufacturer for such use?
[29 CFR 1926.451(c)(2)(iv)]
21. Are supported scaffold poles, legs, posts, frames, Y N N/A ?

and uprights plum and braced to prevent ?
swaying and displacement?
[29 CFR 1926.451(c)(3)]
Access
22. Are ladders, stairs, ramps, or walkways provided Y N N/A ?
to access scaffold platforms more than 2 feet ?
above or below a point of access?
[29 CFR 1926.451(e)(1)]
Note: Cross-braces must not be used as a

means of access.
23. Are portable, hook-on, and attachable ladders Y N N/A ?

positioned to prevent the scaffold from tipping? ?
[29 CFR 1926.451(e)(2)(i)]
24. Are hook-on and attachable ladders positioned Y N N/A ?

so the bottom rung is not more than 24 inches ?
above the scaffold supporting level?
[29 CFR 1926.451(e)(2)(ii)]
25. Are hook-on and attachable ladders designed Y N N/A ?

for the scaffold in use? ?
[29 CFR 1926.451(e)(2)(iv)]
26. Do hook-on and attachable ladders have rung Y N N/A ?

length of at least 11 1/2 inches? ?
[29 CFR 1926.451(e)(2)(v)]
27. Do hook-on and attachable ladders have Y N N/A ?

uniformly spaced rungs with a maximum ?
spacing between rungs of 16-3/4 inches?
[29 CFR 1926.451(e)(2)(vi)]
28. Is the bottom step of stairway-type ladders Y N N/A ?

24 inches or less above the scaffold supporting ?
level?
[29 CFR 1926.451(e)(3)(i)]
29. Do stairway-type ladders have rest platforms Y N N/A ?

?
Y N N/A ?
at 12-foot maximum vertical intervals? ?
[29 CFR 1926.451(e)(3)(ii)]
30. Do stairway-type ladders have a step width of Y N N/A ?

at least 16 inches? ?
[29 CFR 1926.451(e)(3)(iii)]
Note: Mobile scaffold stairway-type ladders

may have a minimum step width of 11 1/2 inches.
31. Do stairway-type ladders have slip-resistant Y N N/A ?

treads on all steps and landings? ?
[29 CFR 1926.451(e)(3)(iv)]
32. Do ramps and walkways 6 feet or more Y N N/A ?

above lower levels have guardrails? ?
[29 CFR 1926.451(e)(5)(i)]
33. Are ramps and walkways inclined with a Y N N/A ?

slope less than 1 vertical to 3 horizontal ?
20 degrees above the horizontal?
[29 CFR 1926.451(e)(5)(ii)]
34. Do ramps and walkways that are steeper than Y N N/A ?

1 vertical in 8 horizontal have cleats 14 inches ?
(or less) apart that are securely fastened to the
planks to provide footing?
[29 CFR 1926.451(e)(5)(iii)]
35. Are integral prefabricated scaffold access Y N N/A ?

frames constructed for use as ladder rungs? ?
[29 CFR 1926.451(e)(6)(i)]
36. Do integral prefabricated scaffold access Y N N/A ?

frames have rung lengths of at least 8 inches? ?
[29 CFR 1926.451(e)(6)(ii)]

Y N N/A ?
?
37. Do students and employees have fall protection Y N N/A ?

if integral prefabricated scaffold access frames ?
with rungs less than 11 1/2 inches are used
as work platforms?
[29 CFR 1926.451(e)(6)(iii)]
38. Are integral prefabricated scaffold access frames Y N N/A ?

uniformly spaced within each frame section? ?
[29 CFR 1926.451(e)(6)(iv)]
39. Do integral prefabricated scaffold access frames Y N N/A ?

have a maximum spacing between rungs of ?
16-3/4 inches?
[29 CFR 1926.451(e)(6)(v)]
Note: Non-uniform rung spacing caused by

joining end frames together is allowed, provide
the resulting spacing is 16-3/4 inches or less.
40. Do steps and rungs of ladder and stairway-type Y N N/A ?

?
access line up vertically with each other
between rest platforms?
[29 CFR 1926.451(e)(7)]
41. Is the horizontal distance 14 inches (or less) Y N N/A ?

and the vertical distance 24 inches (or less) ?
between two surfaces used to provide direct
access between them?
[29 CFR 1926.451(e)(8)]
42. During erecting and dismantling of supported Y N N/A ?

scaffolds, does a competent person provide ?
Y N N/A ?
?
and evaluate safe means of access?
[29 CFR 1926.451(e)(9)(i)]

?
scaffolds, are hook-on or attachable ladders
installed as soon as they can be used safely?
[29 CFR 1926.451(e)(9)(ii)]

scaffolds, are the ends of tubular welded frame ?
scaffolds used as climbing devices for access
only if the horizontal members are parallel, level,

and 22 inches apart (or less) vertically?
[29 CFR 1926.451(e)(9)(iii)]

?
scaffolds, is it prohibited to use the cross braces
on tubular welded frame scaffolds for access
or exit?
[29 CFR 1926.451(e)(9)(iv)]
Use
46. Are scaffolds and scaffold components loaded Y N N/A ?
below their maximum intended loads or rated ?
capacities (whichever is less)?

[29 CFR 1926.451(f)(1)]
47. Is the use of shore or lean-to scaffolds prohibited? Y N N/A ?

?
[29 CFR 1926.451(f)(2)]
48. Does a competent person inspect scaffolds Y N N/A ?
and scaffold components for visible defects ?
before each work shift, and after any occurrence

that could affect a scaffold's structural integrity?
[29 CFR 1926.451(f)(3)]
49. Are parts of a scaffold that are damaged or Y N N/A ?

?
weakened immediately repaired, replaced,
braced, or removed from service until repaired?
[29 CFR 1926.451(f)(4)]
50. Is the horizontal movement of a scaffold Y N N/A ?

prohibited while workers are on the scaffold ?
(unless the scaffold is designed for movement
by a registered professional engineer, or is a

mobile scaffold meeting OSHA standards)?
[29 CFR 1926.451(f)(5)]
51. Are proper clearances (as shown in Tables 1 Y N N/A ?

?
and 2) between scaffolds and power lines
always maintained?
[29 CFR 1926.451(f)(6)]
Note: Scaffolds and materials may be closer
to power lines if such clearance is necessary,

and only after the utility company or electrical
system operator has been notified, and the
utility company or electrical system operator

has deenergized the lines, relocated the lines,
or installed protective coverings to prevent
contact with the lines.
Table 1: Insulated Power Lines
Insulated Lines
Voltage
Less than 300 volts
300 volts to 50 kv
More than 50 kv
Table 2: Uninsulated Power Lines

Uninsulated Line
Voltage
Less than 50 kv
More than 50 kv
52. Are scaffolds erected, moved, dismantled, Y N N/A ?

or altered only under the supervision and ?
direction of a competent person qualified in
scaffold erection, moving, dismantling,
or alteration?
[29 CFR 1926.451(f)(7)]
53. Are scaffolds erected, moved, dismantled, Y N N/A ?
or altered only by experienced and trained ?
employees selected for such work by the
competent person?
[29 CFR 1926.451(f)(7)]
54. Is it prohibited to work on scaffolds covered Y N N/A ?

with snow, ice, or other slippery material, ?
except as necessary to remove such materials?
[29 CFR 1926.451(f)(8)]
55. If swinging loads are hoisted onto or near Y N N/A ?

?
scaffolds, are tag lines or equivalent measures
used to control the loads?
[29 CFR 1926.451(f)(9)]
56. Is working on scaffolds during storms or Y N N/A ?

high winds prohibited unless a competent ?
person has determined that it is safe for
workers to be on the scaffold and workers
are protected by a personal fall arrest
system or wind screens?
[29 CFR 1926.451(f)(12)]
57. Is debris removed from platforms? Y N N/A ?

?
[29 CFR 1926.451(f)(13)]
58. Are makeshift devices, such as boxes and Y N N/A ?

barrels, prohibited on scaffold platforms ?
for increasing the working level height?
[29 CFR 1926.451(f)(14)]
59. Is it prohibited to use ladders on scaffolds Y N N/A ?

to increase the working level height? ?
Y N N/A ?
?
[29 CFR 1926.451(f)(15)]
Note: Ladders may be used on large area

scaffolds if certain conditions are met.
Consult the OSHA regulations for the
required conditions.
60. Are scaffold platforms used only if they deflect Y N N/A ?

1/60 of the span (or less) when loaded? ?
[29 CFR 1926.451(f)(16)]
Definitions:
Competent person: one who can identify hazards in the surroundings or working conditions that are unsanitary, hazardou
Lean-to scaffold: a supported scaffold that is kept erect by tilting it toward and resting it against a building or structure.
Personal fall arrest system: a system used to stop an employee's fall. It consists of an anchorage, connectors, a body bel
Shore scaffold: a supported scaffold that is placed against a building or structure and held in place with props.
Supported scaffold: one or more platforms supported by outrigger beams, brackets, poles, legs, uprights, posts, frames, o
Comments/Corrective action:
Back to the previous page Back to Contents

National Institute for Occupational Safety and Health
Fall Protection
1. Are workers on scaffolds that are more than 10 feet Y N N/A ??
above a lower level protected from falling by one

of the following measures:
a. a personal fall arrest system for workers

on ladder jack scaffolds.
[29 CFR 1926.451(g)(1)(i)]
b. a guardrail system installed within

9 1/2 inches of and along at least one
side of the walkway for workers on a
walkway located within a scaffold.
[29 CFR 1926.451(g)(1)(v)]
c. a personal fall arrest system or guardrail

system to protect workers doing overhand
bricklaying from a supported scaffold
from falling off open sides and ends of
the scaffold (except at the side next to
the wall being laid)?
[29 CFR 1926.451(g)(1)(vi)]
d. a personal fall arrest system or guardrail

system for workers on all other scaffolds.
[29 CFR 1926.451(g)(1)(vii)]
2. Does a competent person determine the feasibility Y N N/A ??
and safety of providing fall protection for workers

erecting or dismantling supported scaffolds?
[29 CFR 1926.451(g)(2)]
3. Do workers erecting or dismantling supported Y N N/A ??
scaffolds use fall protection when it is safe

and feasible?
[29 CFR 1926.451(g)(2)]
4. Are personal fall arrest systems used on scaffolds Y N N/A ??
attached by a lanyard to a vertical lifeline,

horizontal lifeline, or scaffold structural
member?
[29 CFR 1926.451(g)(3)]
5. When vertical lifelines are used, are they Y N N/A ??
fastened to a fixed safe point of anchorage,
independent of the scaffold, and protected
from sharp edges and abrasion?
[29 CFR 1926.451(g)(3)(i)]
Note: Safe points of anchorage include

structural members of buildings, but do not
include standpipes, vents, other piping
systems, electrical conduit, outrigger
beams, or counterweights.
6. When horizontal lifelines are used, are they Y N N/A ??
secured to two or more structural members
of the scaffold?
[29 CFR 1926.451(g)(3)(ii)]
7. Is it prohibited to attach vertical lifelines Y N N/A ??

and independent support lines to one
another, to the same point of anchorage,
and to the same point on the scaffold or
personal fall arrest system?
[29 CFR 1926.451(g)(3)(iv)]
8. When guardrail systems are required, are Y N N/A ??
they installed along all open sides and
Y N N/A ??
ends of platforms?
[29 CFR 1926.451(g)(4)(i)]
Note: Guardrails systems must be installed

before the scaffold is used by workers
other than erecting or dismantling crews.
9. If the scaffolds were manufactured or placed Y N N/A ??

in service after January 1, 2000, is the top
edge height of toprails (or equivalent
member) on supported scaffolds between
38 and 45 inches above the platform surface?
[29 CFR 1926.451(g)(4)(ii)]
Note: When necessary, the height of the

top edge may exceed 45 inches if the
guardrail meets all OSHA requirements.
10. If scaffolds were manufactured or placed Y N N/A ??

in service before January 1, 2000, is the
top edge height of toprails (or equivalent
member) on supported scaffolds between
36 and 45 inches above the platform surface?
[29 CFR 1926.451(g)(4)(ii)]
Note: When necessary, the height of the

top edge may exceed 45 inches if the
guardrail meets all OSHA requirements.
11. Are midrails, screens, mesh, intermediate Y N N/A ??
vertical members, and solid panels (or
equivalent structural members) installed
between the top edge of the guardrail
system and the scaffold platform?
[29 CFR 1926.451(g)(4)(iii)]
12. When midrails are used, are they installed Y N N/A ??
approximately midway between the top
edge of the guardrail system and the
Y N N/A ??
platform surface?
[29 CFR 1926.451(g)(4)(iv)]
13. When screens and mesh are used, do they Y N N/A ??
extend from the top edge of the guardrail
system to the scaffold platform, and along
the entire opening between the supports?
[29 CFR 1926.451(g)(4)(v)]
14. When intermediate members (such as Y N N/A ??

balusters or additional rails) are used, are
they installed 19 inches or less apart?
[29 CFR 1926.451(g)(4)(vi)]
15. Can each toprail (or equivalent member) Y N N/A ??
of a guardrail system withstand (without
failure) a 200-pound force applied in any
downward or horizontal direction at any
point along its top edge?
[29 CFR 1926.451(g)(4)(vii)]
Note: Appendix A of subpart L of the OSHA

regulations gives directions for constructing
acceptable guardrail systems.
16. When a 200 pound force is applied in a Y N N/A ??

downward direction on the toprail (or
equivalent member) of a guardrail system,
does the top edge still maintain the OSHA
required height (see questions 9 and 10)?
[29 CFR 1926.451(g)(4)(viii)]
17. Can midrails, screens, mesh, intermediate Y N N/A ??
vertical members, solid panels, and equivalent
structural members of a guardrail system
withstand (without failure) a 150-pound force
applied in any downward or horizontal
direction at any point along the midrail
or other member?
[29 CFR 1926.451(g)(4)(ix)]
18. Are guardrails surfaced to prevent snagging Y N N/A ??
of clothing and injury from punctures or
lacerations?
[29 CFR 1926.451(g)(4)(xi)]
19. Is it prohibited for rails to overhang the Y N N/A ??
terminal posts, except when such overhang
does not constitute a projection hazard?
[29 CFR 1926.451(g)(4)(xii)]
20. Is the use of steel or plastic banding for Y N N/A ??
toprails or midrails prohibited?
[29 CFR 1926.451(g)(4)(xiii)]
21. If manila, plastic, or other synthetic rope is Y N N/A ??
used for toprails or midrails, is it inspected
by a competent person as necessary to
ensure that it continues to meet the OSHA
strength requirements?
[29 CFR 1926.451(g)(4)(xiv)]
22. If crossbracing is used to replace a midrail, is Y N N/A ??

the crossing point of the two braces between
20 and 30 inches above the work platform?
[29 CFR 1926.451(g)(4)(xv)]
23. If crossbracing is used to replace a toprail, is Y N N/A ??

the crossing point of the two braces between
38 and 48 inches above the work platform?
[29 CFR 1926.451(g)(4)(xv)]
24. If crossbracing is used to replace a midrail or Y N N/A ??

toprail, are the end points at each upright
48 inches apart or less?
[29 CFR 1926.451(g)(4)(xv)]
Falling Object Protection

25. Do workers on scaffolds wear hardhats? Y N N/A ??
[29 CFR 1926.451(h)(1)]
26. Are workers protected from falling hand tools, Y N N/A ??
debris, and other small objects by toeboards,

screens, guardrail systems, debris nets, catch
platforms, or canopy structures that contain
or deflect the falling objects?
[29 CFR 1926.451(h)(1)]
27. If objects are too large, heavy, or massive to Y N N/A ??
be contained or deflected, are they moved
away from the edge of the surface from which
they could fall and secured?
[29 CFR 1926.451(h)(1)]
28. If tools, materials, or equipment could fall Y N N/A ??
from a scaffold and strike workers, are one of
the following protective measures used?
[29 CFR 1926.451(h)(2)]
a. The area below the scaffold to which

objects can fall is barricaded, and
workers are not permitted to enter
the hazard area.
b. A toeboard is erected along the edge

of platforms more than 10 feet above
lower levels for a distance sufficient
to protect workers below.
29. If tools, materials, or equipment are piled higher Y N N/A ??
than the top edge of the toeboard, are one of

the following protective measures used?
[29 CFR 1926.451(h)(2)]
Y N N/A ??
a. Paneling or screening extending from

the toeboard or platform to the top of the
guardrail is erected for a distance
sufficient to protect the workers below.
b. A guardrail system is installed with

openings small enough to prevent
passage of falling objects.
c. A canopy structure, debris net, or catch

platform strong enough to withstand
the impact forces of the falling objects
is erected over the workers.
30. If canopies are used to protect workers, are Y N N/A ??
they installed between the falling object
hazard and the workers?
[29 CFR 1926.451(h)(3)(i)]
31. If toeboards are used to protect workers, can Y N N/A ??
they withstand (without failure) a force of at
least 50 pounds applied in any downward or
horizontal direction at any point along the toeboard?
[29 CFR 1926.451(h)(4)(i)]
Note: Appendix A of Subpart L of the OSHA

regulations provides directions for constructing
acceptable toeboards.
32. If toeboards are used to protect workers, are they Y N N/A ??
at least 3-1/2 inches high from the top edge of the

Y N N/A ??
toeboard to the level of the walking/working surface?
[29 CFR 1926.451(h)(4)(ii)]
securely fastened in place at the outermost edge

of the platform? Do they have 1/4-inch or less
clearance above the walking or working surface?
[29 CFR 1926.451(h)(4)(ii)]
solid or with openings of 1inch or less in the

greatest dimension?
[29 CFR 1926.451(h)(4)(ii)]
Pole Scaffolds
35. When platforms are moved to the next level, are Y N N/A ??
existing platforms left undisturbed until the new

bearers have been set in place and braced?
[29 CFR 1926.452(a)(1)]
36. Is crossbracing installed between the inner and Y N N/A ??
outer set of poles on double pole scaffolds?

[29 CFR 1926.452(a)(2)]
37. Is diagonal bracing that is installed in both Y N N/A ??
directions across the entire inside face of
double-pole scaffolds used to support loads
equivalent to a uniformly distributed load of
50 pounds or more per square foot?
[29 CFR 1926.452(a)(3)]
38. Is diagonal bracing installed in both directions Y N N/A ??
across the entire outside face of all double-
Y N N/A ??
and single-pole scaffolds?

[29 CFR 1926.452(a)(4)]
39. Are runners and bearers installed on edge? Y N N/A ??
[29 CFR 1926.452(a)(5)]
40. Do bearers extend at least 3 inches over the Y N N/A ??
outside edges of the runners?

[29 CFR 1926.452(a)(6)]
41. Do runners extend at least over two poles? Are Y N N/A ??
they supported by bearing blocks that are

securely attached to the poles?
[29 CFR 1926.452(a)(7)]
42. Is it prohibited to splice braces, bearers, and Y N N/A ??
runners between poles?

[29 CFR 1926.452(a)(8)]
43. If wooden poles are spliced, are they square? Does Y N N/A ??
the upper section rest squarely on the lower section?
[29 CFR 1926.452(a)(9)]
Note: Wood splice plates must be on at least two
adjacent sides, and must extend at least 2 feet

on either side of the splice, overlap the abutted
ends equally, and have at least the same
cross-sectional areas as the pole. Splice plates of
other materials of equivalent strength may be used.

Tube and Coupler Scaffolds
44. When platforms are moved to the next level, are Y N N/A ??

bearers have been set in place and braced?
[29 CFR 1926.452(b)(1)]
45. Are transverse braces that form an "X" across the Y N N/A ??
width of the scaffold installed at the scaffold ends

and at least at every 3rd set of posts horizontally
(measured form one end) and every 4th runner
vertically?
[29 CFR 1926.452(b)(2)]
46. Dose bracing extend diagonally from the inner or Y N N/A ??
outer posts or runners upward to the next outer

or inner posts or runners?
[29 CFR 1926.452(b)(2)]
47. Are building ties installed at the bearer levels Y N N/A ??
between the transverse bracing?

[29 CFR 1926.452(b)(2)]
48. On straight run scaffolds, is longitudinal bracing Y N N/A ??
across the inner and outer rows of posts installed
diagonally in both directions? Does bracing

extend from the base of the end posts upward to
the top of the scaffold at approximately a 45º angle?
[29 CFR 1926.452(b)(3)]
Note: On scaffolds whose length is greater than

their height, such bracing must be repeated
beginning at least at every 5th post. On scaffolds
whose length is less than their height, such
bracing must be installed from the base of the
end posts upward to the opposite end posts, and
then in alternating directions until reaching the
top of the scaffold. Bracing must be installed as
close as possible to the intersection of the
bearer and post or runner and post.
49. If bracing cannot be attached to posts, is it Y N N/A ??
attached to the runners as close to the post
as possible?
[29 CFR 1926.452(b)(4)]
50. Are bearers installed transversely between posts? Y N N/A ??
When coupled to the posts, does the inboard

Y N N/A ??
coupler bear directly on the runner coupler?

[29 CFR 1926.452(b)(5)]
Note: When the bearers are coupled to the
runners, the couplers must be as close to the
posts as possible.
51. Do bearers extend beyond the posts and runners, Y N N/A ??
and provide full contact with the coupler?

[29 CFR 1926.452(b)(6)]
52. Are runners installed along the length of the Y N N/A ??
scaffold, on both the inside and outside
posts at level heights?
[29 CFR 1926.452(b)(7)]
Y N N/A ??
Note: When tube and coupler guardrails and

midrails are used on outside posts, they may be
used in place of outside runners.
53. Are runners interlocked on straight runs to form Y N N/A ??
continuous lengths, and coupled to each post?

[29 CFR 1926.452(b)(8)]
Note: Install bottom runners and bearers as

close to the base as possible.
54. Are couplers made of structural metal, such as Y N N/A ??
drop-forged steel, malleable iron, or structural

grade aluminum?
[29 CFR 1926.452(b)(9)]
Note: The use of gray case iron is prohibited.
Fabricated Frame Scaffolds

55. When moving platforms to the next level, are Y N N/A ??
end frames have been set in place and braced?
[29 CFR 1926.452(c)(1)]
56. Are frames and panels braced by cross, horizontal, Y N N/A ??
or diagonal braces (or combinations thereof), to

secure vertical members together laterally?
[29 CFR 1926.452(c)(2)]
Note: The cross braces shall be long enough to
automatically square and align vertical members

so that the erected scaffold is plumb, level, and
square. All brace connections must be secured.
57. Are frames and panels joined together vertically Y N N/A ??
by coupling or stacking pins or equivalent means?
[29 CFR 1926.452(c)(3)]
58. Are frames and panels locked together vertically Y N N/A ??
by pins or equivalent means at points where uplift
could displace scaffold end frames or panels?

[29 CFR 1926.452(c)(4)]
Bricklayers' Square Scaffolds

59. Are wood scaffolds reinforced with gussets on Y N N/A ??
both sides of each corner?

[29 CFR 1926.452(e)(1)]
60. Are diagonal braces installed on all sides of Y N N/A ??
each square?
[29 CFR 1926.452(e)(2)]
61. Are diagonal braces installed between squares on Y N N/A ??
the rear and front sides of the scaffold, and do they
extend from the bottom of each square to the top

of the next square?
[29 CFR 1926.452(e)(3)]
62. Are scaffolds three tiers or less in height? Are they Y N N/A ??
constructed so that one square rests directly above
the other?
[29 CFR 1926.452(e)(4)]
Note: The upper tiers shall stand on a continuous
row of planks laid across the next lower tier, and

shall be nailed down or otherwise secured to
prevent displacement.
Horse Scaffolds
63. Are scaffolds less than 10 high? Are they two tiers Y N N/A ??
high or less?
[29 CFR 1926.452(f)(1)]
64. When horses are arranged in tiers, is each horse Y N N/A ??
place directly over the horse in the tier below?

[29 CFR 1926.452(f)(2)]
65. When horses are arranged in tiers, are the legs of Y N N/A ??
each horse nailed down or otherwise secured to

prevent displacement?
[29 CFR 1926.452(f)(3)]
66. When horses are arranged in tiers, is each tier Y N N/A ??
crossbraced?
[29 CFR 1926.452(f)(4)]
Ladder Jack Scaffolds

67. Are all ladder jack scaffolds 20 feet or less above Y N N/A ??
the ground?
[29 CFR 1926.452(k)(1)]
68. Are ladders that are used to support ladder jack Y N N/A ??
scaffolds in compliance with OSHA regulations (see

Y N N/A ??
subpart X of this part)? - Stairways and Ladders.
[29 CFR 1926.452(k)(2)]
69. Are ladder jacks designed and constructed so that Y N N/A ??
they will bear on the side rails in addition to

the ladder rungs?
[29 CFR 1926.452(k)(3)]
Note: If bearing on rungs only, the bearing area

shall be at least 10 inches on each rung.
70. Are ladders that are used to support ladder jacks Y N N/A ??
placed, fastened, or equipped with devices to

prevent slipping?
[29 CFR 1926.452(k)(4)]
71. Is it prohibited to bridge scaffold platforms one Y N N/A ??
to another?
[29 CFR 1926.452(k)(5)]
Training Requirements
72. Are workers trained to recognize the hazards Y N N/A ??
associated
with the type of scaffold used and to understand the
procedures to control or minimize those hazards?
[29 CFR 1926.454(a)]
Note: Consult the OSHA regulations for the specific
training areas that must be covered.
73. Are trainers qualified in the subject matter? Y N N/A ??
[29 CFR 1926.454(a)]
Y N N/A ??
74. Are workers who erect, disassemble, move, operate, Y N N/A ??
repair, maintain, or inspect a scaffold trained to

recognize hazards associated with the work?
[29 CFR 1926.454(b)]
Note: Consult the OSHA regulations for the

specific training areas that must be covered.
75. Are trainers who train the workers mentioned in Y N N/A ??
question 74 competent?
[29 CFR 1926.454(b)]
76. Are workers retrained when they show a lack of skills Y N N/A ??
or understanding needed for safe work involving

erecting, using or dismantling scaffolds?
[29 CFR 1926.454(c)]
Definitions:
Bearer (putlog): a horizontal transverse scaffold member supported by ledgers or runners. The scaffold platform rests o
Brace: a rigid connection that holds one scaffold member in a fixed position with respect to another member, or to a build
Competent person: one who can identify hazards in the work area or conditions that are unsanitary, hazardous, or dange
Coupler: a device for locking together the tubes of a tube and coupler scaffold.
Gusset: a metal plate used for connections.
Personal fall arrest system: a system used to stop an employee's fall. It consists of an anchorage, connectors, a body bel
Lifeline: a component consisting of a flexible line that connects to an anchorage at one end to hang vertically (vertical lif
Qualified: a person who, by a recognized degree, certificate, or professional standing; or by extensive knowledge, trainin
Runner (ledger or ribbon): the lengthwise horizontal spacing or bracing member that support the bearers.
Supported scaffold: one or more platforms supported by outrigger beams, brackets, poles, legs, uprights, posts, frames, o
Comments/Corrective action:
Back to the previous page Back to Contents
National Institute for Occupational Safety and Health

ers. The scaffold platform rests on the bearer, and the bearer joins scaffold uprights, posts, poles, and similar members.
t to another member, or to a building or structure.
e unsanitary, hazardous, or dangerous, and who has the authority to take prompt corrective measures to eliminate them.
nchorage, connectors, a body belt or body harness, and may include a lanyard, deceleration device, lifeline, or combinations of these.
end to hang vertically (vertical lifeline), or that connects to anchorages at both ends to stretch horizontally (horizontal lifeline). The lifeline
r by extensive knowledge, training, and experience, has successfully demonstrated an ability to solve problems related to a subject matter, w
upport the bearers.
es, legs, uprights, posts, frames, or similar rigid support.

milar members.
eliminate them.
ine, or combinations of these.

ly (horizontal lifeline). The lifeline serves connects other components of a personal fall arrest system to the anchorage.
oblems related to a subject matter, work, or project.

o the anchorage.
Area Reference
29 CFR 1926.503
29 CFR 1926 Subpart M, App. C

OSHA Letter of Interpretation
Integrity Management - OMS
Fall Protection - Defined Practice

Date
Facility
Location
Participants
NA = Not Applicable, N = Needs Attention, CDW= Corrected During Walkthrough, BP=Best Practice
Element: Fall Protection NA, N,
CDW, BP
Training by competent person recorded in training database
Re-training as necessary following an event or observation
Proper equipment for task
Proper tie off point
Rescue Plan in place
Fall Protection equipment listed on safety critical equipment list
Inspected by competent person
Proper fit
Type and length of lanyard for the task

Area Reference
Lifting Operations - Defined Practice


Date
Facility
Location
Participants
NA = Not Applicable, N = Needs Attention, CDW= Corrected During Walkthrough, BP=Best Practice
Element: Lifting NA, N,
CDW, BP
Crane Operator
Has the Crane Operator presented evidence of competency card?
Is the Crane Operator’s evidence of competency card criteria sufficient to operate the
crane to be utilized?
Lift Information (Crane Operator/IA)
Do you know the capacity of the crane at this configuration?
Do you know the weight of the load?
Do you know the gross load on the crane?
Do you have a load chart available in the crane cab?
Do you know what percentage is this load of gross capacity?
Rigging (All)
Was the rigging performed by a competent rigger?
Do all slings have a legible load rating attached?
People (All)
Is the Lift Leader/Issuing Authority present at the lift site?
Have the crane operator and rigger signed the lift permit?
Have non-essential personnel in the vicinity of the lifting operations who are not directly
involved with the lift been controlled to stay out of the area of maximum boom radius?
Critical Lift Criteria (All)
Will the Crane/Hoist Operator lose sight of BOTH the load and signal person at any time
during the lift?
Are you lifting over energized or pressurized equipment?
Is the crane within twice the maximum swing radius of the crane, plus the required
clearance?
Does the lift exceed 80% of the lifting equipment capacity?
Crane Condition (IA)

Has the daily visual inspection been completed?
Is yearly Crane/Hoist inspection current?
Were any deficiencies found during the prior to use inspection?
Is the anti-two block functional
Tag Lines
Use of tag line avoided if possible to eliminate risk
Discussion of hand signals including stop the job signal during lift planning
Lift plan including travel path discussed with crane operator and spotter including walking
surfaces, ground condition, obstructions and escape route
Tag lines appropriate length to avoid potential fall zone
Tag lines inspected and attached securely
Apropriate number of tag lines to stabilize load
Reminder to walking forward only
Spotter hand signals understood and followed
Workers clear of equipment during lifting away or landing

Area Reference
Date
Facility
Location
Participants
Element: Hot Work NA, N,
CDW, BP
Permitting
Did everyone participate in the JSEA?
Was the Permit completed on location?
Does the description of Hot Work activities identified on the permit cover the current tasks
being performed?
Has the Permit been reviewed with the Performing Authority?
Has the Permit been signed by the Issuing Authority?
Are any additional permits required for this job? (Can be Yes or No depending on scope
of work)
Are the energy isolation points properly identified, isolated and documented?
Monitoring
Can hot work be conducted when the LEL is greater than 10%?
Is documentation available to verify that the atmospheric monitor has been calibrated per
manufacturer’s requirements?
Has the Issuing Authority determined the monitoring requirements?
Is continuous atmospheric monitoring required when performing open flame hot work?
Controls
Is a Fire Watch required when performing open flame hot work?
Has the Fire Watch been identified on the Permit and signed in the appropriate area?
(Can be Yes or No depending whether a Fire Watch was required on Lines 6 & 7.)
Is appropriate fire extinguishing equipment identified and readily available? (Yes if open
flame hot work.)
Are alarms and shutdowns by-passed an if so, is it properly documented? (Can be Yes
or No depending on location.)
Can a hot work permit be closed while a Fire Watch is still on duty?
Can a motor vehicle be operated within 10’ of hydrocarbon equipment or piping without a
hot work permit?
Documentation
Are hot work permits valid for more than one shift?
Can a completed permit be retained for less than 30 days?
Can an Issuing Authority close a hot work permit without returning to the site?
Area
Compressed Gas and Air - Recommended Practice
Rick, can you verify this. The reg says 25-50

feet unless a firewall is used at which point is
1 foot.
Group Defined Practice - Inspection and Testing of Equipment in Service
Group Defined Practice - Inspection and Testing of Equipment in Service

Date
Facility
Location
Participants
Inspection Element NA, N, CDW,
BP
Housekeeping
Walkways clear
Equipment stored properly
Shelving anchored
D. WELDING-CUTTING EQUIPMENT AND COMPRESSED GAS CYLINDERS (Safety)

Proper PPE (welder eye protection, gloves, long sleeve shirts, etc.) worn when performing
welding.
Instructions covering the operation/maintenance of oxygen/fuel gas supply equipment
available.
Compressed gas cylinders are legibly marked as to their contents.
Compressed gas cylinders secured in an upright position to prevent against falling (on or
off the vehicles).
Valve protective caps are in place when cylinders are not connected for use.
In buildings, cylinders stored in well-ventilated, dry locations, away from sources of heat
and at least 20 ft from highly combustible material such as oil.
Cylinders shall be located in assigned areas where they will not be damaged or tampered
with.
Oxygen stored at least 20 feet from combustible material, acetylene, carbide cylinders or
other fuel-gas cylinders when not in use, or a firewall can separate the two.
Oxygen cylinders, valves, regulators, etc., must be free from grease or oily substances.
Cylinder valves closed before moving cylinders and when work is finished.
Valves on empty cylinders closed and capped.
Oxygen-acetylene torch handle and welding torches equipped with flashback protection
valves.
Worn / cracked hoses been replaced.
Cylinders are regularly checked for dents and corrosion.
Gas hoses stored with pressure bled off.
Compressed gas cylinders legibly marked, color coded and segregated by contents.
Cylinders stored away from heat and sources of ignition.
Gas cylinder gauges read zero psi when not in use.
Electric Welder
Welding cables free of defects. No repairs within 10' of stinger
Welding equipment proper slicing at clamp connections.
Bench Grinder
Cord free from splices and damage, proper ground, factory end
Wheels inspected and ring tested, proper speed rating, grinding wheel dressed
Tool Rest <1/8" from wheel
Tongue guard < = 1/4" space
Eye shield adjusted, clear
Face protection available and used
Original guard in place, properly adusted, tight
Normal RPM ( motor brushes good condition)
Dust mask utilized as per hazard assessment
Portable Grinder
Wheels inspected and ring tested, proper speed rating for machine
Eye and face protection available and used
Handle installed and used for control
Electric Cut-off saw

Wheels inspected and ring tested, proper speed rating for machine
Eye and face protection available and used
Handle installed and used for control
Drill Press
Proper bit for material
Electric Band saw
Electric Hydraulic Punch Press

Hydraulic system
Hydraulic hoses
Guard in place
Electrical cord proper grounding, stress relief, cracking and wear
Electric Threader
Electrical cord proper grounding, stress relief, cracking and wear
Machine guard(s)
non-portable units bolted to floor
Portable Electric Drill

Inspect electrical cord for wear, splices and proper grounding
Inspect for proper 90 degree handle for high torque work
Inspect brushes for wear
Vise
Inspected for proper mounting
inspect jaws and handles for wear,cracks, bent parts& misuse.
Hand Tools
Wooden handles inspected for cracks, splits and defects, secure at end
Metal tools inspected for wear, misuse
Metal tool handles damage, bent or cracked
Plastic handles inspected for cracks, defects
Air Compressor
Secured to floor
Machine guard(s) in place
PRV tested
Electrical cord inspected for defects, stress relief
Proper grounding
Tank inspected
Condensed fluid removed periodically
Air hoses inspected

Date
Facility
Location
Participants
Area Element Electrical Equip. Inspection
Each cord set, attachment cap, plug and receptacle of cord sets, and any
equipment connected by cord and plug, except cord sets and receptacles which
are fixed and not exposed to damage, shall be visually inspected before each
day's use for external defects, such as deformed or missing pins or insulation
damage, and for indications of possible internal damage.
Equipment found damaged or defective shall not be used until repaired.
Repairs of electrical cords on portable double insulated equipment such as
electrical drills is not permitted except by replacement of the cord as per
manufacturer's specifications
Free from grease, oil or other substances which may degrade outer coverings
( follow manufacturer's recommendations)
Flexible cords shall be used only in continuous lengths without splice or tap. Hard
service flexible cords No. 12 or larger may be repaired if spliced so that the splice
retains the insulation, outer sheath properties, and usage characteristics of the
cord being spliced.
This provision precludes the repair of flexible cords smaller than No.12 (the
higher the number, the smaller the cord). Since hand power tools typically have
flexible power cords smaller than No.12, those cords are not permitted to be
spliced. Heavier cords -- those No. 12 or larger (that is, with a lower gauge
number), may be repaired with a molded or vulcanized splice as long as the
repair returns the cord to at least the equivalent of its original specifications.
Repairs are made by qualified personnel
Cords and electrical tools stored properly, to protect from potential UV,excessive
heat, contact and strain damage.
Extension cords not used for permanent wiring
Extension cords proper guage for load and length
Operator understands guage and load requirement
Damaged cord(s) are tagged out and not used until repaired by a qualified person
Breaker boxes 3' clear for emergency management
Switches are marked as to equipment they control unless obvious
Switches, panels and breakers labelled with arc-flash labels as appropriate
Wall receptacle covers are tightly secured with proper covers
Wall receptacles used near water sources have ground-fault protection
Ground fault receptacles and breakers are tested periodically
CDW, BP
Date
Facility
Location
Participants
Area Element: Production Facility (Developed by Anadarko OS)
Anadarko Minimum Well Site Standard Checklist

Well Name: Date Performed:
Structural Defects
Are all guards (belt guards, machine guards, weight guards) in place with adequate machine guarding and in
SD-001 good working order?
SD-002 Are guards pinned / bolted (not welded) to allow removal for LOTO / Service?
Are there guards and caution signage in place around hot (>140 F) piping / equipment (e.g. compressor
SD-003 discharge / exhaust piping, fire tubes, etc.)?
SD-004 Are all automation and electrical lines properly tied in and secured with no exposed wiring?
SD-005 Are all production lines properly tied in and secured to production equipment and tanks?
Fixed Ladders
L-001 Are all tank ladders, landings secured, level, with all bolts and bracing in place?
L-002 Are ladders that exceed 24 feet equipped with a cage or ladder safety device?
L-003 Is the ladder properly angled to prevent slipping?
L-004 Are fixed ladders angled at no more than 90º from the ground?
L-005 Are the ladder steps properly spaced (no less than 10 inches and no more than 14 inches)?
Is the ladder mounted at least 7 inches and not more than 12 inches away from the wall/tank/fixture behind
L-006 it?
L-007 Are ladders without cages at least 15 inches away from the nearest structure?
L-008 Is the ladder area completely unobstructed?
Stairs
S-001 Are hand rails, mid-rails, and toe boards in place and secure / stable?
S-002 Are there handrails on all stairs having four or more risers?
S-003 Are the stairs at least 22 inches wide?
S-004 Do stairs angle between 30º and 50º from the ground (horizontal)?
S-005 Are stairway handrails located between 34 and 37 inches above the leading edge of stair treads?
S-006 Are step risers on stairs uniform from top to bottom (variation not more than 1/4”)?
S-007 Are steps on stairs slip resistant (designed or provided with a non-slip surface)?
Are elevated surfaces provided with standard 4 inch toe boards (bottom of toe board no more than ¼” above
S-008 landing)?
S-009 Are there any catch / snag points on hand rails?
S-010 Is the stairway path completely unobstructed?
Proper Equipment Foundations

EF-001 Are all foundations level?
EF-002 Are there washouts or erosion under equipment?
Equipment Inspection for Integrity

I-001 Check for leaking or seeping tanks, valves, piping, holes in tank roof
I-002 Check for water pooling around equipment
I-003 Cracks, splits, broken welds
I-004 Threaded Master Valve with Plunger Ops (YES or NO)
Tanks
Is lateral vent located at least 10 ft from public roadway and venting away from ignition source (gas fired
T-001 production units, etc.)?
T-002 Visually inspect seams, valves, piping, load lines for damage or leaks
Check heater treater, separator, or production unit for correct operation (e.g.: liquid level, dump operation,
T-003 temperature controller, etc.).
T-004 Are environmental pots in place on tank load line and drain line (empty, with lid closed and pinned)?
T-005 Do the load lines have bull plugs?
Is the containment ring structurally sound (no holes in panel for a former or existing load line, no missing
T-006 nuts and bolts along the seams)?
T-007 Any erosion features that would allow released fluids to easily bypass the secondary containment?
T-008 All hammer unions on dump lines and water transfer lines secure?
T-009 Is the thief hatch closed and latched properly?
T-010 Does the thief hatch seal properly (lid is aligned to allow proper seating on rubber seal)?
T-011 Is the tank clean and free of oil stains (overfilled or blew oil out thief hatch)?
T-012 Is the manway cover free of any seeps and all nuts and bolts are in place?
T-013 All openings on fiberglass tanks properly protected to prevent bird taking?
T-014 Are the tanks, valves, and associated piping structurally sound (no discoloration, drips, seeps, cracks, etc.)?
T-015 Do all fiberglass tanks have solid fiberglass top?
T-016 Are fiberglass tanks in water service ONLY?
T-017 If fiberglass tank has netted top, is it in good condition? (no holes greater than 1 ½”)
Pumping Units
Check unit fluids for correct levels (e.g.: lube oil, cooling water, lubricator box, day tank, etc.). Do not need
PU-001 to check gear box (part of pm).
PU-002 Check stuffing box for leaks and tighten or replace packing as required.
PU-003 Listen to unit for any unusual noises
PU-004 Visually check unit for mechanical function and structure integrity (alignment, cracking, etc.)
Flammable and Combustible Materials
Flam-001 Are approved containers and tanks used for the storage and handling of flammable and combustible liquids?
Flam-002 Are all flammable liquids kept in closed containers when not in use?
Flam-003 Are storage tanks guarded to prevent damage from vehicles?
Flam-004 Are all connections on drums and combustible liquid and vapor piping tight?
Flam-005 Are storage tanks adequately vented, including being equipped with emergency venting?
Valves and PSVs

PSV-001 Are there any block valves below a PSV upstream? (If yes, notify team leader immediately).
Are there weather caps in place on PSV outlet lines and meter run venting stacks to atmosphere? Are valve
PSV-002 plugs in place on all weather cap valves and line?
Are all PSV discharge vents properly routed outside of enclosure or building and above ridge line of
PSV-003 enclosure/building?
Are the PSV vents extended to a safe elevation (7ft) away from personnel and braced to prevent any possible
PSV-004 rotation during an emergency release?
PSV-005 Are all PSVs installed in the vertical position?
PSV-006 Do all sight glasses have guards installed?
PSV-007 Are all gauges in working condition (if not needed, remove and install plug)?
PSV-008 Can location be isolated with double block and bleed?
Proper Site Maintenance

Is there adequate weed and grass control on immediate lease location? Shut in well for any unsafe condition
SM-001 on well site (fire hazards, snakes, unable to complete job safety due to vegetation)
SM-002 Identify idle equipment (specify). (Shut in for unsafe working operations).
SM-003 Remove all junk from location (specify). (Shut in for unsafe working operations).
SM-004 Any sink holes, uncovered wellhead cellars, etc?
SM-005 Is there any stained soil area around tanks or production equipment?
SM-006 Is there a top door frame of at least 6’8” high and 2’4” wide on the exit of any well site fence?
Identify Electrical Hazards

Ele-001 Are there any loose or bare wires, including power lines?
Ele-002 Is there low overhead wiring that creates an unsafe hazard?
Ele-003 Are there any broken ground wires, including power lines?
Ele-004 Are electric box doors open or broken?
Is the distance of any equipment from power lines <10ft (CAUTION: Visibly determine. DO NOT
Ele-005 MEASURE).
All production units, tanks, pumping units, compressors, separators, flare stacks, dehys, automation RTUs,
Ele-006 heater treaters and electrical motors properly grounded using external ground wire to ground rod.
Ele-007 Inspect automation poles for structural damage.
Ele-008 Are cover panels on electrical control boxes installed and closed?
Ele-009 Are all electrical controls marked and legible?
Ele-010 Is the condition of electrical wiring good?
Ele-011 Are electrical wires properly strung and secured?
Proper Signage
Sgn-001 Are H2S warning signs posted (if well >10 ppm)?
Sgn-002 Are Lease signs posted at lease entry, wellhead, and tank battery?
Sgn-003 Is “Unit starts automatically” sign posted if appropriate?
Sgn-004 Are tank contents w/ hazard warnings posted?
Sgn-005 Are high voltage signs erected if appropriate?
Sgn-006 Are “Underground buried pipe may be present” signs posted?
Sgn-007 Are warning signs clean and visible?
Sgn-008 Are “No Smoking” areas designated and posted?
Sgn-009 Are hearing protection signs posted?
Sgn-010 Are rig anchor markers in place?
Sgn-011 Are emergency phone numbers posted?
Labeling of Containers
Lbl-001 Are barrels, tanks, or other movable containers properly labeled?
Lbl-002 Are the labels legible and prominently displayed?
Does the label include the name of the chemical, the hazard associated with the chemical and the target organ
Lbl-003 affected by the chemical?
Compressors
C-001 Are air filters installed on the compressor intake?
Check unit operating conditions at control panel (e.g.: suction/discharge pressures, rpm, oil pressure, coolant
C-002 temperature, etc.)
C-003 Check for gas and liquid leaks.
C-004 Check fluid level in scrubbers.
C-005 Check distance-piece drip container for fluid and drain as required.
C-006 Confirm scrubber dumps operating correctly.
C-007 Listen to unit for any unusual noises.
Visually check unit for mechanical function and structure integrity (e.g.: excessive vibration, cracked nipples,
C-008 etc.).
C-009 Check unit fluids for correct levels (e.g.: lube oil, cooling water, lubricator box, day tank, etc.).
C-010 Are safety devices on compressed air systems checked frequently?
C-011 Are environmental skids installed? Do they need to be emptied?
General Housekeeping
Hou-001 Proper Tool/Equipment Placement?
Hou-002 Are trip hazards removed and/ or adequately marked (painted yellow, etc.)?
Hou-003 Is all equipment painted consistently?
All tanks, separators, well heads, painted BP tan, on tanks bottom step and top step, hand rails 6 in on
Hou-004 tips safety yellow
All fence panels brown and safety yellow. ( if painted Bp tan and safety yellow 18 in from ground up)
Hou-005 Do not paint brown and yellow panels
Hou-006 BP owned compressors BP green
Hou-007 Pumping unit Gas fired motors BP green or Bp tan ( all gas fired motors replaced BP green)
Pumping units BP tan, weights and horses head have to painted safety orange 6 in on tips as OSHA
Hou-008 requires
Hou-009 All tripping hazards Safety yellow
Hou-010 All above ground piping not fenced in with panels, safety yellow below 6 feet, BP tan above 6 feet
All piping, walkovers and guards not fenced in with panels, safety yellow below 6 feet, BP tan above 6
Hou-011 feet (if fenced in with panels BP tan or safety yellow for tripping hazards)
Hou-012 Is the Wind Sock present and readily visible from at sites with >10ppm?
Lockout/Tagout: Does all equipment required to be de-energized or disengaged and blocked have the design
Hou-013 to be locked out?
Other
O-001 Do all flanged connections have bolts in all holes with 2 threads past the nut?
O-002 If Huber head is present, do visual inspection.
O-003 Lube oil tank specifications – Ensure appropriate tank height, labeling, and secondary containment.
O-004 Is roll line present?
O-005 Are panels in place and properly secured, in good shape?
O-006 Do all reservoirs on location have containment?
O-007 Is all secondary containment free of trash, debris, and liquids?
O-008 Do all stacks have a bird barrier?
O-009 Any Other Safety or Environmental Concerns?
All Findings: specify equipment for required work order and discuss with team leader
Any finding that would be deemed safety critical – Call Team Leader immediately and discuss
Signature: ___________________________________________
Revision Log
Revision Authority
Date
2/4/2006 Dan Lawson
10/10/2006 Dan Lawson

CDW, BP
Standard Checklist
Check Off Needs Attention Comments
Guages
PSV caps

ely and discuss
Date: ______________
Custodian Revision Details
Patti Jones New procedure

Gayla I General Requirements re-
Guenther worded.
Procedure – Took out line that
stated we would store for one
year.
Gayla I Check List – Multiple entries
Guenther added
Gayla I Changes to Check List due to
Guenther S&O Audit
Date
Facility
Location
Participants
Area Element: Ground Disturbance
Pre-Job
Did everyone participate in the JSEA
Was the JSEA completed on location with actual site hazards identified and control
measures applied?
Has a One Call been made and been cleared ?
Did the IA fill and sign the Ground Disturbance Permit?
Is the Ground Disturbance Permit on location?
Have all involved with the excavation read and signed the permit?
Was the search zone marked with white paint or white flags?
Has an Emergency Response Plan been reviewed and available at the work site?
Has a plot plan/drawing of the site been completed?
Have all lines to be crossed been positively identified?
During the Job

What are the hazards at this site?
Is the Issuing Authority on site during the excavation.
Was a sweep performed prior to excavation?
Are there other permits involved with this excavation?
What type of Ground Disturbance training have you received?
Are you comfortable stopping the job if you are unsure about potentially unsafe acts or
conditions?
CDW, BP
Date:
Facility -
Location -
Participants -
NA = Not Applicable N = Needs Attention
NA OK N 1.0 Fire & Emergency Equipment
1.1 Portable Extinguishers: Visible (placard/marking),
mounted; unobstructed access; monthly inspection
completed. CFR 1910.157/ NFPA10
1.2 First Aid Kits: All contents present; and weekly
inspections completed. HSE-DOC-30009-4/55008-4
1.3 Fire Containment: Fire control doors closed and sealed
1.4 Halon System: Zone in normal dump mode; all heads

connected; N2 pull stations charged; all module switches
labeled; and separation doors for Halon systems closed.
NFPA 12A
1.5 Fire Hoses: Inspected in last 5 years; nozzles and
fittings in place; block valves in normal position. NFPA20,
1911,1921
1.6 Emergency Showers & Eye Wash: Charged & monthly
inspection conducted. Protective eyepiece covers in place.
CFR1910/ANSI / HSEDOC-00332-4
1.7 SCBA (Air Packs): All packs, masks, etc. in place; air
bottles full; monthly inspection conducted; enclosure sealed.
CFR 1910.134
NA OK N 2.0 Safety Devices/HVAC
2.1 Critical Valves: All PSVs in service; valve handles and
car-seals in place; defeated devices logged. HSE-DOC-
00202-4/ASH
2.2 Heating & Ventilation Systems: Exhaust fans running (if
needed); switches in correct position; and louvers operating
correctly to maintain air balance switches in correct position;
and louvers operating correctly to maintain air balance
2.3 Emergency Shut Down Valves: All hydraulic/pneumatic

lines open; and defeated devices logged. ASH
2.4. Defeated Devices: Flagged, tagged and properly

logged. HSE-DOC00202-4/ASH
2.5 Signage: Current and appropriate for the hazards
present.
NA OK N 3.0 Physical Safety & Mechanical Concerns
3.1 Hand Tools: Condition, storage and proper use. CFR
1910.24,.244
3.2 Housekeeping: Aisles/stairs/floors clear; drips and spills
cleaned up; trash cans empty and are free of food waste.
CFR1926.25, AK F&G
3.3 Ladders & Climbing Devices: Condition; storage; proper
use; chains/ gates closed. CFR1910.26/ASH
3.4 Walking/Working Surfaces: Dry, unobstructed, clean,
openings guarded. Slipping/Tripping hazards. CFR 1910.22
3.5 Exits: Marking, visibility, lighting, unobstructed access,

exterior stairs cleared of snow/ice, no overhead hazards
(snow and Ice). CFR 1910.37/1910.145
3.6 Machinery: Guards/shields in place; belts, pulleys,
gears, shafts; maintenance and oil leakage; nuts, bolts,
flanges tight. CFR1910.211/.219
3.7 Scaffolding: Secured, properly tagged and load rated.
Toe-boards and handrails installed. CFR1926.451/HSE-
DOC-00044-3, BPGR
3.8 Electrical: Plugs intact; switch covers in place; circuit
breakers identified; circuit panels unobstructed; no open
blanks in box; proper extension cords (GFI). CFR
1910.147/ASH
3.9 Pressure Equipment: Bull plugs installed, valves properly
positioned, proper utility fittings in place. 18AAC 75
3.10 Materials Handling Equipment & Lifting Devices: Load

rating on cranes, hoists, beams, trolley posted; cranes
stored in proper position; slings and wire ropes are in good
repair and not frayed and annual inspection done and color
coded. Stacked materi
3.11 Permanent Handrails, grating, & elevated walkways:
Structural integrity intact (Impact and/or weather
damage)and , grating clips in place.
3.12 Hoses and fittings: Correct application
(service/pressure), signs of damage (hose, fitting, clamping
device), whip-checks in use, working pressure noted on
hose. CFR1926.302
3.13 Compressed Gas Cylinders, properly secured (not tied
off to process lines, chains in place), acetylene cylinders
placed upright, cylinders stored outside or in approved area,
protective caps in place. BP Group N2 Guidelines CFR
1910.101 /ASH
NA OK N 4.0 Hazardous/Flammable Material Control
4.1 Housekeeping: Accumulation of combustible materials
(i.e. oily rags). CFR 1926.25
4.2 Ventilation: No toxic fumes, vapors, mists, smoke and
gases. CFR 1910.1000
4.3 Caustic, Corrosive, & Hazardous Materials: container
labels, MSDS available, storage, disposal, and spill clean-
up. Oxidizers not stored with organic materials. Material
containing Asbestos identified and Warning signs posted.
ASH/HSE-DOC-00153-4 / 00
4.4 Flammable Liquid Storage & Transfer: Ground straps in
use; approved containers used and labeled; containers
provided with self closing valve; drums/container/vessels
labeled (NFPA 704M label) where required; and MSDS
posted. CFR1910.106
5.0 Personal Protective Equipment (PPE)
5.1 PPE: Hard hats, safety shoes, fire retardant clothing,
hand protection and proper eye protection (safety
glasses/side shields). CFR 1910.135 1910.133/ASH
5.2 Fall Protection: Proper equipment being used correctly
when working at heights of 6’ or greater, inspections
completed. CFR 1926.502/ASH BPGR
5.3 Noise Exposure: Areas posted; hearing protection used
(double hearing protection in required areas). CFR
1910.95 /ASH
5.4 Respiratory protection: Correct respirator and cartridge
used; and maintained and stored properly. CFR 1910.134
/ASH
5.5 Gas Meters: Gas/oxygen/H2S/Benzene meters
available, calibrated and charged. ASH
NA OK N 6.0 Permits and Procedures
6.1 Emergency Response Plan: Available and understood;
drills completed; Alarms functional. CFR 1910.120
6.2 Energy Isolation: Energy Isolation List completed and

available; devices tagged, flagged and locked out. CFR
1910.147 /ASH, BPGR.
6.3 Work Permits & Fluid Transfer: Properly completed,
conditions being followed. Fluid Transfer List being followed
for fluid transfers 18AAC 75, 40CFR 112 ASH, BPGR
6.4 Hazard Recognition Process: Critical activities identified.

Hazards noted. Are Safeguards in place?
NA OK N 7.0 Waste Management
7.1 No more than 55 gallons of hazardous waste (per waste
stream) at one SAA. 40 CFR 262
7.2 SAA containers labeled hazardous waste and kept
closed. 40 CFR 262
7.3 All containers or tanks with recyclable hydrocarbons are
labeled as “Used Oil.” 40 CFR 279
7.4 Waste is segregated (oily waste, metal, other for landfill)
before delivery to solid waste site or before placing in
dumpster. 40 CFR 262
7.5 Oily waste properly bagged. No chemicals are mixed in
oily waste bags or in oily waste dumpster. 40 CFR 262
8.0 Spills / Spill Prevention / Storm Water Management

8.1 Use of Surface Liner / Drip Pan Procedure observed. NS
Environmental Field Handbook, NS Unified Procedure
8.2 Are there any hydrocarbon leaks (greater than 4 drops

per min.) or damaged equipment that could cause a leak?
Hydrocarbon Leak Procedure
8.4 Is standing water present in secondary containment,
cellar, or well house? 18AAC75, NPDESAKR-00-A022
8.5 No visible contamination on pad, equipment,
impoundments with potential to contact storm water.
18AAC75, NPDESAKR-00-A022
8.7 Fluid Transfer equipment in good order. 18AAC75,
NPDESAKR-00A022
NA OK N 9.0 Air Quality Management
9.1 Are copies of applicable Air Quality Permit to Operate,
Construction Permits, and Title V Permits “posted?”.
18AAC50
NA OK N 10.0 Housekeeping
10.1 Excess materials and equipment removed
10.2 Storage bins / shelves secure
10.3 Heavy objects stored on lower shelves
10.4 Objects stored on shelves securely
10.5 Objects hanging on walls stored securely
10.6 Walkways and aisles clean, clear of obstructions and
dry
10.7 Permanent aisles and passageways appropriately
marked.
10.8 Elevated storage areas ( above offices, etc.) weight
limit posted and adhered to.
10.9 Elevated Storage areas neat and clean
10.10 4” toeboards where tools or materials might fall on
people or equipment
10.11 No materials stored in elevated storage next to
railings unless guarded
10.12 Stairways have standard handrails 30”-34”from tread
and 3” away from walls, and mid-rails. Platforms have
handrails at min. 42”, mid-rails in center and 4” toeboards.
Handrails and stair rails shall withstand a 200 pound force in
all directions.
10.13 Lighting fixtures guarded when less than 7 feet or that

can be damaged when carrying or moving supplies or tools.
10.14 Overhead hazards marked and cushioned as needed
10.15 Protruding hazards are removed or guarded.

NA OK N 11.0 Electrical
11.1 Electrical panels labeled with purpose, voltage
11.2 Breakers and switches labeled
11.3 3’ clear access around electrical panels, no
combustibles
11.4 Wiring in conduit, not pulled from stress relief
11.5 No extension cords used for permanent wiring
11.6 Extension cords inspected, properly stored
12.0 Flammables and Chemicals
12.1 Flammable materials stored in flammable cabinets
12.2 Flammable cabinets properly vented
12.3 Chemicals other than household quantity
labeled/MSDS
Repairs / Corrections must
be completed by (date)
Repairs / Corrections from

the above have been
completed:
Supervisor ________________________________________________
_
Comments Owner
Date:
____________________________
PSM Site Name Operations Site Last PSM Audit Last SPU
Compliance
Inspection
Sunray Gas Plant Anardarko 20 June, 2008 Feb. 15-17, 2011

Hemphill Gas Plant Anardarko 9-Jun-10 Feb. 15-17, 2011
Block 31 Gas Plant Permian 3 June, 2010 Aug 31-Sept.3
Crane Gas Plant Permian 3 June, 2010 Aug 31-Sept.3
Midland Compressor Permian 6 Nov, 2008 Aug 31-Sept.3
F&H CCDF Arkoma 5 April, 2008 Oct.4-6, 2010
Red Oak Central Arkoma 5 April, 2008 Oct.4-6, 2010
Bayfield San Juan North 1 Jul, 2009 Sept.13-17 2010
Florida River San Juan North 1 Jul, 2009 Sept.13-17 2010
Pascagoula Gas plant Southern 23 June, 2010 Sept. 21-22, 2010
Wattenburg Gas Plant Wattenburg 2 Aug, 2010 Sept. 28-29, 2010
Jayhawk Gas Plant Hugoton 13 Aug,2009 Jan 24-27, 2011
Wamsutter Stab Plant Wamsutter 7 May, 2010 July 26, 2010
Judge Digby (VPP Site) S. La. 12 Oct, 2009 Jan. 11-13, 2011
Morganza (VPP Site) S. La. 12 Oct, 2009 Jan. 11-13, 2011
Port Hudson (VPP Site) S.La. 25 Feb, 2009 Jan. 11-13, 2011
Confirmed
NON-PSM Operations Site Operations Area Last Compliance Last SPU

Name (S&O) Audit Compliance
Inspection
OSHA Scheduled Contact: PSM Contact:HSE
Compliance, Inspection
PSM Review, Preparation
VPP
O,P Complete Dallis Pletcher Gerry Corder
O Complete Dallis Pletcher Gerry Corder
O,P Complete Jay Warren Joe Montez
O, P Complete Jay Warren Joe Montez
O, P Complete Jay Warren Joe Montez
O, P Complete Dale Fisher Van Mason
O, P Complete Dale Fisher Van Mason
O, P, VPP Complete Bob McKibbin Doug Mitchel, Tracy M.
O, P, VPP Complete Bob McKibbin Doug Mitchel, Tracy M.
O Complete Brian Kay/Johnny Oliver Joe Zurovec
O, P Complete Frank Velasquez Craig Powell
O, P, VPP Complete Justin Anderson Nahum Manzano
O Complete Diane Sagan/Mark Tanner Garreth Ratchford
O, VPP Complete Gordon Raines Randy Comeaux
O,VPP Complete Gordon Raines Randy Comeaux
O,VPP Complete Gordon Raines Randy Comeaux
Tentative
OSHA Next Scheduled Contact: OSM Contact: HS Team

Compliance, Inspection Leader
PSM Review
VPP Prep
Manager
Eric Fletcher
Eric Fletcher
K. Mortensen
K. Mortensen
K. Mortensen
Carl Dupuy
Carl Dupuy
Jon Lowe
Jon Lowe
Richard Rose
Mike Deherrera
Len Sisk
Fred Lemond
Doug Woodrow
Doug Woodrow
Doug Woodrow
Date:
Facility:
Location:
Participants:
NA = Not Applicable, N = Needs
Attention, CDW= Corrected During
Walkthrough, BP=Best Practice
Area Element NA, N,

CDW, BP
Inspection Location:
Element
Electrical
Emergency Mgmt.
Energy Isolation
Fire Protection
Hazcom
Housekeeping
IH/PPE
Lifting
Machine Guards
Mechanical
Integrity
Stairways,
Walkways,
Ladders
Training and
Written Programs
Total

Safety Inspection Checklist With OSHA References 2011 Updated

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Observations

Inspection Element Totals

Housekeeping Housekeeping in Welding shop excellent

Housekeeping Housekeeping in Warehouse excellent

Document Link Contractor Orientation/ SafeLandUSA

Document Link Incident Investigation Reports (Tr@ction)

Document Link Contractor Incident Reports (Tr@ction)

BP's SOC Page SOC

SOC for LeadersBehavior Based/ Stop the Job Observations

Tr@ction Incident Investigation Reports

LOTO Tier Three, tier 4 documents (local policy)

Document Link LOTO permits reviewed for accuracy

Document Link Work permits review

Document Link PPE Hazard Asessment

Means of Egress (Exit Signs)

Validate IMP/RMP with control room operators

uction on the reporting of workplace injuries or illnesses?

1904.32(a)(2) Create an annual summary of injuries and

o Are employees provided specific guidance and

Letter of Interpretation OSHA

Means of Egress (Exit Signs)

Accurate Reporting, Observations: SOC: first aid, near

Are emergency response services, specific to the location,

Area Element: LOTO, The Control of Hazardous Energy

Lock-out Devices are Durable

LOTO locks and tags separate from Out of Service designation

See OSHA Reference 29 CFR 1910 Subpart D - Walking-Working Surfaces

Note: The stall load of any scaffold hoist

2. Are all working levels on scaffolds fully Y N N/A ?

3. Are scaffold platform spaces 1inch or less Y N N/A ?

Note: Spaces up to 9 1/2 inches wide are

4. Are all scaffold platforms at least Y N N/A ?

Note: Scaffold platforms less than

guardrails or personal fall arrest

5. Is the distance between the front edge of Y N N/A ?

work 14 inches or less, unless guardrail

Note: Exceptions are permitted under

6. Does the end of each scaffold platform Y N N/A ?

7. If the scaffold platform is 10 feet or less in Y N N/A ?

Note: The end of the scaffold platform may

8. On scaffolds where planks are abutted to form Y N N/A ?

Note: Common support members, such as

9. On scaffolds where platforms overlap to Y N N/A ?

10. At points of a scaffold where the platform Y N N/A ?

Step 1: Lay the platform that rests on a

Step 2: Lay the platform that rests at

11. Is it prohibited to cover wood platforms Y N N/A ?

Note: Platform edges may be covered or

13. Are scaffold components from different Y N N/A ?

14. Are scaffold components made of dissimilar Y N N/A ?

Criteria for Supported Scaffolds

Note: Install guys, ties, and braces at

16. Are supported scaffold poles, legs, posts, Y N N/A ?

18. Is it prohibited to use unstable objects for Y N N/A ?

19. Is it prohibited to use unstable objects as Y N N/A ?

20. Is it prohibited to use front-end loaders and Y N N/A ?

21. Are supported scaffold poles, legs, posts, frames, Y N N/A ?

[29 CFR 1926.451(e)(1)]

Note: Cross-braces must not be used as a

23. Are portable, hook-on, and attachable ladders Y N N/A ?

24. Are hook-on and attachable ladders positioned Y N N/A ?

25. Are hook-on and attachable ladders designed Y N N/A ?

26. Do hook-on and attachable ladders have rung Y N N/A ?