Field Safety AuditField Safety AuditGeneral InformationDate*Time*121234567891011:000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859AMPMDivision*Please Choose OnePipelineNitrogenSub-ContractorSafety AuditorSuperintendent*Project Number*Area Reviewed*Area being audited.Weather *Weather conditions.Conditions*Working conditions.Toolbox Conducted* Yes NoToolbox Topic*Safety Auditor (E-mail Address)*Superintendent (E-mail Address)*Safety Lead If different from Safety AuditorSafety Lead (E-mail Address)If different from Safety AuditorPersonal Protective Equipment001 Hard Hats* Compliant Non-Compliant N/A002 Eye Face* Compliant Non-Compliant N/A003 Respirators* Compliant Non-Compliant N/A004 Hearing* Compliant Non-Compliant N/A005 Hand* Compliant Non-Compliant N/A006 Foot * Compliant Non-Compliant N/A007 FRC* Compliant Non-Compliant N/A008 H V Vests* Compliant Non-Compliant N/AMaterial Handling - Manual009 Technique* Compliant Non-Compliant N/A010 Tools* Compliant Non-Compliant N/AMaterial Handling - Equipment011 Inspections* Compliant Non-Compliant N/A012 Equipment* Compliant Non-Compliant N/AMaterial Handling - Use013 SDS* Compliant Non-Compliant N/A014 PPE * Compliant Non-Compliant N/AMaterial Handling - Storage015 Flammables* Compliant Non-Compliant N/A016 Combustibles* Compliant Non-Compliant N/AJob Safety Analyses017 Completed* Compliant Non-Compliant N/A018 Signed* Compliant Non-Compliant N/AHand/Power Tools019 Condition* Compliant Non-Compliant N/A020 Guarded* Compliant Non-Compliant N/AElectrical021 Grounding* Compliant Non-Compliant N/A022 Aux Generator* Compliant Non-Compliant N/AScaffolds - Ladders023 Inspections* Compliant Non-Compliant N/A024 Use* Compliant Non-Compliant N/AWorking at Heights025 FA Systems* Compliant Non-Compliant N/A026 FA Inspection* Compliant Non-Compliant N/AFire Protection047 Smoking* Compliant Non-Compliant N/A048 Housekeeping* Compliant Non-Compliant N/APressure Testing029 Whip Check* Compliant Non-Compliant N/A030 Barricades* Compliant Non-Compliant N/ASigns and Barricades 031 Installed* Compliant Non-Compliant N/A032 Condition* Compliant Non-Compliant N/AWalking Surfaces033 Holes Guarded* Compliant Non-Compliant N/A034 Surfaces* Compliant Non-Compliant N/AHygiene035 Rest Rooms* Compliant Non-Compliant N/A036 Pot Water* Compliant Non-Compliant N/ATraffic Control037 Flaggers* Compliant Non-Compliant N/A038 Signage* Compliant Non-Compliant N/ALockout Tag out043 Program* Compliant Non-Compliant N/A044 Knowledge* Compliant Non-Compliant N/AExcavations041 Insp Report* Compliant Non-Compliant N/A042 Access Egress* Compliant Non-Compliant N/AConfined Spaces039 Permitted* Compliant Non-Compliant N/A040 Rescue Plan* Compliant Non-Compliant N/AWelding Operations049 PPE* Compliant Non-Compliant N/A050 Cylinders* Compliant Non-Compliant N/A051 Leads * Compliant Non-Compliant N/A052 Fire Protection* Compliant Non-Compliant N/AHaz. Communication045 SDS* Compliant Non-Compliant N/A046 Knowledge * Compliant Non-Compliant N/AHot Work027 Permit* Compliant Non-Compliant N/A028 Fire Watch* Compliant Non-Compliant N/ADrilling/Boring053 JSA* Compliant Non-Compliant N/A054 PPE * Compliant Non-Compliant N/ARadiation055 JSA* Compliant Non-Compliant N/A056 PPE * Compliant Non-Compliant N/AAttachmentsDrop a file here or click to uploadChoose FileMaximum file size: 516MBDocuments, pictures, drawings, etc.Non-Compliance and Actions TakenN/AInclude Line Number and Brief Description of ObservationOverview of Incidents During The DayN/ASimply Add N/A for No IncidentsSignature*signaturekeyboardClearSubmitIf you are human, leave this field blank.