ISAWWA WATER PLANT SYSTEMS SAFETY AUDIT/SURVEY TOOL

Prevention of workplace injuries in Water collection and treatmentplants

Waterplantoperationsinvolveextensivemonitoringofbothinterior and exterior facilities,useofpotentiallyhazardouschemicals, and mechanical repairs which can involve heavy and out of position lifting. Outside winter-time monitoring operations presentsignificantslip/fallhazards.Keyactivitiesincludeproperuseofhandandpower tools,properliftingtechniquesandpractices,properuseofpersonalprotective equipmentandslip/fallprotection,andpropertrainingandoperationsystemsusefor chemicaloperations.

Instructions: Thisisapro-activesafetyauditingtooldesignedforperiodicuse to reduce high risk behaviors and increasesafe behaviors.

  • “Yes” answers should be scored at (1)
  • “No” answers should be scored at (0)

In the correctiveactioncolumn, either a time frame for completingthecorrection ortheactualdatecorrectiveactionwas completedshouldbenoted.Checkthe“NA”columnifthisitemisnotapplicable.Total andtrackauditscoresovertimetotrackup or down trends along with tracking the numberofincidents,accidentsandinjuriessustained. Use the last page to list and describe each corrective action that is needed as well as any additional safety hazards identified during the inspection.

Take pictures of any identified safety hazard and store with completed checklist. Once the correction has been made, take picture of corrected item and keep in file. Set a timeline of no more than 7 days to correct high safety hazards and 15 days for low-moderate safety hazards.

System Information
System Name
City, State
Date of Completion
Type of Work Being Completed
Task/Job Part 1– SafetyTraining / Yes / No / Corrective action date / NA
Trainingcompletedwithpassingscoresinatimely
manner
Trainingproperlyrecorded
Trainingandnewemployeesafetyorientation completed (Including Seasonal)
Trainingandnewemployeesafetyorientation
completedforseasonalworkers(including part time)
Task/Job Part 2 – Monitoring & Communication / Yes / No / Corrective action date / NA
Hazardousatmosphericmonitoringdevicesand alarmsinworkingorder
Allothergasandorchemicalmonitoringdevicesand alarmsinworkingorder
Workcompletedinatimelymannerwithproperuseof
PPE and safe lifting practices
Slip/fallprotectionusedasneeded(outside,
winter-timeconditions)(ie salt)
Procedure and Policy in place for corrective action
Procedure and Policy in place for incident reporting
Task/JobPart3 –WaterPlantOperations-Proper
WorkPractices / Yes / No / Corrective action date / NA
Have a procedure for properposition and lifting techniques
Proper use of hand and power tools during maintenanceoperations
  • Employeesprovided alltoolsandequipment needed
  • Employees provided training for tools and equipment
  • Employeesare not allowed to use personal toolsandequipmentonthejob

Properuseofheavyboots,gloves, eyeprotection, and other PPED during maintenance operations
Propercommunication,safetyequipmentandbackup personnelduringhazardouschemicalandother
higher risk operations
Task/JobPart 4–UseofPersonalProtective
Equipment(PPE) / Yes / No / Corrective action date / NA
PPE is provided that fits the hazard, if needed and training provided. List out
_
_
_
_
_
PPE is good and usable condition
PPE accessible to personnel
PPE for Fall protection provided – list out
_
__

PPE provided for chemical handling – list out
-Non permeable gloves
-Splash type safety glasses
-Reviewed hazard labels for recommended PPE
-_
Task/JobPart5–Properuseofincidentreportingformslogswithproperrecording / Yes / No / Corrective action date / NA
Allworkerinjuriesreportedtosupervisorandrecorded
Allworkeraccidentsinvolvingproperty,chemicals reportedandrecorded using OSHA 300A form if needed.
All“nearmisses”reportedtosupervisorsandrecorded
If a reporting program was inplace, all hazards and potentialhazardsreportedandrecorded
All incidents or accidents involvingcustomers reported and recorded
  • At the time of an accidentorincident,thereisno admissionofliabilityonthe part of the municipality
Allappropriatepublic safetyandEMSagencieswere notified
Task/Job Part 6 – Safety Meetings and Records / Yes / No / Corrective action date / NA
Periodicsafetymeetings attended with training and or incidentinvestigationsandcorrectiveactiontaken
Allrecordsassociatedwithsafety meetings properly maintained
OSHA 300A completed
OSHA Logs are completed and posted in a common area from Feb 1stto April 30th of the following year.
Records retained for 5 years
Task/Job Part 7 – IllnessPreventionandEnvironmental
Safety / Yes / No / Corrective action date / NA
Proper work practices around waterinlets,reservoirs to prevent drowning
Task/JobPart8 –ConfinedSpaceEntryLockoutTag out / Yes / No / Corrective action date / NA
Confined spaces and Permit Confined Spaces have been identified
Confined Spaces ID Chart posted
Training staff on how to identify a confined space
Properairqualityandgasmonitoringbeforeentry, if employees will be entering.
Properfallprotectionandrescuestaffandequipment used
ProperLockout/Tagoutprocedures and communicationsused
Task/JobPart9–Site Safety Equipment in Place and Properly Maintained / Yes / No / Corrective action date / NA
Fire extinguishers – checked every year by third party and clearly marked.
Eyewashesand/or Safety Showers= exercised every week (and recorded) and accessible
First Aid Kit available
Handrails – checked for proper height and security
Utilityname w/ 24 hour telephone contact number “Authorized Personnel Only” or similar sign at entrance gates
Federal No Tampering Sign
Chemical Hazards / Yes / No / Corrective action date / NA
MSDS on site and up to date
Containers labeled with HMIS label and chemicals stored properly
CERCLA form posted
Electrical / Yes / No / Corrective action date / NA
Power line is free of tree limbs
Ground fault circuit interrupters part of new construction
Wall outlets and light switches in good condition
Wall outlets properly grounded
All circuit breakers are labeled
No gaps in breaker panel
All control s are labeled
Total Score
Use this box to describe and comment on all corrective actions needed and any additional safety items identified during the inspection. Be sure to identify location and corrective action to be taken.
ALWAYS record the date the correction was made to ensure complete records.

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Date

Safety Audit Survey v 1.1 DATE