Houston Business Roundtable Field Audit Form Review 2010 Safety Excellence Award Training Field Audit Form Review Presented by: Sharon Todd

Safety Audit Form Current Form. (Revised January 2006) 10 Page Document. Will be emailed out and can be found on the HBR website. www.houbrt.com Use the Form as a Format for your Audit.

Safety Audit Form Sections 26 Sections Audited: ITEM FIELD COMMENTS SCORE 1 2 3 N/A Written Safety Policy: A. Corporate B. Site i. Safety policy communicated to and understood by all employees ii. Safety and Health Manual iii. Written procedures for safety activities (JSA, JHA , committee, etc.) iv. Written operating procedures v. Safety handbook for employees Safety Training Education Hazard Communication Program Process Safety Management Respiratory Protection Program Hearing Conservation Program Emergency Evacuation Plan Personal Protective Equipment Drug and Alcohol Control Program Audit Inspection Program Accident Investigations Recordkeeping Medical / First Aid Program Accident Prevention Program Work Permits Houskeeping Fire Protection and Prevention Environmental Management Tool/Equipment Inspections Electrical Safety Sign, Signals and Barricades LPG/Compressed Gases/Flammable Liquids Ladders Scaffolds Excavation Others Best Practices X X X X X

Section 1: Accident Prevention Program, cont. ITEM FIELD COMMENTS SCORE 1 2 3 N/A vi. Annual safety goals set for continuous improvement vii. Company safety recognition program in place viii. Company safety representative identified ix. Safety representative participates in safety problems/activities x. Safety representative inspects all jobsites X xi. Disciplinary action program xii. Copy of all federal safety and health regulations available on jobs and/or posted as required xiii. Participation in a Contractor Safety Council

Section 26: Best Practices ITEM FIELD COMMENTS SCORE 1 2 3 N/A Are Best Practice(s) Fully Implemented at Site X B. Year to Year Improvement in Site Statistics Section 26- Best Practices and Year to Year Improvements Highlight Company Programs that are considered to be the strongholds of your organizations. Focus on a select few. Emphasize Site and total Company EH&S Statistical Data.

Audit Scoring System Score – 0 (Below Average) No Program in place. Score – 1 (Average) Program in place and meets the minimum requirements. Employees in the field have knowledge of the program. 0 = Below Average 1 = Average 2 = Above Average 3 = Excellent N/A = Not Applicable

Audit Scoring System Score – 2 (Above Average) The Program is in place and exceeds industrial standards. Employees in the field are knowledgeable and participation is high. 0 = Below Average 1 = Average 2 = Above Average 3 = Excellent N/A = Not Applicable

Audit Scoring System Score – 3 (Excellent) The Program is in place and exceeds industrial standards. Employees in the field are knowledgeable and participation is high and exceeds requirements to the extent to where it is recognized as a “Best Practice”. 0 = Below Average 1 = Average 2 = Above Average 3 = Excellent N/A = Not Applicable

Audit Scoring System Score – N/A Should be checked if it is non applicable. Is not counted against the overall score. Calculation is based on an overall percentage. 0 = Below Average 1 = Average 2 = Above Average 3 = Excellent N/A = Not Applicable

Section 27: Final Score Section 27- Final Score 385 141 2.73 Section 27- Final Score Each individual page is totaled for the number of items evaluated and the points scored. Number of Items Evaluated Subtotal of Score Points (bottom of each page) The Sum of the Sub-totals are then divided by the sum of the number of items.

Sections 28-30: Comments and Commitment Completed by auditors. Importance of Client comments. Commitment verified through the audit process. Can be the tie breaker section.

Houston Business Roundtable Field Audit Form Review 2010 Safety Excellence Award Training Field Audit Form Review