P2S Hse Audit: Form 000.653.F0272 Date 17jul2009 Page 1 of 11

Form 000.653.
F0272
Date 17Jul2009
Page 1 of 11
HSE AUDIT PROTOCOL
P2S
HSE AUDIT
Project or Site Name
__________________________________
Assessment Date
_________________________________
Audit Team Members
_________________________________
_________________________________
_________________________________
_________________________________
Copyright © 2010, P2S. All Rights Reserved. Health, Safety, and Environmental
Form 000.653.F0272
Date 17Jul2009
Page 2 of 11
HSE AUDIT PROTOCOL
TABLE OF CONTENTS
EXECUTIVE SUMMARY...........................................................................................................3
CORPORATE HSE AUDIT OBSERVATIONS AND RECOMMENDATIONS.....................5
Other Site-Specific Audit Items to Consider.................................................................................12
ATTACHMENTS [Add at the completion of the audit.]

CORPORATE HSE AUDIT SCORECARD (Form 000.653.F0273)
EXECUTIVE SUMMARY
Form 000.653.F0272
Date 17Jul2009
Page 3 of 11
HSE AUDIT PROTOCOL
On ___(date)______, ___(team)__________ conducted a Comprehensive Corporate HSE Audit at

___________(location)__________________. The auditor(s) used the Corporate HSE Audit Protocol. The
protocol uses a 10-point color-coded scale to score each audit item.
90% - 100% Exceptional
80% - 89% Satisfactory
70% - 79% Improvement Required
0 - 69% Unsatisfactory
The project evaluation was based on compliance with the P2S HSE Management System. The protocol is
divided into 6 sections as follows:
I. Management Leadership and Employee Involvement

II. Worksite Analysis
III. Hazard Prevention and Control
IV. Safety and Health Training
V. Practices and Procedures
VI. Other Site-Specific Audit Items
The project scored a total of _____ points out of a possible ______ representing ____ percent an overall
compliance rate. The scoring system is designed to show areas of strength and areas that need
improvement. All items that fall in the red zone require immediate corrective action.
Recommendations for continued improvement have been noted in the recommendation section of the
report. The project will respond to Corporate HSE in writing, within 30 days, regarding the abatement of
noted items.
I would like to thank you and your staff for your hospitality during my recent visit. Please do not hesitate
to call me if I can be of further assistance to you and your staff.
Regards,
Form 000.653.F0272
Date 17Jul2009
Page 4 of 11
HSE AUDIT PROTOCOL

PROJECT PROFILE
Project Name: P2S Business Unit/Group:
Project Mailing Address (Post Office): Project Address:
Project Number: _____ Self Perform _____ Construction Manage

Project Region: Assessment Type:
___ Americas _____ General
___ Asian Pacific ___ South America _____ Post Fatality
___ Australia ___ Central America _____ Post Incident
___ Africa ___ Canada _____ Requested by Client
___ Europe ___ Caribbean _____ Requested by Project
___ US ___ Other _____ Follow-up
Project Start Dates: Project End Date:
Date of Last Corporate HSE Audit: Is this a Union site?
HSE Manager: Phone Number: E-mail address:
Construction Manager: N/A Phone Number: E-mail address:
Site Manager: Phone Number: E-mail address:
INJURY STATISTICS SUMMARY

SELF-PERFORM STATISTICS CONTRACTOR STATISTICS
CURRENT FY TO PROJECT CURRENT FY TO PROJECT
MONTH DATE TO DATE MONTH DATE TO DATE
Number of P2S Employees Number of P2S Employees
Number of Hours Worked Number of Hours Worked
Number of Fatalities Number of Fatalities
Number of DART Cases Number of DART Cases
Number of DART-L Cases Number of DART-L Cases
Number of DART-R Cases Number of DART-R Cases
Medical Treatment Cases Medical Treatment Cases
Total Recordable Cases Total Recordable Cases
DART (RATE) DART (RATE)
DART-L (RATE) DART-L (RATE)
DART-R (RATE) DART-R (RATE)
TCIR (RATE) TCIR (RATE)
Form 000.653.F0272
Date 17Jul2009
Page 5 of 11
HSE AUDIT PROTOCOL

Corporate HSE Audit Observations and Recommendations
Section I: Management Leadership & Employee Involvement

Project Critical Process Observation Recommendations Responsibility/Status
Management participates in STA meetings.

1
(Adopt-a-crew)
2 Site management communicates lessons learned
3 The site uses the Safety Perception Survey
4 Disciplinary action process
5 Contractors: Prework processes and approvals.
6 Contractors: Oversight and assurance methods.
Management participates in site safety audits (such

7
as: scheduled weekly audits).
Craft employee involvement. i.e. safety

8
committees, audits, JSAs, STAs, etc.
9 Ratio of HSE Representatives to workers.
Awards and recognition for safe behaviors and

10
performance.
Section II: Worksite Analysis
Form 000.653.F0272
Date 17Jul2009
Page 6 of 11
HSE AUDIT PROTOCOL

Site investigates first aid, recordable, and near
1
misses
2 Scored audit process.
Site performs comprehensive self-assessment using

3
protocol in Form 000.653.F0951.
Site performs incident and performance statistic

4
review.
Section III: Hazard Prevention and Control

1 JSA process.
2 STA process.
3 Hazard Elimination Program.
4 Site recovery plan for incident and audit findings.
Section IV: Safety and Health Training

1 HSE orientation process.
2 HSE regulatory training process.
Form 000.653.F0272
Date 17Jul2009
Page 7 of 11
HSE AUDIT PROTOCOL
3 New employee mentoring program.
4 Safety Leadership Training (SLT).
5 HSE toolbox talks.
Section V: Key Practices & Procedures

Site has an approved Site-Specific HSE Manual

1
with signed equivalency form.
2 Site has all appropriate certifications.
3 Substance Abuse Program implemented.
4 Confined space.
5 Excavations.
6 Guarding.
7 Hazardous materials.
Heavy equipment (such as flaggers, operations, and

8
movement).
Form 000.653.F0272
Date 17Jul2009
Page 8 of 11
HSE AUDIT PROTOCOL
9 Hot tap.
10 Lockout/tagout.
11 Material handling (mechanical and nonmechanical).
12 Permitting (such as work, hot, and crane).
13 PPE
14 Pressurized lines/testing.
15 Rigging.
16 Suspended workbaskets.
Environmental (such as waste disposal, air, storm

17
water, spills, and chemical management).
18 Work area housekeeping.
Fall protection (including roofs, grating/guardrail

19
removal, and other “fall-through” hazards).
Inspection process for equipment, tools, cords,

20
plugs, and rigging.
Form 000.653.F0272
Date 17Jul2009
Page 9 of 11
HSE AUDIT PROTOCOL

Client evacuation and alarm system are effective
21
(audibility, visibility, testing, etc.)
Contractor - mandated HSE representatives

22
sufficient for work scope and risk.
Contractor - orientation, training, and Competent

23
Person designation documented.
Contractor - methods for oversight, coordination,

24
and enforcement documented.
Contractor - methods to ensure occupational

25
injuries & illnesses are documented.
Contractor - methods for evaluating performance

26
for future contracts documented.
Contractor’s - HSE MS submitted, reviewed,

27
approved, & documented.
28 Contractor - HSE records are on file at the site.
Contractor - is required to follow P2S HSE

29
procedures (requirement documented).
Contractor - final approval for all contractor HSE

30
documents is documented.
Form 000.653.F0272
Date 17Jul2009
Page 10 of 11
HSE AUDIT PROTOCOL

Section VI: Other Site Specific Audit Items
1 Cranes and hoist.
2 Scaffolds and ladders.
3 Fab shops.
4 Rebar.
5 Barricade tape.
6 Other (specify).
7 Other (specify).
8 Other (specify).
Form 000.653.F0272
Date 17Jul2009
Page 11 of 11
HSE AUDIT PROTOCOL

Other Site-Specific Audit Items to Consider
# Audit Item # Audit Item # Audit Item
1 HSE Policy Statement 27 Waste Management Issues 75 High-Pressure Water Cleaning
2 HSE Management 28-50 Reserved for future Administrative Items 76 Abrasive Blasting
3 HSE Recordkeeping 51 Housekeeping 77 Tank and Piping System Testing
4 Security 52 Communication and Coordination 78 Hot Tapping Procedure
5 Fire Protection 53 Health and Hygiene 79 Traveling and Working Alone
6 Emergency Preparedness 54 Pre-Commissioning and Commissioning 80 Confined Spaces
7 Infectious Diseases 55 Spill Control and Prevention 81 Radiation/Radiography
8 Hazard Communication Program 56 Work Area Lighting 82 Lead
9 Chemical Storage 57 Personal Protective Equipment (PPE.) 83 Fibrous Material and Asbestos
10 Mobile Equipment Operations 58 Hand Tools 84 Tire Management
11 Inspection Procedures 59 Powder-Actuated Tools 85 Marine Operations
12 Respiratory Protection 60 Power Tools and Power Equipment 86 Railroad Operations
13 Enforcement and Discipline 61 Hot Work (Welding, Cutting, Burning) 87 Site Drainage and Sewage
14 Training and Development 62 Electrical 88 Hazardous and Dangerous Waste Management
15 Performance Indicators 63 Equipment Operations 89 Water Quality
16 Accident/Incident Investigation 64 First Line Breaks 90 Storage Tanks
17 Hexavalent Chromium/Cadmium 65 Excavation and Trenching 91 Polychlorinated Biphenyls
18 Safety Task Assignment (STA) 66 Steel Erection and Floor and Wall Opening 92 Pesticide Use
19 Regulatory Agency Inspection/Contact 67 Material Handling and Storage 93 Potable Water
20 Claims Management 68 Signs, Signals, Barricades 94 Occupational Medical/Physical Examinations
21 Process Safety Management (PSM) 69 Traffic Control 95 Potential Exposures – Other Toxics
22 Substance Abuse Program 70 Fire Prevention and Protection
23 Strategic Initiatives 71 Ladders, Scaffolds, and Elevated Work Platforms
24 Air Issues 72 Concrete, Concrete Forms, Shoring, Masonry
25 Electrical 73 Demolition
26 Office Areas 74 Blasting - Use of Explosives
Note: This form is referenced in Practices 000.653.1101 and 000.653.1305.

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Form 000.653.

HSE AUDIT PROTOCOL

Project or Site Name

Audit Team Members

HSE AUDIT PROTOCOL

ATTACHMENTS [Add at the completion of the audit.]

HSE AUDIT PROTOCOL

On ___(date)______, ___(team)__________ conducted a Comprehensive Corporate HSE Audit at

90% - 100% Exceptional

80% - 89% Satisfactory

70% - 79% Improvement Required

I. Management Leadership and Employee Involvement

HSE AUDIT PROTOCOL

Project Mailing Address (Post Office): Project Address:

Project Number: _____ Self Perform _____ Construction Manage

Project Start Dates: Project End Date:

Date of Last Corporate HSE Audit: Is this a Union site?

HSE Manager: Phone Number: E-mail address:

Construction Manager: N/A Phone Number: E-mail address:

Site Manager: Phone Number: E-mail address:

INJURY STATISTICS SUMMARY

Number of P2S Employees Number of P2S Employees

Number of Hours Worked Number of Hours Worked

Number of Fatalities Number of Fatalities

Number of DART Cases Number of DART Cases

Number of DART-L Cases Number of DART-L Cases

Number of DART-R Cases Number of DART-R Cases

Medical Treatment Cases Medical Treatment Cases

Total Recordable Cases Total Recordable Cases

DART (RATE) DART (RATE)

DART-L (RATE) DART-L (RATE)

DART-R (RATE) DART-R (RATE)

TCIR (RATE) TCIR (RATE)

HSE AUDIT PROTOCOL

Section I: Management Leadership & Employee Involvement

Management participates in STA meetings.

2 Site management communicates lessons learned

3 The site uses the Safety Perception Survey

4 Disciplinary action process

5 Contractors: Prework processes and approvals.

6 Contractors: Oversight and assurance methods.

Management participates in site safety audits (such

Craft employee involvement. i.e. safety

9 Ratio of HSE Representatives to workers.

Awards and recognition for safe behaviors and

HSE AUDIT PROTOCOL

2 Scored audit process.

Site performs comprehensive self-assessment using

Site performs incident and performance statistic

Section III: Hazard Prevention and Control

3 Hazard Elimination Program.

4 Site recovery plan for incident and audit findings.

Section IV: Safety and Health Training

1 HSE orientation process.

2 HSE regulatory training process.

HSE AUDIT PROTOCOL

3 New employee mentoring program.

4 Safety Leadership Training (SLT).

5 HSE toolbox talks.

On _(date)__, _(team)__________ conducted a Comprehensive Corporate HSE Audit at

Project Number: _ Self Perform _ Construction Manage