CHESM现场检查记录表

1、 . . . . 17/17 . . HYPERLINK :/ 全球上游 CHESM 现场检查清单Global Upstream CHESM Field Inspection Checklist为了记录在检查期间访问的工作场所进行的观察结果，本清单提供记录格式。用本格式来填写检查结果并算出该承包商的健康、环境、安全（HES）得分。关于这些场所的检查结果和需要改进措施的详细信息（不是得分）需要与承包商现场代表进行沟通。填写完成以后，将清单移交当地HES代表并向工作场所主管/领导提供一份拷贝。公司代表对承包商的工作场所和工作常规进行观察。承包商是：根据适用的工业标准和合同和公司的规格，负责安全与时

2、地完成工作的独立承包商。如果承包商的工作场所或工作常规不安全，立即停止他们的工作并通知承包商代表。之后，承包商负责评估现场情况、采取必要的纠正或补救行动并在可以安全工作时重新开始工作。除非情况紧急，公司不应直接指导工作或向承包商人员提供任何工作指示或纠正措施。除了中止不安全的工作常规，公司检查人员要限制检查行为，获取必须的信息，便于公司对承包商的HES工作常规进行审计和评估。建议在现场检查过程中对承包商现场人员进行面谈，以避免不必要的重复访问。This checklist provides a format for the recording of observations at work s

3、ites visited during the inspection. Use this information for completing the inspection and providing the score required for the contractors health, environment and safety (HES) qualification rating. The summary of the inspection findings and detailed information about the areas needing improvement (

4、not the scoring) shall be communicated to the contractors site representative. After completing this form, turn it in to your local HES representative and provide a copy to the work site supervisor/leader.Company representatives observe the work site and work practices of the contractor. The contrac

5、tor is an independent contractor responsible for the safe and timely completion of the work in accordance with applicable industry standards and the contract and company specifications. If the work site or practices of a contractor are unsafe, stop the work and notify the contractors representative

6、immediately. It is then the contractors responsibility to evaluate the situation, take any necessary corrective or remedial action and restart the work when it is safe to do so. The company should not direct the work or provide any work instructions or corrective measures directly to the contractor

7、personnel, except for situations where imminent danger exists. Other than stopping any unsafe work practices, limit inspections to obtaining information for the companys audit and evaluation of the contractors HES practices.Interviewing contractor site personnel during the tour is advised to avoid m

8、aking two trips.参与检查人员Inspection Participants FORMTEXT FORMTEXT FORMTEXT 地点Location FORMTEXT 日期Date FORMTEXT 承包商公司名Contractor Company Name FORMTEXT 项目名或项目号Project Name or Number FORMTEXT 雪佛龙发起部门Chevron Department Sponsor FORMTEXT 支持雪佛龙作业的工人人数Number of Employees Supporting Chevron Operations FORMTEXT

9、 承包商关键人员Contractor Key Personnel公司厂长/经理Company Director/Manager: FORMTEXT Phone: FORMTEXT Fax: FORMTEXT email: FORMTEXT 现场主管Site Supervisor: FORMTEXT Phone: FORMTEXT Fax: FORMTEXT email: FORMTEXT HES代表HES Representative: FORMTEXT Phone: FORMTEXT Fax: FORMTEXT email: FORMTEXT 走道干净清楚？Walkways clean an

10、d clear?5S方法，GB59-99采光良好？Proper lighting?工作场所无绊倒危险/障碍物？Work area clear of tripping hazards/obstructions?适合的垃圾桶和垃圾处理点？Appropriate trash cans and disposal locations?正确容纳流体？例如，不使用塑料桶容纳烃基流体Proper containment of fluids? For example, no plastic buckets in use for containing hydrocarbon based liquid按照热工工作规

11、指导意见使用电子通信设备？Electronic communication devices in use within hot work guidelines?在工作场所控制进/出？Control of entry/exit on the work site?有指定的吸烟区域？Designated smoking areas?工作安全分析表（JSA）在工作开始前填写完毕？JSA filled out before start of the work?全体人员参与填写JSA并签名？Did the whole crew participate in filling out the JSA and

12、sign off?情况发生变化（天气、人员、工作任务）时填写新JSA？New JSA filled out when a change occurred (weather, people, work tasks)?工作步骤以书面的形式表述清楚（不是预先填写的）？包括现场的特殊考虑？程序使用？Task steps written out (not pre-filled in) to perform the job? Include site specific considerations? Procedure use?已经识别各种危险并有应对措施？Hazards identified and a

13、ddressed?工人遵守书面工作步骤或程序？Worker following the written steps or procedure?如果在同一区域有其他承包商一起工作，JSA是否包含他们或与他们分享JSA？Were other contractors included in the JSA or shared the JSA if working in the same area?工人是否了解“停工授权”？Are workers aware of the “stop work authority”?已经识别了关键行为？Critical behaviors identified?是否进

14、行观察？Observations conducted?在观察后是否给予反馈？Feedback given after observation?观察数据得到交流？Observation data communicated?观察数据被收集/分析/使用，以纠正错误？Observation data collected/analyzed/used to correct?新雇佣的工人可清晰识别？SSEs are visibly identified?给新雇佣工人指派了师傅，且师傅在现场指导？Mentor assigned and available?师傅是否知道他/她被指派，负责新雇佣工人的安全？Doe

15、s the mentor know that he/she is assigned to the SSE and is responsible for the safety of the SSE?全体工人遵守安全工作规？（单人工作组无新雇佣工人，2-4人工作组可有1名新雇佣工人，5人以上工作组新雇佣工人比例不得超过20%，除非得到明确批准）Crew in compliance? (0 SSE on 1 person crew, 1 SSE on 2-4 person crew, and no more than 20% on 5+ person crew or an approved vari

16、ance is in place)坠落保护设备经过检查，处于良好状态？Fall protection equipment inspected and in good condition?锚点已经指定？Anchoragelocation specified?坠落保护设备穿戴正确？Fall protection equipment properly worn?正确连接至指定的锚点？Tiedoff properly to designated anchor?连接距离-救生索长度？Tie-off distance vs. lanyard length?在JSA中有专门的救援计划？Appropriate

17、 rescue plan in JSA?有正确的救援设备？Proper rescue equipment available?当使用坠落保护设备时，是否现场至少有一个人没有穿戴保护背带？Is there at least one person not in a harness on location while the fall protection equipment is in use?挂锁/上牌系统？Lock-out/tag-out systems?线缆受损？Damaged cords?防爆固定设施？Explosion-proof fixtures?空中输电线净空距离？Overhead

18、power line clearance?电气控制面板关闭？Closed power panels?头部？Head?手部？Hand?眼部？Eye?脚？Foot?身体(如果需要)？Body (if required)?呼吸系统（如果需要）？Respiratory (if required)?工具有缺陷？Defective tools?接地良好或双重绝缘？Grounded or double insulated?防护装置就位？Guards in place?使用正确的工具？Appropriate tool used?有操作资质？Authorized to operate?理解限速规定并遵守？Spe

19、ed limits understood and adhered to?车辆操作人员在移动车辆前是否围绕车辆观察以评估危险？Do vehicle operators conduct a walk around hazard assessment before moving the vehicle?首次前进时，车辆是否后退或停住？Are vehicles being backed in or parked for first move forward?吊车合格证？Crane certification?操作人员资质证明？Licensed/certified operators?侧翻保护结构？Ro

20、llover protective structures?运动警报装置（后备警报装置）Movement warning devices (backup alarms)?使用抓斗稳定索？Tag lines used?负荷极限清晰易识？Load limits visibly identifiable?工作记录本在车上，记录日期无遗漏？Log books available and current?组装质量？Quality of assembly?固定良好，无位移？Secured against movement?进出上下安全？Safe access?坠落保护/其他防护措施？Fall protect

21、ion/provisions?扶手、中部横栏、踢脚板到位？Are guard rails, mid-rails, and toeboards in place?脚手架标牌正确？Scaffolds appropriately tagged?气瓶直立存放/位置固定良好？Gas bottles upright/secured?电气焊接设备接地良好？Electric welders grounded?线缆/喷嘴/接头工作正常？Cables/hoses/fittings serviceable?备用看火人员/灭火器？Standby fire watch/fire extinguisher?防止回火装置就

22、位？Are flashback preventers in place?饮用水Drinking water?厕所设施？Toilet facilities?现场住宿条件？Field accommodations?卫生住宿？Hygiene accommodations?物资存放/堆践安全稳固？Materials are securely stored/stacked?物资通道开阔？Clear access to materials?物料存放架上标注负荷额定？Load rating for shelves?架子稳固？Stability of shelving?上锁/挂牌程序？Lock-out/tag

23、-out procedures?热工许可？Hot work permits?受限空间进入？Confined space entry?救援程序？Rescue procedures?救援设备？Rescue equipment?挖掘许可程序？Excavation permit process?应急计划？Emergency response plan?救援设备？Rescue equipment?医疗急救物资？First aid materials?洗眼站？Eye wash stations?消防？Fire protection?疏散程序？Evacuation procedure?工人是否熟悉警报和紧急

24、事件通知程序？Are workers familiar with alarms and emergency notification procedure?入口前5英尺之后有支护/斜墙？Shoring/Wall slope after five feet before entry?下部暗掘？Undermining?浸水问题？Water problems?距离输电线过近？Close proximity to power lines?地下管线位置？Underground utility locations?进出途径合适？Adequate means of access and egress?有合适的方式监视呼吸空间？Appropriate means to monitor breathing space?Guard-rail/barriers or coverings on or around?Floor/Roof/Wall openings?罐/沟渠/基坑/孔洞？Tanks/Trenches/Excavations/Pits/Ditches?梯子摆放正确/稳固？Ladders correc