S No 1 2 3 4 5 6

Standard Control of Contractors Work permit Work at height LOTO Fork Lift Machinery Safety

Summary of the Standards Assessments Assessment Radar - %ge of questions - Compliance r Rating 0 20 40 60 #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

questions - Compliance range 80 100 0 0 0 0 0 0 0 0 0 0 0 0

SAINT-GOBAIN STANDARD CONTROL OF CONTRACTORS S No

I

Theme Question

Requirement in Detail

Compliance

GAIA Score
#DIV/0!

Are all work orders for contractors & externally based SG employees clearly defined with the scope of the work (job, area time etc..) ?
Have you prepared an inventory / list of all activities that are carried out by engaging outside contractors in your entity Have you prepared & documented a Management System manual & Procedures for Engaging the Outside contractors at your entity Does the documented Contractor management System consist of the following Procedure for Gate Entry and Exit systems for outside contractors working at your facility Written down procedure is mandatory, clearly reflecting the Entry and Exit process, Gate pass, request for Entry, authorisation for entry, duration of stay, location of work etc., Specific responsibilities for entry and exit process should be clearly documented The entity should have a list of all the contractable activities possible at its facility. Routine, Non Routine, One time works, works carried out by external aganecies, labour contracts etc., should be part of the list. The entity should have a Documented Contractor Management system which defines various aspects of Contractor engagement within the entity

2 3

b c d e f g h i

List of all the statutory requirements that need to be taken in to consideration Statutory checklist should be part of the procedure, Formats, licenses, while permitting the outside contractors to work inside the facility updating systems etc to be documented System for assessment of the EHS capabilities of the outside contractors prior to engaging them first time System for periodical assessment of the EHS capabilities of the Outside contractors from time to time System for Work permits Defined roles and responsibilities of the Saint-Gobain entity in engagement of outside contractor Defined roles and responsibilities of the Outside contractor engaged for carrying out the work in SG Defined roles and responsibilities of the Management & Staff employees who engage / supervise contrcators under them System for checking the compliances to written down procedures and checklists Mechanism and formats / checklists to be part of the procedure. Minimum acceptable criteria to be defined Mechanism and formats / checklists to be part of the procedure. Minimum acceptable criteria to be defined Mechanism and linkage to the Other CSG Standards is mandatory Clearly documented roles and responsibilities to exist Clearly documented roles and responsibilities to exist Clearly documented roles and responsibilities to exist Clearly documented compliance check system for statutory as well as other requirements is mandatory

Clearly defined format for the contracts containing the clauses - Job, nature of Format for the drafting of contracts should exist. This will standardise the task, No of people, Contractor supervisor, location where the job will be done, content of the contracts. hazards, Risks, controls, penalties, mandatory safety requirements . Have you conducted a formal training on this Documented Contractor management System covering all the Management & Staff employees who engage contractors Have you assessed the learning penetration for these Management & Staff employees about this documented Contractor management System Formal session is mandatory. All the Management and Staff employees who are listed in the inventory as at sl no 1 above to be covered in this session. Mark "Yes" to this checkpoint only if minimum 80% of the listed employees are covered in the training. Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the Formal trainings on this standard are followed up with a Test to check the learning penetration

Have you made it mandatory for any new employee who has a potential to engage a contractor under him / her to undergo this training at the time of his This should be checked w.r.t actualisation of such trainings for new employees / her induction The list should have - Name of agency, no of employees, contracted task, Have you prepared the list of all the contractor agencies working inside your license number, License validity date, whether is a sub agency, applicability of entity PF, ESI, WC etc., The updation of this list is important. This should be maintained current always Have you prepared the list of all the SG employees belonging to "other SaintRecords similar to the above should be maintained. The list should be updated Gobain entities" who are working inside your site as a part of a contract / and should be always current. installation / commissioning / trials etc., It is mandatory to maintain this list for each section / department where Does the list of contractors & externally based SG employees as above contractors / external SG employees are normally enagaged. This should be maintained at each section / department where these employees are normally evidenced at each section / department. Mark this checkpoint as "Yes" only if engaged this list is existing at all departments / sections within your entity Do you have the list of all the contracts that were done during the last one year at your entity The existence of this list is mandatory. The list should contain the details such as - Date, Name of contractor, No of mandays spent, no of workers, activity or task assigned, section / dept where task was carried out, etc., Monthly updation of this list is necessary. The existence of this list is mandatory. The list should contain the details such as - Date, Name of SG employee, No of mandays spent, task assigned, section / dept where task was carried out, etc., Monthly updation of this list is necessary This should cover all activities carried out by contractor employees - Activities of Routine, Non routine, Normal, Statutory nature etc., are to be covered. It is necessary to have written contracts for all contracted tasks. This should cover all activities carried out by external SG employees for your entity. Activities of Routine, Non routine, Normal, Statutory nature etc., are to be covered. It is necessary to have written agreements for all such contracted tasks.

10

11

Do you have the list of all the tasks / activities that were done by external SG employees during the last one year at your entity

12

Have you defined and documented a written contract for each task / activity that is assigned to a contractor during the last one year Have you defined and documented a written contract / agreement for each task / activity that is assigned to an external SG employee during the last one year

13

14

Does each one of the contracts / agreements as above clearly define the scope Verify the contracts. All contracts irrespective of the nature of task to be of task involved, location, agencies involved and the roles and responsibilities checked. Mark Yes only if complying to > 80% of the cases. etc.,

II
1

Do all contractors agree in writing to abide by a defined set of mandatory rules they have to follow when they work inside SG premises?
Have your entity prepared a set of mandatory rules that each contractor needs to follow when he is inside your premises Set of mandatory rules to be followed to exist (example, Do's ad Don'ts, Speed limits, Traffic control, Canteen, Drinking water, basic safety rules etc.,

#DIV/0!

Have you defined and prepared any specific instructions and mandatory rules for the SG employees from external SG company to work in your site

Set of mandatory rules to be separately framed for external SG employees

Do you communicate formally to the contractors, their employees as well as Formal communication should be practiced. This should be evidenced. The the external SG employees about the mandatory EHS requirements that need cross auditor to check the mechanism through Spot assessments to be followed Are the contractors made to understand the various mandatory requirements Signature of the contractor accepting the mandatory rules for compliance is of the EHS specified in the contracts and are made to sign the undertaking mandatory.

III
1

Within the contract are the EHS management responsibilities clearly defined for all relevant personnel?
Do you have a system of documenting the EHS requirements in all the contracts for engagement of outside contractors as well as engaging external SG companies Does the contracts wirtten down and agreed clearly define the roles and responsibilities of SG entity and its personnel Does the contracts wirtten down and agreed clearly define the roles and responsibilities of Contractor agency and its personnel Does the Contract specify who will be the Contractor Supervisor from SG side as well as the Contractor Supervisor from the Contracting agency Have you communicated the roles and responsibilities as drafted in the contract to all the personnel (who are supposed to act as per defined roles) Do you carry out the regular audits of the activities carried out by contractors at your site and record specific observations related to the awareness of employees about their roles and responsibilities as defined in the contracts Do you have a system of penalty / suspension of contract if any violations are noticed in line to the above documented contract Existence of documented and signed contracts is mandatory for all types of contracts. Mark this checklist as "Yes" only if you have documented atleast 80% of the contracts engaged during the last one year. Evidence of EHS alignment is mandatory Evidence is necessary Evidence is necessary Evidence is necessary Communication to be formal. Signatures of the responsible persons in the contract form is mandatory Monthly once audit is mandatory. Records to be checked. One year compliance is necessary to mark this as "Yes" Specific para to be included in all contracts. Implementation evidence is necessary

#DIV/0!

2 3 4

Do you carry out the regular audits of the activities carried out by contractors Monthly once audit is mandatory. It is important to include the observations & External SG companies at your site and record specific observations related related to contract status in the format used for reporting the audit. Records to the contracts as per above requirements to be checked. One year compliance is necessary to mark this as "Yes"

IV

Do the contract requirements include a 'method of work/ prevention plan which specifies risks and control measures to eliminate or reduce risk?
Linkage to sl No I-1 is necessary. Mark this checkpoint as "Yes" only if atleast Have you carried out Risk assessment (as per your entities defined Risk 80% of the activities / job tasks (as listed at I-1) are covered in Risk assessment method in ISO 14001 & OHSAS 18001) for all the activities / job assessement. Records for evidence is needed. All types of activities to be tasks that are done by outside contractors and external SG employees covered routine, non routine, one time etc., Have you prepared and documented operating procedures for all the activities OCP or SOP is mandatory for all job task carried out by contractors.Records to that are listed in risk assessment. be evidenced. Have you reviewed the risk assessment as above atleast once in a year and Records to be evidenced recorded the review observations. Have you assessed the risks related to engaging contractors and external SG employees with reference to work alone situations and implemented This should be the part of work permit. Records to be evidenced. appropriate control measures. Have you assessed the risks related to disposal of wastes generated during the This should be the part of work permit. Records to be evidenced. one time contract activities and implemented appropriate control measures. Have you assessed the risk related to the existence of muliple contracting In such situations it is mandatory to have a site co-ordination meetings agencies & multiple external SG companies within the same job task (e.g. Civil between various agencies involved.Records to be evidenced. construction activity, maintenance, erection & commissioning etc.) Have you defined and documented a JSA / Safe work method statement for all Evidence of existence of such a statement for all one time activities the one time activities / job tasks carried out by outside contractors and necessary.Mark this check point as "yes" only if compliance is atleast 80 %. External SGF employees

#DIV/0!

2 3 4

Have contractors & externally based SG employees been informed in writing of all relevant site specific hazards and risks that may impact on their employees?
Formal session is mandatory. Mark "Yes" to this checkpoint only if minimum Have you conducted a formal training on the SOPs / JSA / Method Statements 80% of the listed employees are covered in the training. to all the concerned Contractor employees and the employees of external SG This should also be part of the Permit to work. SOP / SWMS to be attached companies with the Permits Entity should have the records to evidence this system. Mark "Yes" to this Have you assessed the learning penetration for these contractor employees checkpoint only if all the Formal trainings on these SOPs are followed up with and external SG employees about these SOPs / JSA / SWMS a Test to check the learning penetration. Contractors should have signed the SOP / JSA / SWMS communication register Have you assessed and communicated the hazards and risks associated with the job tasks done by contractors and external SG employees Do you make sure that the Contractor communicates the hazards and Risks assoiated with the tasks to his employees the same way as you have communicated to him Do you carry out the regular audits of the activities carried out by contractors at your site and record specific observations related to the awareness of employees about the hazards and Risks associated with their tasks This should be the part of work permit. Records to be evidenced. Records to be evidenced. SPOT audits to be carried out to check the level of penetration on controls Monthly once audit is mandatory. Records to be checked. One year compliance is necessary to mark this as "Yes"

#DIV/0!

VI

Is there a specific requirement in the contracts that all contract and sub contract employees & externally based SG employees have sufficient training and experience to carry out their work safely?
Have you assessed the job tasks that are likely to be contracted out (both routine and non routine) in your entity and prepared a list of acceptable competencies for each. Have you assessed the job competencies of the contractor employees engaged by you prior to their engagement on the job / task (This is to determine the competency of each employee of the contractor - his / her ability to do work safely - to provide for training where needed) The list of job specific competencies that are necessary to carry out the task should be prepared. Critical competencies (Must Posses types) need to be defined in this list. The minimum acceptability criteria for each job task should be defined. Mark this checklist as "Yes" only if you have covered atleast 80% of the contracted job tasks Existence of specific job related checklists for assessment of knowledge / skill level of each contractor employee prior to his / her employment on the job task.

#DIV/0!

Have you assessed the EHS capabilities of all your contractors prior to Prior approval of Contractors w.r.t EHS is mandatory. Mark this checklist as engaging them as per the criteria set forth in your Management System (This "Yes" only if you have assessed atleast 80% of the contracts engaged during is to assess the preparedeness / capability of the contracting agency to deliver the last one year. Evidence of this assessment is mandatory the results safely) Have you re-assessed the EHS capabilities of all your contractors after engaging them as per the criteria set forth Have you assessed the job tasks that are likley to be sub contracted to 2nd / 3rd level contractors by the main contractor (include all potential cases) As a principal employer, do you have a system of collecting & recording the contracts between the main contractor & his 2nd / 3rd level sub contractors Have you assessed the EHS capabilities of all your sub contractors (2nd / 3rd level) prior to engaging them as per the criteria set forth at B-3c above Periodic updation of approval of Contractors w.r.t EHS is mandatory. Mark this checklist as "Yes" only if you have assessed atleast 80% of the contracts engaged during the last one year. Evidence of this assessment is mandatory Existence of list of job tasks along with the potential for sub contracting certain activities within a contract These records are mandatory to be kept for a period of 3 years. Mark this checkpoint as "Yes" only if you have this complied for all cases Prior approval of Contractors w.r.t EHS is mandatory. Mark this checklist as "Yes" only if you have assessed atleast 80% of the contracts engaged during the last one year. Evidence of this assessment is mandatory Periodic updation of approval of Contractors w.r.t EHS is mandatory. Mark this checklist as "Yes" only if you have assessed atleast 80% of the contracts engaged during the last one year. Evidence of this assessment is mandatory

Have you assessed the EHS capabilities of all your sub contractors (2nd / 3rd level) after engaging them as per the criteria set forth at B-3d above

Do you have a system of rejecting the employment of a contractor employee if This should be part of the procedure in the Documented Contractor competency gaps are found in Critical areas (ie. must posses types) Management System. Evidence of implementation is important

VII
1

Is there a requirement that all tools, equipment and materials brought onto site will be used in compliance with local legal and company requirements?
List should include both powered and non powered tools and equipment. The Have you prepared a list of all the tools and equipment that are expected to list needs to be exhasutive - categorise in to powered and non powered, hand be used by the Contractors for carrying out the tasks tools as well as others Each category of tools and tackles should have a specific checklist for assessing Have you assessed the risks related to the use of tools and equipment used by the hazards and risks. Specific checkpoints to be listed out. A format is contractors suggested for standardisation Have you authorized in writing or through labelling the tools and equipment This should be part of the work permit system. Each equipment that is used by used by contractors. the contractor need to be pre authorised before its use Have you checked the statutory requirements that need to be complied for each tool and tackles used by contractors (even if it is provided by SG entity) Have you identified and listed the specifications for the different PPEs to be used for all job task carried out by contractors. Do you verify through a formal mechanism the compliance to the usage of PPEs by contractors. Have you identified and communicated the areas for storage of materials, equipment, tools and tackles, uniforms, PPEs used by contractors. Checklist to be evidenced, Work Permit format should have a checkpoint Mark this checkpoint as "Yes" only if atleast 80% of the activities / job tasks are covered in PPE assessement. Records for evidence is needed Specific PPE compliance audits at least once in a quarter is necessary. The compliance audits to cover appropriate usage,storage,maintenance and condition of the PPEs. Observations to be recorded as evidence. Physical evidence should be there. Checklist for PPE verification is mandatory Verification of the PPE condition and recording the observations is necessary PPE check before start of work is mandatory for certain PPE's used for hazardous / dangerous tasks

#DIV/0!

2 3 4

Do you carry out the PPE fitness checks and have you maintained the records of such inspections

VIII
1 2 3 4 5

Is a there a named company representative who is responsible for monitoring and reviewing the EHS arrangements of all contract work?
Have you identified and nominated a person as responsible for Contractor management within your entity Have you defined the roles and responsibilities for this function and documented the same in your management system procedure Have you communicated / Formally trained the nominated person(s) about the roles and responsibilities Have you defined the competencies required for that job task to be carried out by the nominated person Have you assessed the competencies of the nominated person w.r.t the set skill sets. It is necessary to nominate a person formally for Contractor management within the entity. Evidence of existence of such a document is necessary. The roles and responsibilities should include all the requirements of contractor management Formal session is necessary with assessment of learning penetration Evidence of having job specific competencies is necessary; the acceptable competancy levels to be defined Evidence of having done the assessment is necessary

#DIV/0!

IX
1

Does the company representative review the Method Statement / Prevention plan (recorded) before work on site is started?
Have you defined as a part of the roles and responsibilities of the nominated person(s) for contractor management, the review and issue of the SOP / Safe Work Method Statement for the job task contracted Does the nominated person review and initiate the Safe Work Method statement for each contrcated task for getting the approvals of the plant manager Is the safe work method statement signed and countersigned by both the noiminated person as well as the contractor Is the Safe work method statement reviewed as per the progress of work Does your internal audit on the contractor management system verify the compliance to the requirement of SWMS The review of the SWMS should be one of the important assignement of the nominated person. This should be documented in the management system SWMS / JSA itself should have a provision for recording the review of the same. Check the SWMS for all contract works to verify compliance to this requirement Evidence is necessary. Check the SWMS Evidence is necessary. Check the SWMS Monthly once audit is mandatory. Records to be checked. One year compliance is necessary to mark this as "Yes"

#DIV/0!

2 3 4 5

X
1 2 3

Does your procedure require that the method statement / Prevention plan must be reviewed and approved by the local responsible manager?
Is the Documented management System for Contrcator specify the approval criteria for the risk assessment as well as the safe work method statement Evidence is necessary. Check the Documented System. The second reviewer and approver should not be the same person as nominated person

#DIV/0!

Are the roles and responsibilities for the review and approval of the risk Check the management system procedure assessment and the SWMS clearly defined Are the Safe Work Method Statements duly approved as per the written down Check the SWMS of the contracted activities procedures

XI
1 2 3

Is a list of persons in charge of approving the method statement/ Prevention plan clearly defined and are they trained?
Do you have the list of persons who are authorised to approve the Safe work method statement Are the persons so identified for reviewing and approval of SWMS formally trained on reviewing and approving the Safe Work Method statement. Does your internal audit on the contractor management system verify the compliance to the requirement of SWMS Is your SWMS / JSA clearly define who are the persons responsible for supervision of various job tasks listed under the SWMS / JSA Are the persons so nominated communicated about the requirements of the SWMS / JSA Have you defined the Do's and Don'ts related to the Supervision of work related to contracted tasks Have you trained your supervisors on the requirement of such a plan List and notification is necessary Formal training is mandatory. They should be aware of what SWMS is and what are key thinkgs he / she should check Monthly once audit is mandatory. Records to be checked. One year compliance is necessary to mark this as "Yes"

#DIV/0!

XII
1 2 3 4

Is an appropriate supervision plan defined according the risk analysis of the work and of the contractors?
Evidence is necessary Formal communication is necessary. Evaluation of their understanding is important. Evidnce of penetration is to be checked This should be documented as a procedure / checklist. Please note that each task will have a different set of supervsion requirements. Evidence of formal training is necessary

#DIV/0!

XIII
1 2 3 4

Does your procedure require specific supervision according to this standard concerning all activities of work at height or excavation conducted by contractors or external SG Employees?
Have you prepared the list of activities that will require continuous supervision Have you made it mandatory for the physical presence of SG supervison during high risk activities like height work and excavation.. All high risk activities will require continuous supervision - Height work, Dangerosu tasks, Confined place entry etc., Evidence in the form of a system procedure. Evidence in the form of work permit notings

#DIV/0!

Is your work permit for high risk activity indicate the names of the people who Evidence to be checked will be SG supervisors during the carrying out of the task Have you defined the contingency supervision plans for high risk activities carried out by contractors to take care of potential conditions Does your internal audit on the contractor management system verify the compliance to the requirement of supervision and verification of permits Check for contingency plans for Change in shift, Emergencies, Lunch / Tea breaks, Multiple task supervision etc., All High risk activity audits are mandatory. Records to be checked. One year compliance is necessary to mark this as "Yes"

XIV
1

Are there specific arrangements for the provision of first aid and any other emergency response that may be required?
For all contracted job task, have you provided for - safe drinking water,first aid This should be part of the written contract or work permits, The format should facilities,toilets,urinals and rest rooms,eating place at the site of work. Have explicitely spell out these parameters and location where these are available you communicated this to the concerned contractors. As a part of the contract, have you defined the emergency response requirements Do you make sure that the contractor ensures atleast 15% of his employees to be trained in First aid and Fire fighting. Do you train the employees of contractors also in Emergency response. If so, have you done any training in the last one year Have you made provisions for Firt aid boxes with appropriate medicines at locations where one time activities of contractors are carried out - example a construction site In case of construction sites engaging contractors beyond 20 people at any given point in time have you made temporary provisions for safe drinking water, toilets and eating place In case of construction site, do you make sure that first aid box and adequate no of Fire extinguishers are available within a distance of 30 mtrs from the location of work This should be part of the written contract or work permits, The format should explicitely spell out these parameters and location where these are available Evidence is necessary. List should be prepared and displayed or made known. Identification of such ERT members should be easier Evidence is necessary. The ERT ,members should have been trained before Evidence is necessary

#DIV/0!

2 3 4 5

Check for contracts, physical evidence where possible

Evidence of availability, appropriateness

8 9

The ambulane should be full fledged. This is mandatory for any construction In case of a construction site, do you make sure that an emergency Ambulance site. The fitness of the ambulance to be checked by the contractor supevisor is available & reach the site of incident within 2 minutes nominee Do you carry out Mock drills to check Emergency response preparedeness Mock drill reports to be evidenced

XV
1 2 3 4 5 6

Does your procedure require that all significant incidents including personal injury, fire, environmental incidents, exposure to asbestos, vehicle overturns and failures of lifting equipment etc are reported?
Do you record the accidents and incidents involving contractor employees. Have you carried out detailed Root cause analysis using 6M investigation method for All Lost time accidents involving contractors All non lost time accidents involving contractors All First Aid cases involving contractors. Evidence of reporting upto TF3 mandatory Records to be evidenced Records to be evidenced Records to be evidenced

#DIV/0!

7 8 9

Records to be evidenced Evidence of reporting TF4 and TF5 cases from Contractor employees is Are your contractor employees encouraged to report Near Misses and Unsafe necessary. There has to be an evidence for recording data for atleast one year act / Conditions. Are they reporting these to mark this as "Yes" Evidence of reporting Environmental Events / Incidents from Contractor Are your contractor employees encouraged to report Environmental incidents. employees is necessary. There has to be an evidence for recording data for Are they reporting these atleast one year to mark this as "Yes" Have you implemented corrective & preventive measures on all the accidents Records to be evidenced & incidents leading upto TF3 involving contractors. Have you reassessed your risks in risk assessment / JSA / Safe work method Records to be evidenced statement after the occurrence of accidents or incidents involving contractors.

XVI
1

Is there adequate control procedure to ensure that no-one can work on site without an authorised site safety induction?
Do you have a mandatory Safety Induction for all the employees of contractors before they are authorised to work inside your entity Does your management system procedure consider the safety induction training for all contrcator employees and defined the responsibilities and process flow Existence of a contractor safety induction module including Mandatory Safety instructions is a must. Evidence of having done the induction to all contractors before authorising them to work should be recorded This should be defined as a part of the management System procedure. Person(s) identified for each stage - starting from entry at gate, to issue of passes to induction training and then posting on job should be notified and responsibilities defined for each stage

#DIV/0!

Does your work permit include specific clauses about the Induction training of each individual employee covered under the work permit and bar anybody Check the work permit system and formats for compliance from getting posted on the job if he / she is not inducted on safety Records of such training to be evidenced. Interview the SG employees who have contractors working under them or those who issue work permits about their involvement in this safety induction process. Mandatory safety induction is different from Work permit - hazard - Risk communication. mark "Yes" if this is implemented for atleast one year All High risk activity audits are mandatory. Records to be checked. One year compliance is necessary to mark this as "Yes"

Have you identified and trained the concerned SG employees who are incharge of alloting various works to the contractors about the necessity of safety induction and the content of safety induction Does your internal audit on the contractor management system verify the compliance to the requirement of safety induction

XVII
1 2 3 4

Are contractors and their employees & externally based SG employees informed (records required) of the types of activities that are prohibited on site without a 'Permit to Work?
Have you listed and notified as per the work permit standard, all the activities that require Permt to Work in your entity Are the employees (both SG as well as Contractors) aware and clear about the work permit requirements Have you notified / displayed at your sites prominently, the works that can not be taken up without a Valid Work Permit Have you trained all your contractors (agencies) on the work permit requirements Procedure and list is necessary Interviews to check awareness List and Display to be notified. Communication to all concerned about this is mandatory Formal class room session with records is mandatory

#DIV/0!

Monthly once audit is mandatory. It is important to include the observations Do you carry out the regular audits of the activities carried out by contractors related to the status on work permits in the format used for reporting the at your site and record specific observations related to the work permit status audit. Records to be checked. One year compliance is necessary to mark this as "Yes"

XVIII Is every contract employee who works on site given a recorded site safety induction by an authorised company representative?
1 2 a b c 3 Have you implemented a system of communicating to the identified SG personnel for contractor safety induction about the arrival of the new contractors at site who require safety induction Are the following details part of your Safety Industion training of contractor employees Training the concerned employee on General EHS awareness related to your entity - Mandatory Safety rules Check the process implemented. Carry out SPOT audits to verify the fool proof system Records as evidence is necessary for a,b & c below

#DIV/0!

General orientation including the internal requirements of your entity. Minimum coverage should be in line with the Delegation EHS guideline EHS-G002 clause no 4.6. Training on job specific SOP / Safe Work method statement / Job Safety Records to be evidenced.Mark this checkpoints as "Yes" only if 80% of such Assessment contractor employees are covered . Training on appropriate use, storage & maintenance of Job specific PPE's & Records to be evidenced.Mark this checkpoints as "Yes" only if 80% of such safety tools & tackles contractor employees are covered. For those contractor employees who have continued to work on job tasks for Records as evidence is necessary. Mark this checkpoints as "Yes" only if 80% of more than one year, have you provided refresher training on the above topics such contractor employees are covered under refresher training. at 1 a, b & c once in a year Do you carry out the regular audits of the activities carried out by contractors at your site and record specific observations related to their safety induction Monthly once audit is mandatory. It is important to include the observations related to their safety induction in the format used for reporting the audit. Records to be checked. One year compliance is necessary to mark this as "Yes"

XIX
1 2 3

Are there procedures to ensure that temporary or agency staff do not work on contracts without an appropriate site safety induction?
Have you defined and documented a similar procedure as per the above requirements to cater to the safety induction of "White Collared" Contracts - Documented procedure and process defined for implementation is necessary Office, IT, Design, R&D etc., Have you prepared a set of mandatory rules to be followed as well as the EHS Records to be evidenced requirements of the job itself for these tasks Shuld be part of Day 1 agenda for all these employees. Records to be Have you trained and recorded the trainings carried out on induction maintained. Mark "Yes" if the system is in place for atleast one year Monthly once audit is mandatory. It is important to include the observations Do you carry out the regular audits and record specific observations related to related to their safety induction in the format used for reporting the audit. their safety induction Records to be checked. One year compliance is necessary to mark this as "Yes"

#DIV/0!

XX
1

In case of plant equipment shared with a contractor, is there a written authorization with a safety condition check before and after the work ?
Do you record the description of the tools, equipment, infrastructure or PPE (belonging to Saint-Gobain entity) that is handed over to contractor for executing a task, in the work permit form Have you assessed the risks related to the use of such tools and equipment (belonging to SG entity) by contractors Have you authorized in writing or through labelling the tools and equipment used by contractors. Do you check the condition of the tools and tackles at the end of the task before it is taken back to custody of SG entity Do you verify the compliance to this requirement through a periodical audit This detail if applicable should be clearly reflected in the work permit format. This should also include the comments about the environmental conditions Each category of tools and tackles should have a specific checklist for assessing the hazards and risks. Specific checkpoints to be listed out. A format is suggested for standardisation This should be part of the work permit system. Each equipment that is used by the contractor need to be pre authorised before its use Checklist to be evidenced, Work Permit format should have a checkpoint Evidence is necessary. Monthly audits are recommended

#DIV/0!

2 3 4 5

XXI
1

Do procedures require appropriate controls to be put in place (such as barriers) to ensure that employees do not enter into hazardous areas whilst contractors are undertaking their work?
The list needs to be comprehensive. Should be detailed with location, nature Do you have the list of access controlled areas that are hazardous and require of access etc. All access controlled areas to be lsited (roof access, access to prior authorisation to enter hazardous areas, silo tops, conveyor bottoms, control rooms, substations,..) Are all these locations appropriately marked as "Entry Prohibited without authorisation" with a Danger symbol. Does your work permit format specify the prohibition of entry of contractors employees to access controlled areas Are the contractor empoloyees made aware of the access controlled areas through a formal session (pep talks / communication of hazards and risks etc as a part of the work permit) Are there physical barriers installed at every access controlled areas to prevent contractors from entering / accessing these areas (intentionally or otherwise) Check for compliance. Mark "Yes" only if more than 80% of the locations are covered. Local language is also necessary Check for inclusion of this specific clause Check for compliance. Work permit register to include the communication details Check the locations and physical barriers, mark "Yes" only if there are physical barriers in more than 80% of locations

#DIV/0!

2 3 4

XXII Is there a system in place to record who of the contractors team & externally based SG employees is on site on each day?

#DIV/0!

Do you have a written down procedure for Gate Entry and Exit systems for outside contractors working at your facility Are the personnel manning the Main gate, other gates and exit points made aware of this written down system procedure Do you record the details of all the contractors as and when they enter the entity Do you record the location where they are expeted to work as a part of the gate entries

2 3 4

Written down procedure is mandatory, clearly reflecting the Entry and Exit process, Gate pass, request for Entry, authorisation for entry, duration of stay, location of work etc., Specific responsibilities for entry and exit process should be clearly documented Formal training is necessary. Records of such training to be evidenced. The procedure copy should be kept at these locations for their reference - local language if needed. Understanding is critical Compliance to the written down procedure is important. Check the details Check the details. It needs to be recorded

This is critical for emergency situations. This record to be available at the gates Do you know at any point of time, how many persons are inside your premises instantly. The time for data retreival should be less than one minute. Mark this and their whereabouts as "Yes" only if the one minute deadline is complied Do you carry out specific compliance check audits where contractors are normally engaged to verify the alignement to ID card / Gate pass / Work permit / Access controls. Observations to be recorded. This compliance check should be done atleast once a week in sample areas. Mark "Yes" only if this is practiced for atleast one year

XXIII
1

Is there a risk review of the contract to ensure that relevant SG employees are advised of the presence of contractors & externally based SG employees and the nature of their work?
Check the format and system. It is necessary to have the signatures of the Does your work permit require the authorisation from the incharge of the area area inchrage before the start of the work. This is required a communication where the work is going to take place before the start of the work tool. All PTW forms should have this checkpoint Does your daily / shift pep talks communicate to the other employees working This is mandatory. Check for compliances. Verify the pep talks by particpating in that location about the upcomming job task handled by contractor in them employees Does your employees give the feedback on the activities that are carried out Records of such suggestions to be evidenced. Written records necessary by contractors in their areas for improvements Do you take corrective actions and review the risks as per the suggetsions / Records to be evidenced feedbacks given by employees

#DIV/0!

2 3 4

XXIV
1 2 3 4 5 6 7

Are there records of the monitoring of the work of contractors & externally based SG employees on site to ensure that EHS procedures and requirements are being followed? (e.g. SMAT's)?
Do you have the list of SMAT schedules on contracted activities for the last one year Have you actualised atleast 80% of the planned schedule Are there observations arising pout of SMAT interactions Do the area incharge / the Permit / contract process owner accompany you when the SMAT interaction is done Are the points realised in SMAT on contracted activities discussed with the area incharge / the PTW / Contract process owner and the process owner agrees to correct the conditions Do you track the closing of the observations related to the SMAT done in contracted activities separately Does your management review discusses the Leading Indicator of SMAT done on contracted activities separately List should cover all areas and activities. Monthwise and personwise schedule Check for the actualisation, Minimum 80% of the schedules should be complied to mark this as "Yes" Check the reports for completeness. All the three observations should exist (Positive, UA and UC), Minimum 30 minutes of interaction time should have been spent per SMAT. Mark "Yes" only if this is adhered to in more than 80% of SMAT's Mark "Yes" only if this is adhered to in more than 80% of SMAT's Mark "Yes" only if this is adhered to in more than 80% of SMAT's This needs to be separate leading indicator. Not to be clubbed with the overall SMAT indicator

#DIV/0!

XXV At the end of contract work is there a procedure to ensure that the area has been left in a safe condition?
1 Do you have a work permit closure verification system implemented in your entity This needs to be done at the end of the task. The permit issuer and the process owner of the area should visit the area of work and verify the conditions before the PTW is closed. Mark "Yes" only if this is complied in more than 80% of cases

#DIV/0!

2 3

In case of long term contracts (like in civil works, installtion of equipment etc), Records of such inspection to be evidenced do you check the site at the end of work Do you carry out housekeeping audits in the areas where the contractors are Physical evidence should be there.Records of such audits to be evidenced. permitted to store their material In case of one time activities do you check the area of work for its upkeep and left over risks before authorizing the permit closure every day (example Hot This should be the part of work permit. Records to be evidenced. works in a construction site, scaffold condition at the end of the day, ) Do you inspect and record the observations related to use of equipment, Tools and PPE used by contractors before start of work every day and at the end of Check for compliances. Recording in PTW is mandatory work every day.

XXVI

Is there a review of the success or otherwise of the control of contractors & externally based SG employees procedure as part of the site safety management system?
The list should include all thye Management & Staff employees who have Have you prepared a detailed list of all the Management and Staff employees contractors working for them or in their departments. This can be in an excel within your entity who engage / supervise contract labour. format. The list should include the Function, Name of employee, Contracted task under his / her supervision. The list should be updated and always kept current. Quarterly review of this Have you kept such a list always updated & Current list is Mandatory Have you developed a Training calendar & Schedule for for training the Management & Staff employees as per the list prepared above. Existence of a Training calendar & schedule, No of employees to be covered, Trainer, Method of training, etc., need to be recorded and be available

#DIV/0!

2 3

Formal session is mandatory. All the Management and Staff employees who Have you conducted a formal training on this CSG Standard and Delegation are listed in the inventory as at sl no 1 above to be covered in this session. guideline covering all the Management & Staff employees listed as at Sl no A1 Mark "Yes" to this checkpoint only if minimum 80% of the listed employees above are covered in the training. Entity should have the records to evidence. Have you assessed the learning penetration for these Management & Staff employees about this standard & guideline Have you set the Minimum Pass %ge for such a learning penetration test & is it 80% Has your entity retrained the employees who have not passed with the requiste minimum pass score of 80% again within a stipulated time frame of three months Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the Formal trainings on this standard are followed up with a Test to check the learning penetration An after the session test / written questionnaire with minimum pass marks (80% as pass marks) is mandatory. Entity should have the records to evidence this system. Anybody failing to score 80% should be taken through the learning module again as a retraining mechanism. Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the retrainings are completed

10

11

12

13

Is your Plant manager, Operational heads & other Management & Staff Mandatory formal training on Contract labour act is essential for all these employees as per list at 1 above formally trained on requirements of Contract category of employees. Mark "Yes" to this checkpoint only if minimum 80% of labour act the listed employees are covered in the training. Entity should have the records to evidence this system. Mark "Yes" to this Have you assessed the learning penetration for these Management & Staff checkpoint only if all the Formal trainings on this standard are followed up employees about the Contract labour act requirements with a Test to check the learning penetration An after the session test / written questionnaire with minimum pass marks Have you set the Minimum Pass %ge for such a learning penetration test & is (80% as pass marks) is mandatory. Entity should have the records to evidence it 80% this system. Anybody failing to score 80% should be taken through the learning module Has your entity retrained the employees who have not passed with the again as a retraining mechanism. Entity should have the records to evidence requiste minimum pass score of 80% again within a stipulated time frame this system. Mark "Yes" to this checkpoint only if all the retrainings are completed The list should have - Name of agency, no of employees, contracted task, Have you prepared the list of all the contractor agencies working inside your license number, License validity date, whether is a sub agency, applicability of entity PF, ESI, WC etc., It is mandatory to maintain this list for each section / department where Does the list of contractors as at sl no 5 above maintained at each section / contractors are normally enagaged. This should be evidenced at each section / department where the contractors are normally engaged department. Mark this checkpoint as "Yes" only if this list is existing at all departments / sections within your entity Do you carry out specific audits for determining the compliance to requirements under the Contract Labour Acts Do you conduct internal audits in the areas / job tasks being done by outside contractors Do you conduct PeP talks / tool box talks etc. at the beginning of each shift engaging all contractor employees. Do you have specific EHS committees involving contractor employees for discussing issues related to EHS. Does these EHS committees meet on monthly basis and meeting minutes are recorded and acted upon. Have you implemented measures aimed at checking medical fitness of contract employees with reference to as per statutory requirement for canteen employees vision test for Crane and FLT operators. Audiometry for persons exposed to noise Fitness check for high risk activities like height work, confined space etc. Quarterly audits to verify the compliances is necessary. Compliance to follow a specific checklist - License validity, Task validity, Muster rolls, Wage registers, Wage disbursemens, Minimum Wages, PF, ESI / WC remittences etc., . The records of such audits to be maintained for evidence (for 3 years) Monthly assessment is mandatory. Records to be evidenced ( logbook) EHS committee involving contractor employees, their supervisor, SG representatives is mandatory. Records to be evidenced.

14

15 16 17 18 19 a b c d 20

Records to be evidenced. Records to be evidenced. Records to be evidenced. Records to be evidenced.

Have you included the statutory compliance of contract labour act and rules in Records to be evidenced. the EHS review by your plant head atleast once in a quarter.

Overall Compliance %ge

#DIV/0!

0% 20% 40% Yes No Not Applicable 60% 80% 100%

0 0 0 0 0 0

SAINT-GOBAIN STANDARD Work Permit Standard

S No
I
1

Theme Question

Requirement in Detail

Compliance

GAIA score
#DIV/0!

Has your Risk assessment identified all high hazard situations where a Permit to Work may be required?
Have you prepared an inventory / list of all activities that require Permit to Work authorisation Have you carried out Risk assessment (as per your entities defined Risk assessment method by the CSG or as in ISO 14001 & OHSAS 18001) for all the activities / job tasks that require work permits Have you reviewed the risk assessment as above atleast once in a year and recorded the review observations. Have you assessed the hazards and risks related to the use, handling and storage of tools, equipment, material handling equipment, PPE's, Safety gadgets etc., that are necessary for carying out of the activity Have you assessed the risks related to work permits in work alone situations and implemented appropriate control measures. Have you assessed the risks related to work permits that are extending in to night shifts Have you assessed the risks related to disposal of wastes generated during the carrying out of assigned job task and implemented appropriate control measures. The entity should have a list of all such activities possible at its facility. Activities / tasks under Routine, Non Routine, One time works, works carried out by external aganecies, Maintenance works etc., should be part of the list. Linkage to sl No B-1 is necessary. Mark this checkpoint as "Yes" only if atleast 80% of the activities / job tasks (as listed at B-1) are covered in Risk assessement. Records for evidence is needed Records to be evidenced This should be recorded as a part of Work permit format. Hazard identification, Risk assessment and identification of control measure should be recorded in the work permit This should be the part of work permit. Records to be evidenced. This should be the part of work permit. Records to be evidenced. This should be the part of work permit. Records to be evidenced.

2 3 4 5 6 7

Have you assessed the risk related to the existence of muliple agencies within In such situations it is mandatory to have a site co-ordination meetings the same job task (e.g. Civil construction activity, maintenance, erection & between various agencies involved.Records to be evidenced. commissioning, Electro-mechanical maintenance etc.) For one time activities and job task, have you provided for - safe drinking water,first aid facilities,toilets,urinals and rest rooms,eating place at the site This should be the part of work permit. Records to be evidenced. of work. Have you communicated this to the concerned employees identified in the work permit. List of breakdown tasks that are low risk to be defined. For attending to low Have you assessed the risks related to certain emergency breakdown risk breakdown conditions, evidence of having used one minute to think conditions that need to be addressed on priority and put in place a safe checklist is important. This should be associated with the breakdwon slips. documenting mechanism for attending to such events All employees who are on the maintenance jobs (only SG employees) need to be trained.

10

II
1

Do you have a Hot Work permit system that meets the requirements of the SG Risk Prevention Manual?
Do you have a separate Hot work Permit that is issued for all Hot works Welding, gas cutting, fabrication etc., the permit system for Hot work can be separate format of can be inlcuded in a global work permit form too. However, all the requirement of Hot work need to be included, check for details

#DIV/0!

If you have a separate and dedicated fabrication area where outsourced It is necessary to issue specific task based hot work permits here also. Check employees or even the SG employees work on fabrication tasks, do you issue for site compliances specific Hot Work permit for the tasks entrusted to them Are the persons who authorise the Hot work permits duly nominated by the plant manager and have they been trained in hot work permits - hazards, risks and controls Does your hot work permit syste prohibit any work beyond 8 hrs duration and if on extension not beyond another 8 hrs maximum List of people authorised to approve the hot work permit should exist. These persons should have been trained. Evidence required

3 4

8 9 10

Since the hot work has potential risks, 2 hrs time is necessary for fire watch Does your hot work permit provides for a cool off period of 2 hrs for ensuring after the closure of the permit. Example if the permit is issued till 5 pm, safe closure of the permit after a fire watch facility should have a fire watch till 7 pm and permit can be closed only after 7 pm. Does your hot work permit procedure prohibits issuing hot work approvals 2 Check the procedure, Check the evidence in the form of start time of the hrs before the scheduled close of the working shift. permits If you have a sprinkler or fire hydrant positined in the area where the hot work is proposed to be done, does your procedure on hot work prohibit the Check the procedure. Check the linkage to the formats and entries start of work if the sprinkler or the hydrant or the extinguishers are in impaired condition When you carry out the hot work, does your permit prohibit storage of any Check the procedure. Check the linkage to the formats and entries combustible material in 10 mtr radius around the area of work Does your hot work permit seek checking the explosive nature of any pipes Check the procedure. Check the linkage to the formats and entries or atmosphere in the area where work is proposed Does your hot work permit specify which type of fire extinguishers are to be used, where they are available, location of alarm call point etc., Check the procedure. Check the linkage to the formats and entries

11

12

Does your hot work permit entries and the work practice indicate the frequent water wetting of the area around the hot work area to cool the hot Check the procedure. Check the linkage to the formats and entries fragents, cinders etc., during the progress of work, Does your hot work permit specify the name of the perosn who will inspect the area of work every 1 hour for a duration of 3 hrs or permanently Check the procedure. Check the linkage to the formats and entries stationed at that location for 1 hr post completion of the work as a fire watch Is the person so nomianted as a Fire watch, duly trained in fire intervention Have you recorded the Fire watch inspection notes in the work permit form for all hot work permits Check the training and awareness Fire watch has to record his inspection notings at the end of 2 hrs of work completion in all hot works. He / she has to inspect the facility at freequent intervals and record the observations at the end of 2 hrs. This is mandatory compliance to Risk Prevention Have you made Hot Work permits applicable to everyone, whether the work Check the system in place. All work permits to be applicable to all category of is carried out by SG personnel or by contracted workforce employees,

13

14

15

III
1 2 3 4

If you have identified potentially hazardous Confined Spaces do you have a suitable Permit to Work Procedure?
Have you identified all the confined places in your entity that require specific confined place entry permit Have you identified and nominated a competent person for authorising the Confined Space entry permit Do you have gas monitoring devices for determining the levels of gases in these confined spaces Do you have a separate Confined Space entry work permit Check for the list. Check the identified competencies, Check for training to bridge the gaps Check the instruments, Check the calibration status Check the format

#DIV/0!

5 6

Do you make it mandatory for the presnece of SG supervisor continuously at Check the procedure, Check the evidences in the permit forms the time of work inside the confiend space Do you record entry and exit times for the personnel Check the evidences

IV
1 2 3 4 5

Do you have a Permit to Work procedure to cover complex energy isolation systems. (Over 3 sources of energy isolation)?
Have you identified and listed all the energies that are used in your entity that require isolation work permit (LOTO permit) Have you identified and nominated a competent person for authorising the Energy isolation work permit Does your procedure for LOTO work permit define the sequence / steps to be followed for de-energisation and re-energisation Does your LOTO work permit require prior authorisation from the concerned process owner before de-energisation and re-energisation Do you have a separate LOTO work permit Do you have a separate work permit system for taking up work on electrical instalations Have you identified and nominated a competent person for authorising the Electrical work permit Does your procedure for Electrical work permit define the sequence / steps to be followed for de-energisation and re-energisation Does the format for electrical work permit contain information about the specific control requirements related to electrical emergencies while carrying the task Have you carried out the Arc Flash assessment of all your electrical installations - HT as well as LT Have you displayed the Arc Flash control requirements on all panels & swiching stations Does your electrical work permit specify the Arc Flash PPE that needs to be worn Check the list Check the identified competencies, Check for training to bridge the gaps Check the format Check the procedure, Check the evidences in the permit forms Check the evidences

#DIV/0!

V
1 2 3 4 5 6 7

Do you have a Permit to Work for electrical Work on High Voltage or near live electrical equipment?
Evidence required Evidence required Evidence required check the format Evidence required Evidence required Evidence required

#DIV/0!

VI
1 2 3 4 5

Do you have a Permit to Work for excavation work?

Do you have separate work permit system and procedure for Civil construction activities Have you identified and nominated a competent person for authorising the Civil work permit Does this permit define specific requirements related to Excavation in construction activities Does your procedure for Excavation work permit define the sequence / steps to be followed for excavation, shoring, mud dumping, etc., Does the format for Excavation work permit contain information about the specific control requirements related to medical emergencies while carrying the task Does your Civil Work permit contain specific information related to Scaffolds, material handling equipment, Earth moving equipment, Trucks, Heavy vehicles, JCB, Cranes, Road rollers, Hydra etc., Have you defiend and included specific approval checklists for authorising Scaffolds, Earth moving equipment etc as at Sl no 6 above in the work permit for civil works Does your work permit prohibit use of wooden supports and wooden planks in any civil construction activity as a primary control Evidence required Evidence required Evidence required Evidence required Evidence required

#DIV/0!

Evidence required

7 8

Evidence required Evidence required in the work permit format

VII
1 2 3 4 5

Do you have a Permit to Work for work on unsafe roof?

Do you have separate work permit system and procedure for working on roofs (flat roof, sloping roof, fragile roof etc., ) Have you identified and nominated a competent person for authorising the roof work permit - preferably the Plant manager Does your procedure for Roof work permit define the requirements related to Access, lifelines, safety belts, medical checks, entry time, exit times, PPE checks, supervision requirement etc., Does your roof work permit require the prior authorisation of these PPE's before start of work every time Does the format for Roof work contain information about the specific control requirements related to medical emergencies while carrying the task Does the Roof work permit require the edge of the roofs to be protected to prevent any accidental fall due to rolling over. Are these conditions respected Do you have the list of all the roofs within your entity and the access plans, nature of the roofing material, its life, hazard and risks

#DIV/0!

6 7

VIII
1 2

Have you a Permit to Work procedure to cover other high hazard and abnormal work situations?
Have you prepared & documented a Management System manual & Procedures for Work Permits at your entity Does the documented Work permit management System consist of the following List of all activities / Job tasks that require Work permits This list requires to be exhaustive. The tasks that may look routine type, but are of high risk category should be included in permit to work. Any activity which requires energy isolation should be under work permit. Similar to B-1 above List and description of different types of work permits to be used in the entity. The description should be detailed. System for combination of different types of work permits to be clearly documented. Example - (Hot+height), (Electrical + Height).. Roles and responsibilities to be clearly defined The required competencies (both technical as well as behavioral) for Permit issue and permit authorisation need to be clearly listed out. Critical competencies out of this list requires to be highlighted This list require to be taskwise / permit wise. Mark "Yes" only if both identification and competency assessment is completed Training list should cover all aspects - standard requirement to technical aspects, statutory links etc., Existence of clear and complete formats covering all aspects of Work Permits Step by step procedure is necessary with defined responsibilities and checkpoints. Do's and Don'ts to be clearly spelt out at each checkpoint The entity should have a Documented Work Permit Management system which defines various aspects of Work Permit management within the entity

#DIV/0!

b c d e f g h i

Different types of Work permits System for combination work permits Specific roles and responsibilities of Permit seeker, Issuer, Authoriser etc., System for identifying the comptencies necessary for Permit issuer and person authorising the same Identifying the personnel who are nominated as Permit issuers and Permit authorisers & assessment of their competencies Training of Permit issuer & Permit authoriser Formats for different permits Defined workflow for Work permits - starting from Permit initation till the Permit closure

j k l

List of ingredients to be recorded in the work permit format System for verification of fitness of the personnel engaged fo carrying out high risk activities under Work Permit System of communicating to the employees involved in work permit, the Hazards & associated Risks and Control measures to be followed before starting the work

List of information that need to be included in the work permit form requires to be spelt out in the documented system and should be clearly explained The list of high risk activities with checkpoints on fitness to work should be included as a part of work permit format Recording this communication is necessary, needs to be made part of work permit form.

Permit issuer should visit the site of activity atleast once to the site of activity System of verifying the compliance to the work permits during the execution and record his / her observations. In case of high risk activities, permit issuer of the work. should visit twice to thesite of activity and record his / her observations. Formal session is mandatory. All the Management and Staff employees who are listed in the inventory as at sl no 1 above to be covered in this session. Mark "Yes" to this checkpoint only if minimum 80% of the listed employees are covered in the training. Entity should have the records to evidence this system. Mark "Yes" to this Have you assessed the learning penetration for these Management & Staff checkpoint only if all the Formal trainings on this standard are followed up employees about this documented Work permit management System with a Test to check the learning penetration An after the session test / written questionnaire with minimum pass marks Have you set the Minimum Pass %ge for such a learning penetration test & is (80% as pass marks) is mandatory. Entity should have the records to it 80% evidence this system. Anybody failing to score 80% should be taken through the learning module Has your entity retrained the employees who have not passed with the again as a retraining mechanism. Entity should have the records to evidence requiste minimum pass score of 80% again within a stipulated time frame this system. Mark "Yes" to this checkpoint only if all the retrainings are completed It is mandatory to have specific and separate work permits for each of these Do you have specific and separate Work Permits for activities Work at Height (other than roofs) Records to be evidenced Have you conducted a formal training on this Documented Work Permit management System covering all the Management & Staff employees who engage contractors as per A1 above Ladders & Scaffolds Material handling equipment (Cherry picker, MEWP, JCB, Cranes, Hydra etc., ) Bulk Fuel / LPG / NG / Nitrogen / Compressed gas / hazardous chemicals unloading General Low risk non routine / one time activities that does not involve any of the above Do you issue the work permits to your own employees as well as those of contractors Records to be evidenced Records to be evidenced Records to be evidenced Records to be evidenced Evidence of having issued this to own employees is necessary for a period of atleast one year to mark this as Yes

7 a b c d e 8

IX
1

Do you have Permits to Work for contractors as required by the Control of Contractors standard?
Have you prepared an inventory / list of all activities that are carried out by engaging outside contractors in your entity that require permit to work Do you have a clause in your work permit format clearly indicating if the work entrusted is being done by contractor employees or the SG employees This list to be verified

#DIV/0!

2 3 4 5

Check for compliance, mark Yes if practiced and sustained for one year

Do you record the names of all the contractor employees who are authorised Check for compliance, mark Yes if practiced and sustained for one year to work as per the Permit to work in the permit format Do you communicate the hazards and risks associated with the task being permitted to the contractor and get his signature in the permit form before Check for compliance the start of the task Do you inspect and record your observation in the work permit form during Check for compliance, mark Yes if practiced and sustained for one year the progress of work

X
1

Is there a person nominated to be responsible for the Permit to Work procedures on the site?
Formal nomination is a must. The identified person will be responsible for making the procedure, documented systes, formats and tracking the compliances. It is mandatory to train the nominated person w.r.t the CSG standard on Have your nominated person undergone a formal training on Permit to Work Work permits. Formal session is necessary either by Sector/eStandard of Saint-Gobain learning/Delegation / any other internal mechanism Have you identified and nominated a person(s) within your entity for being responsible for implementing the work permit system within your entity Is the nominated person made responsible for preparing the documented work permit system procedures, formats, tracking systems etc., Is the nominated person responsible for conducting further trainings within your entity on Work permit system Does the nominated person analyse the implementation of the work permit system within your entity The responsibilities and roles to be clearly defined for this nominated person. Evidence of having conducted trainings is necessary Evidence of the analyses and charts / data depicting the progress of implementation, discussions in the MRM,s is necessary

#DIV/0!

3 4 5

XI
1

Do the Permits to Work and the Procedures meet the 13 key elements listed on Page 3 of the Permit to Work Procedure?
Is the validity of any of the work permit issued by your entity maximum 8 hours. Do you record the start and end times for each work permit Does your work permit format contain provisons for recording the requirements related to the following specific high risk activities Stack monitoring Access to Overhead Water storage tanks Access to any Roof top Access to any Silo top Access to Fuel storage yards Access to Bulk LPG Storage yards Access to Cooling towers Access to Electrical Substations (HT) Access to head room of Cage lifts / Passenger lifts Access to bottom of any Dock levellers / Scissor lifts / Pit & Elevators Acesss to Furnaces / Kilns / Ovens for carrying out repair or maintenance works Access to Pollution control equipment (DC System, ESP, ETP, STP, Scrubbers, etc., ) for repair or maintenance Use of Electrically operated hand tools Use of Cranes, Hydra, Container crane, Fork Lift, JCB and other bulk material loading / unloading equipment hired for use Records to be evidenced The work permit form should have a provision for all these criteria. Mark as "Yes" only if it is included in your format, "NA" if such actvity is does not exist for your entity Records to be evidenced Records to be evidenced Records to be evidenced Records to be evidenced Records to be evidenced Records to be evidenced Records to be evidenced Records to be evidenced Records to be evidenced Records to be evidenced Records to be evidenced Records to be evidenced Records to be evidenced Records to be evidenced

#DIV/0!

2 a b c d e f g h i j k l m n

o 3

Use of Cherrypickers or MEWP's

Records to be evidenced

Do you record the names of all the employees involved in carrying out the job task in the work permit form along with their age, sex, contact number & Records to be evidenced whether he / she is already aquanited with SG site / first time employed Does your Work permit format contain the provision for recording the awareness / knowledge / skill levels of the employees assigned the job task This information is mandatory to be recorded. (example - an employee asigned welding work - whether he knows the basics of welding & its Do's & Don'ts.) Do you check the fitness of the employee assigned the job task to do the Records to be evidenced; Checklists of physical and mental conditions; work prior to issuing the work permit & record such observations in the work behavioural attributes to be part of checklists. Reference to Clause 4.5.9 of permit form Delegation Guideline on Work permit to be adhered to Do you check and authorise for use the equipment like hand tools and powered hand tools that are required for carrying out the job task and record details of such equipment used in the Work permit Do you check and authorise for use the infrastructure / equipment like Compressed gas cylinders, Welding machines, Gas cutting equipment, etc., that are required for carrying out the job task and record details of such equipment used in the Work permit Do you check and authorise for use the material handling equipment like Fork lifts, MEWP, Cherry pickers, Cranes, Hydra, JCB etc., that are required for carrying out of the job task and record details of such equipment in the work permit Do you check and authorise the specific PPE's & Safety gadgets that are required to be used before isuing the Work permit. Records of such authorisation should be part of work permit. These should be included in the Equipment / Tools required section of the work permit. The information necessary to be recorded include - Name of tool / equipment, whethered powered or not, its fitness for use & Remarks These should be included in the Equipment / Tools required section of the work permit. The information necessary to be recorded include - Name of tool / equipment, whethered powered or not, its fitness for use & Remarks These should be included in the Equipment / Tools required section of the work permit. The information necessary to be recorded include - Name of tool / equipment, Capacity, its fitness for use & remarks It is important to note that this is different from recording the PPE required section. The intention is to check the appropriateness of the PPE provided & its suitability before the start of work. Records to be evidenced

9 10 a b c d e f g h i j k l m n o p q r

Does your work permit form specifically record the following details Brief description of the activity / task being permitted Check the form and compliance Location where the activity is being permitted to take place Assessment of Specific hazards and risks associated with the task Permit administration process flow - from permit seeking to authorisation Clearly defined process flow to be depicted in the format to permit closure and post completion audits Name and signature of the Seeker Name and signature of the Permit Issuer Name and signature of the Person authorising the permit Plant manager in case of high risk permits like roof work, confined place work, etc.,

Name and signature of the person incharge of the area where the work permit task is being executed Name and signature of the permit holder / permit owner Description / listing out of any specific tests that need to be carried out Confined place, PPE tests, etc., Emergency response requirements, location of first aid, drinking water, In case of emergency resulting in evacuation, the permit should be cancelled toilets / rest rooms, fire fighting systems availability etc., and fresh permit to issued after all clear signal is given Ability to transfer the authorisation to close the permit to another person (other than the one who issued the permit) Audit remarks SMAT remarks Permit cancellation remarks and signatures Post completion of the task, fire watch audit comments Space for recording any unsafe acts / conditions noticed by the permit holder Space for recording the left over risks / hazards at the end of the task. This to be used for cross referencing for next days permit

XII
1 2 3 4 5

Does the Permit to Work procedure require that the permit to work for each work on the unsafe roof must be validated by the plant manager or his Authorized deputy and the Authorized agent of the contractors?
Does your plant manager authorise the work permit for any entry to the roof. Is the Plant manager formally trained on the Working at Height Standard and the work permit system for roof work Does the safe work method statement for working on roofs validated / authorised by your plant manager Does the plant manager review the work permits issued for accesing and working on roofs every month in his / her operational meetings. Are there minutes / indicators of such preview Have you mock tested the access restrictions to roofs during the last one year atleast twice Check for compliance, mark yes if sustained for one year Evidence is necessary Evidence is necessary Evidenceof having discussed this is necessary Evidence is necessary

#DIV/0!

XIII
1 2

Are copies of old Permits to Work retained for at least 2 years to enable audits of the system?
This is mandatory. The original copy of the work permit issued to the Do you get the original work permit issued to the permit holder back with all permit holder should be kept as a recorded evidence of work completion & the above comments and maintained records permit closure. Do you retain the copies of the work permits for atleast 2 years or as per the Check for compliance, mark yes if sustained for 2 year local laws whichever is longer Do you make an analysis of the work permit effectiveness and track the results in your MRM as leading indicator of progress Categorywise listing of PTW issued, No of hrs on PTW, No of people working on PTW, No of hazardous tasks carried out, No of PTW cancelled, No of PTW extended, No of PTW audited, No of SMAT's done on PTW, etc.,

#DIV/0!

XIV
1 2 3 4 5 a b

Are Permit Issuers suitably trained and authorised in writing that they may issue permits?
Are your Work permit issuers duly notified and authorised in wirting by the plant head to issue the work permit Are your Work permit Authorisers duly notified and authorised in wirting by the plant head to authorise the work permit Have you assessed the competencies (Technical & Behavioural) of all your work permit issuers and developed training needs Have you assessed the competencies (Technical & Behavioural) of all your work permit authorisers and developed training needs Have you formally trained all your Permit issuers & Permit authorisers on Requirement of this Work Permit Standard & procedures Technical requirement of tasks that are likley to be taken up after work permit issue Records to be evidenced Records to be evidenced Authorisation in writing is necessary. List of issuers to be notified for high risk activities separately Authorisation in writing is necessary. List of authorisers to be notified for high risk activities separately Linkage to what is defined in documented work permit management system is necessary. Records to be evidenced Linkage to what is defined in documented work permit management system is necessary. Records to be evidenced

#DIV/0!

c d 6

Statutory & Legal compliances related to work permits Documented Management System for Work Permit Do you conduct refresher trainings for all these Permit issuers and Authorisers once every year

Records to be evidenced Records to be evidenced Mandatory refresher trainings are necessary. Refresher training should include the learnings of past one year of work permit implementation also.

XV
1

Does the Permit to Work procedure require that the Permit Holder is fully briefed about the requirements of the Permit?
The list of Compliance requirements related to Work permit administration Do you brief the Permit Holder about the Do's and Don'ts related to the work (not the hazards and risks related to the work) need to be spelt out in the permits format. This needs to be explained to permit holder. Evidence of such communication is important Does the permit holder countersign the Permit after understanding the Evidence is necessary Pertmit requirements Does the Permit format clearly indicate the sequence of approvals necessary Check the format and evidence of compliance

#DIV/0!

2 3

XVI
1

Does the procedure require that all persons working under a permit are fully briefed about the potential hazards and the control measures they are required to follow whilst working under the Permit?
Have you carried out JSA / Safe work method statement for all the Non routine activities / one time activities / job tasks that require Work permits Have you prepared and documented Standard Operating Procedures (SOP / OCP / Work Instructions .) for all the activities that require Work permits Do you train the employees carrying out the task as per work permit on the SOP / JSA / Safe Work Method Statement requirements prior to issuing of each work permit Do you attach the copy of the SOP / JSA / Safe Work Method Statement along with the work permit as a reference for the employees who are carrying out the job task Have you communicated the general EHS awareness requirements to the employees wo are engaged in the work permit Does your work permit system requires you to take the specific permission of the concerned manager / incharge of the department / area where the work activity is likely to happen Is the work permit getting closed at the end of the assigned task by the same person who has issued the work permit In case if the persons are different, is there any written authorisation by the first issuer to another person to close the permit Does your Permit issuer frequently visit the site of activity (atleast 2 times per shift per work permit) and make his observations Do you have a system of extending the work permit and authorise such extension if the work task is not completed within the time frame allotted. Do you record and analyse such extensions Have you prohibited the transfer of work permit from one Permit owner to another in writing In case the work is being transferred from one executing person to another, do you give fresh and separate work permit In case of change in the no of people / names of the people working in any work permit, do you give prior written approvals and mark these in the permit Do you randomly check the work permits and verify for the compliance w.r.t the names, no of people, task, permit owner, etc., Do you have a system of communicating the work permit task between two relays of shifts(i.e a work permit initiated in first shift but ends in second shift; Permit issuer and Permit closer ae two different persons) Evidence of existence of such a JSA / SWMS for all one time activities necessary.Mark this check point as "yes" only if compliance is atleast 80 %. OCP or SOP is mandatory for all job task carried out by Work Permit system.Records to be evidenced. This is mandatory. Each work permit should record this aspect. Records of such training to be maintained and evidenced This is necessary. Converting the instructions in to understandable steps / pictograms / visible displays is important Records to be evidenced This is mandatory. Recording his / her approval in the Work permit is important

#DIV/0!

4 5 6

XVII Does the procedure require the Permit Issuer to be readily available on site whilst the Permit is Open
1 2 3 4 Check for evidence, practice for one year necessary to mark this as Yes Evidence in the form of written authorisation is necessary in the work permit itself This is mandatory. Compliance to be evidenced Record of extended permits to be separately monitored & evidenced

#DIV/0!

XVIII Does the procedure specify how the Permit to Work may be transferred from one Permit owner to another?
1 2 3 4 Is it documented in the procedure as well as in the format Check for evidence, practice for one year necessary to mark this as Yes Check for evidence, practice for one year necessary to mark this as Yes Check for evidence, practice for one year necessary to mark this as Yes System procedure; its communcation to permit holder and implementation effectiveness evaluation is necessary

#DIV/0!

XIX
1

Does the procedure require that if any safety concern is raised, or safety controls are changed or added, the Permit Holder must stop the work and report to the Permit Issuer?
Does your permit to work system prohibit continuance of the task by the permit holder / permit owner as and when a safety concern is raised by anybody Check for the system. Compliance to be evidenced

#DIV/0!

2 3

Whenever a work assigend under a permit is stopped for safety concern, does your permit issuer cancels the prevailing work permit Are these requirements and conditions specified in the documented procedure as well as in the formats Does your work permit outline the important checkpoints that need to be verified at the compeltion of the job task as per work permit before the permit can be closed Does your permit issuer or the person authorised to close the work permit visit the site of activity at the completion of the job task; verifies the completeness of the job task as per the checklist; records observations before closing the work permit Do you cross refer the previous work permit for left over risks whenever you issue a fresh work permit next day for the same task

Cancelled work permits to be recorded. This should be analysed as a part of the monthly analyses Check for the system procedure as well as the formats

XX
1

Does the procedure require that the permit to work must be updated for every change of condition and at least every day?
System procedure; its communcation to permit holder and implementation effectiveness evaluation is necessary

#DIV/0!

Records to be evidenced

Check for compliance.

XXI
1

Does the procedure require the Permit Issuer to investigate every Safety Concern raised about the work under Permit and not allow the work to continue until he is satisfied that the work may continue?
Whenever a work assigend under a permit is stopped for safety concern, does your permit issuer investigate the causes and record the observations Is there any recorded evidence available for having taken appropriate corrective measure before the work is re-authorised to start Detailed investigations similar to accident investigations is necessary - 6M or alternate method. Evidence is necessary Check for compliance

#DIV/0!

2 3

Is the no of cancelled work permits due to safety concern a matter for review Check the Minutes of such reviews in your plant managers review meetings

XXII Is there a procedure to monitor and audit the use of the Permit to Work System?
1 Does your permit issuer visit the site of activity and record his observations on the work environment, environmental conditions, immediate hazards and risks etc., prior to work permit authorisation by the next level as per work flow Does your permit issuer visit the site of activity during the execution of work and make his observations regarding the compliances to work permit requirement and records his comments in the work permit form for all the work permits Do you analyse the findings of such observations to determine causative factors and take corrective and preventive measures Do you have a system of penalty / suspension of Work Permit if any violations are noticed in line to the above documented Permit Do you carry out SMAT interactions covering areas where Work Permits are issued This is mandatory. Permit to be issued only after physical verification of the site of activity. Evidence is a must. This can be randomly assessed by SPOT audits. This is mandatory. Evidence of recorded observations is a must. Irresepctive of the duration of the work permit; once in 2 hours visit to the site of activity is a must by the issuer of the permit. Records to be evidenced System procedure; its communcation to permit holder and implementation effectiveness evaluation is necessary Records for evidence is necessary

#DIV/0!

3 4 5

XXIII Does the Safety Management System require an annual review of the effectiveness of the Permit to Work system?
The list should include Plant Manager / Head, Operational Managers & all the Management & Staff employees who have activities that require work Have you prepared a detailed list of all the Management and Staff employees permit in their departments. This can be in an excel format. The list should within your entity who are concerned by the Permit to Work system include the Function, Name of employee, task under his / her supervision / department which require Permit to Work Have you kept such a list always updated & Current Have you developed a Training calendar & Schedule for for training the Management & Staff employees as per the list prepared above. Have you conducted a formal training on this CSG Standard and Delegation guideline covering all the Management & Staff employees listed as at Sl no A1 above Have you assessed the learning penetration for these Management & Staff employees about this standard & guideline The list should be updated and always kept current. Quarterly review of this list is Mandatory Existence of a Training calendar & schedule, No of employees to be covered, Trainer, Method of training, etc., need to be recorded and be available Formal session is mandatory. All the Management and Staff employees who are listed in the inventory as at sl no 1 above to be covered in this session. Mark "Yes" to this checkpoint only if minimum 80% of the listed employees are covered in the training. Entity should have the records to evidence.

#DIV/0!

2 3

Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the Formal trainings on this standard are followed up with a Test to check the learning penetration An after the session test / written questionnaire with minimum pass marks Have you set the Minimum Pass %ge for such a learning penetration test & is (80% as pass marks) is mandatory. Entity should have the records to it 80% evidence this system. Anybody failing to score 80% should be taken through the learning module Has your entity retrained the employees who have not passed with the again as a retraining mechanism. Entity should have the records to evidence requiste minimum pass score of 80% again within a stipulated time frame of this system. Mark "Yes" to this checkpoint only if all the retrainings are three months completed Have you conducted a formal training on the Work Permit requirements as per Saint-Gobain Industrial Risk Prevention manual covering all the Management & Staff employees listed as at Sl no A1 above Have you assessed the learning penetration for these Management & Staff employees about this standard & guideline Formal session is mandatory. All the Management and Staff employees who are listed in the inventory as at sl no 1 above to be covered in this session. Mark "Yes" to this checkpoint only if minimum 80% of the listed employees are covered in the training. Entity should have the records to evidence.

9 10 11

Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the Formal trainings on this standard are followed up with a Test to check the learning penetration Do you record the accidents, Incidents, environmental incidents, Unsafe acts Provision should exist in each work permit form. Evidence of adherence is / conditions noticed etc., as a part of each work permit necessary Is the effective implementation of the work permit system in your entity a key review point in your periodical operations / EHS meetings by your plant Records for evidence is necessary head

Overall Compliance %ge

#DIV/0!

0% 20% 40% Yes No Not Applicable 60% 80% 100%

0 0 0 0 0 0

SAINT-GOBAIN STANDARD Work at Height

S No
I
1

GAIA Score
Compliance
#DIV/0!

Theme Question
Does your Risk Assessment process cover all anticipated working at height situations
Have you prepared an inventory / list of all activities that require Permit to Work authorisation for working at height

Requirement in Detail

The entity should have a list of all such activities possible at its facility. Activities / tasks under Routine, Non Routine, One time works, works carried out by external aganecies, Maintenance works etc., should be part of the list.

Have you carried out detailed Risk assessment of the work at height tasks and Evidence of existence of JSA / Safe work method statement is necesarry for all documented JSA / Safe work method statement for all the height work those activities listed. Requires to be attached along with each work permit. activities that are possible at your site. Have you considered all the peripheral hazards and risks associated with height work while carying out such a JSA / Safe work method statement.Ref. Aligment with the guideline expected clause 5.6 of the Delegation guideline Does your permit issuer visit the site of activity and record his observations on This is mandatory. Permit to be issued only after physical verification of the the work environment, environmental conditions, immediate hazards and site of activity. Evidence is a must. This can be randomly assessed by SPOT risks etc., prior to work permit authorisation by the next level as per work flow audits. Does your risk assessment for height works assess the potential risks associated with the installation of the gadgets like life line, anchoring the lanyards, use of MEWP, safety nets, edge protection etc., Check the existence of the system to check these issues. Risk assessment should be complete and detailed

II

Are all employees who are required to work at height and those who supervise them trained and competent. (Records required)?
The list should include Plant managers, Head, Operations managers and all the Management & Staff employees who have activities that require height work Have you prepared a detailed list of all the Management and Staff employees permits in their departments. This can be in an excel format. The list should within your entity who are concerned by the height work permit. include the Function, Name of employee, task owner under his / her supervision. Formal session is mandatory. All the Management and Staff employees who Have you conducted a formal training on this CSG Standard and Delegation are listed in the inventory as at sl no 1 above to be covered in this session. guideline covering all the Management & Staff employees listed as above Mark "Yes" to this checkpoint only if minimum 80% of the listed employees are covered in the training. Entity should have the records to evidence this system.Mark "yes" to this Have you assessed the learning penetration for these Management & Staff checkpoint only if all the formal trainings on this standards are followed up employees about this standard & guideline with a test to check the learning penetration. Have you set the Minimum Pass %ge for such a learning penetration test & is records to be evidenced it 80% Has your entity retrained the employees who have not passed with the requiste minimum pass score of 80% again within a stipulated time frame of records to be evidenced three months Authorisation in writing is necessary. List of issuers to be notified for high risk Are your Work permit issuer for height work duly notified and authorised in activities seprately. Mandatory Pre-Training on CSG standards and guidelines wirting by the plant head to issue such a permit. necessary. Authorisation in writing is necessary. List of issuers to be notified for high risk Are your Work permit Authorisers for height work duly notified and authorised activities seprately. Mandatory Pre-Training on CSG standards and guidelines in wirting by the plant head to authorise the work permit necessary. Have you identified the job specific competencies required for the permit issuer and permit authorizer for height works. Have you assessed the competencies (Technical & Behavioural) of all your work permit issuers and authorizers. Have you identified all the employees (SG, temps as well as contractors) who need to be trained on height work fundamentals Have you trained these identified employees on the principles of height working fundamentals,use of access and protection gear,fall prevention arrangements etc. Does your height work fundametals training include sessions on emergency response and rescue, while doing height work. Have you assessed the learning penetration for these employees on height work fundamentals. Technical competencies, awareness about standard and guidelines, awareness about documented height work system, knowledge about height work fundamentals and behavioural competencies to be listed out. Records to be evidenced This list to be exhaustive. W.r.t the contractors, anticipation of the potential is the key. Records to be evidenced for such training Records to be evidenced for such training Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the Formal trainings on this standard and work practice are followed up with a Test to check the learning penetration

#DIV/0!

3 4 5

9 10 11 12

13

14

Do you conduct annual refresher trainings for the above employees on height Records to be evidenced. work fundamentals For one time works involving a first time contractor, do you check and record the competencies / skill sets available with the contractor and his employees w.r.t height work For any one time work involving a new contractor / first time contractor, do you provide a height work fundamentals training before allowing his employees to start the work, Check the skill / experience of using safety belts, scaffolds, life lines, climbing / alighting, work on roofs, communication etc., Checklist for this should be developed and used to record observations before the permit is issued This is mandatory. Evidence of such pre work permit training is necessary

15

16

III
1

Is there a list showing all personnel permitted to work at height on potentially hazardous tasks?
Have you maintained a height work registry for recording the date, entry, exit times, name of ther persons engaged, type and nature of work authorized etc Mark "yes" if you have covered all the high risk work at height activities in the for Roof entry, working on tall structures, entry to top of bucket elevators, silo registry.Records to be evidenced. top etc. Do you record the names of all the employees involved in height work along with their age, No.of years of acquaintance with SG, awareness about basics of "Mandatory".Records to be evidenced. height working and contact nos. incase of emergency in the work permit.

#DIV/0!

Do you conduct a critical task safe work method training for all the employees "Mandatory" Existence of training module and evidence of records of engaged in height work before the issue of permit and commencing work ( conducting such trainings.These trainings are mandatory everytime the work Topics to be covered - use of PPE, safety nets, scaffolds, climbing and lowering, permit is issued on a high risk activity. work on ladder / scaffold / MEWP /cherrypickers etc) Under the global contract of civil constructions authorizing the contractor to Records to be evidenced. Check for any construction activity that has taken work inside your premises, do you have specific height work permits issued on place and verify the compliance to the permits a day today basis. Do you maintain the list of all employees (including those of contractors) who have done height works on critical tasks (like roof work, confined places at This list is important for any future reference height, entry to tall structures, etc) so that the list can be referenced for any future permits

IV
1

Is all working at height access and safety equipment identified and tested (with records available) at least annually to ensure it is suitable and fit for purpose?
Have you checked and authorized in the work permit form the use of hand tools, power tools used for carrying out the task at height. To be recorded in the permit .Records to be evidenced. Name/Specification of each such hand tools to be recorded. Mark "yes" if you do a minimum of the following: - maintain checklist (what to check,acceptability criteria,usabilitiy criteria,life,testing) - labelling for the unfit ones - stability for scaffold - should have linkage to work permit provision made should be fool proof and communicated to concerned and the same should be covered in JSA / work permit. Records to be evidenced Necessary as per factory act Check the records Checklist and records to be evidenced as a part of permit

#DIV/0!

Have you checked, inspected and authorized the safety gadgets like,harness,nets,scaffolds,helmets,crawler boards,roof ladder etc.

3 4 5 6 7

Have to provided appropriate provision for carrying tools, equipments for persons while climbing Do you have a system implemented in your entity for quarterly internal authorisation for use of tools and tackles, other equipment brought in by contractors Do you insist on external certification by competent person of the tools and tackles, other equipment brought in by contractors Do you have a system for certification of the tools, tackles, equipment owned by your entity by a competent person as per factory act Do you check the condition of the tools and tackles, other equipment owned by your entity and given to contractors for carrying out the task at the completion of the task Have you prepared & documented a Management System manual & Procedures for height Works at your entity Does the documented height work management System consist of the following List of all activities / Job tasks that require height work permit Specific roles and responsibilities of Permit seeker, Issuer, Authoriser etc., System for identifying the comptencies necessary for Permit issuer and person authorising the same

V
1 2 a b c d e f g h i

Does all work at height have a known Safe Working Procedure or is subject to a Permit to Work?
The entity should have a Documented Management system which defines various aspects of height work within the entity

#DIV/0!

This list requires to be exhaustive. The tasks that may look routine type, but are of high risk category should be included in permit to work. Roles and responsibilities to be clearly defined

The required competencies (both technical as well as behavioral) for Permit issue and permit authorisation need to be clearly listed out. Critical competencies out of this list requires to be highlighted Identifying the personnel who are nominated as Permit issuers and Permit This list require to be taskwise / permit wise. Mark "Yes" only if both authorisers & assessment of their competencies identification and competency assessment is completed Training list should cover all aspects - standard requirement to technical Training of Permit issuer & Permit authoriser aspects, statutory links etc., Defined workflow for height Work permits - starting from Permit initation till the Permit closure System for verification of fitness of the personnel engaged fo carrying out height works activities under Work Permit System of communicating to the employees who are working in the area where the height work permit is being issued. System of barricading the work area where height work is carried out. Does you height work permit form includes the checkpoints for inspecting and authorizing the use of the following a) Scaffold b) Ladders c) Handling equipments ( MEWP,Cherrypickers,crane,hydra..) d) PPE ( Harness, helmet, reflective jacket..) System of communicating to the employees involved in work permit, the Hazards & associated Risks and Control measures to be followed before starting the work System of verifying the compliance to the work permits during the execution of the work. Making the presence of saint-gobain supervision mandatory for high risk height work permits. Have you conducted a formal training on this Documented height work management system covering all the Management & Staff employees Have you assessed the learning penetration for these Management & Staff employees about this documented management System Have you set the Minimum Pass %ge for such a learning penetration test & is it 80% Has your entity retrained the employees who have not passed with the requiste minimum pass score of 80% again within a stipulated time frame Step by step procedure is necessary with defined responsibilities and checkpoints. Do's and Don'ts to be clearly spelt out at each checkpoint The list of activities with checkpoints on fitness to work should be included as a part of work permit format. Records to be evidenced. Part of the work permit,

Specific inspection checklist is mandatory for all these critical items these should be annexed or should be included in the work permit.Records to be evidenced.

Recording this communication is necessary, needs to be made part of work permit form. Permit issuer should visit the site of activity atleast once to the site of activity and record his / her observations. In case of high risk activities, permit issuer should visit twice to thesite of activity and record his / her observations. List of high risk activities involving height work to be evidenced.The presence of SG supervisor is mandatory. His name to be recorded in work permit. Formal session is mandatory. All the Management and Staff employees who are listed in the inventory to be covered in this session. Mark "Yes" to this checkpoint only if minimum 80% of the listed employees are covered in the training. Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the Formal trainings on this standard are followed up with a Test to check the learning penetration An after the session test / written questionnaire with minimum pass marks (80% as pass marks) is mandatory. Entity should have the records to evidence this system. Anybody failing to score 80% should be taken through the learning module again as a retraining mechanism. Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the retrainings are completed

Have you prohibited the following height work activities after 6:00 pm a) Roof top works b) Working on tall structures - chimney, scaffolds, overhead water tanks, silo tops, top of fuel storage tank, communication towers.. C) Height work in civil construction activities Do you attach the Standard Operating procedure / JSA / SWMS as developed at I-2 above with each work permit that you issue for work at height

Ref. Clause 5.12 of Delegation guidelines on Working at height.Records to be evidenced.

Check for compliance

VI
1 2 3 4 5

Do you have established emergency and rescue procedures to assist those who have to work at height?
Have you identified and recorded the emergency conditions that are anticipated during the work at height tasks Does your onsite emergency prevention & response plans outline the rescue mechanism w.r.t. to emergencies occuring in height work Have you trained and retrained your Emergency Response teams on the height work as well as emergency rescue from heights Have you conducted mock drills for such emergencies arising out of height works during the last 2 years. As a part of the work permit for height works, do you record the emergency rescue requirements in the permit format. In case of critical height works involving a combination of risks (example height+electrical, Height+hot, Height+confined, working on roof, working on tall scaffolds / tall structures, chimeny works, silo works etc., ) do you notify the concerned teams to be vigilant and be ready for immediate rescue Check the risk assessment. All the potential emergency conditions to be listed list need to be exhaustive Check the Emergency reponse system procedure for compliance Training is mandatory. Retraining frequency is once a year. Mark Yes if it is done for all ERT members Each emergency condition w.r.t height work need to be tested atleast once in two years Check the formats Concerned teams could be first aid, emergency resue teams, ambualance, security teams etc., These people need to be kept informed of the impending high risk work so that they are vigilant & ready in the event of emergency requirement

#DIV/0!

In case of a person falling from height and hanging in mid air because of safety Check the procedure, Check the system in place for such rescue, Check the harness, does your emergency rescue specify that he be rescued & brought to mock drills, training of ERT members for doing such rescues ground level within 20 minutes

VII
1 2 3 5

Do all Employees and Contractors who have to work at height have a Permit to Work that identifies safety control measures?
Have you made it mandatory for any employee who is working at height to be equipped with an approved work permit Does your work permit specify the Hazards and risks associated with the activity being undertaken at height Does your work permit specify the control measures - both collective as well as individual, to be followed while doing the height work Have you checked the fitness of the employees assigned the task of work at height. ( E.g. height phobia, epilepsy, blood pressure, influence of drugs or alcohol, mental fitness etc.) Have you banned the use of mobile phones / walkie talkies while working at height. Have you put in place systems to ensure this at your site Have you banned the use of mobile phones while using the staircase and ladders. Do you use Edge protection and side protection safety nets for slopping roof to prevent roll over falls. Do you use safety nets below the fragile roofs / below the places where the risk of fall though is anticipated Do you use Safety nets around the scaffold. Do you use mobile scaffolds or MEWP / Scissors lift for fixing the safety net below the roof. Do you use Full body harness with double lanyards having scaffold hooks with positive spring loaded latch with shock absorbers. Do you have permanent horizontal lifeline on top of slopping roof along with retractable block. Do you use tripods or support structure for anchoring fall arrestor and safety harness for working on top of storage tanks, entry into silos, any other confined spaces. Do you have physical handrails or masonary parapet walls of 1 m. height for all flat roofs. Incase of handrails the midrails should be spaced 500mm apart with a toe guard for 100 mm height. Do you use mobile scaffolds, MEWP, Scissor lifts, Cherry picker, or handling equipment for maintenance of roof lights, street lights, cobweb cleaning etc. Have you initiated any projects / improvements aimed at minimising the height works in your entity - by way of permanent mezzanine platforms, mechanisms to work from floor level for cleaning etc., This needs to be done irrespective of the category of employment. Check for compliance Check the listing. Listing to be complete with all appropriate cotrol measures To be recorded in the permit based on interactions with the concerned employees or OHC where available.Records to be evidenced. Mandatory requirement.Part of workpermit. Mandatory requirement.Visual display is must.

#DIV/0!

6 7

VIII
1 2 3 4 5 6 7

Do control measures for activities on the roof systematically prioritize collective protection?
edge and side protection should be provided even if its not a fragile roof structure Existence of safety net or availablility to be ensured. Checklist for inspection and certifying for use should exist Existence of safety net or availablility to be ensured. Checklist for inspection and certifying for use should exist Existence of such devices is mandatory. "Mandatory Requirement". Check for such gadgets "Mandatory Requirement", check for compliance Physical verification

#DIV/0!

"Mandatory Requirement", Check for compliance

"Mandatory Requirement", check for compliance

10

Check the projects for compliance & effectiveness

IX
1

Do you monitor, audit and review your arrangements for working at height?
Does your permit issuer visit the site of activity during the execution of work and make his observations regarding the compliances to work permit requirement and records his comments in the height work permit. Do you analyse the findings of such observations to determine causative factors and take corrective and preventive measures Do you have a system of penalty / suspension of height Work Permit if any violations are noticed in line to the above documented Permit Do you have a system of extending the height work permit and authorise such extension if the work task is not completed within the time frame allotted. Do you record and analyse such extensions This is mandatory. Evidence of recorded observations is a must. Irresepctive of the duration of the work permit; once in 2 hours visit to the site of activity is a must by the issuer of the permit. Records to be evidenced System procedure; its communcation to permit holder and implementation effectiveness evaluation is necessary Record of extended permits to be separately monitored & evidenced

#DIV/0!

2 3 4

Do you have a system of communicating the height work permit task between System procedure; its communcation to permit holder and implementation two relays of shifts(i.e a work permit initiated in first shift but ends in second effectiveness evaluation is necessary shift; Permit issuer and Permit closer are two different persons) Does your work permit outline the important checkpoints that need to be System procedure; its communcation to permit holder and implementation verified at the compeltion of the job task as per work permit before the permit effectiveness evaluation is necessary can be closed

9 10 11 12

Does your permit issuer or the person authorised to close the work permit visit the site of activity at the completion of the job task; verifies the Records to be evidenced completeness of the job task as per the checklist; records observations before closing the work permit This is mandatory. The original copy of the work permit issued to the permit Do you get the original work permit issued to the permit holder back with all holder should be kept as a recorded evidence of work completion & permit the above comments and maintained records closure. Do you carry out organized and scheduled audits to asses the compliance to height work standard (e.g. scaffold audit, PPE compliance, Ladder audit, Records to be evidenced. height work permits etc.) Have you scheduled and caried out SMAT interactions in atleast 50% of the System for scheduling the SMAT interaction in a work permit zone. work permits requiring height work Analysis of the findings - datat tracking, leading indicators Do you have a system for recording any abnormalities noticed during the Evidence of records,actions taken on observations height work activity Is the effective implementation of the height work permit system in your entity a key review point in your periodical operations / EHS meetings by your Records for evidence is necessary plant head

X
1

Is a named person responsible for reviewing all working at height arrangements (program administrator)?
Have you identified and nominated a person(s) within your entity for being responsible for implementing the work at height system within your entity Have your nominated person undergone a formal training on Height Work Standard of Saint-Gobain Is the nominated person(s) formally trained on the fundamend=tals of height work, construction safety, use of control measures while working at height, etc., Is the nominated person made responsible for preparing the documented work at Height system procedures, formats, tracking systems etc., Formal nomination is a must. The identified person will be responsible for making the procedure, documented systes, formats and tracking the compliances. It is mandatory to train the nominated person w.r.t the CSG standard on Work at Height. Formal session is necessary either by Sector/e-learning/Delegation / any other internal mechanism Formal training is mandatory. Assessment of his / her competency is important as a program administrator. Technical knowledge is vital The responsibilities and roles to be clearly defined for this nominated person.

#DIV/0!

4 5 6

Is the nominated person responsible for conducting further trainings within Evidence of having conducted trainings is necessary your entity on Work at Height system Does the nominated person analyse the implementation of the work at height Evidence of the analyses and charts / data depicting the progress of system within your entity implementation, discussions in the MRM,s is necessary

XI
1 2 3 4

Is there a procedure for employees to report any hazards such as medical conditions, adverse weather conditions, or faulty equipment they may encounter?
Have you banned the access to roofs during bad weather like. Moonsoon, high Written notification, Visual display, wind and risk of slippery roofs during winters. Have you banned the use of forklifts for man hoisting (Forklift should never be Written notification, Visual display, used for anything other than material handling) Have you banned the use of hydra / cranes for man hoisting. Written notification, Visual display, Have you implemented mechanisms to prevent use of wooden ladders for cleaning, painting, housekeeping, access to tall structures, roof tops etc., Has this been communicated to all personnel within your site Have you banned the use of wooden scaffolds and supports in any civil construction / maintenance activities. Have you implemented a incident reporting system for near misses, unsafe acts and unsafe conditions while performing a work at height Do you have a format / columns available in the work permit for height works to encourage the workers / contractors to report such incidents in the permit itself Defined as a part of system, Visual display banning such use at prominent locations "Mandatory Requirement" Mandatory requirement, Evidence of having recorded and investigated such incidents is a must. Evidence of existence in the format + compliance in the permits to be seen

#DIV/0!

5 6 7

XII
1 2 3 4 5

Is sufficient fall prevention (or as a last resort- fall arrest) equipment and training supplied where people have to work at height?
Does your risk assessment of height works specify type of fall prevention and fall arrestors equipment required for carrying out the work Check the risk assessment and controls proposed. The exact nature / type of such equipment is needed. Specification of the equipment to be available as a control for each risk

#DIV/0!

Do you include the exact quantity and type of fall prevention and fall arresting Check the work permits equipment in your work permits These should be checked and recorded in the permits. Each fall prevention and Do you check the condition of the fall prevention systems as well as the fall fall arresting equipment should be numbered with a unique identifier to arrestors prior to issuing the work permits for height work enable authorisation Have you made provisions and always ensured the anchoring of all fall Should be part of Work permit. arrestors is made above the head level of the employees. Are the personnel who work at height and those who supervise these height works trained on fall prevention and fall arresting equipment , their use and Check the training details maintenance For the locations where you have positioned the fall arrestors or self retracting vertical / horizontal lifelines, do you check and test the working once a month Check for the testing details or whenever the work permit is issued, whichever is earlier

XIII
1 2 3 4

Are the users of safety harness trained (how to check it, how to wear, adjust and connect it, how to store it, ...) ?
Have you identified and trained all the frequent users of the height work permit on the use of safety harness For one time works involving contractor employees, do you provide training on correct use of safety harness to all the employees before clearing them for work Have you specified the correct storage of these safety gadgets Do you conduct audits of the place where these safety gadgets are stored to check if these are stored and maintained appropiately Formal training is necessary with demonstration on the use, rescue in case of emergency etc. Training to be frequent, retraining once a year This is mandatory for all one time works like civil construction and any other one time / occasional height works. Formal session is mandatory Check the system in place Records to be evidenced

#DIV/0!

XIV
1 2 3

Are the concerned employees trained to use safely a ladder?

Have you identified the locations where portable ladders are permitted to be used in your site and made physical provisions for securing the portable ladder List of areas to be recorded, locations to be marked with visual display. at these locations. Do you have a ladder safety checklist and have you implemented the quarterly Ladders to be checked and authorised as fit to use once a quarter safety audit of the ladders Are all your portable ladders numbered with a unique identifier Check the numbering

#DIV/0!

Have you specified at each identified location where the portable ladders can be used, the unique identifier of the ladder that can only be used Have you identified and trained all the frequent users of the height work permit on the use of portable ladders

This is mandatory visual display to take care of errors in judgement. This results in mistake proofing.

The training should cover all aspects including inspection of ladders, transportation to and from storage, anchoring, securing the ladder, inclination etc., Records to be evidenced Straight portable ladders should not be used for perfoming any activity like Have you prohibitted in writing / visual displays in your plant, the use of wall painting, cleaning of cobwebs at height, for adjusting of any overhead straight single portable ladders for perfoming any work other than climbing to valves, street light maintenance, tall structures for doing maintenance etc., reach a floor or coming down to another floor For al these tasks, use of A frame ladders with railings, scaffolds or MEWP to be used Have you made provisions in your entity for storing these portable ladders always in horizontal condition so that it is safer and easier to retrieve. When portable ladders are used for accessing an upper landing surface, have you ensured that the side rails must extend at least 3 feet (.9 m) above the upper landing surface Vertical storage should be prohibitted

Check the portable ladders or fixed vertical ladders for comliance to this

XV
1

Have all roofs, elevated walkways, and platforms been assessed as safe or unsafe?
Have you made a survey of your site w.r.t. Building, tall structures, working Existence of such a list to be evidenced. platforms on equipment, structural walkways etc. and prepared an inventory. Does such an inventory shows - the nature of roofing material,year of installation,status,construction materials,maintenance expected,pipes,stacks,chimney conditions etc (Ref to clause 5.3 of the guideline) Have you assessed the hazards and risks of such infrastructure and categorised them as Safe or unsafe Have you installed and maintained access controls to all unsafe infrastructires as per the list above Have you made it mandatory for any person who is seeking to work at these unsafe insfrastructures to be equipped with an approved work permit

#DIV/0!

Existence of such a inventory to be evidenced. Categorisation is important. Key plan should reflect the unsafe structures and access controls Physical verification Work permit authorisation is mandatrory

3 4 5

XVI

Are the skylights (on roof) protected?

Have you made a survey of your buildings in your entity and listed all the fragile working areas on the roof (example - areas where roof lights are "Mandatory Requirement" provided, Turbovents are installed, Exhaust chimneys are taken out, Gravvent is installed, transluscent sheets are installed etc., ) Have you made physical barriers on top of the roof to prevent any person who Physical verification is working on such roof to accidentally access such unsafe areas Have you made physical fall arresting provision below such unsafe areas to prevent any person from falling through Physical verification

#DIV/0!

2 3

XVII Have all roofs, elevated walkways, and platforms been maintained to prevent corrosion of structural components (paint, leak repair, etc.)?
1 2 3 Do you have an annual inspection of all the roofs, working platforms, structural members, platforms, outside tall structures etc., Have you taken corrective action on the observed points within a resonable period of time (say within a quarter / six months) Annual inspection by a cross functional team / competenet person is necessary. Checklist for verification to be evidenced Issues like corrosion of roof sheets, leaking joints, requiring painting of structures, requiring welding, bolting etc., Assess this question by physical verification of the site

#DIV/0!

Is the structural integrity of the buildings, tall structures etc., its maintenance, Check for evidence a part of discussion in your management reviews

XVIII
1

Are all roof and other high risk elevated work area access points secured with the display of the specific rules access on the Roof at each access?
Have you made a survey of your site w.r.t. access points to roofs, tall structures, water tanks, chimneys, and prepared an inventory. Existence of such a list to be evidenced.

#DIV/0!

Have you access controlled gates for all ladders and staircases located outside the buildings ( provided for access to roof top, chimney, water tanks, fuel tanks, cooling towers, communication towers, silos, conveyor head rooms, Physical verification, This is mandatory, Mark Yes only if compliance is 100% bucket elevator tops, under ground pits and anyother areas which are normally not visited on a routine basis ) Have you made it mandatory for any person who is seeking to use these access points to work on these insfrastructures to be equipped with an approved work permit Work permit authorisation is mandatrory

XIX
1 2

A roof map of the elevated structures and roofs has been created and regularly update indicating which areas are safe, which areas are unsafe?
Do you have a key plan clearly indicating the presence of roofs, tall structures, Roof map is mandatory. Display of this necessary skylights, unsafe roof, safe roofs etc., Do you update this as and when changes happen and maintain the previous Check for evidence versions for a period of 3 years as a record

#DIV/0!

XX
1 2

Are all roofs with fragile materials, with load bearing restrictions, or questionable structural integrity clearly identified and is access physically and visually restricted?
Have you displayed at each location, the details regarding the unsafe roofs, access restrictions, permit requirements for access etc., Have you provided a guardrail and toeboard around every open-sided platform, floor or runway that is 4 feet or higher off the ground or next level. This visual display is mandatory. Mark Yes, if done at 100% locations This is mandatory to prevent anybody accidentally falling in to this while walking on platforms. These need to be visually highlighted

#DIV/0!

XXI
1 2 3

Are the operators of mobile access platforms trained by authorised instructors and licenced to operate the equipment?
Do you check the level of competency / skill / experience of the operators driving mobile access platforms like MEWP, Cherry Pickers, Hydra, Cranes etc that are used for facilitating the height works Do you issue work permits for use of such mobile access platforms Do you provide in house training on the do's and don'ts for the operators of such mobile equipment prior to start of work Check for evidence Check for evidence Should be part of the permits

#DIV/0!

4 5

Do you physically check and ensure that appropriate controls are present and Checklist should exist for having verified and cleared the equipment for use working in the mobile access platforms and mobile equipment Do you check the statutory licenses that are necessary to operate these equipment Have you made it mandatory to use the full body safety harness with double lanyard and scaffold hooks on mobile access platforms like MEWP, Cherry pickers and high lift scissors lifts Check for evidence

XXII Is fall arrest equipment available and used by all personnel on mobile access equipment?
1 Check for evidence of this in work permits

#DIV/0!

2 3 4

Do you check oif there is a provision to anchor the safety harness to a railing / Check for evidence of this in work permits support on these platforrms and record the existence of such facility Have you assessed the hazards and risks associated with the use of MEWP, Cherry pickers in your plant. Do you train the employees who work on these MEWP's, Cherry pickers etc., about the hazards and risks as well as controls Are your ladders usage based on permit to work at height Have you made provisions / displays to indicate the safe working load on the ladders / step ladders Whenever the ladders and step ladders are used, do you physically barridade the area around the foot of the ladder for keeping the area clear of obstructions Does the side railings provided on ladders and step ladders have non conductive coverings to prevent any electrical risks Have you made it mandatory thorugh training and visual displays in your entity about - Not carrying the loads while climbing or coming down - Not to speak on mobile phones while climbing or coming down - To have three point contact always - To face the ladder steps when climbing or comming down Have you checked and ensured that all your portable and fixed ladders have uniform pitch w.r.t the steps. Have you made it mandatory that the width of any portable ladder is atleast 30 cm Do you train the employees and those of contractors on the correct use of ladders as well its maintenance Evidence to be checked Check for evidence

XXIII Are ladders and step ladders (A-frame) only used by personnel who have been trained in their permitted application and use?
1 2 3 4 Cehck for the system Check for display and manufacturers reccomendations. Check for the system and physical verification Check for evidence

#DIV/0!

Check for evidence, Check compliance through SPOT audits

6 7 8

Pitch of steps to be 10 to 14 inches. Uniformity to be ensured. Check for physical evidence Check for evidence Training on ladder safety is important. Check for evidence

XXIV Are all temporary access platforms (scaffolding) erected by trained, and authorised personnel?
1 Have you identified and nominated a competent person within your site for authorizing the use of scaffolds and temporary work platforms. Written notification is "mandatory". Competency check and training on the same is to be evidenced.

#DIV/0!

2 3 4

Does the identified competent person inspects and certifies the scaffold and temporary work platforms everytime the work permit is issued for erection of Records to be evidenced. Visible tags for usability is a must. scaffold. Have you restricted the height of any free standing scaffolds or temporary Written notification and visual display. work platform in the height to base ratio of 3:1 Have you made it mandatory to restrain the scaffold from tipping by tying / using guy ropes / equvt in case the height to base ratio exceeds 3:1 Check for procedure, systems and evidence in permits

5 6 7 8 9 10

Do you make it mandatory for persons working on a scaffold to wear full body safety harness with double lanyard with scaffold hooks & anchor point above Check for evidence and existence of the system, procedure, permits. the shoulder Do you make it mandatory for the scaffold top rail to be 1.2 mtrs above Do you make it mandatory for the presence of mid rails at half way between the toe board and top rail in all scaffolds Do you make it mandatory for use of scaffold footings that always are rested on plane surface and are locked in position Do you check and verify if the scaffold errection and dismantling are done by trained and authorised "riggers" Is there a separate permit to work issued for errection and dismantling of scaffold Check the scaffold inspection sheet Check the scaffold inspection sheet Check the scaffold inspection sheet Check the scaffold inspection sheet This should be different from the work permit issued for carrying out the work at height. Scaffold buidling / dismantling permit should be separate

XXV Do all erected temporary access platforms display a sign that clearly indicates if they are safe or unsafe to use?
1 2 3 4 5 Do you check and estimate the load carrying capacity of the scaffolds and compare with the anticipated loads Does theperson who authorises the scaffold as fit for use, previously trained to authorise one Do you have a checklist for scaffold inspection and authorisation Structural stability checks are mandated Check for his competency, training, past experience Check for compliance

#DIV/0!

Do you tag the scaffold "Red" or "Green" to indicate whether the same is fit Check for compliance for use or should not be used have you trained all your management and staff employees who are required Check for evidence to scaffold at some point in time, on the scaffold safety

XXVI
1 2 3 4 5

Do vertical ladders have a fitted safety cage if they are over 2.5 metres in height. If they are positioned at height is additional protection fitted if a fall is possible?
Incase of very tall structures beyond 6m height have you provided for permanent staircase with double hand rails instead of rung ladder. Physical verification.Mark "yes" only if compliance is 100 %.

#DIV/0!

Have you provided a permanent vertical self retracting lifeline for any vertical "Mandatory Requirement" / inclined ladder having a single flight of more than 3 mtrs. Do you use of permanent retractable fall arrestors for all vertical / inclined "Mandatory Requirement" ladders, where you have not provided the lifeline Have you provided the safety cage for all vertical fixed ladders which are 6 mtr Mandatory requirement, the cage should start 7 feet from floor level (access and higher point) and end 4 feet above the top level (exit point) There should be a platform for changing the flight at 6 mtr level. This is a Have you restricted the height of single flight in a vertical fixed ladder to 6 mtr mandatory requirement. Check for evidence

XXVII Do platforms and walkways at height have suitable substantial barriers at least 1100mm above the platform?

#DIV/0!

1 2 3 4

Have you provided on all the walkways and platforms which are at height, handrails on both sides with top rail, mid rail and toe board Have you posted visual signages on all walkways and platforms Are the ladders entry point at the top of the platform or the walkway provided with spring loaded gate tpo prevent accidental fall If the vertical fixed ladder is at the center of the platform (not at the edge by design), do you have a guard rail around the opening to prevent any accidental fall If the foot of the vertical fixed ladder is landing close to an Aisle where Fork Lift or other handling devices move, have you provided a guard rail at the foot of the ladder to prevent accidents

Height of top rail to be 94 cms to 110 cms, mid rail to be inbetween and toe board to be 100 mm high. Check for compliance Check for evidence and appropriateness Check for compliance Check for compliance

Check for compliance

XXVIII Have all stairways over 3 steps been fitted with suitable handrails?
1 2 3 Physical verification & audit Inventory of such locations, action plan for corrections Have you provided hand railings on both sides of the stairways at all locations This is a must for three point contact, mark Yes only if this is complied at 100% (a railing should be present even if there is a wall) locations Have you ensured that all the handarails are of adequate height and that mid Height of top rail should be more than 75 cm and max 94 cm rails are provided Height of mid rail should be at centerpoint Have you provided hand railings for all staircases that have 3 or more steps

#DIV/0!

XXIX Have all personnel working at height on vehicles a safe operating procedure which includes safe access?
1 Have you implemeted fall arrestor system with access platform for entry in to backside of trucks / top of containers for locking, fastening / taurpaulin Mandatory requirement., Check for compliance loading, entry to fuel tanker top for inspection etc. Have you made it mandatory for persons to use these fall arestors by means of visual displays, trainings, SOP's, SMAT's, TF4 and TF5 incident nreporting etc., Are there sufficient no of fall arrestors per truck Have you provided barricades for safe guarding the personnel working below those areas where work at height is being performed. Does your work permit system requires you to take the specific permission of the concerned manager / incharge of the department / area where the work activity is likely to happen Are the people who are working below informed about the type of work that is being planned at height Have you made it mandatory to provide safety nets below all height works where potential fall through is anticipated (example roof) Have you restricted by design the lanyard length to be 1.8 mtrs and prohibitted any extension of length Have you implemented a mandatory use of retractable blocks for all height works to restrict the height of fall to 2 mtr or less This requires to be checked by SPOT ausits Check for compliance

#DIV/0!

2 3

XXX Is there a procedure to safeguard personnel working below those working at height? For example barricades to prevent access?
1 2 3 This is mandatory. Recording this observation in work permit to be evidenced. This is mandatory. Recording his / her approval in the Work permit is important Check with employees

#DIV/0!

XXXI Is the maximum distance of a potential fall protected by a fall arrest system- 2 metres or less?
1 2 3 Check for systems, Procedures, permits Check for systems, Procedures, permits Check for systems, Procedures, permits

#DIV/0!

Overall Compliance %ge

#DIV/0!

0% 20% 40% Yes No Not Applicable 60% 80% 100%

0 0 0 0 0 0

SAINT-GOBAIN STANDARD Lockout - Tagout

S No
I
1 2 3 4 5 6 7 8

Theme Question

Requirement in Detail

Compliance

GAIA Score
#DIV/0!
Manual, Formats Procedure,

Has a person been nominated as being responsible for the management overview of all plant and equipment isolations on site
Have you identified and nominated a person(s) within your entity for being responsible for implementing the LOTO system within your entity. LOTO Administrator / LOTO Manager Have you defined and documented the roles and responsibilities of the nominated LOTO administrator Is the nominated person made responsible for preparing the documented LOTO system procedures, formats, tracking systems, montoring etc., Is the nominated person responsible for conducting further trainings within your entity on LOTO system Does the nominated person analyse the implementation of the LOTO system within your entity Have you identified and authorised through a formal notification the list of employees (other than LOTO Administrator) who can perform LOTO energisation and de-energisation Have you maintained the up to date list of the authorised employees for LOTO activation Have you defined and documented the roles and responsibilities of the nominated LOTO authorised employees Formal nomination is a must. The identified person will be responsible for making the procedure, documented systes, formats and tracking the compliances. Check for evidence of the document The responsibilities and roles to be clearly defined for this nominated person. Evidence of having conducted trainings is necessary Evidence of the analyses and charts / data depicting the progress of implementation, discussions in the MRM,s is necessary This list is mandatory. Only those who are authorised should be allowed to perform the energisation / de-energisation To mark "yes" have you done the competence assessment of the same. Check for evidence of the document

LOTO KPI & OPI

Skill Matrix

II

Has the nominated person sufficient information and training to enable them to manage their responsibilities competently.
Technical competency, Awareness about Standard & Guideline, Ability to Have you identified the Job specific competencies required for the LOTO develop Documented LOTO System & procedures, LOTO technicalities as well Administrator / LOTO manager. This job specific competencies should be as behavioral competencies should be listed. Capability to drive the program, derived based on the Training matrix of Saint-Gobain as well as the LOTO training of others should be assessed. Critical competencies required for the Standard requirement job should be spelt out. The competencies have to be split between - To Know & To Know how to do categories as per the CSG training matrix Have you assessed the competencies of the LOTO Administrator / LOTO Records to be evidenced as per the listed job specific competencies Manager (nominated person) w.r.t the list of job specific competencies It is mandatory to train the nominated person w.r.t the CSG standard on Have your nominated person undergone a formal training on LOTO Standard LOTO. Formal session is necessary either by Sector/e-learning / Delegation / of Saint-Gobain any other internal mechanism Is the nominated person(s) formally trained on the fundamendtals of LOTO, Formal training is mandatory. Assessment of his / her competency is Isolation energies, Arc Flash, and use of control measures etc., important as a program administrator. Technical knowledge is vital Have you carried out a detailed Training need identification for the employees authorised to operate and use LOTO & developed a training plan Records to be evidenced for minimising the gaps in competencies Have you trained the LOTO authorised employees on the identified training Records to be evidenced needs & assessed his learning penetration. Do you conduct annual refesher trainings on LOTO and assess / reassess the Records to be evidenced level of knowledge, competency etc of the authorised employees

#DIV/0!

3 4 5 6 7

Arc Falsh? - HT Trg Need?

Temp, Gas

III
1

Has a Risk assessment been carried out to identify all situations where energy isolation of plant and equipment would be required?
Did you carry out the risk assessment to identify all situations where LOTO Linkage to risk assessment is essential. LOTO as a control measure as a would be required. derivitive of risk assessment important Have you prepared an inventory / list of all activities that require LOTO activaton. Format. F-020-001 from Delegation guideline can be referred The entity should have a list of all such activities possible at its facility. Activities / tasks under Routine, Non Routine, One time works, works carried out by external aganecies, Maintenance works etc., should be part of the list.

#DIV/0!

F-020-001 from Delegation guideline JSA

3 4

Have you carried out JSA / Safe work method statement for all the activities Records to be evidenced that require LOTO Work permits Do you train the employees carrying out the task as per the LOTO work This is mandatory. Each work permit should record this aspect. Records of permit on the SOP / JSA / Safe Work Method Statement requirements prior such training to be maintained and evidenced to issuing of each work permit

IV
1 2

Is there a written procedure for the safe energy isolation of all plant and equipment?
Have you prepared & documented a Management System manual & Procedures for LOTO at your entity Does the documented & implemented LOTO management System consist of the following List of all activities / Job tasks that require LOTO Different types of Energies to be isolated System for combination of isolations This list requires to be exhaustive. The tasks that may look routine type, but are of high risk category should be included in LOTO permit. Any activity which requires energy isolation should be under work permit. List of different energies to be isolated to be documented System of combined isolation requirements - Electrical + Mechanical, Electrical + Pneumatic, Pneumatic + Heat, Mechanical + gases etc., to be detailed out It is important to have a list of all the equipment and facility within the entity with a clearly defined LOTO organogram. The list shpuld clearly indicate the various levels of energy isolations starting from local isolation & building up to global isolation. The lsit should contain Sl No, Equipment name, Energy types, Isolation for each energy at Local & next level, ... Step by step procedure is necessary with defined responsibilities and checkpoints. Do's and Don'ts to be clearly spelt out at each checkpoint List of information that need to be included in the LOTO work permit form requires to be spelt out in the documented system and should be clearly explained The required competencies (both technical as well as behavioral) for LOTO Permit issue and authorisation need to be clearly listed out. Critical competencies out of this list requires to be highlighted The entity should have a Documented LOTO Management system which defines various aspects of Energy isolation & Permit management within the entity

#DIV/0!

a b c

Equipment wise / Facility wise LOTO sequence / LOTO tree

LOTO Tree

Defined workflow for LOTO Work permits - starting from Permit initation till the Permit closure List of ingredients to be recorded in the LOTO work permit format System for identifying the comptencies necessary for LOTO Permit issuer and person authorising the same

LOTO Register

h i j

Identifying the personnel who are nominated as LOTO Permit issuers and This list require to be taskwise / permit wise. Mark "Yes" only if both LOTO Permit authorisers & assessment of their competencies identification and competency assessment is completed Specific roles and responsibilities of Permit seeker, Issuer, Authoriser etc., Roles and responsibilities to be clearly defined Training of LOTO Permit issuer & Permit authoriser` Identifying & nominating the personnel who will be incharge of LOTO, Energy isolation, Energisation / de-energisation or re-energisation & assessment of their competencies Specific roles and responsibilities of these nominated personnel Training of LOTO Incharge & persons nominated for energy isolation, deenergisation & reenergisation System of communicating to the employees involved in LOTO work permit, the Hazards & associated Risks and Control measures to be followed before starting the work System of communicating to all employees who may be affected due to energy isolation ( E.g. Those who are working in the area where LOTO is applicable) Location wise list of different types of Locks, Tags available within the entity Equipment / facility wise list of locks and tags indicating the appropriate type of lock to be used System of verifying the compliance to the LOTO work permits during the execution of the work. Training list should cover all aspects - standard requirement to technical aspects, statutory links etc., The documented system should include the mechanism for assessment of learning penetration also This system should be clearly documented Roles and responsibilities to be clearly defined Training list should cover all aspects - standard requirement to technical aspects, statutory links etc., The documented system should include the mechanism for assessment of learning penetration also Recording this communication is necessary, needs to be made part of work permit form. Recording this communication is necessary, needs to be made part of work permit form. Records to be evidenced Records to be evidenced Permit issuer should visit the site of activity atleast once to the site of activity and record his / her observations. In case of high risk activities, permit issuer should visit twice to thesite of activity and record his / her observations. The procedure should have clarity w.r.t periodicity, checklists to be used, who will do it, authorisation system, red tags if not found OK etc., The documented system should inlcude step by step procedure with Dspecific Do's and Dont's for all these stages Record to be evidenced Equipment specific loto procedures should provide detailed SOP for Safe Lockout of each machine / equipment / facility etc. To be part of the work permit system, Included in the format itself Employee to be made aware of this - Issuer, employee, accounts . ? LOTO Devices Check list

k l m

o p q

s t u 3 4

System of testing the fitness of the LOTO devices & periodicity De-energising, Locking, Re-energising, Starup trials prior to LOTO permit closure Procedure for desipating the stored energy at the time of isolation (E.g. for capacitors, compressed air, gases in ducts etc.) Have you implemented a procedure for de-energising, Locking, Energising and Startup for each equipment identified in your site. Do you have system for penalty or suspension of work upon EHS violations wrt LOTO

SMAT

Have all relevant employees been trained and had supervised practice at implementing the safe energy isolation of the relevant plant and equipment?
The list should include Plant Manager / Head, Operational Managers & all Have you prepared a detailed list of all the Management and Staff employees the Management & Staff employees who activates or authorises or have within your entity who are concerned by the Permit for Energy Isolation equipment that require isolation in their departments. This can be in an (LOTO) excel format. The list should include the Function, Name of employee, task under his / her supervision / department which require Permit to Work Have you kept such a list always updated & Current Have you developed a Training calendar & Schedule for for training the Management & Staff employees as per the list prepared above. The list should be updated and always kept current. Quarterly review of this list is Mandatory Existence of a Training calendar & schedule, No of employees to be covered, Trainer, Method of training, etc., need to be recorded and be available Formal session is mandatory. All the Management and Staff employees who are listed in the inventory as at sl no 1 above to be covered in this session. Mark "Yes" to this checkpoint only if minimum 80% of the listed employees are covered in the training. Entity should have the records to evidence. Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the Formal trainings on this standard are followed up with a Test to check the learning penetration An after the session test / written questionnaire with minimum pass marks (80% as pass marks) is mandatory. Entity should have the records to evidence this system. Anybody failing to score 80% should be taken through the learning module again as a retraining mechanism. Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the retrainings are completed Formal session is mandatory. All the Management and Staff employees who are listed in the inventory as at sl no 1 above to be covered in this session. Mark "Yes" to this checkpoint only if minimum 80% of the listed employees are covered in the training. Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the Formal trainings on this standard are followed up with a Test to check the learning penetration An after the session test / written questionnaire with minimum pass marks (80% as pass marks) is mandatory. Entity should have the records to evidence this system. Anybody failing to score 80% should be taken through the learning module again as a retraining mechanism. Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the retrainings are completed

#DIV/0!

2 3

Have you conducted a formal training on this CSG Standard and Delegation guideline covering all the Management & Staff employees listed

Have you assessed the learning penetration for these Management & Staff employees about this standard & guideline Have you set the Minimum Pass %ge for such a learning penetration test & is it 80% Has your entity retrained the employees who have not passed with the requiste minimum pass score of 80% again within a stipulated time frame of three months Have you conducted a formal training on this Documented LOTO management System covering all the Management & Staff employees as per the list A1 above Have you assessed the learning penetration for these Management & Staff employees about this documented management System Have you set the Minimum Pass %ge for such a learning penetration test & is it 80% Has your entity retrained the employees who have not passed with the requiste minimum pass score of 80% again within a stipulated time frame

10

11

VI
1 2 3

Is their a list of trained personnel kept and updated on a regular basis

Do you review the list of employees who have been trained on LOTO standard as well as the fundamentals of LOTO application every year Is LOTO standard training and principles of LOTO part of the on induction training for the employees who join your entity Are the employees of contractors trained on LOTO (where they are engaged to work on energy isolation); does the work permit specify the LOTO requirements Check for evidence of the document Check for evidence of the document Check for evidence

#DIV/0!

Induction Contractors? Engg?

VII
1

Are appropriate there suitable and sufficient LOT devices (pad-locks, LOTO tool kits, valve, covers, etc.) available.
Do you have the list of all the LOTO devices that is available in your site with the present condition of usability. (The list shall contain the Name of the Mark "yes" only if you have maintained the list as specified in the guidelines. device, Identification number, Date of procurement, Fitness for use, Qty available, Inspection date, etc.,)

#DIV/0!
P.M. Check List

Do you have a LOTO station where all the LOTO equipment are stored. Have Mark "yes" if you have LOTO station .All types of Locks and tags as per CSG you maintained a register for maintaining the issue and use of Locks and guidelines.Register for recording the usage necessary Tags This list should be exhaustive. The list should have the type of energy to be Do you have the list of all equipment and facilities with the kind of energy isolated for each equipment and the type of lock to be used. The estimated sources that require isolation at the time of maintenance qty of locks and tags should be based on this list Have you defined and implemented LOTO oragnogram / LOTO sequence tree Check for evidence and displayed the same as a visual communication on each equipment Have you displayed the list of authorised LOTO personnel with their contact Physical inspection and audit, Expected compliance 100% nos and photos and other details Have you displayed the visual displays on the correct use of Locks & tags on It is mandatory to have these at all critical locations. The critical locations to critical equipment like control panels, air lines, hot air ducts, dust air ducts, be listed out in the list at 3-d above access control locks etc., Photos - David Visual

4 5 6

VIII
1 2

Is there a system and procedure to ensure that the locks of employees and others cannot be removed without a thorough search and investigation by the nominated responsible person.
Have you defined an Operational Control procedure for the implementation of LOTO & trained your employees on the same Have you formally trained all the LOTO incharges and authorized LOTO personnel about these SOPs. Have you implemented a mandatory communication and specific information transfer mechanism for LOTO under exceptional circumstances like overlapping shifts, end of shifts etc., Are these instructions recorded in Work permit / LOTO communication register Does your procedure requires prior approval from the LOTO administrator under exceptional circumstances wherein the Lock put in by person A needs to be removed by a person B Record and display at locations to be evidenced. Mark "yes" only if all the personnels are trained and their learning is assessed. Mark "yes" if you have a procedure, Communication system and evidence to prove the statement.

#DIV/0!
OCP / SOP

Check the documented procedure the contingency plan for such emergencies

IX
1

Has each installation been equipped with suitable and sufficient energy isolating devices so that equipment can be effectively locked out
Have you assessed the locking and tagging capabilities of all the equipment and facilities in your entity and maintained an up to date listing Where the locking provision do not exist, have you prepared and implemented an action plan with specific time frame and responsibilities for compliance Does your Management of Change procedure or the EHS clearance of any new equipment / facility cover the verification of adequate LOTO provisions prior to approval & is inspected. Do you check the adequacy of the LOTO provisions provided in new / modified installations / equipments / plants prior to commissioning of the same Check the list. This should be part of the list of all equipment and facility made at VII-3 above Check the action plan for corrections Mark "yes" if the need is considered practically on site and the records of such MOC are maintained for past 1 year. Mark " yes" if the action items are identified in MOC and the completion of action items are evident.

#DIV/0!

Action Plan - Non

Engg Team Commu

H/O check list

X
1 2 3

Have all relevant managers and supervisors been trained on the procedures and their obligations to ensure the safe energy isolation of plant and equipment.
Have you trained formally all your Managers, Engineers, Supervisors and employees about the SOP's related to LOTO implementation Does the training on LOTO also include the responsibility of each employee as a member of the group "LOTO affected employee" Does the training include among all other aspects related to Hazards and risks, the sequence of energy isolation - which energy to be isolated first and which one to be energised first Does your LOTO system requires you to take the specific permission of the concerned manager / incharge of the department / area where the energy isolation activity is likely to happen All employees to be trained on the LOTO organogram related to their place of work. List of such training should be evidenced Check for evidence of such communication and training Check the training content This is mandatory. Recording his / her approval in the Work permit is important

#DIV/0!

XI
1 a b c d e f g h 2

Has the Risk Assessment procedure identified where a Permit to Work procedure should be applied? ( where more than 3 isolation points for sources of energy)
Does your LOTO work permit format consist of the following:Equipment / facility requiring isolation Type of energies to be isolated Isolation points and locations as per LOTO organogram Isolation procedure Locks, Tags to be used Desipation of stored energy Restart procedure / steps Check points for re-energization Do you attach the copy of the SOP / JSA / Safe Work Method Statement along with the work permit as a reference for the employees who are carrying out the job task Mark "yes" if it exists in the permit and it is implemented. Mark "yes" if it exists in the permit and it is implemented. Mark "yes" if it exists in the permit and it is implemented. Mark "yes" if it exists in the permit and it is implemented. Mark "yes" if it exists in the permit and it is implemented. Mark "yes" if it exists in the permit and it is implemented. Mark "yes" if it exists in the permit and it is implemented. Mark "yes" if it exists in the permit and it is implemented. This is necessary. Converting the instructions in to understandable steps / pictograms / visible displays is important

#DIV/0!
Permit

XII

Do your procedures require every employee who is 'at risk' applies an individual Lockout device to each source of hazardous energy, thereby ensuring his/her personal safety. One Lock - One Key!
Have you ensured 1 lock, 1 key, 1 person for LOTO implementation. The concept of 1 person, 1 lock and 1 key should be fully implemented to mark this as "Yes". Each authorised employee can lock only for the authorised energy source and authorised location or equipment. Check for compliance

#DIV/0!

2 3

Does the work permit for LOTO specify the energy to be isolated and LOTO Check for compliance employee who will isolate this energy. In case of activities requiring multiple energies to be isolated, does your work Check for evidence permit for LOTO specify different Locks and tags

XIII
1 2

Have the procedures determined the type and number of safety Lockout and Tag devices required,
Does your work permit for LOTO requires the issuer to physically verify the equipment / facility for the LOTO provisions Check the system in place and evidence

#DIV/0!
Permit

Does the LOTO permit issuer, record the observations related to the physical Check the permits verification and specify the type and qty of locks to be used in the permit example - fuse removal by opening a panel as a practice of LOTO should be Have you implemented mistake proofing mechanisms and systems to ensure discouraged (as it could lead to arc flash risks). Instead Panel swich control that no wrong locks are used for energy isolation should be locked to isolate energy. Check for evidence of such controls.

XIV

Is there a procedure to ensure that all safety Lockout devices are safely stored in designated locations and condition checked on a regular basis.

#DIV/0!

1 2 3 4

Do you record the name of the authorised employee in a LOTO register whenever the Lock / Tag is removed from its designated storage location Is the system put in place to know where the missing lock is at any given point in time Do you have monthly audit of the Locks to ensure that they are in good working condition Are the locks stored in a secured place to ensure that it is protected against damages, external environmental conditions as well as theft Does you LOTO procedure clearly specify stepwise requirement of deenergisation and dessipation of any stored energy Have you trained all your authorised employees for LOTO on de-energisation steps and dessipation of stored energy Have you displayed the deactivation and activation sequence on respective panels or the sources of energies Is the LOTO permit for isolation of more than one energy source authorised by the LOTO administrator

Check for evidence Check for evidence Recording of observations / checklists is necessary. It is im[portant to assess the condition of each lock Check physically Audit

XV
1 2 3 4

Do your procedures specifically require that stored or residual energy is dissipated or restrained by an approved method?
Check the SOP's for compliance Check the trainign details Mark "yes" if you have posted the same with identifyable pictures on respective power sources. Check for compliance

#DIV/0!

XVI
1

Do your procedures require that isolation is verified by trying to start the equipment after isolation (provided it is safe to do so!)
This should be part of the LOTO work permit. Permit should clearly specify Do you verify "0" energy state of machine / facility before the maintenance the stages in de-energisation and dessipation with devices to be used and or service activity can begin. controls to be followed This should be part of the SPOT tests. This should be done by the LOTO Do you test the level of competency of your authorised employees often administrator. This is mandatory to ensure that "0" energy state is followed (atleast once in a quarter) to determine if they follow the procedure to rigourously prior to any maintenace. Check for evidence of such SPOT ensure "0" energy state assessments Do you assess the risks of not verifying the "0" energy state prior to start of This should be part of the training. Evidence to be sought the maintenance work and communicated the same to the authorised employees

#DIV/0!

XVII Do your procedures require that a Dynamic Risk Assessment (60 seconds to think) before work commences on isolated equipment,
1 2 Have you incorporated 60 seconds to think checklist with the LOTO permit This is mandatory for all LOTO isolations. Check all the LOTO isolations and system verify the filling of 60 secs to think checklist In case of multiple energy isolations by multiple no of employees, do you make sure that each employee goes through and fills up the 60 secs to think Check for evidence of having done this independantly It is important to assess the risks related to energy isolations, trials and reDo you assess the risks of multiple energy isolations at the time of issuing the energisation of the multiple energies. Evidence of the risk assessment in the permit and carrying out the 60 secs to think assessment work permit for LOTO should be sought

#DIV/0!
1Min%

XVIII

Does your procedure require that for any equipment that is locked out and left unattended, there is a verification check that the locks have not been damaged or removed before work recommences
Prolonged Locks and tags should be available. Energy isolation on redundant Incase of longer duration shutdowns have you implemented "prolonged cables, panels, facilitties should be checked. The list of equipment / facilities duration Lock and Tag" that are locked for longer durations should be available with the LOTO administrator Whenever the long duration locks and tags are to be removed, do you have a Any lock that is not opened beyond a specified duration (say 1 week or more) "Revival" permit that needs to be approved by the LOTO administrator prior should be dealt with this approach. Check with LOTO administraor on the to opening the lock system in place Whenever the long duration locks are removed, do you check the condition of the energy isolation, "0" state of energy and assess the fresh hazards and Check for evidence risks of energisation prior to opening the lock Post removal of such locks do you check the condition of the lock prior to Check for system and evidence posting it back in to LOTO storage area Long

#DIV/0!

3 4

XIX
1

Do your procedures require a safety check of the work area to ensure the safe removal of personnel, equipment and tools from the area before energy is restored.
Does your LOTO permit checklist specify the checkpoints to be verified by the Verify for the existence of such a checklist LOTO authorised employees prior to inching or re-energisation post completion of the task It is essential to make sure that personnel are away from any moving part / Does the chekpoint requires you to verify the presence of people within the energy source at the time of re-energisation. This should be ensured. The area. checkpoint specific to personnel should exist and filled in all the LOTO permits. Check for compliance Does the chekpoint requires you to verify the presence of any equipment, It is necessary to check for presence of tools like spanners, testers, welding tool, tackles, left over debris of fabrication, etc., in the area where the resets, welding bits, fire chances etc., before re-energisation. Look for such energisation is likely ot take place checks and compliance in LOTO permits Is the sequence of re-energisation clearly defined and known as a part of the Check for the flow sheets of re-energisation LOTO permit - check for the flow sheets

#DIV/0!
Permit

3 4

XX
1 2

Does your procedure require that all safety components such as interlocks and guards are fully restored to service before the energy source is reconnected.
Does your procedure require that all interlocks are fully put back in to service Mark "yes" if this reflects in your procedure and controlled with a permit to prior to starting the energisation work. Does the checkpoint requires you to check and confirm that all interlocks, machine guards, barriers etc., are fully put back in place before energisation Have you prohibitted by written notice within your entity, by-passing of safety interlocks for any testing of re-energisation even for a short duration Check the permits for compliance

#DIV/0!

Check for written notice and its statement of intent in the LOTO permit

XXI
1 2

Does your procedure require that all affected employees are informed that the energy resources have been restored and that the equipment is ready for use.
Does your LOTO system requires you to take the specific permission of the concerned manager / incharge of the department / area for re-energisation Does the concerned manager / area incharge check and validate the safety interlocks prior to giving his nod for re-energisation This is mandatory. Recording his / her approval in the LOTO permit is important. Check the permits to verify the compliance This is mandatory. Check the system and practice through a spot audit

#DIV/0!

Is there a requirement that all contractors who work under a Lockout/Tagout system have an Authorised Status or are subject to Permit to XXII Work requirements.
1 Whenever any maintenance task is carried out with employees of contractors (routine contractors or others), do you check if they have been previously been trained on LOTO requirements This is mandatory. Any person who is working on any maintenance activoity should e trained on Do's and Don'ts of LOTO. Check for evidence

#DIV/0!

Do you have a mandatory Do's and Donts checklist for LOTO that requires to Check the evidence be communicated and signed by all contractors as apart of work permit

Do's & Don'ts

Do you make it mandatory use of LOTO for the sub contractor areas / locations inside your premises where contractor activities (like fabrication, machine shop, assembly, testing, anciliary work of production etc activities) are carried out by contractor agencies

Check for evidence of implementing these systems.

Check for evidence of implementing these systems. Check who is performing Are the persons who perform LOTO in these contractor areas are trained and the LOTO. If the contractor employees theselves are doing, check if they are authorised authorised to perform LOTO

If Risk Assessments have identified that Production Employees will have to make frequent access of short duration to equipment during XXIII normal production without full Lo/To provision, have they received specialised training on safe working procedures that will ensure their safety.
Evidence of having prohibited the energy isolation without LOTO should be Have you made it mandatory within your entity that any energy isolation for sought. any intervention even by trained regular production crew will require LOTO Interview the employees at shopfloor (authorised employees), cross check protection irrespective of the duration & freqency of such isolation with them on energy isolation with case studies like these to check the level of understanding Check the list of risks and hazards, visit the shop floor to check such Does your risk assessment identified such frequent / short duration practices. Example - operating emergency swicth and carrying out interventions maintenance work on electrical connection. In case such practices are noticed are they reported and investigated as Check for awareness, practice of incident reporting, etc., unsafe practices

#DIV/0!

2 3

XXIV
1

Is there a procedure to ensure that all temporary staff, agency staff or contractors are informed and trained where necessary on the local requirements for energy isolation?
In case of LOTO work permits, do you train the employees of the contractors This should be evidenced as a part of work permit itself. Training on hazards or others about the Do's and Don'ts of energy isolation and risks should cover energy isolation too. Check for evidence

#DIV/0!
Contractors

XXV Do your procedures ensure that Lo/To is continuous for shift and personnel changes
1 Have you implemented a system of "Transitional Locks & Tags" for isolations Transitional locks and tags should be available, Check the procedure for such that are likely to spread beyond one shift and beyond one person. systems In the event of a change in the personnel (i.e if the lock is put in by person A and is being removed by another person B), does the LOTO work permits specify these requirements Check the work permits for LOTO

#DIV/0!

Are the personnel who are authorised for LOTO trained and have Check the training of authorised personnel infrastructure (different set of locks, tags etc.,) for ensuring Transitional Locks

XXVI Do you have a procedure for the safe removal of Lo/To devices in the event of someone accidentally leaving them in place?
1 Does your LOTO administrator visit the site of LOTO periodically and check the validity of the Locks and tags. Whether such inspections are recorded Check the assessment details

#DIV/0!

Is there a provision in your documented system to for authorising an opening of a Lock under exceptional circumstances (example if the Lock is left in place Check the system procedure and implementation evidence even after the completion of the task due to non availability of the person who locked it) Do you record the details of such waivers in the work permits and does these Check for evidence waivers part of the LOTO administrators summary analysis every month

XXVII Have you an audit and review procedure to ensure that all the requirements of your Plant and Equipment Isolations are effective?.
1 Does your LOTO incharge visit the site of activity during the execution of work and make his observations regarding the compliances to LOTO requirement and records his comments in the work permit. This is mandatory. Evidence of recorded observations is a must. Irresepctive of the duration of the work permit; once in 2 hours visit to the site of activity is a must by the LOTO Incharge. Mark "yes" if you have a documented procedure for conducting the audit, Do you conduct LOTO compliance audits every month; evidence of such the audit is conducted in the said frequency and if the observation are audits is necessary tracked to closure, Do you carryout SMAT interactions covering the areas where LOTO isolations Mark "yes" if you have carried out SMATS in atleast 25 % of LOTO work are done. permits. Is the effective implementation of LOTO in your entity a key review point in Records to be evidenced your periodical operations or EHS meetings by your plant head.

#DIV/0!

2 3 4

Overall Compliance %ge

#DIV/0!

0% 20% 40% Yes No Not Applicable 60% 80% 100%

0 0 0 0 0 0

SAINT-GOBAIN STANDARD Lockout - Tagout

S No
I
1 2 3 4 5 6 7 8

Theme Question

Requirement in Detail

Compliance

GAIA Score
#DIV/0!
Manual, Formats Procedure,

Has a person been nominated as being responsible for the management overview of all plant and equipment isolations on site
Have you identified and nominated a person(s) within your entity for being responsible for implementing the LOTO system within your entity. LOTO Administrator / LOTO Manager Have you defined and documented the roles and responsibilities of the nominated LOTO administrator Is the nominated person made responsible for preparing the documented LOTO system procedures, formats, tracking systems, montoring etc., Is the nominated person responsible for conducting further trainings within your entity on LOTO system Does the nominated person analyse the implementation of the LOTO system within your entity Have you identified and authorised through a formal notification the list of employees (other than LOTO Administrator) who can perform LOTO energisation and de-energisation Have you maintained the up to date list of the authorised employees for LOTO activation Have you defined and documented the roles and responsibilities of the nominated LOTO authorised employees Formal nomination is a must. The identified person will be responsible for making the procedure, documented systes, formats and tracking the compliances. Check for evidence of the document The responsibilities and roles to be clearly defined for this nominated person. Evidence of having conducted trainings is necessary Evidence of the analyses and charts / data depicting the progress of implementation, discussions in the MRM,s is necessary This list is mandatory. Only those who are authorised should be allowed to perform the energisation / de-energisation To mark "yes" have you done the competence assessment of the same. Check for evidence of the document

LOTO KPI & OPI

Skill Matrix

II

Has the nominated person sufficient information and training to enable them to manage their responsibilities competently.
Technical competency, Awareness about Standard & Guideline, Ability to Have you identified the Job specific competencies required for the LOTO develop Documented LOTO System & procedures, LOTO technicalities as well Administrator / LOTO manager. This job specific competencies should be as behavioral competencies should be listed. Capability to drive the program, derived based on the Training matrix of Saint-Gobain as well as the LOTO training of others should be assessed. Critical competencies required for the Standard requirement job should be spelt out. The competencies have to be split between - To Know & To Know how to do categories as per the CSG training matrix Have you assessed the competencies of the LOTO Administrator / LOTO Records to be evidenced as per the listed job specific competencies Manager (nominated person) w.r.t the list of job specific competencies It is mandatory to train the nominated person w.r.t the CSG standard on Have your nominated person undergone a formal training on LOTO Standard LOTO. Formal session is necessary either by Sector/e-learning / Delegation / of Saint-Gobain any other internal mechanism Is the nominated person(s) formally trained on the fundamendtals of LOTO, Formal training is mandatory. Assessment of his / her competency is Isolation energies, Arc Flash, and use of control measures etc., important as a program administrator. Technical knowledge is vital Have you carried out a detailed Training need identification for the employees authorised to operate and use LOTO & developed a training plan Records to be evidenced for minimising the gaps in competencies Have you trained the LOTO authorised employees on the identified training Records to be evidenced needs & assessed his learning penetration. Do you conduct annual refesher trainings on LOTO and assess / reassess the Records to be evidenced level of knowledge, competency etc of the authorised employees

#DIV/0!

3 4 5 6 7

Arc Falsh? - HT Trg Need?

Temp, Gas

III
1

Has a Risk assessment been carried out to identify all situations where energy isolation of plant and equipment would be required?
Did you carry out the risk assessment to identify all situations where LOTO Linkage to risk assessment is essential. LOTO as a control measure as a would be required. derivitive of risk assessment important Have you prepared an inventory / list of all activities that require LOTO activaton. Format. F-020-001 from Delegation guideline can be referred The entity should have a list of all such activities possible at its facility. Activities / tasks under Routine, Non Routine, One time works, works carried out by external aganecies, Maintenance works etc., should be part of the list.

#DIV/0!

F-020-001 from Delegation guideline JSA

3 4

Have you carried out JSA / Safe work method statement for all the activities Records to be evidenced that require LOTO Work permits Do you train the employees carrying out the task as per the LOTO work This is mandatory. Each work permit should record this aspect. Records of permit on the SOP / JSA / Safe Work Method Statement requirements prior such training to be maintained and evidenced to issuing of each work permit

IV
1 2

Is there a written procedure for the safe energy isolation of all plant and equipment?
Have you prepared & documented a Management System manual & Procedures for LOTO at your entity Does the documented & implemented LOTO management System consist of the following List of all activities / Job tasks that require LOTO Different types of Energies to be isolated System for combination of isolations This list requires to be exhaustive. The tasks that may look routine type, but are of high risk category should be included in LOTO permit. Any activity which requires energy isolation should be under work permit. List of different energies to be isolated to be documented System of combined isolation requirements - Electrical + Mechanical, Electrical + Pneumatic, Pneumatic + Heat, Mechanical + gases etc., to be detailed out It is important to have a list of all the equipment and facility within the entity with a clearly defined LOTO organogram. The list shpuld clearly indicate the various levels of energy isolations starting from local isolation & building up to global isolation. The lsit should contain Sl No, Equipment name, Energy types, Isolation for each energy at Local & next level, ... Step by step procedure is necessary with defined responsibilities and checkpoints. Do's and Don'ts to be clearly spelt out at each checkpoint List of information that need to be included in the LOTO work permit form requires to be spelt out in the documented system and should be clearly explained The required competencies (both technical as well as behavioral) for LOTO Permit issue and authorisation need to be clearly listed out. Critical competencies out of this list requires to be highlighted The entity should have a Documented LOTO Management system which defines various aspects of Energy isolation & Permit management within the entity

#DIV/0!

a b c

Equipment wise / Facility wise LOTO sequence / LOTO tree

LOTO Tree

Defined workflow for LOTO Work permits - starting from Permit initation till the Permit closure List of ingredients to be recorded in the LOTO work permit format System for identifying the comptencies necessary for LOTO Permit issuer and person authorising the same

LOTO Register

h i j

Identifying the personnel who are nominated as LOTO Permit issuers and This list require to be taskwise / permit wise. Mark "Yes" only if both LOTO Permit authorisers & assessment of their competencies identification and competency assessment is completed Specific roles and responsibilities of Permit seeker, Issuer, Authoriser etc., Roles and responsibilities to be clearly defined Training of LOTO Permit issuer & Permit authoriser` Identifying & nominating the personnel who will be incharge of LOTO, Energy isolation, Energisation / de-energisation or re-energisation & assessment of their competencies Specific roles and responsibilities of these nominated personnel Training of LOTO Incharge & persons nominated for energy isolation, deenergisation & reenergisation System of communicating to the employees involved in LOTO work permit, the Hazards & associated Risks and Control measures to be followed before starting the work System of communicating to all employees who may be affected due to energy isolation ( E.g. Those who are working in the area where LOTO is applicable) Location wise list of different types of Locks, Tags available within the entity Equipment / facility wise list of locks and tags indicating the appropriate type of lock to be used System of verifying the compliance to the LOTO work permits during the execution of the work. Training list should cover all aspects - standard requirement to technical aspects, statutory links etc., The documented system should include the mechanism for assessment of learning penetration also This system should be clearly documented Roles and responsibilities to be clearly defined Training list should cover all aspects - standard requirement to technical aspects, statutory links etc., The documented system should include the mechanism for assessment of learning penetration also Recording this communication is necessary, needs to be made part of work permit form. Recording this communication is necessary, needs to be made part of work permit form. Records to be evidenced Records to be evidenced Permit issuer should visit the site of activity atleast once to the site of activity and record his / her observations. In case of high risk activities, permit issuer should visit twice to thesite of activity and record his / her observations. The procedure should have clarity w.r.t periodicity, checklists to be used, who will do it, authorisation system, red tags if not found OK etc., The documented system should inlcude step by step procedure with Dspecific Do's and Dont's for all these stages Record to be evidenced Equipment specific loto procedures should provide detailed SOP for Safe Lockout of each machine / equipment / facility etc. To be part of the work permit system, Included in the format itself Employee to be made aware of this - Issuer, employee, accounts . ? LOTO Devices Check list

k l m

o p q

s t u 3 4

System of testing the fitness of the LOTO devices & periodicity De-energising, Locking, Re-energising, Starup trials prior to LOTO permit closure Procedure for desipating the stored energy at the time of isolation (E.g. for capacitors, compressed air, gases in ducts etc.) Have you implemented a procedure for de-energising, Locking, Energising and Startup for each equipment identified in your site. Do you have system for penalty or suspension of work upon EHS violations wrt LOTO

SMAT

Have all relevant employees been trained and had supervised practice at implementing the safe energy isolation of the relevant plant and equipment?
The list should include Plant Manager / Head, Operational Managers & all Have you prepared a detailed list of all the Management and Staff employees the Management & Staff employees who activates or authorises or have within your entity who are concerned by the Permit for Energy Isolation equipment that require isolation in their departments. This can be in an (LOTO) excel format. The list should include the Function, Name of employee, task under his / her supervision / department which require Permit to Work Have you kept such a list always updated & Current Have you developed a Training calendar & Schedule for for training the Management & Staff employees as per the list prepared above. The list should be updated and always kept current. Quarterly review of this list is Mandatory Existence of a Training calendar & schedule, No of employees to be covered, Trainer, Method of training, etc., need to be recorded and be available Formal session is mandatory. All the Management and Staff employees who are listed in the inventory as at sl no 1 above to be covered in this session. Mark "Yes" to this checkpoint only if minimum 80% of the listed employees are covered in the training. Entity should have the records to evidence. Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the Formal trainings on this standard are followed up with a Test to check the learning penetration An after the session test / written questionnaire with minimum pass marks (80% as pass marks) is mandatory. Entity should have the records to evidence this system. Anybody failing to score 80% should be taken through the learning module again as a retraining mechanism. Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the retrainings are completed Formal session is mandatory. All the Management and Staff employees who are listed in the inventory as at sl no 1 above to be covered in this session. Mark "Yes" to this checkpoint only if minimum 80% of the listed employees are covered in the training. Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the Formal trainings on this standard are followed up with a Test to check the learning penetration An after the session test / written questionnaire with minimum pass marks (80% as pass marks) is mandatory. Entity should have the records to evidence this system. Anybody failing to score 80% should be taken through the learning module again as a retraining mechanism. Entity should have the records to evidence this system. Mark "Yes" to this checkpoint only if all the retrainings are completed

#DIV/0!

2 3

Have you conducted a formal training on this CSG Standard and Delegation guideline covering all the Management & Staff employees listed

Have you assessed the learning penetration for these Management & Staff employees about this standard & guideline Have you set the Minimum Pass %ge for such a learning penetration test & is it 80% Has your entity retrained the employees who have not passed with the requiste minimum pass score of 80% again within a stipulated time frame of three months Have you conducted a formal training on this Documented LOTO management System covering all the Management & Staff employees as per the list A1 above Have you assessed the learning penetration for these Management & Staff employees about this documented management System Have you set the Minimum Pass %ge for such a learning penetration test & is it 80% Has your entity retrained the employees who have not passed with the requiste minimum pass score of 80% again within a stipulated time frame

10

11

VI
1 2 3

Is their a list of trained personnel kept and updated on a regular basis

Do you review the list of employees who have been trained on LOTO standard as well as the fundamentals of LOTO application every year Is LOTO standard training and principles of LOTO part of the on induction training for the employees who join your entity Are the employees of contractors trained on LOTO (where they are engaged to work on energy isolation); does the work permit specify the LOTO requirements Check for evidence of the document Check for evidence of the document Check for evidence

#DIV/0!

Induction Contractors? Engg?

VII
1

Are appropriate there suitable and sufficient LOT devices (pad-locks, LOTO tool kits, valve, covers, etc.) available.
Do you have the list of all the LOTO devices that is available in your site with the present condition of usability. (The list shall contain the Name of the Mark "yes" only if you have maintained the list as specified in the guidelines. device, Identification number, Date of procurement, Fitness for use, Qty available, Inspection date, etc.,)

#DIV/0!
P.M. Check List

Do you have a LOTO station where all the LOTO equipment are stored. Have Mark "yes" if you have LOTO station .All types of Locks and tags as per CSG you maintained a register for maintaining the issue and use of Locks and guidelines.Register for recording the usage necessary Tags This list should be exhaustive. The list should have the type of energy to be Do you have the list of all equipment and facilities with the kind of energy isolated for each equipment and the type of lock to be used. The estimated sources that require isolation at the time of maintenance qty of locks and tags should be based on this list Have you defined and implemented LOTO oragnogram / LOTO sequence tree Check for evidence and displayed the same as a visual communication on each equipment Have you displayed the list of authorised LOTO personnel with their contact Physical inspection and audit, Expected compliance 100% nos and photos and other details Have you displayed the visual displays on the correct use of Locks & tags on It is mandatory to have these at all critical locations. The critical locations to critical equipment like control panels, air lines, hot air ducts, dust air ducts, be listed out in the list at 3-d above access control locks etc., Photos - David Visual

4 5 6

VIII
1 2

Is there a system and procedure to ensure that the locks of employees and others cannot be removed without a thorough search and investigation by the nominated responsible person.
Have you defined an Operational Control procedure for the implementation of LOTO & trained your employees on the same Have you formally trained all the LOTO incharges and authorized LOTO personnel about these SOPs. Have you implemented a mandatory communication and specific information transfer mechanism for LOTO under exceptional circumstances like overlapping shifts, end of shifts etc., Are these instructions recorded in Work permit / LOTO communication register Does your procedure requires prior approval from the LOTO administrator under exceptional circumstances wherein the Lock put in by person A needs to be removed by a person B Record and display at locations to be evidenced. Mark "yes" only if all the personnels are trained and their learning is assessed. Mark "yes" if you have a procedure, Communication system and evidence to prove the statement.

#DIV/0!
OCP / SOP

Check the documented procedure the contingency plan for such emergencies

IX
1

Has each installation been equipped with suitable and sufficient energy isolating devices so that equipment can be effectively locked out
Have you assessed the locking and tagging capabilities of all the equipment and facilities in your entity and maintained an up to date listing Where the locking provision do not exist, have you prepared and implemented an action plan with specific time frame and responsibilities for compliance Does your Management of Change procedure or the EHS clearance of any new equipment / facility cover the verification of adequate LOTO provisions prior to approval & is inspected. Do you check the adequacy of the LOTO provisions provided in new / modified installations / equipments / plants prior to commissioning of the same Check the list. This should be part of the list of all equipment and facility made at VII-3 above Check the action plan for corrections Mark "yes" if the need is considered practically on site and the records of such MOC are maintained for past 1 year. Mark " yes" if the action items are identified in MOC and the completion of action items are evident.

#DIV/0!

Action Plan - Non

Engg Team Commu

H/O check list

X
1 2 3

Have all relevant managers and supervisors been trained on the procedures and their obligations to ensure the safe energy isolation of plant and equipment.
Have you trained formally all your Managers, Engineers, Supervisors and employees about the SOP's related to LOTO implementation Does the training on LOTO also include the responsibility of each employee as a member of the group "LOTO affected employee" Does the training include among all other aspects related to Hazards and risks, the sequence of energy isolation - which energy to be isolated first and which one to be energised first Does your LOTO system requires you to take the specific permission of the concerned manager / incharge of the department / area where the energy isolation activity is likely to happen All employees to be trained on the LOTO organogram related to their place of work. List of such training should be evidenced Check for evidence of such communication and training Check the training content This is mandatory. Recording his / her approval in the Work permit is important

#DIV/0!

XI
1 a b c d e f g h 2

Has the Risk Assessment procedure identified where a Permit to Work procedure should be applied? ( where more than 3 isolation points for sources of energy)
Does your LOTO work permit format consist of the following:Equipment / facility requiring isolation Type of energies to be isolated Isolation points and locations as per LOTO organogram Isolation procedure Locks, Tags to be used Desipation of stored energy Restart procedure / steps Check points for re-energization Do you attach the copy of the SOP / JSA / Safe Work Method Statement along with the work permit as a reference for the employees who are carrying out the job task Mark "yes" if it exists in the permit and it is implemented. Mark "yes" if it exists in the permit and it is implemented. Mark "yes" if it exists in the permit and it is implemented. Mark "yes" if it exists in the permit and it is implemented. Mark "yes" if it exists in the permit and it is implemented. Mark "yes" if it exists in the permit and it is implemented. Mark "yes" if it exists in the permit and it is implemented. Mark "yes" if it exists in the permit and it is implemented. This is necessary. Converting the instructions in to understandable steps / pictograms / visible displays is important

#DIV/0!
Permit

XII

Do your procedures require every employee who is 'at risk' applies an individual Lockout device to each source of hazardous energy, thereby ensuring his/her personal safety. One Lock - One Key!
Have you ensured 1 lock, 1 key, 1 person for LOTO implementation. The concept of 1 person, 1 lock and 1 key should be fully implemented to mark this as "Yes". Each authorised employee can lock only for the authorised energy source and authorised location or equipment. Check for compliance

#DIV/0!

2 3

Does the work permit for LOTO specify the energy to be isolated and LOTO Check for compliance employee who will isolate this energy. In case of activities requiring multiple energies to be isolated, does your work Check for evidence permit for LOTO specify different Locks and tags

XIII
1 2

Have the procedures determined the type and number of safety Lockout and Tag devices required,
Does your work permit for LOTO requires the issuer to physically verify the equipment / facility for the LOTO provisions Check the system in place and evidence

#DIV/0!
Permit

Does the LOTO permit issuer, record the observations related to the physical Check the permits verification and specify the type and qty of locks to be used in the permit example - fuse removal by opening a panel as a practice of LOTO should be Have you implemented mistake proofing mechanisms and systems to ensure discouraged (as it could lead to arc flash risks). Instead Panel swich control that no wrong locks are used for energy isolation should be locked to isolate energy. Check for evidence of such controls.

XIV

Is there a procedure to ensure that all safety Lockout devices are safely stored in designated locations and condition checked on a regular basis.

#DIV/0!

1 2 3 4

Do you record the name of the authorised employee in a LOTO register whenever the Lock / Tag is removed from its designated storage location Is the system put in place to know where the missing lock is at any given point in time Do you have monthly audit of the Locks to ensure that they are in good working condition Are the locks stored in a secured place to ensure that it is protected against damages, external environmental conditions as well as theft Does you LOTO procedure clearly specify stepwise requirement of deenergisation and dessipation of any stored energy Have you trained all your authorised employees for LOTO on de-energisation steps and dessipation of stored energy Have you displayed the deactivation and activation sequence on respective panels or the sources of energies Is the LOTO permit for isolation of more than one energy source authorised by the LOTO administrator

Check for evidence Check for evidence Recording of observations / checklists is necessary. It is im[portant to assess the condition of each lock Check physically Audit

XV
1 2 3 4

Do your procedures specifically require that stored or residual energy is dissipated or restrained by an approved method?
Check the SOP's for compliance Check the trainign details Mark "yes" if you have posted the same with identifyable pictures on respective power sources. Check for compliance

#DIV/0!

XVI
1

Do your procedures require that isolation is verified by trying to start the equipment after isolation (provided it is safe to do so!)
This should be part of the LOTO work permit. Permit should clearly specify Do you verify "0" energy state of machine / facility before the maintenance the stages in de-energisation and dessipation with devices to be used and or service activity can begin. controls to be followed This should be part of the SPOT tests. This should be done by the LOTO Do you test the level of competency of your authorised employees often administrator. This is mandatory to ensure that "0" energy state is followed (atleast once in a quarter) to determine if they follow the procedure to rigourously prior to any maintenace. Check for evidence of such SPOT ensure "0" energy state assessments Do you assess the risks of not verifying the "0" energy state prior to start of This should be part of the training. Evidence to be sought the maintenance work and communicated the same to the authorised employees

#DIV/0!

XVII Do your procedures require that a Dynamic Risk Assessment (60 seconds to think) before work commences on isolated equipment,
1 Have you incorporated 60 seconds to think checklist with the LOTO permit This is mandatory for all LOTO isolations. Check all the LOTO isolations and system verify the filling of 60 secs to think checklist In case of multiple energy isolations by multiple no of employees, do you make sure that each employee goes through and fills up the 60 secs to think Check for evidence of having done this independantly It is important to assess the risks related to energy isolations, trials and reDo you assess the risks of multiple energy isolations at the time of issuing the energisation of the multiple energies. Evidence of the risk assessment in the permit and carrying out the 60 secs to think assessment work permit for LOTO should be sought

#DIV/0!
1Min%

XVIII

Does your procedure require that for any equipment that is locked out and left unattended, there is a verification check that the locks have not been damaged or removed before work recommences
Prolonged Locks and tags should be available. Energy isolation on redundant Incase of longer duration shutdowns have you implemented "prolonged cables, panels, facilitties should be checked. The list of equipment / facilities duration Lock and Tag" that are locked for longer durations should be available with the LOTO administrator Whenever the long duration locks and tags are to be removed, do you have a Any lock that is not opened beyond a specified duration (say 1 week or more) "Revival" permit that needs to be approved by the LOTO administrator prior should be dealt with this approach. Check with LOTO administraor on the to opening the lock system in place Whenever the long duration locks are removed, do you check the condition of the energy isolation, "0" state of energy and assess the fresh hazards and Check for evidence risks of energisation prior to opening the lock Post removal of such locks do you check the condition of the lock prior to Check for system and evidence posting it back in to LOTO storage area Long

#DIV/0!

3 4

XIX
1

Do your procedures require a safety check of the work area to ensure the safe removal of personnel, equipment and tools from the area before energy is restored.
Does your LOTO permit checklist specify the checkpoints to be verified by the Verify for the existence of such a checklist LOTO authorised employees prior to inching or re-energisation post completion of the task It is essential to make sure that personnel are away from any moving part / Does the chekpoint requires you to verify the presence of people within the energy source at the time of re-energisation. This should be ensured. The area. checkpoint specific to personnel should exist and filled in all the LOTO permits. Check for compliance Does the chekpoint requires you to verify the presence of any equipment, It is necessary to check for presence of tools like spanners, testers, welding tool, tackles, left over debris of fabrication, etc., in the area where the resets, welding bits, fire chances etc., before re-energisation. Look for such energisation is likely ot take place checks and compliance in LOTO permits Is the sequence of re-energisation clearly defined and known as a part of the Check for the flow sheets of re-energisation LOTO permit - check for the flow sheets

#DIV/0!
Permit

3 4

XX
1 2

Does your procedure require that all safety components such as interlocks and guards are fully restored to service before the energy source is reconnected.
Does your procedure require that all interlocks are fully put back in to Mark "yes" if this reflects in your procedure and controlled with a permit to service prior to starting the energisation work. Does the checkpoint requires you to check and confirm that all interlocks, machine guards, barriers etc., are fully put back in place before energisation Have you prohibitted by written notice within your entity, by-passing of safety interlocks for any testing of re-energisation even for a short duration Check the permits for compliance

#DIV/0!

Check for written notice and its statement of intent in the LOTO permit

XXI
1 2

Does your procedure require that all affected employees are informed that the energy resources have been restored and that the equipment is ready for use.
Does your LOTO system requires you to take the specific permission of the concerned manager / incharge of the department / area for re-energisation Does the concerned manager / area incharge check and validate the safety interlocks prior to giving his nod for re-energisation This is mandatory. Recording his / her approval in the LOTO permit is important. Check the permits to verify the compliance This is mandatory. Check the system and practice through a spot audit

#DIV/0!

Is there a requirement that all contractors who work under a Lockout/Tagout system have an Authorised Status or are subject to Permit to XXII Work requirements.
1 Whenever any maintenance task is carried out with employees of This is mandatory. Any person who is working on any maintenance activoity contractors (routine contractors or others), do you check if they have been should e trained on Do's and Don'ts of LOTO. Check for evidence previously been trained on LOTO requirements Do you have a mandatory Do's and Donts checklist for LOTO that requires to Check the evidence be communicated and signed by all contractors as apart of work permit

#DIV/0!

Do's & Don'ts

Do you make it mandatory use of LOTO for the sub contractor areas / locations inside your premises where contractor activities (like fabrication, machine shop, assembly, testing, anciliary work of production etc activities) are carried out by contractor agencies

Check for evidence of implementing these systems.

Check for evidence of implementing these systems. Check who is performing Are the persons who perform LOTO in these contractor areas are trained and the LOTO. If the contractor employees theselves are doing, check if they are authorised authorised to perform LOTO

If Risk Assessments have identified that Production Employees will have to make frequent access of short duration to equipment during XXIII normal production without full Lo/To provision, have they received specialised training on safe working procedures that will ensure their safety.
Evidence of having prohibited the energy isolation without LOTO should be Have you made it mandatory within your entity that any energy isolation for sought. any intervention even by trained regular production crew will require LOTO Interview the employees at shopfloor (authorised employees), cross check protection irrespective of the duration & freqency of such isolation with them on energy isolation with case studies like these to check the level of understanding Check the list of risks and hazards, visit the shop floor to check such Does your risk assessment identified such frequent / short duration practices. Example - operating emergency swicth and carrying out interventions maintenance work on electrical connection. In case such practices are noticed are they reported and investigated as Check for awareness, practice of incident reporting, etc., unsafe practices

#DIV/0!

2 3

XXIV
1

Is there a procedure to ensure that all temporary staff, agency staff or contractors are informed and trained where necessary on the local requirements for energy isolation?
In case of LOTO work permits, do you train the employees of the contractors or others about the Do's and Don'ts of energy isolation This should be evidenced as a part of work permit itself. Training on hazards and risks should cover energy isolation too. Check for evidence

#DIV/0!
Contractors

XXV Do your procedures ensure that Lo/To is continuous for shift and personnel changes
1 Have you implemented a system of "Transitional Locks & Tags" for isolations that are likely to spread beyond one shift and beyond one person. In the event of a change in the personnel (i.e if the lock is put in by person A and is being removed by another person B), does the LOTO work permits specify these requirements Transitional locks and tags should be available, Check the procedure for such systems Check the work permits for LOTO

#DIV/0!

Are the personnel who are authorised for LOTO trained and have Check the training of authorised personnel infrastructure (different set of locks, tags etc.,) for ensuring Transitional Locks

XXVI Do you have a procedure for the safe removal of Lo/To devices in the event of someone accidentally leaving them in place?
1 Does your LOTO administrator visit the site of LOTO periodically and check the validity of the Locks and tags. Whether such inspections are recorded Check the assessment details

#DIV/0!

Is there a provision in your documented system to for authorising an opening of a Lock under exceptional circumstances (example if the Lock is left in place Check the system procedure and implementation evidence even after the completion of the task due to non availability of the person who locked it) Do you record the details of such waivers in the work permits and does these Check for evidence waivers part of the LOTO administrators summary analysis every month

XXVII Have you an audit and review procedure to ensure that all the requirements of your Plant and Equipment Isolations are effective?.
1 Does your LOTO incharge visit the site of activity during the execution of work and make his observations regarding the compliances to LOTO requirement and records his comments in the work permit. This is mandatory. Evidence of recorded observations is a must. Irresepctive of the duration of the work permit; once in 2 hours visit to the site of activity is a must by the LOTO Incharge. Mark "yes" if you have a documented procedure for conducting the audit, Do you conduct LOTO compliance audits every month; evidence of such the audit is conducted in the said frequency and if the observation are audits is necessary tracked to closure, Do you carryout SMAT interactions covering the areas where LOTO Mark "yes" if you have carried out SMATS in atleast 25 % of LOTO work isolations are done. permits. Is the effective implementation of LOTO in your entity a key review point in Records to be evidenced your periodical operations or EHS meetings by your plant head.

#DIV/0!

2 3 4

Overall Compliance %ge

#DIV/0!

0% 20% 40% Yes No Not Applicable 60% 80% 100%

0 0 0 0 0 0

SAINT-GOBAIN STANDARD Fork Lifts

S No
I
1 2

GAIA Score

Theme Question
Have you risk assessed all traffic routes where FLT's and pedestrians can collide?
Have you prepared a layout of the plant or area where the Fork lifts, Stackers and Material handling devices are expected to operate Have you marked on the layout the areas where Forklift and pedestrians coexist, or where there are road / Aisle crossings for fork lifts or pedestrians

Requirement in Detail

Compliance
#DIV/0!

The expected path of movement to be clearly marked in the layout. The expected interactions between pedestrians and fork lift to be clearly marked in the layout

The risks associated with the use of Fork lifts can not be generic along with the global risk assessment of the ISO systems. This needs to be separately done and can be annexed to the ISO systems. All the hazards and risks arising out of Did you carry out the risk assessment on Fork Lift usage as per the defined the use of Fork lifts need to be detailed out - examples - route taken, slopes, method movement on roads, intersections, pedestrians, lifting and lowering of loads, use of attachements, maintenance of FLT, toppling risks, Fire risks, battery charging station risks, reversal risks, tyre inflation risks, collision of FLT etc., Is the risk assessment of the FLT movement also taken in to consideration the presence of cross roads, other equipment & facilities like street lights, Check the risk assessment substations, overhead lines, water lines, drains, culverts, weigh bridges etc Does the risk assessment on fork lift usage taken in to consideration the maintenance activities on plant equipment that are carried out by personnel Check the risk assessment standing in Aisle (like weighscale maintenance, AC maintenance, Fire extinguisher maintenance, etc.,)

II
1

Have you clearly designated pedestrian routes in areas where pedestrians and FLT's mix?
The pedestrian walkways to be physically barricaded to prevent FLT and Have you defined and designated the pedestrian walk ways inside your pedestrian interactions. The Layout showing the movement of FLT and premises where the Fork lifts are operated pedestrian both inside and outside the buidlings to be prominently displayed as a communication strategy Physical evidence and audit of the place. Display of the direction of parking Have you designated a parking place for Fork lifts parking when not in use. etc., to be evidenced Are these pedestrian walks ways provided with railings and self closing gates at Check for physical evidence entry and exit points Are the entry and exit points on each pedestrian walk ways provided with distinct signages to communicate mandatory use of these by pedestrians Are the employees working in the areas close to where FLT's are moving appropriately protected by barricaeds Are the personnel working in the plant trained and communicated to report any deviations / violations w.r.t pedestrians walking ouside the desugnated walkways Are there corrective actions initiated post reporting of any such violations Check for physical evidence Check for the equipment, work area and FLT movements. The risks associated should be assessed Check the reflex through a Spot audit. Check for TF4 / TF5 reportings. Check the systems in place Check the actions initiated on the identified unsafe acts / Near misses w.r.t pedestrian walkway violations

#DIV/0!

2 3 4 5 6 7

III
1 2 3 4

Have you designated safe maximum speed limits and are these enforced
Have you defined and displayed the safe speed limits for Fork Lift movements Check for evidence within your entity - both inside and outside the plant buildings Do you have physical control measures installed in your fork lift for adhereing to these speed linits Are the personnel working in the plant trained and communicated to report any deviations / violations w.r.t speed limits Are there corrective actions initiated post reporting of any speed violations Use of Speed Governors is necessary. Restraint systems on Speed control should be fool proof Check the reflex through a Spot audit. Check for TF4 / TF5 reportings. Check the systems in place Check the actions initiated on the identified unsafe acts / Near misses w.r.t speed

#DIV/0!

IV

Have you risk assessed all operations carried out by FLT's including loading, stacking, moving equipment or skips and any use of attachments such as fork extensions etc?
Have you prepared an inventory / list of all activities that require use of Fork Lift Trucks., Stackers and other Mobile devices used for Material Handling The entity should have a list of all such activities possible at its facility. All activities that are expected to be carried out by Fork Lifts, Stackers etc., to be listed. Activities / tasks under Routine, Non Routine, One time works, works carried out by external aganecies, Projects, Maintenance works etc., should be part of the list. Check the risk assessment

#DIV/0!

Does your risk assessment of Fork lift operations include the risks associated while loading, stacking, lifting of loads, working inside containers etc

Have you defined and implemented Safe Operating Procedures for Loading, SOP is mandatory for all these. Unloading, Carrying the materials, Lifting or lowering the loads, Working inside Communication of the SOP to all FLT drivers through formal training is containers, Working on slopes, in rain etc., for Fork Lifts necessary Have you displayed the Safe Lifting Load, date of inspection, due date for inspection, FLT number etc., as per statutory requirement on FLT Physical inspection and audit, expected compliance 100%. Needs to be painted / by permanent sticker (no paper display)

V
1 2 3 4 5

Are vehicles tested and maintained by competent personnel in accordance to the manufacturers instructions or more frequently if required
Have you established and implemented annual statutory examination of all the Records to be evidenced Fork lifts by engaging competent persons Do you take up your FLT for mandatory preventive maintenance checks every Records to be evidenced with a checklist on detials of maintenace carried out fortnight once or based on distance run. Are the personnel who are engaged for maintenance and testing of FLT trained Evidence is required by the manufacturer / through a formal training by an FLT training istitute Are there preventive maintenance checks defined - Weekly, Monthly, Quarterly and Annual After preventive maintenance of the Forklift, do you check that all the interlocks are put back fully before it is taken over for operation Check for existence and evidence Checklist is mandatory. Recording the observations related to the working of all safety interlocks is a must

#DIV/0!

VI
1

Is there a system where the FLT's are checked and the results recorded for safety critical items on at least a daily basis.
The list to be exhasutive - Technical details to be detailed Do you check the compliance to the Fork Lift checklist at the beginning of each The minimum acceptability criteria - mandatory compliance requirements to shift and also at the end of each shift and record observations be spelt out It is necessary to verify atleast 1/3rd of the shifts. Equal distribution in all three Does your Fork Lift incharge verify the authenticity of the entries made in the shifts necessary to sensitise this importance. checklists randlomly Evidence of such checks to be recorded Do you check the condition of the mast / sliders, cylinder seals, fuel These checkpoints should be included in the checklist. Check for evidence of connections, working of sensors if any, on a daily basis before start of the compliance every shift / day Do you have an operational register or O&M ledger / sheet wherein you Handshake on the job is expected. However, in most cases it is not feasible or record the condition of the Forklift at the end of each shift. This is necessary as possible, recording the fitness of the FLT at the end of the shift is mandatory a comunication to next shift employee w.r.t critical issues Does your FLT has provision to record the mileage run Daily Km run to be recorded in such cases Does your Fork Lift incharge visit the area where FLT is being used and records This is mandatory. Evidence of recorded observations is a must. his observations on the safe usage of FLT Recorded observations every day is necessary Have you ensured that the hand brakes and normal brakes are in good operating condition always and that the hand brakes are applied when the FLT Mandatory compliance. is in parking condition

#DIV/0!

4 5 6 7

VII
1 2 3 4 5

Do you ensure that drivers do not use any attachments without recorded appropriate training
This list with appropriate photos to be approved in writing by the plant Have you defined and authorised the attachements that are permitted to be manager used on Fork lifts The photographs to be diplayed prominently as appropriatre The attachments used for lifting of personnel to be banned Are these attachements subject to annual statutory inspections Check the evidence of having certified the FLT for these attachements Is the Safe Lifting load checked and displayed for the FLT when these attachements are used Are the FLT operators and the personnle who maintain the FLT's trained on the Do's and Don'ts related to attachements In case of any attachements, that is used less frequently (say less than once / twice a month), does the Forklift incharge checks and approves the use of attachement Check the evidence. Training on fitness, handling, usage of these attachements. Check for evidence Written approval is necessary for infrequent usage. It can be included in the daily checklist itself

VIII
1 2 3 4 5 6

Are suitable and appropriate visual and audible warning systems fitted to all vehicles. The audible signal is automatically in operation as long as the reverse gear is engaged.
Does your Fork lift is fitted with a revolving light at the top indicating that the Fork lift is in motion Does your Fork lift is fitted with an audible reverse alarm which becomes operational as soon as reverse gear is engaged Have you installed gas detecting sensors in all your Fork Lifts driven on Gas. Are these detectors interlocked with the ignition system / gas regulation valve to shut off the supply in case of leaks Do you have detecting sensors at the rear side of the forklift to detect any object in the way when the fork lift is reversing Have you fitted a spot coloured light on top of the FLT (both at front & rear) which beams the light on the floor when the FLT is in motion. Have you fitted your FLT with the turning indicators which will be operational on activation at all turnings Physical inspection and audit, Expected compliance 100% Interlocking with the ignition system is mandatory Physical inspection and audit, Expected compliance 100% Interlocking with the reverse gear system is mandatory Installation on all fork lifts with Gas is mandatory Installation on all fork lifts is mandatory Interlocking with the brakes is necessary This is essential to intimate the pedestrians about the movement of the FLT. This is in addition to the rotating light as well as the audible alarms. This is a secondary line of defense This is essential to be fitted. Drivers need to be trained on the usage of these

#DIV/0!

IX
1

Are all your FLT's fitted with suitable driver protection and restraint systems?
Have you equipped your FLT with the seat belt Physical inspection and audit, Expected compliance 100% System put in place at the shop floor to make sure that every FLT driver uses this needs to be evidenced

#DIV/0!

In places where the FLT is being used for lifting / lowering loads above the top The top canopy of the fork lift should be covered with an appropriate size canopy of the forklift, have you provided with a mesh guard of appropriate mesh. Visibility should be ensured strength to prevent any head injuries to the operator Have you prohibitted the pillion riding on Forklifts in your entity Check for controls - both physical as well as administrative. Visual display should include this prohibition This is to be banned by administrative controls, physical controls as well as through training. No man hoisting should be permitted on Fork lifts even by using attachements. Visible display as a part of Fork lift standard implementation should include this.

Have you prohibitted the Man hoisting on Forklifts

X
1 2

Do you ensure that all FLT drivers are medically suitable for the task
Do you have a procedure for medical tests for drivers of Fork Lifts Check the SOP.

#DIV/0!

Have you listed the various medical tests that are necessary for the FLT drivers Check the listing. Minimum standards of acceptance (to define medically fit to with reference to the nature of work and area of exposures. operate the FLT) should be defined Does your SOP clearly define the frequency of such medical tests, the requirements at the time of induction on the job or in case of change in job Check the relevance of the SOP w.r.t the details location etc., Have your FLT drivers medically examined as per the listed requiremnts and Records to be evidenced frequency Are the medical reports of FLT drivers clearly state if they are fit to operatethe Check the summary conclusions FLT or not

3 4 5

XI
1 2

Have your drivers been given suitable basic training with a competence test for the type of FLT they are driving
Have you identified & listed the job sepcific requirements that are necessary List should exist with details. It is like a Job description. for a Fork Lift driver The list should be current, Have you identified and listed all the personnel who will be Fork lift drivers The list should have the approval of the plant manager The list should have a validity status Do you have a procedure which describes the various stages involved and System should define the eligibility criteria (LMV-FLT license), medical fitness, training topics / authorisation systems for putting a forklift driver on the job FLT training, authorisation to operate and maintain the FLT etc., First training to be detailed one before the start on the job. The training details Have you trained all the authorised fork lift drivers on all aspects related to to be evidenced. Normally this training will be exhaustive one by engaging Fork lift operation, routine maintenance, trouble shooting as well as handling external experts/ training centers. If an inhouse training is given first time, the of loads. competency of the trainer should have been pre established

#DIV/0!

Does the trainer / licensing authorities certify the person as eligible to drive This is a mandatory requirement the FLT

XII
1 2 3 4

Have your drivers been given specific training with supervisory assessment for all tasks they are expected to do?
Are the Fork Lift Drivers given specific training related to the tasks that they are expected to handle inside the entity All tasks associated with lifting, lowering of loads, transport, movement inside containers, confined areas, warehouses etc., should be covered. Check for the training related documents Training on risks and control measures is important. Check the evidence, knowledge and application of controls

#DIV/0!

Are the Fork lift drivers trained on the hazards and risks associated with the areas where they operate the Forklifts Have you trained the Fork lift drivers on the daily safety checks that they need Check for training data, check for awareness and the method of safety checks to perform on the FLT before starting the work Are the FLT drivers trained on the fault finding & trouble shooting tips on Fork Check for training data, check for awareness and the method of trouble lifts shooting. Is there a checklist on trouble shooting and Do's and Don'ts

XIII
` 2 3 4

Have you procedures for the safe loading/ unloading and stacking of materials / objects handled by FLT's?
Do you have documented procedures for loading, unloading, movement and stacking of all kinds of materials that require FLT in your entity Have you trained your FLT drivers on these SOP's SOP is mandatory for all these. Communication of the SOP to all FLT drivers through formal training is necessary

#DIV/0!

Are there displays in the plant indicating the correct and safe loading, Check for evidence unloading, movement and stacking of loads using FLT Does your forklift administrator checks the compliance to these SOP's through Check the compliance and records of such audits a mechanism of Fork lift audits atleast twice a year

XIV
1

Do all drivers have written authorization such as a license to drive a FLT

Do you have the list of all the authorised Fork lift drivers The list should be current, The list should have the approval of the plant manager. The list should have a validity status The list should be displayed with photographs in the plant at prominent locations The ID card should have the details as above. The drivers should have their ID always in person Please mark Yes only if you have a technical and commercial solution on hand and if you intend doing this within next one year This is similar to a small A4 sized board. The board to be displayed on the FLT by the driver who operates the FLT during that shift

#DIV/0!

2 3 4 5

Do you have the ID cards issued to all the authorised FLT drivers

Do you have plans to automate the access control to Fork lifts through electronic swipe card system to prevent unauthorised usage Have you implemented a Driver tracking system in your entity which requires the details of the current driver to be displayed on the FLT Do you know at any point in time the validity status of the authorisation issued Check the system in place. to FLT drivers

XV
1

Have all your drivers been re- tested for competence within every 5 years?
Have you retrained the Fork lift drivers once every year Records to be evidenced Does the Training / re-training on Fork Lifts cover the following topics in addition to the technical topics as at C 4 above:1. Use of Seat belts 2. Use of FLT in slopes Records to be evidenced 3. How to drive in reverse if the load is higher & prohibits forward movement 4. When and where to sound horn 5. How to drive inside containers or wagons 6. How to climb up & climb down the FLT (3 point contacts) Check for retraining based on Addition of New FLT major overhauling of FLT Is the procedure for training- retraining requires you to retrain the FLT drivers Incident involving FLT within the entity or anywhere as & when specific conditions / instances happen Change in the SOP / change in the area layout / addition of any new process impacting FLT operation / change in loading / unloading / stacking pattern / change in packing configuration

#DIV/0!

XVI
1 2 3 4

Do you ensure that drivers wear restraint systems where required?

Have you trained all your drivers on the importance of wearing of seat belts when driving the Fork lifts Does the daily safety checklist on Fork lift verify the working condition of the seat belt Does your Fork Lift administrator check the condition of the seat belt also as a part of his assessment and record the observations Is the usage of Seat belt electronically interlocked with the ignition system of the FLT Check for training records, communication mechanisms Checkpoint bshould include the verification of the seat belt Check the evidence Providing this and interlocking is necessary

#DIV/0!

XVII Do you a system to ensure that unauthorized personnel cannot drive the FLT's
1 Have you put up notices and displays prominently in your plants indicating This needs to be displayed prominently. prohibition of unauthorised use of Fork lifts. Provision for collecting the Ignition keys at the beginning of the shift Have you defined and implemented a fool proof system for management of Provision for handing over the keys when the FLT is not in use or is parked Fork Lift ignition keys to make sure that unautorised usage is eliminated. Provision for not leaving the key on the FLT when the FLT driver is not in driver seat Have you implemented a restratint system / chain system to make sure that Mistake proofing is more impoirtant here. A system like a tie band to hand, the drivers do not leave behind the ignition keys on the machine when they belt, linked to ID card etc., should be explored alight from the fork lift even for a short duration Have you defined and authorised in writing the list of activities for which the The list should cover all the expected activities. Refer to question B1 above Fork lift is permitted to be used within your entity. The plant manager should have authorised these activities in writing Have you banned the lifting of persons using Fork Lifts in your entity. Visual displays for ensuring compliance to this requirement is mandatory

#DIV/0!

4 5

XVIII Do you ensure that drivers do not drive forwards when their view is dangerously restricted?
1 2 3 Have you defined safe height of the load (above the floor level) that can be carried on the forks when the fork lift is moving forward When the load height is more, are the Forklift drivers instructed to drive in reverse direction Have you trained your drivers to drive in reverse while carrying the load for longer distances Are your Fork lifts equipped with audible horns Check this height. This should be defined and displayed on each fork lift. When the person is sitting and driving the FLT, the load should be well below his normal eye view. Check for evidence and systems in place The driver training should include this aspect. Check the drivers training module or the topics covered

#DIV/0!

XIX
1

Do you train your drivers to sound the horn when they approach hazardous situations such as doorways and corners?
Check the compliance pysically

#DIV/0!

2 3 4 5

Are your drivers of forklifts trained to sound horn mandatorily at all junctions, turnings and blind corners Are there signages inside your plant where "mandatory Sound Horn" signage is displayed for FLT's Does your Forklift equipped with 3 appropriate working mirrors - one at the center for rear view and two at two sides for rear view have you installed convex mirrors at all the intersections where forklift movement is expected (as defined in the layout) Have you assessed the slip and fall risk while the drivers enter and alight the fork lifts Have you put in place control measures to prevent the slip and fall of drivers while entering / alighting the forklifts Have you displayed the 3 point contact requirement while climbing up / alighting from the FLT on the FLT itself

Check the system of communication, awareness of drivers Check the compliance pysically Mandatory compliance on all fork lifts. Check the condition Mandatory compliance

XX
1 2 3

Do you train your drivers how to enter and leave the vehicle safely (3 points of contact) and monitor that this is actually done?
Check the assessment of risks Check for presence of hand rails, anti skid steps, etc., Check if the provision exists on both sides of the FLT Check for such displays - This should be close to the place of entry / exit.

#DIV/0!

XXI
1 2 3 4

Have you risk assessed refueling procedures and developed safe operating procedures to train the drivers in the process including the identification of suitable PPE?
Have you done the risk assessment of the refuelling activities (like Cylinder loading to FLT, Fuel loading, battery charging, etc., ) The risk assessment of fork loift activities should include the refuelling activities also. Check for evidence

#DIV/0!

Do you have a Safe Operating Procedure for refuelling of your Fork lift (Diesel, Records to be evidenced. Check the control measures Bettery energisation, LPG). Have you trained the concerned persons on this Have you trained your drivers / persons who does this activity on the safe handling procedures Do you have appropriate handling devices, PPE's, Emergency control devices at these locations Does your risk assessment of Fork Lift operations and maintenance lists environmental aspects and impacts Do you have a safe operating procedure for FLT Tyre repairs. Are there provisions for ensuring safe repair in your shop floor Do you audit the areas where the FLT maintenance is carried out to check the environmental compliances If you wash your FLT's, do you have facility to treat the effluent generated due to such washings Do the wastes generated on account of FLT maintenance & repair taken in to consideration in your hazardous waste permits and are stored and disposed according to the statutory requirements Do you check the quality of emissions from the exhaust gases Check the training, awareness Check the adequacy and conditions of usage

XXII Have you carried out a risk assessment to identified any potentially hazardous environmental conditions?
1 2 3 4 5 6 Check the risk assessment for details related to environmental risks Records to be evidenced Physical verification of the site of repair Records to be evidenced Check the compliance and physical facility Check the HWM license, Check the storage and disposal systems Check the emission checks

#DIV/0!

XXIII Do you have a system to monitor and control the effective compliance of your FLT safety policy?
Have you prepared a detailed list of all the Management and Staff employees within your entity who are concerned by the Fork Lift Standard The list should include Plant Manager / Head, Operational Managers & all the Management & Staff employees who authorises or have FLT in their departments. This can be in an excel format. The list should include the Function, Name of employee, task under his / her supervision / department which uses Forklift The list should be updated and always kept current. Quarterly review of this list is Mandatory Formal session is mandatory. All the Management and Staff employees who are listed in the inventory as at sl no 1 above to be covered in this session. Mark "Yes" to this checkpoint only if minimum 80% of the listed employees are covered in the training. Entity should have the records to evidence. The entity should have a Documented Management system which defines various aspects of usage, hazards, risks, responsibilitiues and controls associated with Fork lifts.

#DIV/0!

Have you kept such a list always updated & Current

Have you conducted a formal training on this CSG Standard covering all the Management & Staff employees listed as at Sl no A1 above

4 5 a

Have you prepared & documented a Management System manual & Procedures for Fork Lift, Stackers and other Mobile devices at your entity Does the documented Fork Lift management System consist of the following List of all activities / Job tasks that require use of Fork Lifts, Stackers etc.,

This list requires to be exhaustive as at Sl No B1 above All relevant details like no of fork lifts, where they are used, numbering of FLT's, year of manufacture, make, capacity, specifications, additional fittings, any retrofittings done, nature of fuel used, intrinsic safety features, interlocks provided etc., This listing has to be maintained as an annexure to the documented system

Details of the Fork lift truck, Stacker

c d

The layout of the plant or area where these Fork lifts, Stackers and Material The expected path of movement to be clearly marked in the layout. handling devices are expected to operate Marking on the layout the areas where Forklift and pedestrians co-exist, or The expected interactions between pedestrians and fork lift to be clearly where there are road / Aisle crossings for fork lifts or pedestrians marked in the layout Detailed roles and responsibilities of - Plant Manager, Maintenance, EHS personnel, Authorised persons for Forklift operation, Admin, HR, Service providers and other employees need to be clearly spelt out in the documented system The risks associated with the use of Fork lifts can not be generic along with the Defined method for carrying out the risk assessment of the use of Forklifts. global risk assessment of the ISO systems. This needs to be separately done and can be annexed to the ISO systems. System for identifying & authorising the persons for operating the forklifts The required competencies (both technical as well as behavioral) for Fork Lift (FLT operators), the pre requirements, qualifications, minimum operation need to be clearly listed out. Critical components out of this list requirements, training, competencies, retraining, on the job assessments requires to be highlighted. etc ID Card, Validity, Date of joinig, date of training, Date of medical exam, competency to drive, retraining date, photo, Display in person while driving Identifying the personnel who are authorised as FLT operators the FLT, signature of the person authorising the ID card etc., to be documented Defined roles and responsibilities of various personnel to implement the Fork lift standard System of Inspection & certification of fitness for the Fork lifts, Stackers etc., Checklist to be documented. Statutory inspections periodicity to be defined Minimum acceptability criteria for operation of the FLT to be defined Identification and nomination of the personnel who certify the FLT for use

Training of personnel who inspect / certify / authorise / carry out FLT SMAT's

Defined control measures at locations where Fork Lift and pedestrian interactions are expected (refer the question at 3d above, all the marked locations should have appropriate controls)

Have you conducted a formal training on this Documented Fork Lift management System covering all the Management & Staff employees

List of such people to e documented and made known. They have to be trained formally on various aspects of FLT standard as well as technical aspects of FLT operation and maintenance. The system should define the periodicity and content of such trainings List of all marked interactions as at 3d above should exist For each of these interactions, control measure to ensure safety of people and property to be defined and documented. System of communicating these controls to be documeted (training, display etc.,) Formal session is mandatory. All the Management and Staff employees who are listed in the inventory as at sl no 1 above to be covered in this session. Mark "Yes" to this checkpoint only if minimum 80% of the listed employees are covered in the training.

7 8

9 10 11

Have you displayed the list of authorised FLT personnel with their contact nos Physical inspection and audit, Expected compliance 100% and photos and other details Have you displayed the visual displays on the correct use of FLT (including Do's It is mandatory to have these at all critical locations. Visible big boards of size and Donts) on the FLT itself as well as at prominent locations inside the areas not less than A2 where the FLT is used Mark "yes" if you have a documented procedure for conducting the audit, the Do you conduct Fork Lift compliance audits every month; evidence of such audit is conducted in the said frequency and if the observation are tracked to audits is necessary closure, Do you carryout SMAT interactions covering the areas where FLT are operated Mark "yes" if you have carried out one SMAT every week Is the effective implementation of Fork Lift Standard in your entity a key Records to be evidenced review point in your periodical operations or EHS meetings by your plant head. Does your Forklift driver fills up the log book at the end of each shift recording his observations on the working of Forklift during the shift (say oil leakage, Records to be evidenced brakes condition, floor condition, unsafe condition etc) Have you identified and nominated a competent person(s) (preferably a It is necessary for the Plant Manager / Head of the Plant to nominate a Management employee) in your site as incharge of implementing the Fork Lift competent person as Fork Lift incharge of the facility. This needs to be notified Standard in writing Is the person(s) so identified trained in the Fork Lift standard as well as the Documented evidence of such training is necessary; mark "Yes" only if you various technical aspects related to operation and maintenance of Fork lifts have identified and trained the person on all aspects

12

13

14

Overall Compliance %ge

#DIV/0!

0% 20% 40% Yes No Not Applicable 60% 80% 100%

0 0 0 0 0 0

SAINT-GOBAIN STANDARD Confined Place

S No
I
1

Theme Question
Does the site have access to all legal and company requirements on confined space management
Have you established and implemented a legal register as required under the ISO 14001 / OHSAS 18001 systems Have you included the section 33, 35 and 36 of the Indian Factory act and relevant linked rules by respective state govt in your Legal register Have you included the specific compliance requirements as defined by the CSG Standard on confined place entry in the legal register Have you trained all the Management personnel & staff on the requirements of the statutory requirement related to confined places as well as CSG standard on confined place Have you trained all your maintenance personnel who are responsible for confined place maintenance tasks on these statutory and CSG requirements Have you reviewed the present condition of the confined place manaement in your site and assessed the gaps w.r.t the statutory and CSG requirements Do you have a compliance review plan for statutory and CSG requirements and does it include the confined place management. Records to be evidenced for such reviews

2 3 4

II
1 2

Does the site have access to a competent person(s) who can assess the Confined Space safety status of the site to l requirements
Have you identified a competent person as required under the Factories Act who can assess the Confined space safety requirements Have you made a formal contract order with the identified competent person for assessing the status of the confined spaces within your entity Have you established a detailed checklist alongwith the competent person for assessing the status of the confined spaces in your site

3 4 5 6 7 8 9 10 11 12

13 14 15

III
1 2 3 4 5 6

Has the site been surveyed by a competent person to identify all potential confined spaces
Have you conducted the assessment of all the confined spaces within your site during the last one year with the help of the competent person Are the cheklists as prepared above at sl no 2 above are duly filled Do you plan corrective actions based on gaps identified in such assessments Does the plant manager review the recordings of such checklists and develop action plans for improvements

IV
1 2 3 4 5 6 7 8 9

Does the site have an inventory list of all confined spaces including permit and non permit required areas.
Have you defined a set of criteria as per CSG standard and Statutory requirements for classifying the confined spaces Are these criteria made known to all concerned employees Do you have a list of all the confined spaces in your site Are the confined spaces in your site marked on the key plan / floor plan of the plant / factory premises

V
1 2 3 4 5 6 7

Has a competent Permit to Work Responsible Person(s) been appointed

VI
1 2 3 4 5

Has a competent Permit to Work Issuer(s) been appointed

6 7 8

VII
1 2 3 4 5 6 7

Have persons been nominated to enter Permit Required Confined Spaces.

VIII
1 2 a b c d e f g h i j k l m 3 4 5 6 7 a b c d e

Have all the persons nominated to work in confined spaces been suitably trained in the Safe Operating procedures Emergency arrangements..

IX
1 2 3 4 5

Have persons been trained to carry out the responsibilities of Confined Space Attendant or Standby Person

X
1 2 3 4 5

Have sufficient numbers of personnel been trained to carry out gas testing in confined spaces, which include know calibration and use of testing equipment.

XI
1 2 a b c d e f g h i j k l m n o 3 4 5 6 7 8

Do the gas testers know the SG gas limits and about the requirement to ensure the whole confined space is safe

9 10 a b c d e f g h i j k l m n o p q r

XII
1 2 3 4 5

Have all Permit Required Confined Spaces been suitably visibly identified at all potential access points

XIII
1 2 3

Has the site a suitable range of entry/rescue/ retrieval equipment for Confined Space Entry.

XIV
1 2 3 4 5 a b

Is the confined space entry/ rescue and retrieval equipment stored in a suitable location

c d 6

XV
1 2 3

Is there a robust communication system and procedure between confined space entrants and the attendant/ stand

XVI
1 2 3 4 5 6

Is there a robust communication system and procedure between the attendant and an emergency response person

XVII Does the emergency response person know what the Emergency Plans are and how and when to Initiate them
1 2 3 4

XVIII Is there equipment available to ventilate confined spaces if required

1 2 3 4 5

XIX
1 2 3

Is there an Emergency Plan for every Permit Required Confined Space

XX
1 2 3

Does the Confined Space Permit to Work meet all the requirements of this standard

XXI
1 2 3

Have all permits issued in the last 12 months been completed and closed correctly

XXII Have there been any Confined Space Emergency plan practices carried out in the last 12 months

1 2 3 4 5

XXIII Do the local rules specify that all contractors and sub-contractors have to comply with this standard before enterin
1 2 3 4 5 6 7 8

XXIV Are all the documents and records required by this standard and local legislation kept in a secure location for inspe

XXV Is there a recorded annual review of all the safety requirements of this standard and associated local legislation

XXVI

Are all personnel aware of the possibility of small rooms, trenches etc becoming permit required confined spaces d conditions

Yes No Not Applicable

NT-GOBAIN STANDARD Confined Place

Requirement in Detail Compliance

GAIA Score

ments on confined space management

Check for existence of the legal register, Its review status. Mark Yes only if the register is current (reviewed and updated within last 6 months, with clear reflection on what is updated) Check for inclusion of these specific clauses in the list Check the compliance requirements related to these specific clauses / sections Check for training records. Formal training on confined spaces is necessary. Seek the records Check for training records. Formal training on confined spaces is necessary. Seek the records Seek the gap assessment records Check the complaince review status of the confined space statutory and SG requirements

#DIV/0!

n assess the Confined Space safety status of the site to legal and company
Seek the information related to this. If any person is identified check the authorisation status Check the contracts status It is necessary to document the current status of the confined spaces within the entity. Seek the information related to existence of a checklist for such gap assessment

#DIV/0!

tify all potential confined spaces

It is necessary to carry out the assessment of all the confined spaces to determine the status and imprpvement that need to be carried out. This process is annual with the help of external competent person Check the records Check the action plans Check the evidence of such reviews

#DIV/0!

ncluding permit and non permit required areas.

Check the set of criteria Check the list of concerned employees and their awareness about the criteria Check the existence of the inventory list Check the drawings

#DIV/0!

en appointed

#DIV/0!

#DIV/0!

onfined Spaces.

#DIV/0!

s been suitably trained in the Safe Operating procedures of such work including

#DIV/0!

of Confined Space Attendant or Standby Person

#DIV/0!

y out gas testing in confined spaces, which include knowledge of gas hazards and

#DIV/0!

quirement to ensure the whole confined space is safe

#DIV/0!

sibly identified at all potential access points

#DIV/0!

ipment for Confined Space Entry.

#DIV/0!

nt stored in a suitable location

#DIV/0!

tween confined space entrants and the attendant/ standby person

#DIV/0!

tween the attendant and an emergency response person/s.

#DIV/0!

rgency Plans are and how and when to Initiate them

#DIV/0!

f required

#DIV/0!

ined Space

#DIV/0!

irements of this standard

#DIV/0!

ted and closed correctly

#DIV/0!

ices carried out in the last 12 months

#DIV/0!

ractors have to comply with this standard before entering a confined space

#DIV/0!

d and local legislation kept in a secure location for inspection and auditing

#DIV/0!

ments of this standard and associated local legislation

renches etc becoming permit required confined spaces due to local work or

Overall Compliance %ge

#DIV/0!

#DIV/0!

SAINT-GOBAIN STANDARD Machinery Safety

S No
I
1 2

Theme Question
Does the plant have access to all legal and company requirements about machinery safety, including guarding?
Have you identified and nominated a person for implementation of this standard within your entity Is the person nominated to spearhead the implementation of this Standard formally trained on Statutory aspects related to machine safety as well as the technical aspects related to machinery safety Have you defined and documented the roles and responsibilities of the nominated person w.r.t the implementation of Machinery Safety Standard Have you listed the detailed legal and statutory requirements as specified under various acts and rules w.r.t Machinery Safety Have you implemented a mechanism for keeping this information and list current Do you have the copies of the International codes of practice (IS codes for example) related to Machine Guarding, Safety interlocks, Pressure vessels, Inspection and testing of lifting tackles, etc., Is your nominated person trained on the requirements of these IS standards Is the protocolos to be used for cheking the compliance to Machinery safety clearly defined Have you defined and documented the list of safety requirements that need to be complied for each machine

3 4 5

6 7 8 9

II
1 2 3 4 5 6 7 8

Does the plant have access to a competent person who can assess the status of machinery safety compliance with requirements?
Have you identified an external competent person authorised by the respective statutory agency (like factory inspectorate, Pollution control Board, CCoE etc.,) Have you defined and executed a written contract with such a competent person Have you included specific requirements defined in the Mahineery Safety standard in these written contracts Are the protocols / reference standards to be used for checking the machinery safety compliances clearly specified in the contracts Is the nominated person for spearheading the implementation of the Machinery Safety standard validating the written contracts through his approvals Have you identified any personnel inside your entity as competent to check the requirements related to machinery safety Have you assessed their competencies and formally trained these identified personnel on machinery safety assessments Is the list of such authorised competent personnel displayed proinently in ypour plant

III

Are all machines brought to the site checked by a competent person to ensure that they comply with this standard
Do you have a written down procedure for all machines and equipment that require prior safety authorisation by an external competent person before its first use inside the premises as per Statutory requirements Have you got all the machines and equipment tested and certified by the external competent person and maintained the records for the same Do you have a written down procedure for all machines and equipment that require prior safety authorisation by an internal competent person before its first use inside the premises as per company / safety requirements (as per MOC) Have you got all the machines and equipment tested and certified by the internal competent person and maintained the records for the same. This is for all other equipment and machines that are not generally covered under statutory checks Do you have a system implemented for authorising the machines and tools that are brought in by outside contractors Do you have a tagging / labelling system implemented as per the statutory requirements for all machines Do you have a tagging / labelling system implemented for all machines and tools brought in by outside contrctors In the event of any machine or equipment brought in (either by the SG entity or the contractor) is found to be inadequately protected w.r.t safety, do you have a system in place to prevent unauthorised use

5 6 7 8

IV
1 2 3 4

Does the plant have an inventory list of all machines that may require guarding?
Do you have the list of all machines and equipment that are used in your entity Do you keep the list always current and updated (as and when any addition, deletion or modicifcation is carried out) Does the list so prepared and updated, contain specific machine guarding information Are the machines or equipment designated with unique numbers as per the listing

V
1 2 3 4 5 6

Is a record maintained of all formal machinery safety inspections? (guards, interlocks, etc.) (date, who did it, etc.)
Do you have a written down procedure for machine safety inspections including the frequency of such checks Do you have a documented safety checklist for all equipment inspections Have you carried out the safety inspections using this checklist and maintained records of such inspections for last one year Have you identified critical and high risk machines / equipment from the above list Are these critical equipment subjected to more periodical inspections (may be daily / pre start checks every day) Have you defined minimum acceptability critera for operating these equipment or machines

VI
1

Is there a system to record, prioritise, implement and track the status of any recommendations from the formal ma
Do you record and analyse the findings of the machinery inspections (statutory or otherwise)

2 3 4 5 6

If there are observations requiring action; have you investigated the root cause for such problems / non conformities Are the observation points arising out of such inspections corrected by deploying specific measurable objective and targets (who will do it, when it will be done, what corrections, resources required, etc., ) Are the corrective actions initiated to mitigate the observation points subject to periodical review by the plant manager Are the reports arising out of such machinery inspections circulated to the concerned area process owners (shop floor engineers and supervisors) Is the date of inspection and status of the inspection displayed on the machine Have you carried out Job Safety assessment and recorded the observations for all the machines and equipment Have you assessed the hazards and risks associated with the normal operation of each machine and equipment Does your risk assessment of the machine cover all the aspects of Hazards such as Physical, Chemical, Biological, Radiation, etc., Are the employees who work on these machines and equipment trained on identification of hazards and risks Does the risk assessment evaluate the experience of the operator (fresh or experienced) when handling the machine Have you defined the control measures for each of the identified Hazards and risks associated with the machine

VII
1 2 3 4 5 6

Have all machines on the site had a recorded risk assessment involving operators, taking normal operations into co

VIII
1 2 3

Have all machines on the site had a recorded risk assessment involving operators, taking process intervention and consideration?
Does the risk assessment / JSA done at the task level at each machine / equipment take in to consideration the cleaning requirements also Does the risk assessment / JSA take in to account the hazards and risks related to batch changes, setup changes, changes to process, speed variations, etc., Have you chekced the compatibility of the risk assessment w.r.t cleaning of machines and LOTO requirement , Work permit etc., Have you defined the control measures for each of the identified hazards and risks associated with the batch changes, process changes, speed variations, cleaning and other interventions that are needed on the machine

IX
1

Have all machines on the site had a recorded risk assessment involving operators and foremen, taking regular or fo operations into consideration?
Does the risk assessment / JSA done at the task level at each machine / equipment take in to consideration the maintenance requirements also Have you defined the control measures for each of the identified hazards and risks associated with the maintenance interventions that are needed on the machine Are the guards constructed of standard materials and are free from sharp edges and burrs

2 3

X
1 2

For modified machines, are the risk assessments reviewed before the machine is put back into operation?
Do you follow the MOC route for any changes / modifications that are to be perfomed on the machine Does your MOC procedure cover the steps needed

3 4 5

have you carried out a detailed risk assessment / JSA on the machine before executing the MOC approval Does your authorised / competent person inspects and clears the machine as fit for use after any such modifications are done Do the list of machines as prepared by your site, indicate the changes made, date of such change and approval status

XI
1 2 3 4 5 6

Are all machinery safety risk assessments reviewed at least once every two years?
Have you listed out the number of signifcant risks arising out of the machinery risk assessment Do you have a defined target for reduction in the number of such significant risks Do you have action plans for reducing the no of such identified significant risks Has your plant manager reviewed the risk minimisation targets and action plans atleast once a quarter. Have you reviewed the risk assessment related to the specific machines atleast once during the last 2 years Do you review the risk assessment / JSA of the machine as and when any TF incident occurs for that machine

XII
1

Is there a system to ensure that control measures arising from risk assessments are prioritosed and implemented
This is similar to XI above

XIII
1 2 3 4

Is there an inspection / maintenance schedule for all machinery safety protection devices
Do you have a preventive maintenance / inspection schedule defined for all the safety protection devices like sensors, limit switches, guards, light curtains, etc., Do you have a checklist for each of these safety protection device clearly specifying what needs to be checked, frequency and by whom Do you check the safety protection devices as per the schedule and checklist. Are records maintained for last one year Is there a diplay on or near the safety protection device indicating that it has been inspected & found OK

XIV
1 2 3 4 5 6

is there a list of authorised machine operators

Have you defined and documented a system procedure for authorising an employee to work on a machine in your site Have you listed the parameters / criteria that required to be fulfilled by any employee to get this authorisation Have you trained and formally authorised the employees as machine operators. Is the list of authorised employees who can operate specific machines diplayed Is there a re-training procedure for authorised employees Are new employees, temp Employees etc who operate the equipment undergo this authorisation process as a part of their induction

XV
1 2 3

Are emergency stops on all powered machinery readily accessible to operators?

Do you have emergency stops on all machines which are electrically powered Are the emergency stops easily accessible to the operators for activation and deactivation Do you check the working condition of the emergency stops on a monthly basis. Are records available for such inspections

In case of a single emergency stop being used for stopping multiple machines (example a machine line), does the restart of the line after deactivating the emergency stop give out an audible siren / rotating light / an audible recorded message to warn the personnel to be away from the machines In the event of an equipment located in remote location (example bucket elevator motor, conveyor motor, pumps etc., ), do you have the emergency stops with keys as close to the electrical equipment as possible

XVI
1

Is the by-passing of safety devices prohibited without written authorisation?

Do you have the list of all the safety devices that are mounted on each of your equipment (example - pull cords, limit switches, light guards, sensors, safety valves, pressure relief valves, interlocks etc.,) Have you banned by written instructions the bypassing of safety devices like interlocks, sensors, light guards, pull cords, limit switches etc., that are used in your site Do you conduct monthly audits of all the safety devices and record the observations Is the check of the interlocks and safety devices a pre requirement before start of the machine every time, every shift, every day

2 3 4

XVII
1

Have all areas where employees could be entrapped, entangled or otherwise harmed by parts of machinery been id appropriate protection devices?
Has your risk assessment identified machines or areas that have potential to cause employee entrapment / entanglement and have guards to prevent such incidents Has your risk assessment identified machines or areas that have potential to cause burn injuries and have guards to prevent burn injuries Has your risk assessment identified machines or areas that have potential to cause slip, trip and fall injuries and have appropriate protection devices like railings, toe guards, fences, covers etc., to prevent such incidents Has your risk assessment identified all the rotating parts like rollers, chains, belt drives, impellers, drums, gears, etc., which could cause harm / injury to people and have appropriate control devices like guards, covers to mitigate such incidents Has your risk assessment identified Arc flash risks associated with all electrical control panels and provided appropriate control measures like safe distance, railings, Arc flash suits etc., Has your risk assessment identified machines or areas where material falling from height on the persons below is identified as a risk and suitabel barricading guards with interlocks are provided Has your risk assessment identified the machines or areas where radiation risks exist and provided appropriate guards to prevent working people to get exposed to such risks. Safe distance from the source to be displayed Has your risk assessment identified the machines or areas where projections / obstructions can cause injuries to people. Are appropriate guards provided to take care of such incidents Are both sides of the belt / chain conveyors protected with guards / railings to prevent unauthorised entry below such conveyor Are the bottom of the dust collection system structures protected with guards / railings to prevent unauthorised entry to below the DC system hoppers

8 9 10

11

Are the underground pits for Bucket elevators, belt conveyors, grizzly hoppers protected by railings and lockable gates to prevent any unauthorised access Are the machines that have hazardosu reciprocating motions (like planers, shapers, etc.,) provided with access protection guards with interlocks when the machine is in operation Are the rotating machines in the machine shop like Lathe provided with chuck guard, chip guard and face shield Are the bench griners used in your site provided with tool rest as well as the face shiled guard. Tool rest gap should be <=1/8 inch Are the transfer points on roller conveyors in your site guarded Are the power transmission shafts (connecting the motor to the fan / impellar) guarded Are the danger zones in the Winders and Unwinders identified and appropraitely access controlled Are the belt conveyors used for transfer of materials provided with barrier guards with mesh or deterrent railings at adequate distance on the side where people movement is expected (or where walking platform is provided). Barrier guard is not necessary where the conveyor is protected with a dust hood Where service ways and throughways run parallel or underneath the coveyors, have you provided access restrictions / barriers / detterents at all identified danger zones. Are these prominently marked Have you provided guards of adequate size to the return rollers on overhead conveyors to prevent injuries on account of roller fall Have you identified the roller shaft ends that project beyond 1/2 inch outiside and provided each with a roller end cap Are the exhaust fans provided in kitchens, pantries, toilets and rest rooms guarded with an appropriate sized mesh to prevent fingure injuries Are all the Lifting hooks used in your site provided with spring loaded locks to prevent accidental fall of the loads Are the pressure vessels operating in the plant provided with safety guages and pressure relief valve, Have you provided mesh guards of appropriate size on both sides of all the belt drives that are operating in your site Have you identified in your risk assessment all the nip points of rollers, needle looms, punches etc., and provided appropriate guards to prevent any incidents Have you provided for mandatory two hand operation of all your presses hydraulic, mechanical, pneumatic or otherwise (Both the hands to be engaged with the controls as long as the press is under operation) Are all your presses (hydarulic, Mechanical, pneumatic etc., ) equipped with light guards with interlocks (to stop the machine on intervention) Are all guards, line protection fences, access control gates equipped with electrical / electronic interlocks to ensure stoppage of the line on infringement

12 13 14 15 16 17

18

19

20 21 22 23 24 25 26

27

28

29

XVIII

Have all inspection/ access panels to hazardous parts of machines and process equipment been secured so they req and are there warning notices or protective screens to prevent inadvertant access or exposure to hazards?

Have you secured the access to all your electrical control panels so that it can be opened for any maintenance only under autorisation & LOTO Have you secured the access gates to all the risky areas like Elevator pits, Conveyor pits, Grizzly pits etc., with interlocked gates which will trip the machine & sound alarm hooter on opening Have you secured the access gates to all the lines & critical equipment with interlocks to ensure that the machine trips when the gate is opened Are entry gates / doors to Ovens, Kilns, batch furnaces, cold rooms, storage areas, confined places etc., equipped with warning devices & interlocks to shutoff operation & give out audible alarms upon infringement Have you made it mandatory for a prior written authorisation from the identified and nominated personnel to open any fixed machine guard Have you done the risk assesment of the guards w.r.t the Reach principle Are the height of the fence guards, opening of the mesh size adequate and appropriately distanced from the risk Are the "Start" push buttons on control panels / pendants appropriately protected where people movement is high, to prevent inadvertant switching on Have you barricaded with suitable railings and provided an interlocked gates to all the material transfer lifts / hoists / scissor lifts / cage lifts

5 6 7 8

XIX
1 2 3 4 5

Do all fixed guards require tools to open them? (No wingnuts!)

Are all the fixed guards and railing fences fastened to the location using Hex bolts of adequate strength with spring washer or use Hex nut Do you use torque wrench to tighten these bolts and nuts Are the spanners used for these fasteners authorised, coded and is part of LOTO Have you banned by written instructions the use of wing nuts on any fixed guards. Have you standardised the nut size / bolt size for all fixed guards so that only one tool can be used to open all the fixed guards. And that the use of such a tool follows the autorisation protocol

XX
1

Do all access points to high hazard areas, without physical barriers, have appropriate protection devices, e.g, light
Have you identified all the potential risky areas within your site where physical barriers is not feasible (practically) and equipped such areas with through beam light guards to stop the machine when an infringment occurs Do you check the working conditions of these light guards / sensrs on a monthly basis and label the same as inspected OK Is the check of the working of such a sensor part of the daily checklist prior to start of the machine Do you have the list of all machines / areas where such light curtains are installed with the type and nature of light curtain installed Do you have in your inventory adequate number of lght curtains / spare parts of each specification to ensure quick replacement in the event of a failure of the installed one.

2 3 4 5

In the event of the activation of the light curtain resulting in stopping of the equipment, do you have any additional engineering control (example - a web camera) to make sure that there are no persons inside these hazardous areas before restarting the machines / lines Have you mock tested the conditions of entarpments in these areas during the last 1 year

XXI
1 2 3 4 5 6

Do operators carry out recorded visual safety checks of their work areas during every shift? (Generic or machine-sp used)
Is there a checklist at each work station which require the operators to record their observations every shift Does the checklist specifically record observations related to Guarding, Electrical connections, Electrical panel conditions, Safety interlocks, Safety relief valves, gauges, light curtains, etc., Are the operators responsible for such checks appropriately trained to examine the conditions visually and record the observations Are the forms filled in by operators every shift & are records maintained for atleast last one year Is the minimum acceptability criteria for operation of the machine defined and made known to operators. Is it displayed. Is the record of such data analysed over a period of time to determine any common concerns Does your Safety committee / EHS committee meetings deliberate on machinery safety concenrs Are operators reporting and recording the unsafe conditions related to machine safety concerns Are the operators responsible for machine operation / maintenance record the condition of the machine at the end of the shift in a log book / form as an input to next shift personnel Is there a formal mechanism to communicate the incidents up to near miss to all the employees within the site - through daily pep talks Whenever a safety concern is raised by an operator, do you fix up a time frame for addressing the concern and post implementation, communicate to the employees that the said concern is addressed Have you made it mandatory for a LOTO activation before any maintenance activity is undertaken on any machine Are the machine specific procedures indicate the use of LOTO as mandatory Have you identified the different sources of energies that require to be isolated for each machine Is there a LOTO organogram for each machine Have you made it mandatory for prior authorisation from the nominated person to open a Machine guard on certain hazardous / critical equipment. Are these notidfied through displays Have you made it mandatory for the authorisation of work permits for any maintenance activity perforemed on any machine - irrespective of whether it is performed by SG employee or others Are all the guards (fixed or others) bolted in sucha way that it is necessary to use a tool to open them. Hand opening should not be permitted

XXII Is there a system to record employees' safety concerns about machinery safety?
1 2 3 4 5

XXIII Do local procedures specify in which conditions the use of LO/TO for maintenance or access inside machines is requ
1 2 3 4 5

XXIV Is there a list of all machines that require a permit to work for maintenance?
1

3 4

Where routine operational maintenace like lubrication, cleaning, gauge settings etc., is to be performed (which requires no opening of machine guards & there is infringment in to access controlled areas); have you implemented 60 seconds to think for such activities Have you trained your employees on 60 seconds to think Do you have a machine safety checklist indicating the checkpoints that need to be verified for all machines Have you implemented a half yearly machine safety audit using this checklist & maintained records Have you prepared and established a machinery specification sheet for each machine indicating the requirements of machine garding and other safety cocnerns Are the machine safety surveys undertaken during the last survey made available at each machine in your shop floor (example - lathe safety survey, band saw safety survey etc., ) Is the result of the machine safety standard reviewed by your plant manager on a monthly basis with reference to the action plans set

XXV Is there a monitoring system to measure the level of compliance with the requirements of this standard?
1 2 3

4 5

XXVI
1 2 3 4

Is the status of machinery safety formally reviewed by the site manager at least once a year before approval of the 12 months?
Is the annual EHS plan of your site take in to consideration the improvement actions needed on machine Safety w.r.t the standard Is there a formal review of the complaince to this standard by the plant manager. Are records maintained of such review Is there a summary of the machine Safety audit findings. Is the summary communicated across to all sections Are the machine safety audit results reviewed by the plant manager on a half yearly basis as and when the audit gets completed

Yes No Not Applicable

NT-GOBAIN STANDARD Machinery Safety

Requirement in Detail Compliance GAIA Score
#DIV/0!

ements about machinery safety, including guarding?

Seek the formal notification of such nomination Check for formal training of the nominated person w.r.t factory Act, Electricity rules, SMPV rules, Petroleum rules, etc., as well as the machinery safety fundamentals Check for system documentation and the defined roles and responsibilities Check for existence of such a list. The list should be exhaustive Check the updation frequency, Look for most current changes to the regulatory requirements. Seek information on the sources for information, check for compliances Check for existence of such codes. Check for training and awareness Check for existence of such protocolos (example - Lifting tackles, pressure vessels, machine guarding, Interlocks, pressure testing etc., ) Check the existence of such a checklist (all equipment to be included)

n assess the status of machinery safety compliance with legal and company
Check for existence of such persons, check for their curent licensing details. Certificate of authorisation should be checked. Mark Yes only if all the Acts and rules are complied Check for existence of written contracts. Mark yes only if all the acts and rules are complied Check the contracts for inclusions Check the defined IS codes / Rules Check for the approval systems in place Check the list of authorised persons Check the training and competency records Check the existence of such displays with contact details

#DIV/0!

nt person to ensure that they comply with this standard before they are used?

#DIV/0!

Check the procedure

Check the records. Existence of the certificates for fitness to use is important

Check the procedure

Check the records. Existence of the certificates for fitness to use is important Check the implemented system for compliance. This authorsiation should be linked to Work permit system Check the compliance as per statutory requirement - plant rounds is important for observing compliance Check the compliance as per statutory requirement - plant rounds is important for observing compliance Check the mistake proofing of the system. Carry out plant checks to determine existence of any such equipment

may require guarding?

The list of all machines and equipment used within the entity with their year of installation, make, power ratings, safety interlocks, machine guarding requiremens etc., should be prepared Check for revision status Check if the guarding information is listed - example type of guard, mechanical / interlocked, safety interlocks on guards etc., Best practice requirement

#DIV/0!

ctions? (guards, interlocks, etc.) (date, who did it, etc.)

Check the procedure, Frequency, who is authorised to check, Check for existence of such a checklist. Check the records. Existence of the certificates for fitness to use is important where statutory inspections are carried out Check such identification Check the existence of such frequencies Check the existence of such a criteria

#DIV/0!

k the status of any recommendations from the formal machine inspections?

Check the existence of such analyis.

#DIV/0!

Check the investigations and root causes Check the existence of system similar to PDCA (similar to EMP's) Check the operational reviews, records to be evidenced Check the existence of such reports at shop floor, awareness about the contents is important Check the existence of such displays

ent involving operators, taking normal operations into consideration

Existence of risk assessment machine wise is important. The risk assessment need to be done at the task level w.r.t each machine Check for existence of risk assessment (JSA) and existence of appropriate control measures Hazard identification should not be restricted. Check the type of hazards identified and risks assessed Check the formal trainings, Check the awareness about the hazards and risks, Conduct spot assessments by asking answers to specific hazards and risks Check the system Check the control measures defined. Check the awareness of the employees who operate the machine.

#DIV/0!

ent involving operators, taking process intervention and cleaning into

Check the depth of risk assessment Check for such changes. Check for adoption of FMEA method Check for such interlinking Written document / display is needed. Check the awareness of the people. Training records to be seen

#DIV/0!

ent involving operators and foremen, taking regular or foreseeable maintenance

Check the depth of risk assessment w.r.t preventive and breakdown maintenace Written document / display is needed. Check the awareness of the people. Training records to be seen Check the guards physically

#DIV/0!

before the machine is put back into operation?

Whenever the machine specification is getting altered, the MOC is mandatory. Check for the changes and existence of MOC Check the MOC procedure

#DIV/0!

Check the MOC's and existence of risk assessment - machine wise Check if there is any validation done by the competent person identified. Written document to support this is essential Check for the existence of such an update

t once every two years?

Check the risk assessment, number of identified signiifcant risks Check the objectiev and target for reduction in risks specific to machines Check for the action plans. The plans should be SMART. Check for evidence of such reviews. These are specific to machine safety risk reduction Check for updates and reviews. The result of the reviews to be recorded Check the TFx data and seek the risk assessment review

#DIV/0!

rom risk assessments are prioritosed and implemented

#DIV/0! #DIV/0!

inery safety protection devices

Check for evidence Check for evidence Check for evidence Check for evidence

#DIV/0!
Check for evidence Check for evidence Check for evidence Check for evidence Check for evidence Check for evidence

essible to operators?
Check the existence of emergency stops. The list of machines should contain a separate column indicating the existence and type of emergency stop provided Check physical evidence Check for the existence of a mechanism in place for such inspections.

#DIV/0!

Check the existence of such a system

Check the existence physically

ten authorisation?
Check this list. It can be part of the list of machines Written instruction is mandatory. Display at proinent locations is a must. Safety device bypass should be on Zero Tolerance Check for the existence of the mechansim Check for the methods adopted. This should be evidenced at the shop floor. Display at each machine is a best practice

#DIV/0!

ngled or otherwise harmed by parts of machinery been identified and fitted with

#DIV/0!

Check the risk assessment and also physical evidence

Check the risk assessment and also physical evidence

Check the risk assessment and also physical evidence

Check the risk assessment and also physical evidence

Check the risk assessment and also physical evidence

Check the risk assessment and also physical evidence

Check the risk assessment and also physical evidence

Check the risk assessment and also physical evidence Check the risk assessment and also physical evidence Check the risk assessment and also physical evidence

Check the risk assessment and also physical evidence

Check the risk assessment and also physical evidence Check physical evidence Check physical evidence Check physical evidence Check physical evidence Check physical evidence

Check physical evidence

Check physical evidence

Check physical evidence Check physical evidence Check the risk assessment and also physical evidence Check the risk assessment and also physical evidence Check the risk assessment and also physical evidence Check the risk assessment and also physical evidence Check the risk assessment and also physical evidence

Check the risk assessment and also physical evidence

Check the risk assessment and also physical evidence

Check the risk assessment and also physical evidence

achines and process equipment been secured so they require tools to open them, vent inadvertant access or exposure to hazards?

#DIV/0!

Physical verification. The bolting / lock on the panel should require specific tool / key to open. This should be under authorisation. Mistake proofing is important Physical verification.Mistake proofing is important

Physical verification.Mistake proofing is important

Physical verification.Mistake proofing is important

Work permit is mandatory Reach principle is the reach of the body part w.r.t the moving part / risk w.r.t the opening in the guard. Check for compliance Physical verification.Mistake proofing is important Physical verification.Mistake proofing is important

Physical verification.Mistake proofing is important

uts!)
All guards to be fastened with Hex bolts with spring washer or Hex nut This is to ensure that the guards are appropriately tightened. Also to prevent hand tightening The use of this should be authorised to prevent any unauthorised opening of the guards Check the instruction as well as any displays banning the same. Physical evidence is a must Check the evidence

#DIV/0!

barriers, have appropriate protection devices, e.g, light curtains?

Physical evidence of existence. Check for light curtains / cut off sensors in machines that start automatically, robotics, pick & place devices etc., Date of inspection is important. Check inspection details. Check the working by random checks Check for evidence Check the list Check the strategy, Check the inventory

#DIV/0!

This is a requirement in areas which are remote from control panels or where the person entrapment poses serious risks. Look for such areas, assess the risks and provide secondary protections. In areas where the level of risk is lower, manual checks could be considered Mock testing through Spot audits is critical to make sure that these systems are always functional including emergency response

eir work areas during every shift? (Generic or machine-specific checklists may be
Check the existence of such a checklist (all equipment to be included) Check for evidence Check the training and competency records Check for evidence The critical conditions which will require the machine to be stopped has to be defined and made known. Check for evidence

#DIV/0!

out machinery safety?

Check for evidence, Verify the minutes Check for evidence, Verify the data This is critical. Check for the practice Check the evidence Check the system in place

#DIV/0!

LO/TO for maintenance or access inside machines is required?

Check the compliance w.r.t LOTO; Check the machine specific procedure Check the energy tree for the machine Check for evidence Check for evidence

#DIV/0!

for maintenance?
Check the permits

#DIV/0!

Physical evidence

Physical evidence Check the awareness

liance with the requirements of this standard?

Check for physical evidence Check for physical evidence Check for physical evidence

#DIV/0!

Check for physical evidence Check for physical evidence

site manager at least once a year before approval of the action plan for the next
Check for physical evidence Check for physical evidence Check for physical evidence Check for physical evidence

#DIV/0!

Overall Compliance %ge

#DIV/0!

0% 20% 40% 60% 80% 100%

0 0 0 0 0 0

SAINT-GOBAIN STANDARD Warehouse

S No
I
1 2 3 4 5 6 7 8 9 10

Theme Question
Does the site have access to all legal and company requirements on warehousing and loading/unloading vehicles

II
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Does the site have access to a competent person who can assess the Warehousing and Loading/Unloading safety st company requirements

III
1 2

Has a comprehensive Risk Assessment process been completed for the Warehousing and Loading/Unloading Areas

3 4 5 6

IV
1 2 3 4 5

Does the Risk Assessment process cover all hazards within the warehousing and loading/unloading areas

V
1 2 3 4 5 6 7

Are there local rules for visiting drivers covering traffic routes, speed limits, parking areas, loading/unloading locat welfare facilities, emergency procedures, PPE requirements and loading/ unloading safety procedures.

VI
1 2 3 4 5 6 7 8

Are the local safety rules for visiting drivers available in an easily understandable format and available in appropria

VII
1 2 3 4 5 6 7

Is there an a system to record, prioritise, implement and track the status of any recommendations for safety impro warehousing and loading/ unloading areas.

VIII
1 2 a b c d e f g h i j k l m 3 4 5 6 7 a b c d e 8

If any drivers have to climb onto their vehicles and/or loads is provision made for their safe access, and are arrange required to prevent or restrain falls from height like fall arrest equipment

IX
1 2 3 4 5

Are arrangements in place to prevent vehicles being driven or rolling away whilst loading or unloading. The immob chocking, dock restraints, ignition key, air brake locks (glad hand locks) or similar devices

X
1

Are drivers and any helpers given clear instructions where they should and should not stand or sit whilst the vehicl unloaded, and is this monitored and enforced?

2 3 4 5

XI
1 2 a b c d e f g h i j k l m n o 3 4 5 6 7 8 9 10 a b c d e f g h

Are personnel involved in the loading/unloading process trained and competent in the local safe operating procedu

i j k l m n o p q r

XII
1 2 3 4 5

Are Fork Lift drivers and operators of other equipment empowered to stop the activity if personnel enter the dang local procedures.

XIII
1 2 3

Do employees and other personnel working or walking in potential vehicle movement areas ear appropriate PPE in clothing?

XIV
1 2 3 4 5 a b c d 6

Are personnel loading or unloading vehicles and working in the warehouse, given appropriate information about a with the loads such as stability, chemical, biological, fire hazards or any other.

XV
1 2 3

Are there separate entrances doors for vehicles and pedestrians and is there use monitored.

XVI
1 2 3 4 5 6

Are Fork Lift Trucks forbidden to drive forward in areas where there could be pedestrians or other moving vehicles vision is obscured by the load?

XVII Are pedestrian routes clearly marked in the warehousing area?

1 2 3 4

XVIII
1 2 3 4 5

Are any storage equipment or area that has limits by weight, dimension, quantity and stability clearly identified to loading?

XIX
1 2 3

Are mirrors installed for vehicles at blind corners?

XX
1 2 3

Are a Good 5S type standards established and maintained?

XXI
1 2 3

Are there safe storage standards and procedures for all items and materials stored in the warehouse?

XXII
1 2 3 4

Is all storage equipment inspected on a regular basis by competent personnel to ensure that it complies with legal and maintained in a good safe condition

XXIII
1 2 3 4 5 6 7 8

Is the air quality in the warehouse area free from any harmful gases, vapours or particulates. If not is the atmosph that it meets local legal requirements

XXIV Is all mobile equipment and machinery used in the warehouse compliant to the SG standards on Vehicles and Mach

XXV

Are the Refueling areas segregated well ventilated locations and charging stations in ventilated areas away from so segregated from combustible materials?

XXVI

Does the risk assessment process cover manual handling and have all identified high risks been controlled to reduc acceptable level?

XXVII Are all the documents and records required by this standard and local legislation kept in a secure location for inspe

XXVIII Is there a procedure to allow employees and others to raise safety concerns with management about warehousing

XXIX Is there a recorded annual review of all the safety requirements of this standard and associated local legislation

Yes No Not Applicable

NT-GOBAIN STANDARD Warehouse

Requirement in Detail Compliance

GAIA Score

ments on warehousing and loading/unloading vehicles

#DIV/0!

assess the Warehousing and Loading/Unloading safety status against legal and

#DIV/0!

eted for the Warehousing and Loading/Unloading Areas

#DIV/0!

the warehousing and loading/unloading areas

#DIV/0!

tes, speed limits, parking areas, loading/unloading locations, reception areas, s and loading/ unloading safety procedures.

#DIV/0!

easily understandable format and available in appropriate languages

#DIV/0!

ack the status of any recommendations for safety improvement to the

#DIV/0!

s is provision made for their safe access, and are arrangements in place where rest equipment

#DIV/0!

n or rolling away whilst loading or unloading. The immobilisation should be by d hand locks) or similar devices

#DIV/0!

they should and should not stand or sit whilst the vehicle is being loaded or

#DIV/0!

ained and competent in the local safe operating procedures.

#DIV/0!

powered to stop the activity if personnel enter the danger zone or do not follow

#DIV/0!

potential vehicle movement areas ear appropriate PPE including high visibility

#DIV/0!

n the warehouse, given appropriate information about any hazards associated azards or any other.

#DIV/0!

trians and is there use monitored.

#DIV/0!

ere there could be pedestrians or other moving vehicles if the their forward

#DIV/0!

rea?

#DIV/0!

ht, dimension, quantity and stability clearly identified to prevent incorrect

#DIV/0!

#DIV/0!

#DIV/0!

ms and materials stored in the warehouse?

#DIV/0!

mpetent personnel to ensure that it complies with legal and company standards

#DIV/0!

mful gases, vapours or particulates. If not is the atmosphere monitored to ensure

#DIV/0!

use compliant to the SG standards on Vehicles and Machinery?

#DIV/0!

ns and charging stations in ventilated areas away from sources of ignition and

nd have all identified high risks been controlled to reduce the residual risk to an

d and local legislation kept in a secure location for inspection and auditing

e safety concerns with management about warehousing, loading and unloading

ments of this standard and associated local legislation

Overall Compliance %ge

#DIV/0!

#DIV/0!

SAINT-GOBAIN STANDARD Vehicle, Pedestrian Safety

S No
I
1 2 3 4 5 6 7 8 9 10

Theme Question
Does the site have access to all legal and company requirements on vehicles and pedestrian management

II
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Does the site have access to a competent person who can assess Vehicle and Pedestrian safety status to legal and c

III
1

Are all company vehicles used by employees or others on site checked by a competent person that they comply wi legislation before use.

2 3 4 5 6

IV
1 2 3 4 5

Does the plant have an inventory list of all company vehicles and are records kept of maintenance and safety check

V
1 2 3 4 5 6 7

Are pre-start safety checks done on all vehicles and the vehicles taken out of service for safety critical faults

VI
1 2 3 4 5 6 7 8

Is there an a system to record, prioritise, implement and track the status of any recommendations from the inspec operations and vehicle and pedestrian routes

VII
1 2 3 4 5 6 7

Have all vehicle and pedestrian routes been subject to formal inspections and subsequent risk assessment reviews

VIII
1 2 a b c d e f g h i j k l m 3 4 5 6 7 a b c d e 8

Have all employees and contractors been given suitable instruction on the local requirements for pedestrian move

IX
1 2 3 4 5

Have all vehicle operations (see para f on page 2) been subject to regular auditing to ensure that the current safe o suitable and sufficient.

X
1 2 3

One way systems or a suitable mirrors to aid visibility are used in case of Sharp or blind bends on vehicle routes.

4 5

XI
1 2 a b c d e f g h i j k l m n o 3 4 5 6 7 8 9 10 a b c d e f g h i

Barriers are erected for footpaths around corners of buildings and for Pedestrian routes exiting a building immedia and for others in high-risk areas,

j k l m n o p q r

XII
1 2 3 4 5

High visibility clothing are taken in consideration and are mandatory in areas where pedestrians and vehicles are m clearly designated with appropriate signage.

XIII
1 2 3

Where possible entrances for vehicles and pedestrians are separate. Where not possible bollards or other barriers

XIV
1 2 3 4 5 a b c d 6

Are suitable arrangements in place to reduce the risk to visitors from vehicles and vehicle movement in the workpl

XV
1 2 3

Are arrangements in place to ensure that the vehicle and pedestrian routes are kept as safe as possible in adverse w as snow and ice?

XVI
1 2

Is there a system to ensure that control measures arising from risk assessments are prioritised, actioned, and susta

3 4 5 6

XVII Is there an inspection schedule for all pedestrian and vehicle routes.
1 2 3 4

XVIII Do stairways have suitable treads and handrails

1 2 3 4 5

XIX
1 2 3

Are visiting drivers given appropriate information and advice on health and safety hazards and local procedural req

XX
1 2 3

Where vehicles have to reverse are suitable arrangements in place to prevent pedestrians being harmed.

XXI
1 2 3

Are there clearly identified traffic routes and speed limits

XXII Is the behaviour of pedestrians and vehicle drivers subject to monitoring and feedback through the use of SMAT ty
1 2 3 4 5

XXIII Have all employee and contractor drivers been suitably trained and do they hold appropriate licences
1 2 3

4 5 6 7 8

XXIV Are all industrial type vehicles fitted with suitable lights, reflectors, flashing lights, reversing alarms and other safe

XXV Are all vehicles fitted with suitable seating and seat belts.

XXVI Are all tipping operations subject to a risk assessment and all appropriate safety control measures put in place

XXVII Are all the documents and records required by this standard and local legislation kept in a secure location for inspe

XXVIII

Are suitable and safe parking and storage arrangements made for all types of vehicle. So that stationary vehicles d the workplace. Reverse parking rules are in place.

XXIX

Is there a procedure to allow employees and others to raise safety concerns with management about vehicles and routes

XXX Is there a recorded annual review of all the safety requirements of this standard and associated local legislation

Yes No Not Applicable

NT-GOBAIN STANDARD hicle, Pedestrian Safety

Requirement in Detail Compliance

GAIA Score

ments on vehicles and pedestrian management

#DIV/0!

assess Vehicle and Pedestrian safety status to legal and company requirements

#DIV/0!

ite checked by a competent person that they comply with this standard and local

#DIV/0!

es and are records kept of maintenance and safety checks.

#DIV/0!

hicles taken out of service for safety critical faults

#DIV/0!

ack the status of any recommendations from the inspections of vehicles, vehicle

#DIV/0!

mal inspections and subsequent risk assessment reviews at least once per year.

#DIV/0!

struction on the local requirements for pedestrian movements.

#DIV/0!

ject to regular auditing to ensure that the current safe operating procedures are

#DIV/0!

used in case of Sharp or blind bends on vehicle routes.

#DIV/0!

ngs and for Pedestrian routes exiting a building immediately into vehicle routes

#DIV/0!

mandatory in areas where pedestrians and vehicles are mixing. Such areas are

#DIV/0!

separate. Where not possible bollards or other barriers are used.

#DIV/0!

sitors from vehicles and vehicle movement in the workplace.

#DIV/0!

edestrian routes are kept as safe as possible in adverse weather conditions such

#DIV/0!

rom risk assessments are prioritised, actioned, and sustained

#DIV/0!

le routes.

#DIV/0!

#DIV/0!

ce on health and safety hazards and local procedural requirements

#DIV/0!

in place to prevent pedestrians being harmed.

#DIV/0!

#DIV/0!

to monitoring and feedback through the use of SMAT type interviews

#DIV/0!

ined and do they hold appropriate licences

#DIV/0!

eflectors, flashing lights, reversing alarms and other safety devices as appropriate

#DIV/0!

all appropriate safety control measures put in place

d and local legislation kept in a secure location for inspection and auditing

ade for all types of vehicle. So that stationary vehicles do not create a hazard in

e safety concerns with management about vehicles and vehicle and pedestrian

ments of this standard and associated local legislation

Overall Compliance %ge

#DIV/0!

#DIV/0!