HSE Element’s Checklist - Core work place safety

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About
Services
Resources
HSE Checklist
COR/SECOR Guide
Blog
Contact

HSE ELEMENT S CHECKLIST

Checklist

HSE Checklist Form

Part 1: Identify which documents below you would like to include in your HSE Management System (HSE MS).

Name *

Email *

Phone Number *

Required Policies

Health, Safety & Environment
Respectful Workplace (Violence & Harassment)
Fitness for Duty

Optional Policies

Code of Business Conduct
Environment
Health & Safety
Stakeholder Relations

Additional Policies (ACSA)

Emergency Management
Incident Management
Inspections
Orientation & Training
Personal Protective Equipment
Preventative Maintenance
Progressive Discipline
Safe Work Practice

Corporate Standards

HSE MS Overview
Leadership, Communication & Commitment
Fitness for Duty
Hazard Management
Personal Protective Equipment
Audits & Inspections
Orientation, Training & Competency
Emergency Management
Incident Management
Contractor/Subcontractor Management

Codes of Practice (AB OHS) / Exposure Control Plans (WSBC) – based on substance-specific/operational hazards

Asbestos Exposure
Benzene Exposure
Biological Hazards Exposure
Confined Space Entry
Diesel Fuel Exposure (under development)
Drilling Fluids Exposure
Hydrogen Exposure
Hydrogen Sulphide Exposure
Lead Exposure
Methanol Exposure
NORM Exposure
Respiratory Protection
Silica Dust Exposure
UV Radiation (under development)

Safe Work Practices (AB OHS/WSBC) – based on operational hazards

Blanking & Blinding
Bonding & Grounding
Caisson Wellsite Entry
Chemical Hazard Management
Concurrent Operations
Drilling & Completion Operations
Electrical Hazard Management
Energy Isolation
Environmental Management
Fatigue Management
Fire & Explosion Hazard Management
Firearm Use
Flammable & Combustible Liquids Management
General Safety Requirements
Ground Disturbance Operations
Hazardous Atmospheres Exposure Management
Hazardous Substances Exposure Management
Hot Work Operations
Lone Worker Management
Management of Change

Safe Work

Manual Materials Handling
Mechanical Lifting Operations
Noise Exposure Management
Occupational Health Management
Office Safety & Ergonomics
Off-Highway Vehicle (ATV) Operation
Oil & Gas Operations
Overhead Power Lines
Pipeline Operations
Powered Mobile Equipment Operation
Safe Work Permitting
Scaffolding Use
Site Transfer Agreements
Social Media Use
Temperature Extremes Exposure Management
Vehicle Operation & Journey Management
Waste Management
Wildlife Encounter Management
Working at Heights
Other (contact H2Safety)

Part 2: Identify which forms below you would like to include in your HSE MS. Forms associated with documents identified in Part 1 will automatically be included

NCR Permits / Hard Copy Booklets

Concurrent Operations Permit (NCR)
Confined Space Entry Permit (NCR)
Ground Disturbance Permit (NCR)
Pre-Job HSE Meeting (NCR)
Safe Work Permit (NCR)
TDG Shipping Document (NCR)
Term Permit (NCR)
Hazard Identification Card (Booklet)
Worker Observation Card (Booklet)

COR/SECOR

Formal Hazard Assessment
Job Task Inventory
Audits & Inspection Training Record
ERP Position Training Record
Hazard Management Training Record
Incident Management Training Record
PPE Training Record
Supervisor Leadership Training Record

JHSC

JHSC Agenda
JHSC Employer Recommendation
JHSC Meeting Minutes
JHSC Terms of Reference

Operations

Competency Assessment
Confined Space Entry Log
Confined Space Rescue Plan
Critical / Serious Lift Plan
Daily Compliance Checklist
Energy Isolation (LOTO) Record
Fall Protection Plan
Field Level Hazard Assessment
Fire & Explosion Prevention Plan
First Aid Assessment Worksheet
First Aid / Injured Worker Transportation Plan
Gas Monitor Bump Test Log
Ground Disturbance Line Locate Verification
HSE Orientation/Indoctrination Record
Incident Investigation Report Template (OHS/WSBC)
Incident Report
Job Safety Analysis
Journey Management Plan (under development)
Landowner Contact Form
Management of Change Record

Operations

Manual Material Handling Hazard Assessment
Motor Vehicle Incident Report
Non-Conformance Record
Notice of Worksite Supervisor/Prime Contractor
Physical Demands Analysis
Pre-Start-Up Safety Reviews (Simple/Complex)
Progressive Discipline Flowchart
Progressive Discipline Record
Risk Assessment Matrix
Safe Operating Procedure Template
Safety Meeting Minutes Template
Scaffolding Tags
Site Transfer Agreement
Stakeholder Concern Report
Surface Runoff Release Checklist
Unplanned Release Report
Worksite HSE Plan
Working Alone Control Plan
Worksite Emergency Contact Summary
Other (contact H2Safety)

Inspections

ATV Inspection (Pre-Trip)
Fall Protection Harness Inspection
Fire Extinguisher Inspection
First Aid Kit Inspection
Ground Disturbance Backfill Inspection
PPE Inspection
Scaffolding Inspection
Vehicle Inspection (Pre-Trip)
Vehicle Inspection (Monthly)
Vehicle Safety Kit Inspection
Worksite Inspection (Blank)
Worksite Inspection (Drilling & Completions Rig)
Worksite Inspection (General)
Worksite Inspection (Office)
Worksite Inspection (Oil & Gas Facility)
Worksite Inspection (Remote Camp)

Contractor Management

Contractor HSE MS / Safety Program Evaluation
Contractor Pre-Qualification Evaluation
Contractor On-Site Evaluation
Contractor Variance Approval
WS Supervisor Competency Assessment (IRP 7)
WS Supervisor Orientation/Qualification Record

Calgary, Alberta, Canada | Phone: 403-988-6994 | Email: info@coreworkplacesafety.com

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