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Competency Verification/Job Task Observation
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Date/Time Observation Conducted
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Location (Physical Location of the Observation)
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Name of Individual Observed
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Observed Individual Employee ID
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BOL #
*
Railcar #
*
Trailer Pup #
*
BPL Observation Type
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Attended
At a Distance
Competency Verification
Virtual
Transfer Equipment
PTO Pump
Hydraulic Pump
Conveyor
Blower
Compressor
Auger
Gravity
Silo
Air compressor
Diaphragm pump
Mobile Gantry
Bucket elevator
Bagging machine
Transfer Rack
Other
Mobile Equipment
Carry Lift
Front-end Loader
Railcar Mover
Skid Steer
Excavator
Yard Truck
Fork Lift
Pump Truck
Mobile Conveyor
Man Lift
Other
Operations Observed
*
Operations Observed
Safe Work Methods
Observed individual uses 2 hands and one foot,faces towards the grip points while ascending or descending with nothing in their hands.
Follows Standard
Intervention Needed
LEAD (Looks before stepping, establishes firm footing, adjusts to changing conditions, does not run) used properly
Follows Standard
Intervention Needed
All equipment being used is free of defects and defective equipment is placed out of service and tagged
Follows Standard
Intervention Needed
Worker bends at the knees, lifts with legs not with the back
Follows Standard
Intervention Needed
Objects and equipment kept in “power zone”
Follows Standard
Intervention Needed
Appropriate tools and positions used to minimize exertion and strain
Follows Standard
Intervention Needed
Worker avoids twisting upper body, pivots feet to change direction
Follows Standard
Intervention Needed
All required and approved PPE used, safety boots – fully laced and in good condition
Follows Standard
Intervention Needed
A neat, clean, and orderly work area is maintained with no trip or fall hazards
Follows Standard
Intervention Needed
Worker assesses site hazards prior to starting load/unload process
Follows Standard
Intervention Needed
Proper distance from moving parts and heavy equipment is maintained
Follows Standard
Intervention Needed
Vehicle and equipment secured according to procedure
Follows Standard
Intervention Needed
All workers have proper training documentation for task being completed
Follows Standard
Intervention Needed
Safe Work Methods - Deviation from Standard and Action Taken
*
Fall Protection
Harness has been inspected and is free of defects prior to use
Follows Standard
Intervention Needed
Fall harness properly adjusted
Follows Standard
Intervention Needed
Approved harness and connector is worn
Follows Standard
Intervention Needed
Correct anchor points used
Follows Standard
Intervention Needed
Fall protection is correctly used at all times
Follows Standard
Intervention Needed
Hand rails on equipment and stairs secured and confirmed safe for use
Follows Standard
Intervention Needed
Fall Protection - Deviation from Standard and Action Taken
*
Dangerous Goods
Vessels free of defects and contain valid stenciled inspection dates
Follows Standard
Intervention Needed
All containers are properly labeled and placarded
Follows Standard
Intervention Needed
All required inspections are completed and documented prior to loading
Follows Standard
Intervention Needed
Are all shipping documents confirmed and verified with contents prior to product transfer
Follows Standard
Intervention Needed
All transfer fittings and hoses approved for use, and test dates verified.
Follows Standard
Intervention Needed
Are containers such as trailers, railcars, ISO tanks, secured prior to transfer i.e. wheel chocks, hand brakes and are under loaders control
Follows Standard
Intervention Needed
All necessary grounding cables connected prior to connecting product lines
Follows Standard
Intervention Needed
All required emergency equipment available and in good condition (Spill Kit, Fire Extinguisher, Safety Shower, Eyewash, First Aid Kit)
Follows Standard
Intervention Needed
Dangerous Goods - Deviation from Standard and Action Taken
*
Conveyor Transfer
All belts have been inspected and properly adjusted
Follows Standard
Intervention Needed
All guards are in place and protecting spinning parts from inadvertent contact
Follows Standard
Intervention Needed
Conveyor has been cleaned properly between products to prevent contamination
Follows Standard
Intervention Needed
All emergency shut off switches are in good working condition
Follows Standard
Intervention Needed
All conveyors are in correct loading position to prevent spills or contamination
Follows Standard
Intervention Needed
Electrical plug-in’s and cords are in good condition
Follows Standard
Intervention Needed
Belt lacing is in good condition
Follows Standard
Intervention Needed
Conveyor cables and frame are free of corrosion damage
Follows Standard
Intervention Needed
Worker scans work zone and remains engaged and in control during the entire time of loading/unloading process
Follows Standard
Intervention Needed
Conveyor secured with wheel chocks to prevent movement
Follows Standard
Intervention Needed
Quantity and amounts of loaded products reviewed prior to trailer leaving loading terminal
Follows Standard
Intervention Needed
Trailers have been validated to be clean or compatible last contained product, prior to loading procedure
Follows Standard
Intervention Needed
Conveyor Transfer - Deviation from Standard and Action Taken
*
Transfer Rack
Railcar inventory verified and matches white board
Follows Standard
Intervention Needed
Railcars and pipe lines frequently checked for leaks
Follows Standard
Intervention Needed
Trailers compartment capacity verified prior to loading
Follows Standard
Intervention Needed
Inventory volumes frequently updated
Follows Standard
Intervention Needed
Railcars are verified as being secure, i.e. hand brakes & wheel chocks
Follows Standard
Intervention Needed
Valves opened according to procedure prior to starting pump
Follows Standard
Intervention Needed
Railcars secured prior to employees leaving the area
Follows Standard
Intervention Needed
Worker scans work zone and remains engaged and in control during the entire time of loading/unloading process
Follows Standard
Intervention Needed
Quantity and amounts of loaded product is reviewed prior to trailer leaving loading terminal
Follows Standard
Intervention Needed
All cam locks are secured with a securement device
Follows Standard
Intervention Needed
All hoses disconnected/cleared in accordance to procedure
Follows Standard
Intervention Needed
Hoses capped, plugged and stored in accordance to procedure
Follows Standard
Intervention Needed
Correct delivery information is on documentation (bill of lading)
Follows Standard
Intervention Needed
Transfer Rack - Deviation from Standard and Action Taken
*
Silo Transfer
Worker is aware of silo levels prior to loading
Follows Standard
Intervention Needed
Product type confirmed with load documents prior to loading/unloading
Follows Standard
Intervention Needed
All personnel in the area are wearing correct PPE
Follows Standard
Intervention Needed
Silo maintained in good condition and any defects found are properly reported/fixed
Follows Standard
Intervention Needed
Worker scans work zone and remains engaged and in control during the entire time of loading/unloading process
Follows Standard
Intervention Needed
Trailers have been validated to be clean or compatible last contained product, prior to loading procedure
Follows Standard
Intervention Needed
All cam locks are secured with a securement device
Follows Standard
Intervention Needed
Correct delivery information is on documentation (bill of lading)
Follows Standard
Intervention Needed
Were silos locked prior to transfer
Follows Standard
Intervention Needed
BPL employee present during the unlocking of the silo intended for transfer
Follows Standard
Intervention Needed
Verification that the silos are closed and secured at the completion of the silo transfer
Follows Standard
Intervention Needed
Silos are properly labeled with its contents at the completion of the transfer
Follows Standard
Intervention Needed
If Silos are ”tagged” with product types, insure shipping documents or work instructions agree with contents prior to transfer
Follows Standard
Intervention Needed
Silo Transfer - Deviation from Standard and Action Taken
*
Spotting/Swapping
Worker is familiar with hand signals and has reviewed them with operator
Follows Standard
Intervention Needed
Worker stays in the operator’s line of sight
Follows Standard
Intervention Needed
Worker is always aware of moving equipment and is aware of potential hazards
Follows Standard
Intervention Needed
Worker clearly demonstrates hand signals
Follows Standard
Intervention Needed
Worker keeps clear of “red zone” areas of equipment and product
Follows Standard
Intervention Needed
Worker and operator hold safety briefing prior to starting given task
Follows Standard
Intervention Needed
Product information is properly documented (Tallies, pipe length, etc..)
Follows Standard
Intervention Needed
All banding is properly cleaned up according to procedures
Follows Standard
Intervention Needed
Correct body positioning is used when cutting banding/straps
Follows Standard
Intervention Needed
Correct tool is used for cutting banding/ strapping
Follows Standard
Intervention Needed
Spotting/Swapping - Deviation from Standard and Action Taken
Follows Standard
Intervention Needed
Rail Movement
Workers are properly trained for their task and carry all necessary training certificates
Follows Standard
Intervention Needed
Workers conduct and document safety briefing prior to the start of rail movement
Follows Standard
Intervention Needed
Proper radio communication is used
Follows Standard
Intervention Needed
Proper push pull tests are conducted when connecting/ disconnecting equipment
Follows Standard
Intervention Needed
Track clearances verified and no equipment has been left foul
Follows Standard
Intervention Needed
Air horns and bells used properly
Follows Standard
Intervention Needed
Railcars are secured properly
Follows Standard
Intervention Needed
Railcar air brake system used properly (I.E. Connections checked, pressure at a minimum of 90 P.S.I.)
Follows Standard
Intervention Needed
Railcar mover has been inspected, and a walk around preformed
Follows Standard
Intervention Needed
Switches have been properly aligned and verified (No gaps between switch points and switch handle pinned)
Follows Standard
Intervention Needed
Job briefing updates conducted during movements and communicated properly
Follows Standard
Intervention Needed
Proper 3 point protection and communicating used when workers enter “red zone”
Follows Standard
Intervention Needed
Rail Movement - Deviation from Standard and Action Taken
*
Equipment Operation
Mirrors adjusted according to procedure
Follows Standard
Intervention Needed
Seat and steering wheel properly adjusted according to procedure
Follows Standard
Intervention Needed
Seatbelt is properly worn and adjusted at all times
Follows Standard
Intervention Needed
Proper pre-trip inspection conducted prior to operating equipment
Follows Standard
Intervention Needed
Safe operating speed maintained
Follows Standard
Intervention Needed
Operator prevents in-cab distractions per Trimac’s distracted driving policy
Follows Standard
Intervention Needed
Operator is aware of surroundings and properly adjusts to perceived hazards
Follows Standard
Intervention Needed
Operator stops and looks for movement at all rail crossings
Follows Standard
Intervention Needed
Equipment controls are operated smoothly and fluently
Follows Standard
Intervention Needed
Appropriate tools and equipment utilized for the job
Follows Standard
Intervention Needed
Operator completes 360 degree walk around according to load/unload procedure and prior to moving unit
Follows Standard
Intervention Needed
Equipment parked in accordance to site requirement with brakes applied and wheel chocks in place (if required)
Follows Standard
Intervention Needed
Working area protected to prevent any unwanted movement within working area
Follows Standard
Intervention Needed
Equipment Operation - Deviation from Standard and Action Taken
Follows Standard
Intervention Needed
Pre-Trip Inspection
All fluid level’s checked and no signs of fluid leaks present
Follows Standard
Intervention Needed
Lights, gauges, and alarms are operational
Follows Standard
Intervention Needed
Tires in good condition
Follows Standard
Intervention Needed
Mirrors and windshields checked for chips and cracks
Follows Standard
Intervention Needed
All belts and hoses free of defects
Follows Standard
Intervention Needed
All warning stickers are visible and in good repair
Follows Standard
Intervention Needed
Frame, body, and attachments are free of any defects
Follows Standard
Intervention Needed
DVIR (Pre-trip form) completed, previous day reviewed and signed prior to operation
Follows Standard
Intervention Needed
Pre-Trip Inspection - Deviation from Standard and Action Taken
*
Liquid Transfer
Hoses free of defects and contain valid inspection dates
Follows Standard
Intervention Needed
Load documents validated to be clean or have compatible last contained product and correct volumes, prior to beginning loading procedure
Follows Standard
Intervention Needed
Drip buckets in place under all required connections
Follows Standard
Intervention Needed
Hoses have locking cams that are in good condition
Follows Standard
Intervention Needed
All connections to the railcar and the trailer been double checked and signed off prior to product transfer
Follows Standard
Intervention Needed
All equipment (Hoses, fittings, pumps, and gaskets) are in good condition and compatible with product being transferred
Follows Standard
Intervention Needed
Caps and plugs carefully removed, always with hose end pointing away from themselves and others
Follows Standard
Intervention Needed
Worker is aware of potential hose tension and positions hose and body in ergonomically safe positions
Follows Standard
Intervention Needed
All tanks are vented properly prior to starting transfer
Follows Standard
Intervention Needed
All tanks have operational safety devices (i.e. pressure relief valves, fusible caps, and rupture disks)
Follows Standard
Intervention Needed
All vessels product level checked frequently during transfer
Follows Standard
Intervention Needed
Worker engages pump at idle, starts pump, checks all lines /connection points for leaks and proper flow
Follows Standard
Intervention Needed
Worker scans work zone and remains engaged and in control during the entire time of loading/unloading process
Follows Standard
Intervention Needed
All hoses disconnected, cleared, capped, plugged and stored in accordance to procedure
Follows Standard
Intervention Needed
Depressurization completed and verified in accordance to procedure
Follows Standard
Intervention Needed
Correct quantity of product loaded and delivery information is documented (bill of lading, dispatch documents)
Follows Standard
Intervention Needed
Liquid Transfer - Deviation from Standard and Action Taken
*
Bagging Plant Operation
Workers stay in safe work zones at all times
Follows Standard
Intervention Needed
Plant malfunctions are detected and fixed promptly
Follows Standard
Intervention Needed
Lock-out tag-out procedures are followed
Follows Standard
Intervention Needed
Properly fitted dust masks are worn for product being handled
Follows Standard
Intervention Needed
All packaging stored properly according to their set out procedures
Follows Standard
Intervention Needed
Bagging Plant Operation - Deviation from Standard and Action Taken
*
Track Protection
Is track blue flagged/ blue lighted properly placed prior to work being commenced on the track
Follows Standard
Intervention Needed
Are tracks lined away and locked properly from working tracks
Follows Standard
Intervention Needed
Derails have been properly applied and locked
Follows Standard
Intervention Needed
Track Protection - Deviation from Standard and Action Taken
*
Lock-out Tag-out
Units are shut down and de-energized properly prior to being worked on
Follows Standard
Intervention Needed
Lock out locks have been installed properly to prevent unauthorized start ups
Follows Standard
Intervention Needed
Proper tags have been installed with locks to identify type of work and who is completing it
Follows Standard
Intervention Needed
All workers who are working on equipment have installed locks and keep their keys with them
Follows Standard
Intervention Needed
Locks are only removed by the workers who have installed them
Follows Standard
Intervention Needed
All locks being used have separate keys and are approved for lock-out tag-out use
Follows Standard
Intervention Needed
Lock-out Tag-out - Deviation from Standard and Action Taken
*
Hand/Yard Tool Operation
Tools are in good working condition prior to use
Follows Standard
Intervention Needed
Plug- in’s and cords are in good condition
Follows Standard
Intervention Needed
All guarding is in place and in good working condition
Follows Standard
Intervention Needed
Worker use safe operating techniques of tools
Follows Standard
Intervention Needed
Hand/Yard Tool Operation - Deviation from Standard and Action Taken
*
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Satisfaction Rating
Level 1 - Satisfactory Observation
Level 2 - Monitoring Required
Level 3 - Immediate Action Required
Observed Individuals Response to Observation
*
Open To Coaching
Not Receptive to Comments
Observed Individual Unavailable
Comments/Training Instructions Given
*
Observed Employee/IC Commitments
*
A copy of this Job Task Observation will be automatically forwarded to the region safety manager.
Name of Observer
*
Observer Email Address
*
*
*
Branch Manager Email Address
*
*
*
Email address of Individual being observed
*
*
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