Ref. No.

6-2

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Health, Safety & Environmental (HSE)

Management System Audit Questions

Ref. No. 6-2

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1. Management System Element: Management Commitment & Direction

POINTS
Performance Criteria Yes No Comments Available Achieved

1. Has the site adopted the Corporate HSE Policy? 10

2. Has the policy been communicated to all employees? 10
3. Do employees understand the policy and its contents? 10
4. Do employees feel the policy is practiced and that 10
HSE has equal priority to other business activities?
(e.g. – production, quality, costs, etc.)
5. Are adequate resources provided for HSE? 10
6. Is HSE integrated into all aspects of the business? 10
7. Is management held accountable for HSE (e.g., MRAs 10
and objectives) and do objectives include key actions
versus primarily statistical measures?
8. Has the facility established objectives for the 10
reduction in releases to the air, water and the
generation of wastes?
9. Is management visibly involved in HSE and actively 10
participate in the HSE process (e.g., audits,
investigations, meetings, observations, etc.)?
10. Do all levels of management respond to HSE issues in 10
a timely manner?
11. Is there an organization for HSE (e.g., committee 10
structure)?
12. Does it provide for special subcommittees/working 10
groups or forums?
Ref. No. 6-2

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13. Do the committees and/or subcommittees have annual 10

objectives?
14. Do they meet regularly and publish minutes of their 10
meetings?
15. Are all levels of the organization involved in the 10
committee structure?
16. Is the physical condition of the site and hazard control 10
reflective of high standards?
17. Are standards/work practices/procedures consistently 10
applied and reinforced?

TOTALS 170

2. Management System Element: Employee Roles & Responsibilities

Ref. No. 6-2

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POINTS
Performance Criteria Yes No Comments Available Achieved
1. Do employees feel that they are responsible for their 10
own safety and the safety of their co-workers?
2. Do employees regularly correct at-risk behavior and 10
reinforce safe behavior when they observe it?
3. Do employees take actions to minimize waste, prevent 10
pollution and clean up/report spills?
4. Are employees given the opportunity to and actively 10
participate in the HSE process?
5. Do employees have input into the development of 10
HSE rules, policies and annual programs?
6. Do employees follow HSE rules, procedures and 10
display high standards?
7. Has the site assigned an individual (s) as the HSE 10
Coordinator?
8. Has the individual (s) role and responsibilities been 10
clearly defined?
9. Does the individual (s) have good credibility? 10
10. Is the individual (s) technically competent? 10
11. Does the individual (s) have specific developmental 10
needs?
12. Is there an action plan in place to address 10
developmental needs?

13. Is the individual (s) assigned to mange the HSE 10

program knowledgeable on FMC Technologies HSE
Ref. No. 6-2

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requirements & applicable laws & regulations?

TOTALS 130

3. Management System Element: Hazard Control & Risk Management

Ref. No. 6-2

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POINTS
Performance Criteria Yes No Comments Available Achieved
1. Is the engineering function knowledgeable of 10
applicable HSE codes and regulatory requirements?
2. Are specific hazards adequately controlled? 10
3. Has a risk assessment been conducted to select 10
appropriate personal protective equipment (PPE)?
4. Have employees been instructed in the proper 10
selection, use, limitations and maintenance of PPE?
5. Is PPE being used and maintained? 10
6. Has a quantitative inventory been developed of wastes 10
generated and releases to the air, water and land?
7. Has an inventory been established that identifies 10
activities, products and services that have aspects that
interact with the environment?
8. Does the inventory include abnormal as well as 10
normal operations, start-up and shutdown activities,
use of raw materials and natural resources, aesthetic
aspects (noise, glare, etc.) and past activities?
9. Do hazard reviews conducted prior to new process 10
introduction and/or significant modifications assess
the environmental impact of releases, regulatory
requirements, etc.?
10. Has the site implemented engineering and operating 10
controls to improve prevention of and early detection
of releases that may contaminate the groundwater?
11. Have past practices been evaluated to address 10
potential environmental issues?
12. Has an action plan been developed to address and 10
control environmental risks?
Ref. No. 6-2

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13. Has a written strategy been developed to implement 10

the FMC Technologies Industrial Hygiene Protocol?
14. Has sufficient personal and area IH monitoring been 10
conducted to adequately profile worker’s exposures?
15. Have engineering, administrative and PPE controls 10
been put in place to control exposures?
16. Is housekeeping kept at a high standard? 10
17. Has a written strategy been developed to implement 10
the OSHA Process Safety Standard?
18. Is a management of change procedure in place? 10
19. Does the planning process for new plants and/or 10
processes include a review of potential HSE aspects?
20. Does the design of new plants and/or processes 10
incorporate appropriate measures to prevent
pollution and protect the environment?
21. Does the construction of new plants and/or processes 10
employ methods and procedures to minimize adverse
impacts on the environment?
22. Are HSE issues addressed during reviews of all new 10
designs and plant modifications?
23. When shutting down and decommissioning equipment 10
or operating units, has the business considered HSE
impacts and liability, and maximized the salvage
value of company assets?
24. Are hazardous materials data sheets available to 10
employees?

25. Does the site conduct regular assessments on the 10

materials used or processed to determine whether
improvements can be made to the way materials are
Ref. No. 6-2

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stored, handled or processed?

26. Are periodic assessments conducted to determine 10
whether there are more suitable alternatives available
that reduce hazards to human health or the
environment?
27. Are raw material and product stored and handled in 10
a manner that protects the environment?
28. Have environmental impacts been considered in the 10
development of safe work procedures?

TOTALS 280

4. Management System Element: Laws & Regulations

POINTS
Ref. No. 6-2

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Performance Criteria Yes No Comments Available Achieved

1. Has the facility management identified and complies 10
with all laws & regulations, ordinances & other legal
requirements relevant to its activities and operations?
2. Are all required permits, licenses, approvals, etc. 10
maintained in current and operable status?
3. Does the business have a mechanism for tracking 10
changes in potentially applicable laws and
regulations?
4. Does the organization have access to up-to-date legal 10
and other requirements?
5. Are records available that document compliance with 10
applicable laws & regulations?

TOTALS 50

5. Management System Element: Education & Training

POINTS
Ref. No. 6-2

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Performance Criteria Yes No Comments Available Achieved

1. Is a formal HSE training program in place for all 10
employees at the site (managers, technical, staff &
office, temporary, new employees, service &
contractors)?
2. Are employees aware of the FMC Technologies HSE 10
policy, standards, compliance requirements and
potential HSE risks?
3. Are HSE meetings used for training? 10
4. Are training records documented? 10
5. Is training adequate when non-routine jobs are 10
performed?
6. Have all FMC Technologies and government required 10
training topics been identified and training
conducted?
7. Are employees transferred into different jobs 10
adequately trained on hazards and their HSE
responsibilities?
8. Are methods in place to verify training effectiveness 10
(e.g., testing, supervisory observation, evaluation
checklists, etc.)?
9. Is an HSE orientation program in place for new hires, 10
contractors and visitors?

TOTALS 90

6. Management System Element: HSE Comunications

POINTS
Performance Criteria Yes No Comments Available Achieved
Ref. No. 6-2

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1. Are HSE issues, activities, programs, etc. regularly 10

communicated?
2. Are the available modes of communication effective? 10
3. Does the site regularly (at least annually) 10
communicate HSE objectives, targets, improvements
& responsibilities to all employees?
4. Are HSE topics included in staff meetings and 10
management reports?
5. Are signs, banners and incentive programs used to 10
communicate HSE?
6. Are HSE meetings routinely conducted? 10
7. Are HSE meetings well planned? 10
8. Do employees get adequate feedback on HSE issues, 10
suggestions or audits?
9. Has a procedure been established to 10
manage/communicate/respond to external interested
parties’ issues/concerns or inquires on the hazards of
operations and hazardous materials handled?
10. Does the facility personnel interact with neighbors and 10
appropriate local agencies & authorities to minimize
risk posed by the operations?
Does the facility management maintain a positive 10
relationship with the community in which it operates?

TOTALS 110

7. Management System Element: Rules & Procedures

Ref. No. 6-2

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POINTS
Performance Criteria Yes No Available Achieved
1. Are appropriate rules and procedures in place (e.g., 10
control of energy, hot work, confined space entry,
hazard communication, etc.)?
2. Are they up-to-date and available to all employees? 10
3. Do employees help write and review the site’s HSE 10
rules and procedures?
4. Are rules and procedures periodically reviewed and 10
updated with employees and the results documented?
5. Are rules and procedures understood, followed and 10
uniformly enforced?
6. Do departments have HSE rules and procedures 10
specific to exposures in their areas?

TOTALS 60

8. Management System Element: Emergency Planning & Medical Surveillance

POINTS
Ref. No. 6-2

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Performance Criteria Yes No Comments Available Achieved

1. Has an assessment been made to identify potential 10
emergency situations (e.g., natural, injury/illness, fire,
environmental release, community impact, etc.)?
2. Has a written plan been developed to address these 10
situations?
3. Have appropriate emergency equipment and/or 10
facilities been provided and are maintained in
working order?
4. Does the site review and revise, as necessary, its 10
emergency plans on a periodic basis and after the
occurrence of accidents or emergency situations?
5. Have all employees been trained on emergency 10
evacuation procedures?
6. Are employees responsible for responding to 10
emergencies properly trained?
7. Are annual drills held to ensure that employees know 10
how to evacuate or respond to emergency situations?
8. Has the emergency plan been coordinated with the 10
community’s plan?
9. Have local fire and emergency personnel visited the 10
site and participated in drills?
10. Has a medical surveillance program been 10
implemented that meets applicable FMC
Technologies and regulatory requirements?

11. Does the site have a “light duty” return-to-work 10

program?
12. Does the site have arrangements with a local 10
Ref. No. 6-2

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clinic/physician to treat occupational injuries,

illnesses, physical exams, etc.?
13. Is the physician familiar with the medical surveillance 10
program, drug testing program, nature of work at the
site, return-to-work program, OSHA or country
injury/illness recording, etc.?
14. Does the site have a random testing program for 10
substance abuse that meets FMC Technologies
standards?

TOTALS 140

9. Management System Element: Documents & Records

Ref. No. 6-2

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POINTS
Performance Criteria Yes No Comments Available Achieved
1. Has the site developed an HSE management system 10
sufficient to comply with FMC Technologies policy,
standards and procedures?
2. Are HSE records maintained in conformance with 10
applicable regulatory requirements and with the
FMC Technologies’ Records Retention Policy?
3. Are documents organized and maintained so they can 10
be located, reviewed and checked for their retention
status and compliance with regulatory requirements?

4. Are documents periodically reviewed, revised as 10

necessary, and approved for adequacy by authorized
personnel?
5. Are obsolete documents promptly removed from all 10
points of use, or otherwise assured against unintended
use?
6. Are any obsolete documents retained for legal and/or 10
knowledge preservation purposes suitably identified?

TOTALS 60

10. Management System Element: Contractor and Vendor (Supplier) Management

1. Does the site have a written procedure for contractors 10

Ref. No. 6-2

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and vendors?
2. Does the procedure require that the 10
contractor/vendor’s HSE performance and program
be evaluated prior to final selection?
3. Does the contractor/vendor procedure describe 10
methods of enforcing facility policies, procedures and
how authority over contractor/vendors will be
administered?
4. Does the program require that contractor/vendor 10
employees report all injuries, illnesses and
environmental releases?
5. Is a training/orientation program in place for 10
contractor/vendor employees working on FMC
Technologies sites to train them to perform their
duties in a manner that complies with applicable HSE
requirements, FMC Technologies policies & procedures?
6. Are periodic HSE audits performed for 10
contractor/vendors to ensure they are following site
rules and procedures?
7. Is there a written procedure for selecting, retaining 10
and reviewing waste contractors and contract
manufacturers?
8. Is an initial evaluation of the contractor/contract 10
manufacturer conducted, including a site visit and
inspection, review of waste management records,
financial condition and report of findings?

9. Is there a requirement for follow-up visits to waste 10

contractors/contract manufacturers?
10. Is there a process for decertifying waste 10
Ref. No. 6-2

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contractors/contract manufacturers?
11. Is there requirement that only approved waste 10
contractors/contract manufacturer be used?

TOTALS 110

11. Management System Element: Product Safety

POINTS
Ref. No. 6-2

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Performance Criteria Yes No Comments Available Achieved

1. Does the facility/business have a process in place to 10
evaluate new and existing products design and
hazards?
2. Does the process evaluate HSE regulatory and 10
labeling requirements?
3. Does the process evaluate HSE risks during the pre- 10
design stage?
4. Once a product has been manufactured/assembled is 10
a hazard assessment conducted?
5. Once a product has been manufactured/ 10
assembled/changed are manuals updated, safety
training provided for users and/or service and
maintenance personnel?
6. Is job training provided for employees who have been 10
assigned responsibilities for product risk assessment
and regulatory compliance?
7. Are product related incidents reported and 10
investigated?
8. Is there a product management of change process in 10
place?

TOTALS 80
Ref. No. 6-2

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12. Management System Element: Security & Travel Safety

POINTS
Performance Criteria Yes No Comments Available Achieved
1. Has a site security coordinator been assigned? 10
2. Is an effective program in place to recognize, provide 10
notification of and investigate security incidents
including IT incidents?
3. Within the past three years, has the existing program 10
been evaluated by either the company Security
Director or a consultant approved by the Security
Director with corrective actions identified and
implemented?
4. Have background checks been done for all FMC 10
Technologies permanent and part-time employees in
accordance with FMC Technologies standards? (This
requirement is not applicable if prohibited by local laws or
union contracts)
5. Does the site have an effective substance abuse 10
program that covers employees and contractors who
are working full time on the site? (This requirement is
not applicable if prohibited by local laws or union
contracts)
6. Does the site have an effective workplace violence 10
prevention and response plan that covers employees
and others working on the site?
Ref. No. 6-2

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7. Does the site have an effective integrated perimeter 10

control system that can deter, delay, detect and
defend against unauthorized entry?
8. Is there a central control point that all visitors must 10
go to in order to be authorized for entry into the
facility? Are visitors escorted throughout the site and
required to wear identification badges?
9. Have employees and contractors been educated not to 10
divulge critical and sensitive information and has the
unit taken steps to mark and protect that
information?
10. Is there a formal program to ensure that employees 10
are aware of the unit’s security procedures, the
rationale for these procedures, and actions expected
from the employees?
11. Is there a current Emergency Response Plan that 10
includes the location’s IT Business Resumption Plan
and has a link to the Corporate Crisis Management
Plan? Has it been tested in the past 2 years?
12. Is there a formal program to ensure that contractors 10
are aware of security procedures, and the responses
expected from the contractors?
13. Does the management team know the nine points of 10
making a statement to the news media during a crisis
situation and are at least two people at the site trained
to respond to the news media?
14. Are any FMC Technologies materials stored offsite 10
that represent terrorist targets (e.g., rail cars on
tracks outside the site, tank trucks)?
Ref. No. 6-2

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15. Does the site have a program for ensuring that health 10
issues, including immunizations, are addressed for
employees who travel/work at international sites?
16. Do international traveling employees carry SOS or 10
equivalent cards?
17. Do employees who drive on company business receive 10
defensive driving training?
18. Is the site aware of and regularly use the Corporate 10
Security Web Site to review travel safety guidelines,
travel bans or advisories, country profiles, etc.?
19. Are contact persons established for persons who 10
travel internationally and/or to remote areas?
20. Are important phone contact numbers given to key 10
personnel (supervisor) at the home base?

TOTALS 200
Ref. No. 6-2

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13. Management System Element: Audits & Inspections

POINTS
Performance Criteria Yes No Comments Available Achieved
1. Is a formal written audit and inspection program in 10
place?
2. Do all levels of the organization participate in the 10
audit and inspection program?
3. Are audits and inspections planned on a periodic 10
basis an is conformance to the audit schedule
reviewed?
4. Do audits and inspections focus on both conditions 10
and behavior?
5. Do audits and inspections cover all areas, shifts and 10
employees?
6. Do the audits and inspections require feedback to 10
persons being observed?
7. Is there a system in place to document closure to audit 10
recommendations?
8. Is there a formal behavioral observation program in 10
place?
9. Does the behavioral observation meet the 10
requirements of the START Process? (e.g.,
committee, champion, observation datasheet, % safe
measurement, action planning, communication of
data, regular update of key behaviors)
10. Are fire and emergency equipment regularly 10
inspected and records maintained?
11. Is environmental monitoring equipment calibrated 10
Ref. No. 6-2

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and maintained and records of these activities

maintained?
12. Is there a formal preventative maintenance (PM) 10
program in place critical operating equipment (e.g.,
fire and rescue, slings/chains, cranes and hoists, fork
trucks, bores/lathes/bending machines, etc.)?
13. Does the preventative maintenance program include 10
regular inspections of pollution prevention
equipment?
14. Are the results of the PM program documented? 10

TOTALS 140

14. Management System Element: Incident Investigation & Reporting

Ref. No. 6-2

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POINTS
Performance Criteria Yes No Comments Available Achieved
1. Are all employees (FMC Technologies, contractors, 10
visitors, etc.) encouraged to report all incidents
including recordables, near miss, first air,
environmental releases/spills, etc.?
2. Is there a written procedure for investigating 10
incidents?
3. Are all incidents investigated? 10
4. Are significant incident investigations communicated 10
to all employees (e.g., site specific, lessons learned
from other sites, etc.)?
5. Are incident investigation reports analyzed to identify 10
trends, targets, and specific causes?
6. Are incident investigation reports used to update the 10
site behavioral observation checklist?
7. Is there a system in place to identify, implement, 10
track and document incident investigation corrective
actions?

TOTALS 70
Ref. No. 6-2

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15. Management System Element: Process Assessment & Improvement

POINTS
Performance Criteria Yes No Comments Available Achieved
1. Is the overall HSE program evaluated on an annual 10
basis by the site management team and/or Corporate
HSE Audit Team?
2. Did the evaluation focus on the FMC Technologies 10
HSEMS, regulatory requirements, high risk activities
and major causes of incidents?
3. Was a report generated which identifies findings and 10
recommendations for improvement?
4. Was the report used to develop a site annual action 10
plan?
5. Were all levels of the organization given an 10
opportunity to have input into the development of the
annual action plan?
6. Are facility goal and objectives documented for 10
reductions in injury/illness, air emissions, effluent
discharge, waste generation and risk management
costs?
7. Does the facility show continual improvement in these 10
areas?
Ref. No. 6-2

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8. Is the annual action plan and goals/objectives 10

communicated to all employees?
9. Is the annual HSE program monitored for progress to 10
objectives during the year and modifications made as
necessary throughout the year?

TOTALS 90