Rev 03/03

QP-1ANNUAL INTERNAL AUDIT REPORT / CHECKLIST

FOR SSPC CERTIFIED CONTRACTORS

Company Name:Street Address:City: State: Zip:Phone: Fax:E-mail: Web: http://

Performed By:Corporate QA/QC Mgr. (print) Signature

Office Audit:Date

Job Audit:Date Name of Site

*Approved By:S & H Officer (print) Signature

* Required if Health & Safety portion of audit is performed by someone other than the QA/QC Mgr.

Approved By:President, CEO, COO (print) Signature

Note: This internal audit report / checklist must be approved by the CEO, Chief

Operations Officer, or President in order to be accepted by SSPC

ANNUAL QP 1 INTERNAL AUDIT REPORT

The following questions must be answered by the contractor's representative performing theAnnual QP 1 Internal Audit.

1. Have you replaced key management personnel in the past year?Yes No (If Yes, list names and titles below).

Name Title

2. Has your company undergone (within the past 12-18 months) or planning to undergo anymajor organizational changes (e.g. name change; change in ownership; Chapter 7, 11, 13;purchase or takeover of another contracting firm, etc. If yes, please attach explanation.

Yes No

3. Have you completed and signed the annual Internal Audit Report?Yes No

(The certification cannot be continued without performing an annual internal audit and reporting the results to SSPC.)

4. a. Is your company now or has it in the past been associated in any way with acontracting firm operating under another name which has been disciplined by theSSPC under the DAC? Yes No If yes, please explain - attach sheet to application

b. Are any of your company’s officers, directors, owners, managing agents, managersnow exercising (or have previously exercised) directly or indirectly control,management or ownership of another contracting firm which has been disciplinedby the SSPC under the DAC?

Yes No If yes, please explain - attach sheet to application

If no such association with a firm previously disciplined under the DAC exists, you must state so below.

No, there has not been an association.Yes, there has been an association (attach explanation).

5. Has your company been disqualified or disbarred from any bidder’s list in the past 24months. Yes NoIf yes, please provide the reason for the disqualification or disbarrment and the name of the facility owner.

6. a. Have the previous SSPC QP 1 external audit results been reviewed prior to completing this Internal Audit? Yes No

b. Have previous deficiencies cited at both your last external audit and the most recent internal audit been reviewed and the corrective actions verified? Yes No

ANNUAL QP 1 INTERNAL AUDIT CHECKLIST

Rating Procedure

The QP 1 program contains thirty-three (33) items of information to which contractors mustrespond.

To complete this Annual Internal Audit Checklist, rate your company on each item using thescale of 0-3 as explained below.

At a minimum, the internal audit process used should parallel the SSPC external auditprocess. That is, compliance should be evaluated with QP 1 procedures at both anappropriate industrial painting job site, and in the office.

Internal audits should be planned so they can be performed when paint crews are activeduring the paint season. PCCP requires one internal audit be performed annually, butencourages QP 1 certified contractors to perform as many as are needed to ensure fieldoperations are in conformance with SSPC QP 1 certification procedures.

Mail SSPC one copy of the following:• internal audit report• active job site information• corrective actions taken as a result of the internal audit• Annual Maintenance Fee• Supplemental Safety Information, (EMR, OSHA 300 Log, OSHA Serious/Willful

Violations, Environmental Violations, or other regulatory violations)• List of current and recently completed (12 months) industrial painting jobs

SSPC will arrange for an on-site external audit, if applicable.

Response Ratings range from 0 to 3 on the following basis:

0 = Non-responsive (No answer, or one that has no connection to the givenmatter).

1 = Unsatisfactory Response (pertinent, but inadequate answer).

2 = Satisfactory Response (minimally acceptable).

3 = Superior Response (exceeds minimum standard).

Rev 03/03 Page 4 of 11

NOTE: Item numbers in left-hand column match item numbers in the application.

MANAGEMENT PROCEDURESCOMPANY POLICY

QP-1 Reference M.A.R. Score1. Mission Statement • Mission statement available.

• On company letterhead and signed by thePresident/CEO and dated.

• Posted at office and job sites.• Must address: Quality; Safety & Health,

Environmental Protection.• Randomly ask “employees” if they have ever seen

the company mission statement.

0 1 2 3

0 1 2 3

0 1 2 30 1 2 3

0 1 2 3

2. DisseminatingCompany Policies

• Management has implemented procedures todisseminate policies to employees. Examples maybe:• employee manual or handbook• new employee orientation• work force conferences

0 1 2 3

MANAGEMENT PROCEDURES / ORGANIZATION AND PERSONNEL3. Organization Chart • Organization chart exists.

• Lines of responsibility are shown.• Must be dated

0 1 2 3

4. Job Descriptions forManagement andother KeyPersonnel

• Written job descriptions for management and thosepersonnel responsible for quality control andsafety exist.

• Responsibilities and duties are clearly stated• Required experience, licenses, certifications and

training are stated.• Documentation confirms that duties match job

descriptions.

0 1 2 3

MANAGEMENT PROCEDURES / ADMINISTRATION AND MANAGEMENT5. Financial Record-

keeping• A recognized accounting system is in place.• Evidence exists that tax returns are submitted.• Evidence that worker’s compensation, liability and

other insurances are paid and current.

0 1 2 3

6. Estimating andScheduling

• Estimates for work are recorded.• Estimates take into account such items as labor,

materials, equipment, training, worker protectionand overhead.

• Written job schedules are available that outlinemajor activities such as

(1) mobilization, (2) cleaning,(3) surface preparation, (4) prime,(5) topcoat, (6) demobilization.

0 1 2 3

7. Procedures forReviewingSpecifications andBiddingDocumentation

• Procedure in place, either a checklist or otherdocumentation, that shows that managementreviews specification and inquiry documents.

• Auditor checks date of spec vs. date of reviewdocumentation.

• Evaluation criteria are used to define requirements.• Internal discussion is coordinated and results are

recorded in writing. (e.g., Project DocumentationLog)

0 1 2 3

Rev 03/03 Page 5 of 11

QP-1 Reference M.A.R. Score8. Procedures for

Complying withRegulationsCRITICAL ITEM

• Someone is designated (in writing) to keep abreastof environmental, safety and health regulationsaffecting the contractor’s operations.

• There is a history of someone performing theseduties. (6 months)

• Current versions of regulations applicable tospecific projects are available at the job site or

accessible to the job site.

0 1 2 3

TECHNICAL CAPABILITIESPERSONNEL QUALIFICATIONS

9. PersonnelQualifications -Worker Training

CRITICAL ITEM

• There are training records, certificates, relevantcorrespondence which indicate that qualifiedsurface preparation equipment operators andpainters have received training required toperform job functions. Examples of trainingproviders are:

• labor organization (e.g., IBPAT)• craft training organization (e.g., ABC; AGC)• material and equipment suppliers• trade or vo-tech schools• coatings consultants• documented in-house training

0 1 2 3

10. PerformanceEvaluation ofWorkers

• The performance of craft workers is systematicallyreviewed and documented regularly bymanagement and immediate supervisors.

• Corrective actions to improve sub par performanceare taken, as appropriate and documented.

0 1 2 3

TECHNICAL CAPABILITIES / TECHNICAL RESOURCES11. Industry Group

AffiliationsReview of current membership certificates andcorrespondence confirms that contractor maintainsaffiliation(s) with industry group(s) that provideinformation on protective coatings technology.

0 1 2 3

12. 3.2.2.bTechnical StandardsLibrary

CRITICAL ITEM

Personnel have access to and are aware of currentversions of• SSPC Standards (Vol. 1 & 2)• SSPC Coatings & Linings Inspection Handbook

(1997)• ASTM Standards• NACE Standards• Current versions of technical standards and

references applicable to the job are kept at the jobsite or are accessible to the job site.

• There is evidence of their use.

0 1 2 3

TECHNICAL CAPABILITIES / TECHNICAL PROCEDURES13. Document Control

Procedures thatRecord Specs andRevisions

CRITICAL ITEM

• Contractor records/logs receipt ofspecifications/revisions.

• Record is kept of who gets copies.• Superseded or obsolete documents are removed

from the workplace.

0 1 2 3

Rev 03/03 Page 6 of 11

QP-1 Reference M.A.R. Score14. Procedures for

ClarifyingAmbiguous Specs

CRITICAL ITEM

There is correspondence or other communicationnoting exceptions to specifications or otherclarification.

0 1 2 3

15. CommunicatingContract & TechnicalRequirements

CRITICAL ITEM

• There is a procedure in place that shows thatcurrent contract and technical requirements arecommunicated to supervisory personnel at the jobsite.

0 1 2 3

16. Documentation thatthe contractor iscurrently involved inor has completedindustrial paintingjobs within the last12 months. Thedocumentation shallinclude:

The company have records of current and pastindustrial painting jobs within the last 12 months.

The documentation includes:

• Facility name, address, including zip code,telephone and fax number, owner’s and primecontractor’s representative in charge of your fieldoperations.

• Scope of work performed• Materials applied and approximate quantities• Equipment used for surface preparation and

coating application• Types (e.g., painters; blaster; helpers) and number

of personnel field employed.• Special safety (e.g., protection from lead; working

at heights) or environmental (e.g., containment)requirements.

• Duration of project (start date; finish date)NOTE: List should include all jobs under contract toyour firm regardless of whether all or any portion ofthe job was subcontracted.

0 1 2 3

TECHNICAL CAPABILITIES / EXPERIENCE, EQUIPMENT, AND FACILITIES17. Maintenance/Repair

of Equipment

CRITICAL ITEM

•Contractor has a written preventive maintenance(PM) plan or copies of manufacturer’s maintenancemanual and repair intervals for major equipment.•There is evidence (e.g., maintenance records;service/repair invoices;) that maintenanceschedules are followed.NOTE: Checking oil and running equipment till itbreaks down are not considered PM.

0 1 2 3

QUALITY CONTROLPERSONNEL QUALIFICATIONS18a. Personnel

Qualifications/Q.C. Supervisor

CRITICAL ITEM

QC Supervisor

• There is a history of someone in this position.• The QC supervisor has 3 - 5 years’ (full time) varied

protective coatings experience appropriate for the QCtasks at hand. (e.g., inspection, calibration,corrective re-work)

• The QC supervisor has completed formal QC trainingfrom a recognized coatings training provider. Examplesare: CCC&L; KTA-Tator, Inc., NACE International, S.G.Pinney Associates.

0 1 2 3

Rev 03/03 Page 7 of 11

QP-1 Reference M.A.R. Score18b

.Inspectors

CRITICAL ITEM

Inspectors• QC inspectors have formal inspection training documentedwith a certificate and at least 2 years experience in theprotective coating industry.

0 1 2 3

19. Authority of QCPersonnel

CRITICAL ITEM

•There is written authority for the Q.C. Inspectors toreport directly to management, and to stop nonconformingwork and inform the production supervisor of requiredcorrective rework.

0 1 2 3

20. IdentifyingNonconforming Work

CRITICAL ITEM

• There are procedures for checking for non conformingwork and stopping work, if necessary. There isevidence that these procedures are used by on-siteQ.C. Personnel when necessary.

• QC inspectors notify operations supervisors (e.g.,NCRs, hold tags) of nonconforming work and identify re-work requirements.

• Nonconformances and required corrective actions areroutinely recorded by QC inspectors.

• Re-work inspections are performed and/or NCRs or holdtags are removed when work is accepted by QC.

• Deviations from above procedures for specifiedcircumstances (e.g., client request) are clearlycontrolled and documented.

0 1 2 3

QUALITY CONTROL / INSPECTION PROCEDURES AND RECORDING SYSTEMS21. Documentation of

Coating Inspectionand Filing Results

CRITICAL ITEM

• Written inspection reports and results of tests aremaintained for each project. Inspection reportsare prepared on a daily basis during surfacepreparation and application operations.

Reports shall contain (as a minimum) the following:• compressed air cleanliness• dry film thickness• air temperature• humidity• dew point• surface temperature• abrasive cleanliness• degree of cleanliness achieved• surface profile• batch numbers of paint used• batch numbers of thinner used• mixing according to specification

0 1 2 3

Subscore 0 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 30 1 2 3

22. CalibrationStandards--Checking Accuracyof InspectionInstruments

CRITICAL ITEM

• Calibration standards exist for use by QualityControl personnel on site.

• Inspection equipment on site is checked foraccuracy before use.

• Records of calibration/accuracy checks ofinspection equipment used on site aremaintained.

• Planned maintenance of inspection equipment iscarried out.

0 1 2 3

0 1 2 3

0 1 2 3

0 1 2 3

Rev 03/03 Page 8 of 11

QP-1 Reference M.A.R. Score23. Verifying Proper

Surface Preparation& CoatingApplication

CRITICAL ITEM

There is a written procedure either general or sitespecific defining how the company’s site personnelare to ensure that proper surface preparation andcoating application takes place in the field.• This procedure is available to and utilized by sitepersonnel

Note: QC Procedure Manual

0 1 2 3

24. Hold PointInspections

Hold point inspections are conducted during eachmajor operation. Examples of inspections done:• pre-cleaning• surface preparation• primer• intermediate coat• top coat

• cure

0 1 2 3

SAFETYPROCEDURES25. Safety Program and

Safety Education

CRITICAL ITEM

• Contractor has written Safety and HealthCompliance Program based on OSHA orequivalent standards applicable to its operations.

At a minimum, the program must address applicableportions of the following topics:• Hazardous Materials• Personal Protective Equipment• General Safety & Health Provisions• Occupational Health & Environmental Controls as

applicable to the coating industry• Personal Protective & Life Saving Equipment• Fire Protection & Prevention• Signs Signals, and Barricades• Materials Handling, Storage, Use, and Disposal• Hand and Power Tools• Welding and Cutting• Electrical• Scaffolds• Fall Protection• Cranes, Derricks, Hoists, Elevators, and

Conveyors• Ladders• Toxic & Hazardous Substances• Airless Injection• HPWJ• Program requirements are communicated to

workers• General and job-specific safety rules are enforced• Workers receive general safety refresher training

(at least annually for full-time employees) or asrequired by applicable regulations

• Work area safety assessments are conductedand corrective actions taken when necessary tocorrect existing or potential hazards at leastmonthly or required by the customer

0 1 2 3

0 1 2 3

0 1 2 3

0 1 2 3

0 1 2 3

Rev 03/03 Page 9 of 11

QP-1 Reference M.A.R. Score25.

(Cont.)Safety Program andSafety Education

CRITICAL ITEM

• Safety performance is part of each manager’swritten job description (if contractor is managedby a non-owner).

• The safety and health program is also reviewed byownership or management at least annually toevaluate whether the goal of protecting workersat all work sites is being achieved.

0 1 2 3

0 1 2 3

26. Pre-job SafetyMeetings

• A written job specific implementation plan isdeveloped as a result of the pre-job hazardanalysis.

• In this plan, Safety and health hazards are identifiedand documented by the corporate safety officer ordesignated safety professional for each job/phaseactivity during the pre-job hazard analysis.

0 1 2 3

27. Accident Reporting •Contractor has a written accident reportingprocedure.

Subscores • Accident reports address:-- what happened-- to whom-- where it happened-- how it happened-- root cause-- immediate follow-up actions to preventrecurrence

• The procedure is used (e.g., compare againstOSHA 200 log; workers’ compensation loss runs)

• Supervisors assigned follow up actions completenecessary corrective action at the job site within aweek after the accident, if feasible, to ensurehazard is removed or properly controlled.

0 1 2 3

0 1 2 3

0 1 2 3

0 1 2 3

28. Monitoring Safetyand Loss Control

• The contractor’s owners or managers review safetyperformance at least annually.

• OSHA incidence rates are within industry norms(N/EH x 200,000).

• Workers’ compensation experience rating (EMR)averaged over most recent 3 year period does notexceed 1.10. No single E.M.R., during the 3 yearperiod exceeds 1.25.

0 1 2 3

0 1 2 3

0 1 2 3

29. SOPs for MajorEquipment

• Written Safe Operating Procedures (SOP’s) formajor equipment are available at job site.(Pressured equipment)

• Owners and/or managers have approved theseprocedures.

• These procedures have also been reviewed by thecontractor’s safety director or designated safetyprofessional.

• These procedures incorporate equipment manufacturers’ recommendations for safe operation.

0 1 2 3

0 1 2 3

0 1 2 3

0 1 2 3

Rev 03/03 Page 10 of 11

QP-1 Reference M.A.R. Score30. Personal Protective

Equipment andRespiratoryProtection

CRITICAL ITEM

• As part of contractor’s comprehensive Health andSafety Program, the contractor has writtenrespiratory protection program based on OSHA1910.134 or equivalent regulation or standard.

•• Contractor also has written procedures for issuingand use of other personal protective equipment(PPE) such as protective clothing for skinprotection, devices for eye protection, devices forhearing protection, foot protection, headprotection, life jackets if applicable, life savingequipment.

•• Required respirators and protective equipmentare available.

•• There is evidence that workers use respiratorsand PPE.

•• There is evidence that workers are trained in theuse and maintenance of respirators and PPE.

•• The contractor uses a formal system to check theeffectiveness of PPE used on site and to maintainPPE used on site in good working condition.

0 1 2 3

Subscores 0 1 2 3

0 1 2 3

0 1 2 3

0 1 2 3

0 1 2 331. First Aid-Trained

Employees• An approved first aid kit is available on the job site

and is accessible in case of an emergency. Checkto see that it is filled.

• There is at least one person available on each jobsite who has first aid (and CPR) training certificatesissued by the Red Cross or an equivalentorganization. NOTE: This is applicable to a crewof 6 or more are on project that lasts 2 or moredays. Check credentials on site.

• Emergency telephone numbers (e.g., police, fire,ambulance) are posted at each job site where 911service is unavailable.

0 1 2 3

0 1 2 3

0 1 2 3

32. CompliancePlan/Procedure

CRITICAL ITEM

• Contractor owners or management keep records ofnon compliance with federal, state and localregulations.

• Corrective actions taken to avoid receiving citationsfor repeat violations are documented.

0 1 2 3

0 1 2 3

33. Sources of SafetyInformation

• Contractor operates a formal program to acquireinformation on safety and safety equipment fromsuch recognized sources as:

-- OSHA and NIOSH bulletins-- BNA Occupational Safety and Health Reporter-- ASA Safety Handbook-- PDCA Safety Manual-- Trade publications/clipping services-- AIHA publications and journals

• Relevant safety information and materials areavailable to on-site personnel.

0 1 2 3

0 1 2 3

Rev 03/03 Page 11 of 11

SSPC

Internal Audit Corrective Actions

Painting Contractor Certification Program (PCCP)

(Use Separate Sheet for each Audit Type & Location)

Contractor Name: Reference #:

Location: Date:

Page of

Type of Audit: QP 1 QP 2 QP 3 and Initial Annual Follow-up(Circle all that apply)

Location ofCorrective Action: Job Site Office(Circle location & give name of job)

Corrective Actions are for scores of 2 (QP1 & QP3 audits only)

ITEM # Corrective Action(s)

Contractors Signature: Auditors Signature:

Printed Name & Title: Printed Name:

Contractors signature is to confirm receipt of the above listed Corrective Actions and that thecontractor is responsible for implementing the proper corrective actions and follow up. Failure of thecontractor to fix corrective actions will be cause for issuing a deficiency.PCCP Corrective Action Form 03/03