COVER SHEET

  • Document No.

  • Inspection Title (Group/ Squadron)

  • Program Inspection

  • Facility Inspection

  • Squadron Commander (Rank, Full Name)

  • Safety Inspection Personnel (Rank, Name)

  • Prepared by (Rank, Name, Unit, Office Symbol)

EXECUTIVE SUMMARY

EXECUTIVE SUMMARY

  • Summary

    ** This annual safety program assessment and facilities inspection meets and satisfies the mandatory safety requirements of AFI91-202. **

    1. Upon completion of the inspection, 128th ARW Safety has 15 days to complete the inspection report for Commander coordination.

    2. All noted program and facility (if applicable) findings from this report require corrective actions. Once the report is received by the unit, corrective actions must be sent to the safety office within 30 days.

    3. Upon receipt of the report, the Unit Safety Representative (USR) will ensure all appropriate functional/facility managers receive a copy of the safety inspection report. Each noted finding requires a reply.

    4. Observations do not require reply, but should be addressed in a timely manner. The USR will consolidate responses and forward corrective actions taken or planned, along with an estimated completion date (ECD), to the safety office. If a work order request was submitted, enter the work order number, and the date the work request was submitted to base CE. Submission of a work request is NOT considered a closing action; only when the item is actually corrected.

    5. Each open finding requires follow-up and a status sent to Wing Safety by the workcenter supervisor every 30 days until all actions are completed. Once finding is corrected this will be verified by Wing Safety and officially closed in the report.

  • Overall Unit Score

  • Commander's Support of Safety

  • Unit Supervisor's Support of Safety

  • Weapons Safety Program Score

  • Squadron Flight Safety Officer's Score

  • Best Practices

  • Inspection Report Sent to Unit

  • Inspection Follow-up Due to Wing Safety

IN-BRIEF

IN-BRIEF RECAP

  • In-Brief Date/ Time

  • In-Brief Attendees (Rank, Name, Unit)

  • Total Number Attended

  • FY Mishap Trends (Past Year - Current Year)

  • Mishap Trend Comments

  • Open Discrepancies

  • Open Discrepancy Comments

  • Open Hazards (Hazard Abatement)

  • Hazard Abatement Comments

PROGRAM ASSESSMENT

  • Program Assessment?

OCCUPATIONAL SAFETY

  • COMMANDER SAFETY POLICY LETTER

  • POLICY
  • Has the Unit Commander published their safety policy and goals?

  • UNIT SAFETY REPRESENTATIVE (USR)

  • USR
  • Has the Unit Commander appointed a primary and alternate Unit Safety Representative (USR)?

  • Has USR been trained within 60 days of appointment?

  • Is the USR appointment letter accurate and up-to-date?

  • USR SPOT INSP: USRs shall conduct and document monthly spot inspections in conjunction with facility managers when possible and IAW paragraph 3.5 of this instruction. This will encompass 100% of the workplaces annually. AFI 91-202 para 2.2.2.2.<br>- The activity or work are inspected.<br>- The date and time of the inspection.<br>- The name of the person conducting the spot inspection.<br>- Brief description of the area or hazard.<br>- Applicable RAC, if assigned by Bio, Safety, Fire.<br>- Corrective actions taken or planned.<br>- Follow-up actions every 30 days until closed.

  • ADVISE CC: USRs shall advise the commander on safety related matters at least on a quarterly basis or more frequently as necessary and document key elements briefed. AFI 91-202 para 8.5.1.

  • SAFETY BRIEFING: USRs shall conduct safety briefings and provide unit personnel with educational safety materials. AFI 91-202 para 2.2.2.5.

  • MOTORCYCLE SAFETY REPRESENTATIVE (MSR)

  • MSR
  • Has the Unit Commander appointed at least one Motorcycle Safety Representative (MSR) in writing coordinate the Motorcycle Safety Program?

  • Has the MSR been trained within 30 days of appointment?

  • Is the MSR appointment letter accurate and up-to-date?

  • Is the commander completing annual safety brief for all motorcycle riders?

  • Are all motorcycle riders tracked in AFSAS/MUSTT?

  • HIGH RISK ACTIVITIES PROGRAM

  • HRAP
  • Has the Unit Commander provided a Risk Activity Briefing to all unit personnel whether they chose to participate in high risk activities or not?

  • MICT
  • Has squadron accomplished the following MICT checklists: 1. Unit Safety Representative (USR) Responsibilities/ 2. Supervisor Occupational Safety Responsibilities (within the squadron)/ 3. Commander below Installation Level Responsibilities Communicator

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Recommendation

  • Reference

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

WEAPONS SAFETY

  • WEAPONS SAFETY: APPLICABLE/NON-APPLICABLE

  • ADDITIONAL DUTY WEAPONS SAFETY REPRESENTATIVE (ADWSR)

  • ADWSR
  • Has the Unit Commander appointed at least one Additional Duty Weapons Safety Representative (ADWSR) in writing coordinate the Weapons Safety Program?

  • Has the ADWSR been trained within 30 days of appointment?

  • Is the ADWSR appointment letter accurate and up-to-date?

  • ADWSR SPOT INSP: ADWSR's shall conduct and document monthly spot inspections in conjunction with facility managers when possible and IAW paragraph 3.5 of this instruction. This will encompass 100% of the workplaces annually. AFI 91-202 para 2.2.2.2.<br>- The activity or work are inspected.<br>- The date and time of the inspection.<br>- The name of the person conducting the spot inspection.<br>- Brief description of the area or hazard.<br>- Applicable RAC, if assigned by Bio, Safety, Fire.<br>- Corrective actions taken or planned.<br>- Follow-up actions every 30 days until closed.

  • SAFETY BRIEFING: USRs shall conduct safety briefings and provide unit personnel with educational safety materials. AFI 91-202 para 2.2.2.5.

  • ADVISE CC: ADWSR's shall advise the commander on safety related matters at least on a quarterly basis or more frequently as necessary and document key elements briefed. AFI 91-202 para 8.5.1.

  • MICT
  • Has squadron accomplished the following MICT checklists: 1. SEW-3 Weapons Safety program Management - AFI90-201, Para. 5.4.

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

FLIGHT SAFETY

  • FLIGHT SAFETY: APPLICABLE/NON-APPLICABLE

  • SQUADRON FLIGHT SAFETY OFFICER (SFSO)

  • SFSO
  • Has the Unit Commander appointed at least one Squadron Flight Safety Officer (SFSO) in writing coordinate the Flight Safety Program?

  • Has the SFSO been trained within 30 days of appointment?

  • Is the SFSO appointment letter accurate and up-to-date?

  • MICT
  • Has squadron accomplished the following MICT checklists: 1. SE F01 - Aviation Safety/ 2. AMC SEF Sup - Aviation Safety - AMC Sup - AFI90-201, Para. 5.4.

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

JOB SAFETY TRAINING OUTLINE (JSTO)

  • Method of documenting safety training:

  • JSTO
  • Does the JSTO COVER THE 16 mandatory items from AFI 91-202, Attachment 4?

  • Does the JSTO cover specific hazards to include both task specific and work environment hazards?

  • Are all workcenter specific items cover in second section of JSTO?

  • Supervisor annual review:

  • When was the review last accomplished?

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

HAZARDOUS ENERGY CONTROL PROGRAM

  • OCCUPATIONAL SAFETY: APPLICABLE/NON-APPLICABLE

  • HAZARDOUS ENERGY CONTROL PROGRAM

  • LOTO
  • Is an adequate supply of safety tags and locks available for use? Reference 21.3.3

  • Are procedures developed and documented for safe and proper use of locks and tags? Reference 21.2.1.4

  • Has a training plan been developed for initial and recurring training on lockout and tagout procedures? Reference 21.2.1.6

  • Are LOTO devices (typically locks) used as a positive means of isolating energy sources and preventing unexpected start-up of machines and equipment? Reference 21.2.1.7

  • Is an inspection of the lockout and tagout program conducted annually? Reference 21.2.1.10

  • Are all workers responsible for recognizing when LOTO is used, the general reasons for LOTO and the importance of not tampering with or removing LOTO devices? Reference 21.3.4.1

  • Have equipment-specific, written procedures been developed for use when equipment or machinery undergoes servicing, modification or maintenance? Reference 21.3.8

  • Has squadron accomplished the following MICT checklists: 1. SE F01 - Aviation Safety/ 2. AMC SEF Sup - Aviation Safety - AMC Sup - AFI90-201, Para. 5.4.

  • Was a management above supervisor review accomplished?

  • Management above supervisor review:

  • Date of management review

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

CONFINED SPACE PROGRAM

  • OCCUPATIONAL SAFETY: APPLICABLE/NON-APPLICABLE

  • CONFINED SPACE

  • Confined Space
  • Has the commander and/or functional manager developed and implemented a written confined space program? Reference 23.2.7

  • Does the commander and/or functional manager ensure personnel who support the permit-required confined space program are properly trained, equipped and qualified? Reference 23.2.7.2<br>-Does the organization have an effective training program that incorporates safe work practices and techniques? Reference 23.7.1<br>-Does the organization ensure all individuals authorized and assigned permit-required confined space entry duties complete site-specific training? Reference 23.7.2<br>-Is confined space training documented on an AF IMT 55, Employee Safety and Health Record, or an authorized computerized information management system? Reference 23.7.5

  • Does the commander and/or functional manager ensure required equipment is available and properly maintained? Reference 23.2.7.3

  • Does the commander and/or functional manager maintain a current list of all confined spaces, both permit-required and non-permit, under the control of their organization? Reference 23.2.7.4.

  • Does the entry supervisor have a copy of the MEP? Reference 23.2.8.1

  • Are entry permits, including those canceled or revoked, retained on file for one year? Reference 23.5.1.2

  • Does the organization have a MEP, as appropriate? Reference 23.5.4.10

  • Does the entry supervisor ensure the inspection, testing, maintenance and documentation of safety and rescue equipment are accomplished prior to an operation being performed? Reference 23.6.2

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

FALL PROTECTION PROGRAM

  • OCCUPATIONAL SAFETY: APPLICABLE/NON-APPLICABLE

  • FALL PROTECTION

  • Fall Protection
  • Are workers provided fall protection when exposed to falls of four (4) feet or more? Reference 13.2.2

  • Are all PFAS components marked to indicate compliance with ANSI Z359.1.? Reference 13.4.6.2

  • Can anchorage connectors withstand a 5000 pound load for each PFAS connected? Reference 13.4.6.7

  • Do workers inspect their PFAS prior to each use for mildew, wear, damage and other deterioration? Reference 13.4.6.10.2

  • Does the competent person thoroughly inspect all PFAS components at least quarterly and keep the record of inspection for at least one year? Reference 13.4.6.10.3

  • Are competent persons trained and appointed in writing by the commander?

  • Is recurring fall protection training conducted annually, when work conditions change or when new fall protection/fall arrest systems are procured and does it contain a rescue plan developed to assure prompt rescue of fallen workers? Reference 13.6, 13.7

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

GOVERNMENT-VEHICLE OPERATOR TRAINING

  • GOVERNMENT-VEHICLE OPERATOR TRAINING: APPLICABLE/NON-APPLICABLE

  • GOVERNMENT-VEHICLE OPERATOR TRAINING

  • Vehicle
  • Do workers who operate vehicle-mounted elevating and rotating work platforms receive thorough training to include hands-on-training prior to actual on-the-job training tasks? is training documented in individuals training records? (623's, 797's, ARCNET)

  • Does training meet minimum mandatory requirements for Aerial Lift Training and Training Plans in AFI 91-203, Attachment 2?

  • Is training/certification documented on AF Form 483

  • Is the instructor for forklift trucks/MHE qualified as an instructor?

  • Does the qualified instructor evaluate each operator at least every 3 years and provide refresher training if needed? Is there a written record of each operations evaluation on file for review? Is recertification annotated in operators training record or in TBA?

  • Does Materials handling and lifting equipment training include:
    Reference AFI 91-203 Para. 35.3.3.4

  • Is training/certification documented on AF Form 2293

  • Equipment design, to include restrictions, limitations and hazards relative to the environment where used, e.g., steering, maneuvering and visibility.

  • Operating and maintenance instructions, including manufacturer’s instructions and those contained in this standard.

  • Safe loading and unloading requirements.

  • Flight line rules and regulations, when applicable.

  • Operating techniques inside and outside of warehouses.

  • Fire extinguisher training (initial and annual). Refer to Chapter 6, Fire Protection and Prevention, for additional guidance.

  • Use of attachments such as extended forks or tines or personnel lift pallets.

  • Clearances, heights and limitations.

  • Safety clothing and equipment. Refer to Chapter 14, Personal Protective Equipment (PPE), for additional guidance.

  • Fire protection, fuel spills, maintenance of equipment, smoking, etc. Refer to Chapter 6 for additional guidance.

  • Operating restrictions in potentially hazardous storage areas, which include flammable, toxic, lumber, coal, etc. Refer to Chapter 22, Flammable and Combustible Liquids, for additional guidance.

  • Load composition and stability.

  • Damage that may be caused by acid or caustic material.

  • Workplace related topics such as surface condition; local policies on stacking, unstacking, and load manipulation; pedestrian traffic; and narrow aisles.

  • Applicable information contained in paragraphs 35.2. and 35.3.2.1. of this standard.

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

OFFICE AREAS

  • OFFICE AREAS

  • Office Area

  • Office
  • BLDG, Room Number and Responsible Section

  • Floors and walking surfaces free of potential tripping hazards such as tools, Elec, cords, air hoses, materials and liquids?

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Electrical receptacles & cover plates free from cracks and secured in place?<br>

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are receptacles located in damp or wet locations protected by GFCI breakers or receptacles?

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is the prohibition of multiple plug adapters enforced to prevent overloading electrical<br>circuits?

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are cords that show signs of fraying, cracking, wearing or damage removed from service?

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are electrical extension cords used as outlined in the NEC and not used as a substitute for<br>fixed wiring?

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are electrical extension cords not run through holes in ceilings, walls, floors, doorways,<br>windows or similar openings?

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Unless their purpose is evident, are circuit breakers and fuse boxes legibly marked to indicate<br>their purpose?<br>Is access to fuses, circuit breakers and electrical controls clear and unobstructed? Reference 10.5.7.6

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are telephone and electrical cords located where they do not pose a tripping hazard?

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are all defects, such as floor tiles, broken steps, torn carpet or curled mats identified until<br>repaired or replaced?

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are heavy materials stored in the bottom of file cabinets?

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are stepstools or ladders used to access anything above shoulder level? Reference 10.2.2.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are drawers and file cabinets closed when not being used?

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are heating appliances, such as coffee makers, plugged directly into a facility outlet and unplugged at the end of the work shift? Reference 10.5.7.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do not place cords under rugs, carpets or other combustible material. AFI 91-203 para 8.4.1.16.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Exit sign: The illuminated surface value of the exit sign should have a value of not less than five foot-candles. 29 CFR 1910.37 ( b )( 6 )

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Exit signs shall be clearly visible from all directions of egress and shall not be obstructed at any time. If occupancy is permitted at night, or if normal lighting levels are reduced at times during working hours, exit signs shall be suitably illuminated by a reliable light source. New exit signs shall be the internally illuminated, light emitting diode (LED) type. Existing signs may be internally or externally illuminated. AFI 91-203 para 25.4.9.5.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Monthly testing of exit lights shall be accomplished IAW NFPA 101, The Life Safety Code. AFI 91-203 para 25.4.9.10.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Fire exits shall be clearly marked and exit paths shall be kept clear of equipment and materials, emergency lighting shall be provided and all workers trained in proper evacuation procedures. AFI 91-203 para 6.3.2.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Floors or means of egress shall be illuminated to at least one (1) foot-candle (measured at all points at the floor), including angles and intersections of corridors and passageways, stairways, landings of stairs and exit doors. AFI 91-203 para 6.3.8.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Doors, passageways or stairways which are neither exits nor ways to an exit but may be mistaken for an exit, shall be clearly marked ―NOT AN EXIT or a sign indicating their actual use; for example, ―STORAGE ROOM or ―BASEMENT. AFI 91-203 para 6.3.3.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Ensure escape routes are kept free of obstruction—to include stairways and office doors. Ensure doors leading outside open easily. AFI 91-203 para 6.2.15.2.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

INDUSTRIAL AREAS

  • Industrial Areas (Housekeeping, General Checklists)

  • Housekeeping
  • BLDG, Room Number and Responsible Section

  • Keep areas where personnel walk and work free of potential tripping and slipping hazards such as tools, electrical cords, air lines and packaging materials. AFI 91-203 para 5.1.<br>Are aisles and passageways kept clear of stacked materials? Reference 5.7

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are fire extinguishers visually inspected by the workcenter supervisor at a minimum of 30-day intervals to detect and correct discrepancies? Reference 6.2.4.7

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are exterior garbage cans securely covered when not actually being filled or emptied? Reference 5.9.1<br>Are trash and garbage cans leak-proof and adequate in number and size? Reference 5.9.2

  • Discrepancy:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Reference:

  • Unit corrective actions:

  • RAC

  • Maintain ceilings in good repair and free of loose plaster. Replace damaged, broken or missing fire rated ceiling tiles. Openings in ceilings can delay activation of smoke detectors and sprinkler heads. AFI 91-203 Para. 5.5

  • Discrepancy:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Reference:

  • Unit corrective actions:

  • RAC

  • Are protruding nails, brads and staples removed from packing materials to prevent injury to personnel? Reference 5.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is material stacked less then 15 feet at least 18-inches below ceiling sprinkler heads, joists, rafters, beams and roof trusses. If material is stacked more than 15 feet is there at least 36 inches of clearance from ceiling sprinkler heads, joists, rafters, beams and roof trusses. Is all stacked material positioned to ensure a 18 inch clearance around light or heating fixtures, or follow manufactures instructions, regardless of height. Reference 5.7

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do all fluorescent light fixtures without self-locking tubes have shields, clamps or other devices installed to keep the tubes from falling out of the fixture. AFI 91-203 Para 5.7

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are all surfaces maintained as free as practicable of accumulations of dust, lead, chromium, cadmium or any other foreign particles.? Are floors kept clean and spills cleaned up as soon as possible.? Reference 5.10.9

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is apparel not needed to perform official duties stored in lockers and not stored on top of or under clothing lockers? Reference 5.10.8

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are packing materials such as excelsior (fine wood shavings), packing straw and shredded paper stored in an isolated fire-resistant building? Reference 5.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are cords not placed under rugs, carpets or other combustible material. AFI 91-203 para 8.4.1.16.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Exit sign: The illuminated surface value of the exit sign should have a value of not less than five foot-candles. 29 CFR 1910.37 ( b )( 6 )

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Exit signs shall be clearly visible from all directions of egress and shall not be obstructed at any time. If occupancy is permitted at night, or if normal lighting levels are reduced at times during working hours, exit signs shall be suitably illuminated by a reliable light source. New exit signs shall be the internally illuminated, light emitting diode (LED) type. Existing signs may be internally or externally illuminated. AFI 91-203 para 25.4.9.5.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Monthly testing of exit lights shall be accomplished IAW NFPA 101, The Life Safety Code. AFI 91-203 para 25.4.9.10.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Fire exits shall be clearly marked and exit paths shall be kept clear of equipment and materials, emergency lighting shall be provided and all workers trained in proper evacuation procedures. AFI 91-203 para 6.3.2.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Floors or means of egress shall be illuminated to at least one (1) foot-candle (measured at all points at the floor), including angles and intersections of corridors and passageways, stairways, landings of stairs and exit doors. AFI 91-203 para 6.3.8.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Doors, passageways or stairways which are neither exits nor ways to an exit but may be mistaken for an exit, shall be clearly marked ―NOT AN EXIT or a sign indicating their actual use; for example, ―STORAGE ROOM or ―BASEMENT. AFI 91-203 para 6.3.3.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Ensure escape routes are kept free of obstruction—to include stairways and office doors. Ensure doors leading outside open easily. AFI 91-203 para 6.2.15.2.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • Unit corrective actions:

  • RAC

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

  • Safety Color Coding, Labeling and Marking for Piping Systems

  • Labeling Piping
  • BLDG, Room Number and Responsible Section

  • Is each location evaluated and the number of markings kept at a minimum? Reference 20.3.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are piping systems labeled and color coded IAW guidance in paragraph 20.3.4.? Reference 20.3.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Does the method of identification of piping systems conform to the requirements in paragraph 20.3.5.? Reference 20.3.5.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do the colors used to distinguish the hazard potential of piping systems conform to those in this standard? Reference 20.3.5.5.1

  • Discrepancy:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Reference:

  • Unit corrective actions:

  • RAC

  • Are hazardous materials in piping systems clearly identified? Reference 20.3.5.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is a secondary warning color applied to a piping system possessing a secondary hazard? Reference 20.3.5.5.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

  • Personal Protective Equipment

  • PPE
  • BLDG, Room Number and Responsible Section

  • Are workers provided appropriate eye or face protection when exposed to hazards from flying particles, molten metal, liquid chemicals, corrosives, caustics, chemical gases, vapors or potentially injurious radiation? Reference 14.4.2<br>Do supervisors ensure PPE is provided, used and maintained in a sanitary, serviceable condition? Reference 14.3.2<br>Is previously used PPE disinfected before reissue to another worker? Reference 14.4.2.15.<br>Do workers maintain and disinfect eye and/or face protection equipment IAW the following instructions: Reference 14.4.2.16<br>- Several methods for disinfecting eye-protective equipment are acceptable. The most effective method is to disassemble the goggles or spectacles and thoroughly clean all parts with soap and warm water. Carefully rinse all traces of soap and replace defective parts with new ones. Swab thoroughly or immerse all parts for 10 minutes in a solution of germicidal deodorant fungicide. Remove parts from solution and suspend in clean place after air drying at room temperature or with heated air. Do not rinse after removing parts from the solution because this will remove the germicidal residue.<br>- Ultraviolet disinfecting equipment or spray type disinfecting solutions may be used in conjunction with the washing procedure.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do management, supervisors and visitors wear appropriate PPE while within a hazardous area? Reference 14.4.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are protective helmets provided for and used by workers exposed to injury from falling or flying objects, bumping head against a fixed object or electrical shock or burns? Reference 14.4.3<br>Do protective helmets have the manufacturer’s name, ANSI designation and the class identified inside the shell? Reference 14.4.3.1.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are chemical protective gloves worn by personnel handling acids, alkalis, organic solvents and other harmful chemicals? Reference 14.4.7.2<br>Are workers able to remove gloves without causing skin contamination? Reference 14.4.7.2.4.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is contaminated PPE that cannot be decontaminated disposed of in a manner that protects employees from exposure to hazards? Reference 14.4.7.2.5

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is protective footwear provided and worn when there is a reasonable possibility of foot injuries? Reference 14.4.10

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

AIRCRAFT FACILITY

  • Aircraft Maintenance Facilities

  • BLDG, Room Number and Responsible Section

  • Are pressure regulators installed to prevent over-pressurization of components being serviced with compressed air? Reference 24.2.5.2.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are suitable fire extinguishers placed throughout maintenance areas? Reference 24.3.3.6

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do parking lines have spots painted where the nose or forward wheel of the aircraft are positioned on aircraft parking spaces on the flight line and in maintenance hangars? Reference 24.5.5

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • At the end of each day or shift, are flammable waste containers emptied or removed to an approved location outside the shop for pickup and disposal? Reference 24.11.2.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are flammable storage areas kept cool (55o to 80o F) and free from spark or heat-producing equipment? Reference 24.11.2.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are tire cages used when servicing aircraft tires in the tire shop? Reference 24.12.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are FOD Check signs posted at entrances to ramp area/flight line? Reference 24.13.13

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are pintle assemblies and towing connections secured with a pintle hook safety locking device or cotter pin that will positively lock towing connections? Reference 24.7.16

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do facility managers conduct monthly inspections of hangar door operational and safety features? Reference 24.14.8.7

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is temporary or makeshift electrical wiring prohibited in hangars? Reference 24.14.13

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do supervisors prohibit wear of finger rings and loose clothing when they pose a hazard to workers? Reference 24.15.1.6

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are locking pins or other devices, as required, in place IAW manufacturer’s specifications before anyone is allowed to ascend the stairs or ladder? Reference 24.16.7.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is fall protection available and used by workers exposed to a fall of 4 feet/10 feet or more? Reference 24.16

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

MATERIALS HANDLING / WAREHOUSE

  • MATERIALS HANDLING/WAREHOUSE

  • Materials Handling Checklist

  • Warehouse
  • BLDG, Room Number and Responsible Section

  • Are manual materials handling activities kept to a minimum through the application and use of engineering controls when possible? Reference 4.5.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is PPE provided and used when needed to protect the hands and feet of workers involved in manual materials handling activities? Reference 4.7.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Have training outlines been developed for all material handling equipment? Reference 35.3.3.2<br>(Forklifts)<br>

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Have qualified personnel been identified as training instructors? Reference 35.3.3.1<br>(Forklifts)

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Does the instructor provide written certification of training completion to the OR&L? Reference 35.3.3.3. (Forklifts)

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do materials handling and lifting equipment operators conduct daily or prior-to-use inspections and document them on AF Form 1800 per requirements of paragraph 35.1.1? Reference 35.3.6 (Forklifts)

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are inspections of manual hoisting and pulling devices conducted annually? Reference 35.5.2.3.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do Storage Racks have load rating posted on the unit? Reference 35.2.5.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are storage racks/shelving inspected per manufacturer's instructions and is it documented properly. Reference 35.2.5.5

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Unit corrective actions:

  • RAC

  • Recommendation

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

HYDROCARBIN FUELS COMPLEX

  • HYDROCARBON FUELS

  • POL
  • BLDG, Room Number and Responsible Section

  • Have possible sources of ignition been identified and prohibited from areas where flammable vapor may exist? Reference 36.1.5.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Have all damaged static grounds been repaired and retested for resistance values? Reference 36.1.6.5

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Have all personnel in work environments where petroleum products are present been instructed on hazards of static electricity? Reference 36.2.2.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are all personnel involved in fuel handling operations trained in minimizing the possibility of fuel spills and proper response procedures if a spill does occur? Reference 36.2.2.5

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are proper procedures used when entering petroleum storage tanks? Reference 36.2.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are the minimum safety features present in locations where petroleum products are handled or stored? Reference 36.2.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are fuel transport vehicles electrically bonded to the offloading header during fuel handling operations? Reference 36.3.2.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are emergency shower and eyewash units in place IAW Chapter 19? Reference 36.2.4.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are proper procedures utilized for fuel transfer operations, including gauging and temperature measurement? Reference 36.3.2.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is fire protection equipment properly located prior to fuel handling operations? Reference 36.3.2.6

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do local fuel movement procedures include emergency shutdown procedures? Reference 36.3.2.9

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Has a Fuel Servicing Safety Zone (FSSZ) been established for fuel servicing operations? Reference 36.4.1.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are spotters used when backing refueling trucks toward the aircraft? Reference 36.4.2.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are the specific precautions for hydrant system fueling being followed? Reference 36.4.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

VEHICLE MAINTENANCE

  • VEHICLE MAINTENANCE

  • Vehicle Maintenance

  • VM
  • BLDG, Room Number and Responsible Section

  • Are vehicle maintenance operations, such as painting, welding, battery work, and wheel and tire maintenance operations performed in separate parts of the facility to prevent operations of one kind from being hazardous to another? Reference 32.2.4.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are vented lockers provided for workers‘ clothing? Reference 32.2.4.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do vehicle operators and mechanics ensure roll down or side sliding doors are completely opened before a vehicle enters or exits the maintenance shop? Reference 32.4.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are tools not in use kept in suitable containers? Reference 32.4.15.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are emergency eyewash station(s) provided for workers who may come in contact with corrosive materials? Reference 32.4.7

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do workers remove all items of jewelry before working on or around shop equipment or vehicles? Reference 32.4.8

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is clear, unrestricted access maintained to on-off power control switches and stations? Reference 32.8.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are all compressed gas cylinders stored upright with valves closed and protective caps in place? Reference 32.12.2.5.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are current OSHA tire charts (such as OSHA 3086), rim manuals, and applicable TOs available to ensure extensive damage to equipment and serious or fatal injuries to personnel are prevented? Reference 32.14.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are vehicles with leaking fuel tanks immediately removed from the maintenance shop? Reference 32.15.6.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are open flame and spark-producing devices kept at least 50 feet from the refueling maintenance shop? Reference 32.15.7.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is maintenance of fuel servicing vehicles prohibited in maintenance shops with other vehicular equipment? Reference 32.15.8.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do vehicle operators and mechanics sound vehicle horns before backing, intermittently during backing (unless vehicle is equipped with backup alarms) and prior to entering or leaving the maintenance shop? Reference 32.4.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Where compressed air is used for cleaning, is the discharge end of the air line restricted to less than 30 psi? Reference 32.4.14.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are workers prohibited from storing fuel-contaminated clothing in lockers or other confined areas? Reference 32.7.1.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are workers prohibited from working under vehicles supported only on hydraulic floor jacks, post jacks or mechanical jacks? Reference 32.13.3.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

COMMUNICATIONS CABLE, ANTENNA and COMMUNICATIONS SYSTEMS

  • Communications Cable, Antenna and Communications Systems Checklist

  • Communications Cable, Antenna and Communications Systems Checklist

  • Computer
  • BLDG, Room Number and Responsible Section

  • Are flammable wastes disposed of at the end of each shift in clearly marked metal<br>containers? Reference 30.1.1.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are electrical circuits de-energized, and locked and tagged out before attempting any<br>work, unless the work requires the circuits to remain energized? Reference 30.3.5.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are metal workbenches and those that are metal framed or metal legged, which are<br>used for repairing and testing electronic equipment, grounded? Reference 30.3.14.1.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is the soldering work area free of combustible materials and equipped with fire<br>extinguishers? References 30.3.15

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is proper face protection used by personnel performing soldering tasks? Reference<br>30.3.15.1.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is the soldering work area properly ventilated? Reference 30.3.15.2.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Have all workers required to perform duties on communications systems or act as<br>safety observers received first aid and CPR training? Reference 30.4.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are hard hats issued to personnel who work on and around poles, overhead<br>structures, tower and antenna construction jobs? Reference 30.5.8.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are all tools and equipment maintained in safe condition? Reference 30.6.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

DFAC

  • Dining Facility

  • Dining Facility

  • DFAC
  • BLDG, Room Number and Responsible Section

  • Are all food service workers trained in proper lifting, safe use of cutlery and food processing machinery, handling of hot foods, and the dangers of falls? Reference 44.2.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are cleaning supplies kept separate from food products? Reference 44.3.2.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are drain plugs designed so pot and pan sinks can be drained without the employee having to place their hands in hot water? Reference 44.3.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is a by-pass or other type device installed on doors of walk-in freezers or refrigerated spaces to permit escape from inside if an employee is locked in? Reference 44.3.5.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do supervisors ensure outside stairways, entrances, sidewalks, loading docks and ramps are cleared of snow and ice and that abrasive materials are used during inclement weather? Reference 44.4.1.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are floor surfaces kept clean and in good condition, free of water, defects and slippery materials? Reference 44.4.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are defective electrical equipment/cords taken out of service immediately? Reference 44.5.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are all control switches (on and off) accessible to workers at their normal operating positions so workers do not reach over moving machine parts to activate the switch? Reference 44.5.14

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do supervisors maintain manufacturer’s manuals or locally developed guidance for all machinery or equipment under their control? Reference 44.6.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Does the supervisor or a designated trainer train personnel prior to allowing them to operate machinery or equipment? Reference 44.6.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do supervisors ensure all machines are inspected at least every 60 days unless the manufacturer’s manual, use or working environment requires more frequent inspections? Reference 44.7.2.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are all machine guards securely in place and operational? Reference 44.7.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Does the supervisor provide food services personnel fire prevention training initially and annually thereafter? Reference 44.8.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are doors leading to passageways or providing access to rooms blocked only with approval of the installation FES Flight? Reference 44.8.3.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are garbage cans securely covered when not being filled or emptied? Reference 44.10.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are garbage cans washed with hot soapy water and sanitized weekly, or more often if required to control odor or vermin? Reference 44.10.8

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

EMERGENCY SHOWER & EYEWASH UNITS

  • EMERGENCY SHOWER & EYEWASH

  • Emergency shower & eyewash

  • Shower
  • BLDG, Room Number and Responsible Section

  • Do supervisors ensure emergency showers and eyewashes are provided, inspected, tested and maintained IAW this standard? Reference 19.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are emergency shower and eyewash units in conspicuously identified accessible locations that do not require more than 10 seconds to reach? Reference 19.5

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are emergency shower and eyewash units located so the water spray does not contact any electrical circuit? Reference 19.5

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are emergency showers installed in conjunction with, or in close proximity to, eye and face or eyewash facilities? Reference 19.5

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are the units connected to a supply of water free from contamination and equal in purity to potable water? Reference 19.6

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is the delivered water temperature in a comfortable range that would not discourage use of the unit? Reference 19.6.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are self-contained units and the water supply lines of permanently-installed units protected from freezing and from sunlight or other heat sources that could cause extremes in water temperature? Reference 19.6.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are permanently-installed and self-contained units installed in a fixed location identified with a highly visible sign and well lighted? Reference 19.6.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Where shutoff valves are installed on water supply lines to emergency shower and eyewash units, have signs or tags been installed to prevent accidental shutoff? Reference 19.6.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • When actuated, does the water flow remain on without use of the operator’s hands? Reference 19.7.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is the actuating device (pull handle, walk-on treadle, or push handle) readily accessible and easily located? Reference 19.7.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • If audible alarms or blinking lights are installed to show that the unit is in use, are they working properly? Reference 19.8

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do supervisors activate permanently installed shower and eyewash units weekly to verify proper operation? Reference 19.9.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are units installed in unoccupied or infrequently used areas tested prior to commencing any operations that could expose personnel to hazardous substances? Reference 19.9.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do supervisors inspect permanently installed units monthly IAW instructions in paragraph 19.12.? Reference 19.9.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are eyewash bottles and self contained eyewash stations maintained IAW the manufacturer’s instructions? Reference 19.9.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are emergency shower and eyewash actuating devices easy to locate and readily accessible to the user? Reference 19.12.2.1.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is the stored fluid in self-contained units protected against contaminants and temperature extremes, and are instructions permanently affixed to the unit? Reference 19.12.5

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Have procedures been developed to prevent eyewash bottles from being exposed to extreme temperatures, and are the instructions and expiration dates permanently affixed to the unit? Reference 19.12.6

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

FLAMMABLE COMBUSTABLE

  • FLAMMABLE AND COMBUSTIBLE

  • Flammable
  • BLDG, Room Number and Responsible Section

  • Cabinets shall be labeled with conspicuous lettering, ―Flammable — Keep Fire Away. Additional guidance for marking storage containers is contained in Chapter 20, Safety Color Coding, Labeling, and Marking. AFI 91-203 para. 22.5.3.2.<br>Cabinets shall be conspicuously labeled in red letter on contrasting background FLAMMABLE--KEEP AWAY. AFI 91-203 para. 22.5.3.2 & Uniform Fire Code 79.202(c)(3)(a)

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • The combined quantity of Class I and Class II liquids in a cabinet shall not exceed 60 gallons per cabinet, and the total quantities of all liquids shall not exceed 120 gallons. AFI 91-203 22.5.3 & Uniform Fire Code 79.202 (c)(2)

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Doors shall be well fitted, self-closing and equipped with a latch. AFI 22.5.3.4.2 & Uniform Fire Code 79.202 (c)(3)(b)

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • The bottom of the cabinet shall be liquid-tight to a height of at least 2 inches. AFI 91-203 para 22.5.3.4.2 & Uniform Fire Code 79.202 (c)(3)(c)

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Functional Managers and/or Supervisors shall ensure:<br>- All workers and handlers of flammable or combustibles have accomplished appropriate training associated with tasks and hazards related to the work environment.<br>- Personnel handling, storing or using hazardous materials are trained IAW AFI 90-821.<br>- Individuals involved in dispensing of flammable or combustible liquids are instructed on hazards of static electricity.<br>- Workers handling and storing flammable or combustible liquids are trained in fire prevention and protection as it relates to their duties.<br>- Appropriate spill and containment control materials are readily available at storage or dispensing areas.<br>- PPE is available and appropriately worn when handling flammable or combustible liquids.<br>AFI 91-203 para 22.4.1.6.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

MACHINERY

  • Does this section have Powered Machinery?

  • Powered Machinery

  • Machinery
  • BLDG, Room Number and Responsible Section

  • Does the hood cover the part of the saw blade exposed above the material? Reference 18.4.2.1.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is a spreader provided at the table saw to prevent the wood from clamping down on the saw blade? Reference 18.4.2.1.2<br>Are anti-kickback dogs and fingers or safety hold-down wheels installed when material is being ripped? Reference 18.4.2.1.4<br>Are anti-kickback dogs and fingers inspected before each use? Reference 18.4.2.1.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are table throat openings kept as small as possible to prevent material from dropping below the level of the table? Reference 18.4.2.1.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are radial saws equipped with a hood that encloses the saw blade and arbor ends? Reference 18.4.2.2.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Reference:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

HAND TOOLS

  • Hand Tools

  • Hand Tools
  • BLDG, Room Number and Responsible Section

  • Are tools stored on racks or shelves or in boxes when not in use? Reference 12.3.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are power tools unplugged and properly stored when not in use? Reference 12.3.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do workers carry tools in tool belts or other carrying devices such as shoulder bags or backpacks when climbing ladders or while working at elevated heights such as scaffolds, platforms or work stands? Reference 12.3.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are tools inspected for defects, and defective tools immediately removed from service? Reference 12.3.5

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are chisels, punches and hammers with mushroom heads removed from service? Reference 12.4.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are blades such as knives, razor blades, utility knives, exacto knives, etc., properly protected or sheathed? Reference 12.4.7

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • When power hand tools are used, is care taken to prevent cords and hoses from becoming tripping hazards? Reference 12.5.1.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are power tools equipped with a constant pressure switch or control that shuts off the tools when released? Reference 12.5.2.1<br>Are switches on power tools protected against accidental start-up or operation? Reference 12.5.2.1<br>Are portable electric tools with exposed metal parts properly grounded or double insulated? Reference 12.5.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are all portable circular saws with a blade diameter over two (2) inches equipped with guards above and below the base plate shoe? Reference 12.6.1<br>When the saw is withdrawn from the stock being cut, does the lower guard automatically and instantly return to cover the blade? Reference 12.6.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

BATTERIES

  • BATTERIES SECTION

  • Batteries
  • BLDG, Room Number and Responsible Section

  • Is appropriate PPE used when charging, maintaining, removing or replacing batteries? Reference 31.2.1<br>-Do workers wear a face shield, splash resistant chemical goggles and chemical resistant gloves and apron when handling electrolyte? Reference 31.2.1.1<br>-Do workers wear acid resistant gloves, arm gauntlets, aprons, face protection and ANSI/ISEA Z87.1 approved eye protection with side shields when handling vehicle or support equipment batteries, or working in the battery room or maintenance areas? Reference 31.2.1.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do exit doors of battery shops/rooms swing outwards? Reference 31.3.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are warning signs posted inside and outside the battery room prohibiting smoking, sparks, flames and warning of electric shock and slipping hazards? Reference 31.3.9

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Does management ensure vented lead-acid and vented NICAD battery rooms have their own separate ventilation systems? Reference 31.5.3.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are mechanical lifting devices used on batteries that cannot be safely handled by two people? Reference 31.8.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

WELDING, CUTTING AND BRAZING

  • WELDING

  • Welding, cutting and brazing

  • Welding
  • BLDG, Room Number and Responsible Section

  • Do personal protective clothing and equipment meet or exceed the requirements of Chapter 14, Personal Protective Equipment (PPE)? Reference 27.2.3<br>-Is only approved respirator equipment used when working in atmospheres of hazardous concentrations of airborne contaminants? Reference 27.7.8<br>-Do all welding helmets meet 29 CFR 1910.252, Welding, Cutting, and Brazing - General Requirements, requirements? Reference 27.7.9.1<br>-Are goggles or other suitable eye protection used during all gas welding or oxygen cutting operations? Reference 27.7.9.3<br>-Is eye protection in the form of suitable tinted goggles or spectacles provided for brazing operations? Reference 27.7.9.5<br>-Are ventilated goggles used to prevent fogging of the lenses? Reference 27.7.10.5

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are acetylene cylinders used and stored in an upright position? Reference 27.3.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is the fuel gas and oxygen supply to the torch shut off when left unattended or not used for extended periods of time, i.e., when left unattended for 30 minutes or more? Reference 27.3.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Does the welding operation supervisor ensure installed fire protection sprinkler systems are operational before the welding operation begins, or, if not, ensure other means of fire detection, reporting and extinguishing have been approved by the installation FES Flight? Reference 27.3.12.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are welding hoses visually checked for damage once a shift, before each use? Reference 27.4.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are warning signs posted to prevent personnel from inadvertently touching hot items when left unattended? Reference 27.4.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Have workers and other personnel adjacent to the welding areas been protected from radiant energy or spatter by use of noncombustible and/or flameproof screens? Reference 27.5.1.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are walls, screens, and non-rigid heat and spark barriers finished to limit reflectivity? Reference 27.5.1.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Have procedures been established to prevent personnel from entering an inside welding area and inadvertently being exposed to welding hazards? Reference 27.5.1.4<br>-Are welding operations roped off or segregated by physical barriers to prevent unauthorized entry into the area? Reference 27.5.2.1<br>-Are outside welding operations placarded to warn bystanders that welding operations are in progress? Reference 27.5.2.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is a fully charged and operational fire extinguisher, appropriate for the task, kept in the work area at all times? Reference 27.5.1.6

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Has a written permit been obtained from the installation FES Flight prior to the start of welding operations? Reference 27.5.2.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is the welding operation environment free of flammable liquids and vapors? Reference 27.5.2.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are approved flash arresters installed between each cylinder and the coupler block when acetylene cylinders are coupled? Reference 27.6.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Has backflow protection been provided that shall prevent oxygen from flowing into the fuel-gas system or fuel from flowing into the oxygen system? Reference 27.6.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Has flashback protection been provided by an approved device? Reference 27.6.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Have cables with damaged insulation or exposed conductors been repaired or replaced? Reference 27.15.2.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are electrode holders, when not in use, placed where they cannot make electrical contact with personnel, conducting objects, fuel or compressed gas cylinders? Reference 27.15.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

COMPRESSED GASES STORAGE/USE

  • Compressed Gases Checklist

  • Compressed Gases Checklist

  • Compressed Gases
  • BLDG, Room Number and Responsible Section

  • Are cylinders inspected for damage (i.e., dents, gouges, evidence of leakage or cracks) when received and before use? Reference 40.2.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Have compressed gas cylinders been hydrostatically tested within the last five (5) years? Reference 40.2.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are compressed gas cylinders properly handled and secured? Reference 40.2.6

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • When cylinders are not in use, are they capped and secured to solid fixtures to prevent cylinders from falling over? Reference 40.3.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • When cylinders are attached to a manifold, are they also secured to a solid fixture to prevent cylinders from falling over? Reference 40.3.1.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are cylinder enclosures posted as No Smoking Areas? Reference 40.3.1.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are cylinders stored in locations where their temperatures will not rise above 125° F? Reference 40.3.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are cylinders stored in areas where there is no danger of accidental damage? Reference 40.3.2.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Have empty cylinders been plainly marked EMPTY and stored separately from full cylinders? Reference 40.3.2.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • When cylinders are stored indoors, are these areas ventilated to prevent accumulation of flammable or asphyxiating gases? Reference 40.3.2.5

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are cryogenic cylinders fitted with only stainless steel or other suitable plumbing? Reference 40.3.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do stored cylinders (either indoors or outdoors) obstruct exit routes or other traffic areas? Reference 40.3.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are oxygen cylinders stored at least 20 feet from combustible materials (i.e., oil, grease), or near any other substance likely to cause or accelerate fire? Reference 40.3.6

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

LICENSED FACILITY / MUNITIONS STORAGE

  • BLDG, Room Number and Responsible Section

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

INTERIOR SPRAY PAINTING

  • Interior Spray Painting

  • Spray Painting Operations

  • Paint Operations
  • BLDG, Room Number and Responsible Section

  • Is paint or dope mixing done in designated, adequately ventilated rooms constructed of fire-resistant materials? Reference 28.2.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are all sources of ignition prohibited in mixing areas? Reference 28.2.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do mixing rooms have spill control and cleanup measures? Reference 28.2.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are soiled wiping rags kept in self-closing metal waste containers? Reference 28.2.4 <br>Are contaminated materials, i.e., solvent or paint-soiled rags, paper towels and kraft paper, removed and placed in approved self-closing metal containers? Reference 28.4.8 <br>At the end of each day or shift, are the contents of these containers disposed of? Reference 28.4.8

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do personnel engaged in painting and paint removal wear protective clothing, respiratory devices (if required) and appropriate face, eye and hand protection? Reference 28.2.5 and <br>Are all respirators used during painting operations approved by BE? Reference 28.2.7

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are liquid, solid and gaseous waste products from painting and paint removal operations disposed of IAW AFIs 32-7040, 32-7041 and 32-7042? Reference 28.3.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is storage of paints and solvents IAW Chapter 22? Reference 28.4.6<br>-Is paint stored in work shops kept in tightly covered metal containers? Reference 28.2.4<br>-Are the quantity of paints, lacquers, thinners, solvents and other flammable and combustible liquids kept near spraying operations limited to a one day’s supply? Reference 28.6.1<br>-Is bulk storage of these liquids in a separate building, detached from other buildings, or in rooms specifically designed and constructed to meet flammable storage room requirements? Reference 28.6.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are portable fire extinguishers installed near all paint spraying areas? Reference 28.4.10

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is mechanical ventilation in operation while spraying operations are conducted and for a sufficient time thereafter to ensure vapors are completely exhausted? Reference 28.5.1<br>Are ducts periodically inspected for accumulation of paint deposits and cleaned as needed? Reference 28.5.3<br>Are ventilation systems periodically evaluated as identified in BE’s OEH risk assessment? Reference 28.5.7

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are all metal parts of spray booths, exhaust ducts, and piping systems conveying flammable or combustible liquids or aerated combustible solids electrically grounded? Reference 28.7.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are pressure hoses and couplings regularly inspected for poor condition and replaced, as needed? Reference 28.9.8<br>Are pressure relief valves set to open at pressures not more than 10 pounds above the required working pressure? Reference 28.10.1<br>Are all air hoses checked prior to each shift to ensure they are properly connected to both their pipe outlets and the equipment to be used? Reference 28.10.2<br>To prevent hose whipping, is the loose end secured prior to connecting hose to a compressed air outlet? Reference 28.10.2<br>

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are all paint pressure tanks and spray guns cleaned after each use and before being stored? Reference 28.10.5.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • When spray painting aircraft, are the aircraft isolated and adequate fire prevention measures taken? Reference 28.12.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is proper ventilation provided when spray painting aircraft? Reference 28.12.3<br>Are all aircraft spray paint areas kept free from the accumulation of deposits of combustible residues? Reference 28.12.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do supervisors ensure office waste cans are not used for the disposal of spray paint cans, wiping rags or other hazardous waste materials? Reference 28.16.4.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

FIXED INDUSTRIAL STAIRS, AND PORTABLE AND FIXED LADDERS

  • Does section have Fixed Industrial Stairs and fixed ladders?

  • Does section have Fixed Industrial Stairs and fixed ladders

  • Fixed Industrial Stairs and Fixed Ladders

  • Fixed Stairs and Ladder
  • BLDG, Room Number and Responsible Section

  • Are open grating type treads used on stairs which are not enclosed? Reference 7.3.2.10

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is every flight of fixed industrial stairs with four (4) or more risers equipped with standard guardrails or standard handrails? Reference 7.3.2.12.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do stairs less than 44 inches wide, having both sides enclosed, have at least one handrail, preferably on the right side going down? Reference 7.3.2.12.1.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are spiraling and winding stairs equipped with a handrail offset to stop people from walking on the parts of the treads that are less than six (6) inches wide? Reference 7.3.2.12.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are stairs and ramps lighted so all treads and landings are visible? Reference 7.3.2.13

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are stairs and ramps kept clean, free of obstructions or slippery substances and in good repair? Reference 7.3.2.15

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are slippery surfaces replaced or made safe by coating them with nonslip surface materials? Reference 7.3.2.15.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are guardrails and handrails smooth, free of splinters or burrs and securely mounted? Reference 7.3.2.15.6

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are fixed industrial stairs provided as a means of access to roofs, pits, silos, towers, tanks and limited-access areas, where access is daily or during each shift for gauging, inspection, regular maintenance, etc.? Reference 7.4.2.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is adequate illumination provided when using ladders? Reference 7.4.2.5

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Where unauthorized use of a fixed ladder is a problem, such as in a public area, is the bottom seven (7) feet guarded? Reference 7.4.2.6

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are electrical conductors not installed on or adjacent to fixed metal ladders, unless they are beyond reach and cannot be used as a handrail or grabbed in an emergency? Reference 7.4.2.8

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are iron rung ladders built into the walls of each manhole over 12 feet deep? Reference 7.4.2.9

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are formal, fully documented inspections of all fixed ladders accomplished upon installation and at least every three (3) years thereafter? Reference 7.4.3.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are modifications to ladder components, safety climb devices or related equipment approved by the installation CE, property manager and Occupational Safety office? Reference 7.4.4.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do supervisors ensure personnel are properly trained on climbing and using ladders? Reference 7.4.6

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

  • Does this section use Portable ladders?

  • Portable Ladders

  • Portable Ladder
  • BLDG, Room Number and Responsible Section

  • Do workers perform an inspection of ladders prior to use? Reference 7.5.2.2<br>Are hardware, fittings and related equipment checked frequently and kept in proper working condition? Reference 7.5.2.3<br>Are safety feet and other parts of the unit’s ladders kept in good working condition? Reference 7.5.2.3.3<br>Are wood ladders not painted with an opaque coating, avoiding a cover-up of possible defects? Reference 7.5.2.3.4<br>When location demands, are metal ladders protected against corrosion? Reference 7.5.2.3.4<br>Are ladders with defects which cannot be immediately repaired, removed from service and action taken to ensure they are scheduled for repair or destruction and are danger tags used to warn workers that the ladder cannot be used? Reference 7.5.2.4

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are personnel who use ladders adequately trained by the supervisor in the care and use of different type ladders when a worker is first assigned? Reference 7.5.2.7

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are ladders stored in a way that provides easy access for inspection and permits their safe withdrawal for use? Reference 7.5.2.5.3<br>Are wood ladders stored in a location free from exposure to the elements and excessive heat or dampness? Reference 7.5.2.5.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

HOISTS

  • Hoists

  • Hoists
  • BLDG, Room Number and Responsible Section

  • Are hoists inspected daily or prior to each use for items such as loose or worn parts, cracked or broken welds, deformed hooks or chain, and bent or deformed pawls? Reference 4.9.3.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are hoists operated only by personnel who are trained and qualified to use the equipment? Reference 35.6.3.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are inspections of hoists and related equipment performed periodically and documented per requirements of paragraph 35.1.1? Reference 35.6.3.5.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do maintenance activities use lockout/tagout procedures IAW Chapter 21? Reference 35.6.3.6.5.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Have operational (no load) and load tests been performed on all new hoists and those which have had load-suspension parts altered, replaced or repaired? Reference 35.6.3.7.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are annual load tests performed on nuclear-certified hoists? Reference 35.6.3.7.3<br>Are annual load tests performed on hoists required to lift critical loads? Reference 35.6.3.7.4<br>Are records of periodic inspections, repairs and tests of hoists maintained indefinitely? Reference 35.6.3.8

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do all slings comply with the design and manufacturing requirements of 29 CFR 1910.184 and ANSI B30.9? Reference 35.7.2.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are slings marked or identified with all required information on the sling or a durable and legible tag or label? Reference 35.7.2.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are documented sling inspections conducted by a qualified person? Reference 35.7.2.3.2<br>Is a record of each sling‘s most recent load test maintained on file? Reference 35.7.2.4.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are all repaired or reconditioned slings appropriately load tested? Reference 35.7.2.4.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

OUT-BRIEF

OUT-BRIEF

  • Out-Brief Date/ Time

  • Out-Brief Attendees (Rank, Name/ Unit)

  • Total Findings

  • Current Year (FY)

  • Last Year (FY)

  • Safety Program Recommendations:

SIGNATURES (e-SSS)

  • 128 ARW/SEG Occupational Safety Specialist

  • 128 ARW/SE Chief of Safety

  • 128 ARW/SEG Occupational Safety Manager

  • Unit Commander

  • Group Commander

  • Wing Commander

FIRE PROTECTION AND PREVENTION

  • FIRE PROTECTION AND PREVENTION

  • Fire Protection
  • BLDG, Room Number and Responsible Section

  • Exit sign: The illuminated surface value of the exit sign should have a value of not less than five foot-candles. 29 CFR 1910.37 ( b )( 6 )

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Exit signs shall be clearly visible from all directions of egress and shall not be obstructed at any time. If occupancy is permitted at night, or if normal lighting levels are reduced at times during working hours, exit signs shall be suitably illuminated by a reliable light source. New exit signs shall be the internally illuminated, light emitting diode (LED) type. Existing signs may be internally or externally illuminated. AFI 91-203 para 25.4.9.5.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Monthly testing of exit lights shall be accomplished IAW NFPA 101, The Life Safety Code. AFI 91-203 para 25.4.9.10.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Fire exits shall be clearly marked and exit paths shall be kept clear of equipment and materials, emergency lighting shall be provided and all workers trained in proper evacuation procedures. AFI 91-203 para 6.3.2.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Floors or means of egress shall be illuminated to at least one (1) foot-candle (measured at all points at the floor), including angles and intersections of corridors and passageways, stairways, landings of stairs and exit doors. AFI 91-203 para 6.3.8.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Doors, passageways or stairways which are neither exits nor ways to an exit but may be mistaken for an exit, shall be clearly marked ―NOT AN EXIT or a sign indicating their actual use; for example, ―STORAGE ROOM or ―BASEMENT. AFI 91-203 para 6.3.3.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Ensure escape routes are kept free of obstruction—to include stairways and office doors. Ensure doors leading outside open easily. AFI 91-203 para 6.2.15.2.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Ensure escape routes are kept free of obstruction—to include stairways and office doors. Ensure doors leading outside open easily. AFI 91-203 para 6.2.15.2.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Ensure escape routes are kept free of obstruction—to include stairways and office doors. Ensure doors leading outside open easily. AFI 91-203 para 6.2.15.2.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

PERSONAL PROTECTIVE EQUIPMENT (PPE)

  • Personal Protective Equipment

  • Personal Protective Equipment

  • PPE
  • BLDG, Room Number and Responsible Section

  • Do supervisors ensure PPE is provided, used and maintained in a sanitary, serviceable condition? Reference 14.3.2<br>Is previously used PPE disinfected before reissue to another worker? Reference 14.4.2.15.<br>Do workers maintain and disinfect eye and/or face protection equipment IAW the following instructions: Reference 14.4.2.16<br>- Several methods for disinfecting eye-protective equipment are acceptable. The most effective method is to disassemble the goggles or spectacles and thoroughly clean all parts with soap and warm water. Carefully rinse all traces of soap and replace defective parts with new ones. Swab thoroughly or immerse all parts for 10 minutes in a solution of germicidal deodorant fungicide. Remove parts from solution and suspend in clean place after air drying at room temperature or with heated air. Do not rinse after removing parts from the solution because this will remove the germicidal residue.<br>- Ultraviolet disinfecting equipment or spray type disinfecting solutions may be used in conjunction with the washing procedure.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do supervisors ensure required PPE job safety training is documented as required by AFI 91-202? Reference 14.3.2.1

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are workers provided appropriate eye or face protection when exposed to hazards from flying particles, molten metal, liquid chemicals, corrosives, caustics, chemical gases, vapors or potentially injurious radiation? Reference 14.4.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do management, supervisors and visitors wear appropriate PPE while within a hazardous area? Reference 14.4.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are protective helmets provided for and used by workers exposed to injury from falling or flying objects, bumping head against a fixed object or electrical shock or burns? Reference 14.4.3<br>Do protective helmets have the manufacturer’s name, ANSI designation and the class identified inside the shell? Reference 14.4.3.1.3

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Are chemical protective gloves worn by personnel handling acids, alkalis, organic solvents and other harmful chemicals? Reference 14.4.7.2<br>Are workers able to remove gloves without causing skin contamination? Reference 14.4.7.2.4.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is contaminated PPE that cannot be decontaminated disposed of in a manner that protects employees from exposure to hazards? Reference 14.4.7.2.5

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Is protective footwear provided and worn when there is a reasonable possibility of foot injuries? Reference 14.4.10

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do supervisors review SDS requirements, then verify proper selection of chemical protective clothing with BE before original issue? Reference 14.4.11.1<br>Look for BE Survey that's lists process and required PPE.

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Do personnel exposed to vehicle or aircraft traffic during hours of darkness or periods of reduced visibility, or as part of construction or maintenance activities, use reflective vests/accessories? Reference 14.5.10.2

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

MARKINGS FOR PIPING SYSTEMS

  • Markings for Piping Systems

  • BLDG, Room Number and Responsible Section

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

Template

  • BLDG, Room Number and Responsible Section

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • Discrepancy:

  • Reference:

  • Recommendation:

  • Cause of deficiencies or hazard:

  • Unit corrective actions:

  • RAC

  • DISCREPANCY

  • Discrepancy
  • Discrepancy

  • Reference

  • Recommendation

  • RAC

  • Unit corrective actions:

  • Database Reference # (For Internal Use Only)

  • Add media

  • Open/Closed

  • Date Closed

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.