Audit
Has the commander appointed a primary and alternate USR in writing? AFI 91-202 1.8.21.2
Does the USR brief their commander quarterly on the units safety program? AFI 91-202 2.2.2.1
Has the USR attended or completed USR training? AFI 91-202 2.2
If deficient select the appropriate designator below.
Remarks :
Is leadership actively involved in safety? AFI 91- 202 1.4.1.4
Ask personnel about theit Commander's/Supervisor's take on safety.
Do commanders ensure discrepancies are completed within 30 days or tracked and reported to the safety office every 30 days until complete? AFI 91-202 1.8.21.6
If deficient select the appropriate designator below.
Remarks :
Is a safety board available and visible?
Is the required information posted?
Af 457, Af 457 directions, AFVA 91-307, commanders safety endorsement, mishap prevention brief, CA-10, mishap reporting procedures, SEG-15, SEW-15
If deficient select the appropriate designator below.
Ask personnel if they know: Emergency phone numbers, emergency EXIT locations, fire extinguishers and pull stations location and operation, location of the rally point, and location of the severe weather shelter in place locations.
Do personnel know emergency procedures for their area?
Has an emergency action plan been developed?
Has a written emergency action plan been written that meets the requirement of 29 CFR 1910.38
Are emergency procedures briefed annually?
Are briefings documented?
If deficient select the appropriate designator below.
Remarks :
Is the Supervisor or USR conducting monthly workplace inspections? AFI 91-202 2.2.2.2
Are inspections documented IAW AFI 91-202 3.7?
Are emergency light tests being conducted monthly? OSHA 1910.37 & NFPA 101
Are they documented?
Are fire extinguishers inspected and signed off monthly? 91-203 41.2.2.2 and NFPA 10
Is the Supervisor or USR conducting monthly safety meetings? AFI 91-202 2.2.2.5
Are on and off duty safety items briefed?
Are safety meetings documented?
If deficient select the appropriate designator below.
Remarks :
Has a Job Safety Train Guide (JSTG) been developed for this section? AFI 91-202 Attachment 4
Does the JSTG meet AFI 91-202 Attachment 4 requirements?
Has the JSTG been reviewed annually and documented? AFI 91-202 1.8.22.4
Is the safety training documeted on an AFTO 55 or electronic equivalent (i.e. ARCNET)? AFI 91-202 1.8.22.5.1
Do NCO'S, Air Force civilians, and commissioned officers in a supervisory roll receive Supervisor's Safety Training (SST)? 91-202 1.8.22.13
If deficient select the appropriate designator below.
Remarks :
Has the supervisor assessed all PPE needs for the work area? AFI 91-202 1.8.18.11.5
Are PPE inspections performed? AFI 91-202 1.8.23.5
Was any unserviceable PPE found during the assessment?
If deficient select the appropriate designator below.
Remarks:
Do workers perform duties at 4ft or greater?
If deficient select the appropriate designator below.
Remarks:
Does this section have a Lockout/Tagout Program?
If deficient select the appropriate designator below.
Remarks:
Does the section use a forklift or any powered industrial equipment? 29 CFR 1910.178
If deficient select the appropriate designator below.
Is this an Industrial area? (Assess items below and document findings)
Remarks :
Does the shop maintain chemicals?
If deficient select the appropriate designator below.
Remarks :
Does the area have confined spaces?
Supervisor's Occupational
USR
Commander
Were any mishaps reported over the past 12 months? If yes add total number in notes.
Number of mishaps
