14001 - Form 432-01-24-01 General EH&S Inspection Checklist

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Instructions: Check each section as Satisfactory (YES), or Unsatisfactory (NO). If you check NO, describe the hazardous condition or unsafe practices observed during the inspection and make recommendations for correction on 14001 - Form 432-01-24-02 EH&S Inspection Corrective Action Summary Form. Each Corrective Action must be assigned to a Responsible Person to follow-up. Auditors are required to notify those who are assigned Corrective actions. Completion of corrective actions must be documented and sent to EH&S.

A. FIRE PROTECTION

• 1. Are extinguishers charged, serviced within the last year, tagged, and accessible (at least 30" clearance)?

  Yes

  No

  N/A

• 2. Have extinguishers been inspected within the last month and has this been indicated on the tag.

  Yes

  No

  N/A

• 3. Are fire hydrants accessible?

  Yes

  No

  N/A

• 4. Is there a minimum of 18" clearance around all fire sprinkler heads?

  Yes

  No

  N/A

• 5. Are all risers clear and free of debris?

  Yes

  No

  N/A

B. EGRESS

• 1. Are all exits visible, unobstructed, and accessible?

  Yes

  No

  N/A

• 2. Are doors that are not exits marked as "Not an Exit"?

  Yes

  No

  N/A

• 3. Are all exits marked with visible sign?

  Yes

  No

  N/A

C. WORK AREAS

• 1. Are all walking and work surfaces clear of obstructions?

  Yes

  No

  N/A

• 2. Are all trip hazards identified and marked?

  Yes

  No

  N/A

• 3. Are work areas, storerooms, lunchrooms, washrooms, and other occupied areas clean, orderly, and sanitary?

  Yes

  No

  N/A

D. STAIRS

• 1. Is there adequate lighting on stairs?

  Yes

  No

  N/A

• 2. Is non-skid material in place and in good condition?

  Yes

  No

  N/A

• 3. Are handrails and treadways present and secure?

  Yes

  No

  N/A

• 4a. Is there storage under the stairs.

  Yes

  No

  N/A

• 4b. If there is storage under the stairs, are sprinklers present and unobstructed by a minimum of 18"?

  Yes

  No

  N/A

E. LADDERS

• 1. Are supplied ladders appropriate for their intended use?

  Yes

  No

  N/A

• 2. Are ladders in good operating condition (rungs, hinges, locks, rubber cleats, frame)?

  Yes

  No

  N/A

• 3. Are ladders being properly stored?

  Yes

  No

  N/A

• 4. Are ladders secured or tied off when in use?

  Yes

  No

  N/A

• 5. Are all metal ladders marked "Keep Away from Electrical Sources"?

  Yes

  No

  N/A

F. RAMPS, PLATFORMS, AND CATWALKS

• 1. Are walking and working surfaces clear of obstructions?

  Yes

  No

  N/A

• 2. Are handrails and toe boards intact and secure?

  Yes

  No

  N/A

G. COMPRESSED GAS CYLINDERS/TANKS

• 1. Are current Inspection Certificates posted on pressure tanks?

  Yes

  No

  N/A

• 2. Are gas cylinders stored upright, properly secured, and labeled?

  Yes

  No

  N/A

• 3. Are empty and full Gas Cylinders separated?

  Yes

  No

  N/A

• 4. Are gas cylinders properly segregated (i.e. O2 away from flammables)?

  Yes

  No

  N/A

• 5. Are Gas Cylinders stored with valve protection caps in place?

  Yes

  No

  N/A

H. ELECTRICAL

• 1. Is wiring clear of combustibles and/or flammables?

  Yes

  No

  N/A

• 2. Is there adequate clearance (36") around control panels?

  Yes

  No

  N/A

• 3. Are all control panel switches clearly identified?

  Yes

  No

  N/A

• 4. Extension cords not used as permanent wiring?

  Yes

  No

  N/A

• 5. Are all electrical outlet boxes sealed with a cover plate?

  Yes

  No

  N/A

• 6. Is wiring in good condition and secured adequately?

  Yes

  No

  N/A

• 7. Is proper PPE (gloves, eye protection, etc.) being used when working on panels?

  Yes

  No

  N/A

I. SAFE WORK PRACTICES

• 1. Is proper PPE (eye, hearing, fall, gloves, respirators, etc...) in use when required?

  Yes

  No

  N/A

• 2. Are safe lifting practices being observed?

  Yes

  No

  N/A

• 3. Is PPE being properly stored and maintained?

  Yes

  No

  N/A

J. INDUSTRIAL POWERED LIFT TRUCKS

• 1. Are trucks being inspected daily?

  Yes

  No

  N/A

• 2. Are all operators certified and instructed in safe operation?

  Yes

  No

  N/A

• 3. Are appropriate safety precautions being taken during recharging?

  Yes

  No

  N/A

• 4. Are driving lanes clearly identified?

  Yes

  No

  N/A

• 5. Are all drivers using seat belts and/ or appropriate restraints when operating the equipment?

  Yes

  No

  N/A

K. MACHINERY AND EQUIPMENT

• 1. Are moving parts properly guarded?

  Yes

  No

  N/A

• 2. Are all hazard areas clearly defined by signs?

  Yes

  No

  N/A

• 3. Are guards interlocked into power source?

  Yes

  No

  N/A

• 4. Are Lock-Out/Tag-Out procedures in use when applicable?

  Yes

  No

  N/A

• 5. Are data plates, capacities, and instructions posted on equipment?

  Yes

  No

  N/A

L. POWER HAND TOOLS

• 1. Are constant-pressure switches used on tools?

  Yes

  No

  N/A

• 2. Are all power tools double-insulated or grounded?

  Yes

  No

  N/A

• 3. Is equipment in good working condition?

  Yes

  No

  N/A

M. CHEMICAL STORAGE AND USE

• 1. Are all flammable liquids kept in approved & labeled safety containers/cabinets?

  Yes

  No

  N/A

• 2. Are "NO SMOKING OR OPEN FLAME" signs posted near flammable storage areas?

  Yes

  No

  N/A

• 3. Are ventilation systems in place and operational (if required)?

  Yes

  No

  N/A

• 4. Is a Shelter in Place Kit available for the inspected work area (contents complete)?

  Yes

  No

  N/A

• 5. Are Material Safety Data Sheets/Safety Data Sheets (MSDS/SDS) available?

  Yes

  No

  N/A

• 6. Are hazardous materials containers properly labeled as to the contents and hazard warnings?

  Yes

  No

  N/A

• 7. Are incompatible chemicals stored in different locations (i.e. acids/bases separated)?

  Yes

  No

  N/A

• 8. Are lids and caps replaced on all containers when not in use?

  Yes

  No

  N/A

• 9. Are eyewashes available, clearly marked, accessible (30" clearance), and inspected/flushed monthly?

  Yes

  No

  N/A

• 10. Are flammable liquids grounded and bonded when dispensed?

  Yes

  No

  N/A

CORRECTIVE ACTIONS

• Input any corrective actions to be undertaken, identify employee responsible to carry out the corrective action(s), and appropriate timeline for completion.

• Section A Items:

• Section B Items:

• Section C Items:

• Section D Items:

• Section E Items:

• Section F Items:

• Section G Items:

• Section H Items:

• Section I Items:

• Section J Items:

• Section K Items:

• Section L Items:

• Section M Items:

• Other:

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• Auditor's signature:

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