182 Ground Safety Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Program Management

• Does this inspection include Program Management?

  Yes

  No

  N/A

Commander & USR Responsibilities

• Has the commander appointed a primary and alternate Safety Representative to assist them in implementing their Safety Program? AFI 91-202, 1.5.20.1

  Yes

  No

  N/A

• Did the commander notify the host safety office, in writing, of the appointment of USRs in order to schedule USRs for training? AFI 91-202 para 1.5.20.1.

  Yes

  No

  N/A

• Commander shall ensure all personnel are briefed on the findings and recommendations contained in Bioenvironmental Engineering industrial hygiene surveys and reports. A copy of the survey report will be posted on the work place bulletin board for a period of 10 days after receipt to allow all workers free access to the findings. These reports will be maintained on file in the work place for a minimum of two years. AFI 91-202 para 1.5.20.10.

  Yes

  No

  N/A

• USRs for active duty units will complete initial training within 30 working days after appointment. AFI 91-202 para 2.2.

  Yes

  No

  N/A

• USRs will complete the Air Force Risk Management (RM) Fundamentals course IAW AFI 90-802 requirements. AFI 91-202 para 2.2.1.

  Yes

  No

  N/A

• 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 2.2.4.2.<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.

  Yes

  No

  N/A

• USRs shall conduct safety briefings and provide unit personnel with educational safety materials. AFI 91-202 para 2.2.4.5.

  Yes

  No

  N/A

• 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.

  Yes

  No

  N/A

• USRs shall evaluate the unit motorcycle safety program to ensure compliance with AFI 91-207. AFI 91-202 para 8.5.7.

  Yes

  No

  N/A

• USRs shall support the installation safety program and attend USR meetings as determined by MAJCOM/Host safety office. AFI 91-202 para 8.5.8.

  Yes

  No

  N/A

• USRs shall post AFVA 91-307, Air Force Occupational Safety and Health Program, in a conspicuous location readily accessible to all employees and applicants for employment. AFI 91-202 para 8.5.9.

  Yes

  No

  N/A

Supervisor Responsibilities

• Conduct a JSA for each work task not governed by TO or other definitive guidance and anytime a new work task or process is introduced into the workplace to determine potential hazards. AFI 91-202 para 1.5.21.2.

  Yes

  No

  N/A

• Develop a work center specific Job Safety Training Outline (JSTO) based on Attachment 5, Job Safety Training Outline (JSTO), on safety, fire protection/prevention and health requirements. AFI 91-202 para 1.5.21.4.

  Yes

  No

  N/A

• Supervisors will provide job safety training to all newly assigned individuals (i.e., PCS, PCA or work center change to include deployment) on the hazards of their job before they start work and immediately when there is a change in equipment, processes or safety, fire and health requirements. AFI 91-202 para 2.3.3.1

  Yes

  No

  N/A

• JSTO reviews will be accomplished by the supervisor and documented with the date of review and the person conducting review. AFI 91-202 para 2.3.3.2.

  Yes

  No

  N/A

• Document safety, fire and health training as specified in paragraph 1.5.21.4 Documentation will be maintained by the supervisor within the work center. AFI 91-202 para 2.3.3.3.

  Yes

  No

  N/A

• Method of documentation may include, but are not limited to, the AF Form 55, Employee Safety and Health Record, electronic mediums such as AFFORMs/MAF LOG C2/CAS-B/G081 or locally developed products. If the AF Form 55 is mandated for use as the training documentation device, the entity that mandated the form usage will prescribe the requirement in writing. AFI 91-202 para 1.5.21.4.1.

  Yes

  No

  N/A

• Ensure AF Form 1118, Notice of Hazard, issued by safety, fire protection and Bioenvironmental Engineering officials is posted to alert employees to the hazardous conditions. Ensure any hazards identified by an AF Form 1118 are added to the JSTO and employees are trained on the interim control measures and documented IAW Attachment 5, Section A5.4. AFI 91-202 para 1.5.21.8.

  Yes

  No

  N/A

• Attend Air Force Supervisor Safety Training (SST). AFI 91-202 para 1.5.21.14.

  Yes

  No

  N/A

• Conduct and document monthly spot inspections of 100% of their work areas annually IAW paragraph 3.5 of this instruction.<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.

  Yes

  No

  N/A

Motorcycle Program Management

• Commanders shall appoint in writing, at least one MSR, when riders are assigned to the unit, to coordinate the motorcycle safety program. Ensure motorcycle riders in their units are identified to the MSR and required information is provided to populate the MUSTT/Training module database. Units with a limited number of riders may establish a common MSR(s) across multiple organizations. AFI 91-207 para 1.3.4.3.

  Yes

  No

  N/A

• Commanders shall ensure motorcycle riders attend commander’s initial motorcycle safety briefing within 30 duty days of arrival at a new unit assignment, identification as a rider or purchase of a motorcycle. AFI 91-207 para 1.3.4.4.

  Yes

  No

  N/A

• Commanders shall Ensure on-road motorcycle riders attend an annual/pre-season motorcycle riders’ briefing; seasonal considerations will be factored in when scheduling this briefing. AFI 91-207 para 1.3.4.5.

  Yes

  No

  N/A

• MSRs shall Use the MUSTT/Training module to track unit motorcycle (on and off-road), motor scooters, and three wheeled vehicle riders. AFI 91-207 para 1.3.9.1.

  Yes

  No

  N/A

• MSRs shall assist the commander in conducting the commander’s initial and annual/pre-season motorcycle safety briefing. AFI 91-207 para 1.3.9.5.

  Yes

  No

  N/A

Lock Out/Tag out

• Does this unit have a lock out/tag out program?

  Yes

  No

  N/A
Tap to enter information

• Tagout devices shall:? AFI 91-203 para 21.3.3.6.<br>- Be constructed and printed so they do not deteriorate or become illegible, especially in wet or corrosive environments. Laminated devices (tags) are acceptable.<br>- Warn against hazardous conditions if equipment or machinery is energized.<br>- Clearly identify the worker who applies them.<br>- Be secured with a self-locking, non-reusable and non-releasable attachment, such as a nylon or plastic cable tie, with a minimum unlocking strength of 50 pounds.

  Yes

  No

  N/A

• Service/Administrative locks and tags appropriate for the hazard level shall be used to lock equipment that will not be repaired or serviced immediately. AFI 91-203 para 21.3.4.3.1.

  Yes

  No

  N/A

• Supervisors shall generate and maintain equipment-specific written LOTO procedures, i.e., a LOTO continuity book. AFI 91-203 para 21.3.5.1.

  Yes

  No

  N/A

• Supervisors shall perform a self-assessment of work environments using these procedures at least annually. AFI 91-203 para 21.3.5.2. & 21.6.1.<br>Minimum Requirements:<br>- Identification of equipment and machinery for which the LOTO program applies.<br>- Review of LOTO log books for equipment or machinery in LOTO program.<br>- A review of each worker‘s responsibilities under the program.<br>- That all necessary training has been conducted, is current and properly documented.<br>- The date of the inspection and the unit representative conducting the self-inspection.

  Yes

  No

  N/A

• Supervisors shall assign and document worker LOTO authorization. AFI 91-203 Para 21.3.5.5.

  Yes

  No

  N/A

• Supervisors shall keep accurate LOTO logs. AFI 91-203 Para 21.3.5.7.

  Yes

  No

  N/A

• Does the LOTO program follow the Nine Step LOTO Process? AFI 91-203 para Para 21.4.2.

  Yes

  No

  N/A

• Does the LOTO program follow the three Step Release from Lockout/Tagout Process? AFI 91-203 Para 21.4.5.

  Yes

  No

  N/A

• Service/Administrative locks and tags shall be clearly distinguishable from locks and tags used for lockout/tagout. AFI 91-203 para 21.4.9.1.1.1.

  Yes

  No

  N/A

• Recurring LOTO training shall be performed at least annually. The training shall establish employee proficiency, include an in-depth review of current and previous procedures and introduce new or revised control methods and procedures, as necessary. AFI 91-203 para 21.5.3.

  Yes

  No

  N/A

• Annual Inspection. Functional managers and commanders shall ensure annual inspections of LOTO procedures within their organization are conducted by an individual above the shop level supervisor. A qualified ground safety inspector shall review LOTO inspection reports during organization safety inspections to ensure compliance. AFI 91-203 para 21.6.2.<br>Minimum Requirements:<br>- Review of LOTO procedures with authorized workers.<br>- Observation of LOTO procedures to ensure workers understand and follow procedures.<br>- Review of training and self-assessment documentation to ensure LOTO requirements are met.<br>- Out-brief of shop or unit supervisor or, as appropriate, documented in the written report.

  Yes

  No

  N/A

Confined Spaces

• Does this unit have confined spaces program?

  Yes

  No

  N/A
Tap to enter information

• Commanders and/or Functional Managers will ensure a written MEP and confined space program are developed, implemented and approved by the CSPT (only required for permit-required confined space programs). AFI 91-203 para 23.2.7.1.

  Yes

  No

  N/A

• Ensure all personnel assigned duties and responsibilities that support permit-required confined space program tasks are properly trained, equipped and qualified. AFI 91-203 para 23.2.7.2.

  Yes

  No

  N/A

• Ensure required equipment is procured to support entry into confined spaces. Equipment shall be available and properly maintained (operational). AFI 91-203 para 23.2.7.3

  Yes

  No

  N/A

• Ensure a current list of all confined spaces, both permit-required and non-permit, under the control of the organization or function, is maintained. AFI 91-203 para 23.2.7.4.

  Yes

  No

  N/A

• Provide a copy of the list of all confined spaces, permit-required and non-permit, to the installation CSPT and Environmental Management office. AFI 91-203 para 23.2.7.5.

  Yes

  No

  N/A

• Designate entry supervisors. AFI 91-203 para 23.2.7.6.

  Yes

  No

  N/A

• Obtain BE approval for purchase of monitoring equipment for units requiring atmospheric testing and monitoring equipment. Each unit shall maintain a list of personnel trained and qualified to conduct atmospheric testing of confined spaces. AFI 91-203 para 23.2.7.9.

  Yes

  No

  N/A

• Establish emergency procedures to rescue persons incapacitated in the confined space. AFI 91-203 para 23.2.8.12.

  Yes

  No

  N/A

• Shop Supervisor will: AFI 91-203 para 23.2.11<br>- Annually assess the section‘s or unit‘s known confined space workplace(s).<br>- Include specific confined spaces requirements and safety training in the Job Safety Lesson Plan and document training.

  Yes

  No

  N/A

• Inspection of Safety Equipment. Prior to a confined space operation, entry supervisors will ensure inspection, testing, maintenance and documentation of safety and rescue equipment is accomplished IAW Chapter 14. AFI 91-203 para 23.6.2.

  Yes

  No

  N/A

Specialty Vehicle Program

• Does this unit have a specialty vehicle program?

  Yes

  No

  N/A
Tap to enter information

• Have All Terrain Vehicle operators completed Specialty Vehicle Institute of America's ATV Rider Course? AFI 91-207 para 4.5.8.3.

  Yes

  No

  N/A

• Are operator's of OGMVCs educated on the Wing Commander's RM policy prior to operating? AFI 91-207 para 2.2.5.

  Yes

  No

  N/A

• 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.

  Yes

  No

  N/A

• 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.

  Yes

  No

  N/A

• Stacking Materials: AFI 91-203 para 5.6.<br>- Stack materials so they may be easily reached but do not protrude into aisles or passageways.<br>- When materials are stacked to a height less than 15 feet, maintain an 18-inch clearance below ceiling sprinkler deflectors, joists, rafters, beams and roof trusses.<br>- If the stack is over 15 feet in height, increase the clearance to 36 inches.<br>- Position all stacks of materials to ensure an 18-inch clearance around light or heating fixtures, or follow manufacturer‘s instructions, regardless of height.

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Combustible materials shall be placed in covered self-closing metal containers. AFI 91-203 para 5.9.8.

  Yes

  No

  N/A

Commercial Food Service Equipment

• Does this unit contain commercial food service equipment?

  Yes

  No

  N/A

• Grease filters shall be installed in all grease hoods and extraction systems designed with filters covering equipment. The filters shall be continually maintained in proper operating condition and shall fit properly. AFI 91-203 para 6.2.2.2.1.

  Yes

  No

  N/A

• All installed grease filters and exposed surfaces of hoods shall be thoroughly cleaned daily, or more often if necessary, to prevent grease buildup. AFI 91-203 para 6.2.2.2.2.

  Yes

  No

  N/A

• Hood and exhaust ducts serving food service equipment shall be thoroughly cleaned every 6 months, or more frequently when determined by the installation FES Flight. AFI 91-203 para 6.2.2.2.3.

  Yes

  No

  N/A

• The exhaust system shall continually operate while the food service equipment is in use. If an exhaust fan is shut down or removed for repair or replacement, equipment served by that exhaust system shall not be used until the fan is returned to full service. AFI 91-203 para 6.2.2.2.4.

  Yes

  No

  N/A

• Portable, mobile or temporary food service equipment that uses grease or oil, such as donut machines and deep-fat fryers, shall be located beneath a system complying with paragraph 6.2.2.2 or have an integral grease removal and fire suppression listed by a NRTL IAW NSF/ANSI Standard 4: Commercial Cooking, Rethermalization and Powered Hot Food Holding, and Transport. AFI 91-203 para 6.2.2.2.5.

  Yes

  No

  N/A

Extinguishers

• Managers and supervisors at all levels shall ensure a visual inspection of fire extinguishers are performed at a minimum of 30-day intervals and documented for all fire extinguishers under their control. AFI 91-203 para 6.2.4.7.

  Yes

  No

  N/A

Electrical

• Are space heaters approved by local fire protection office, 36 inches from combustibles, unplugged when unattended, and plugged directly into wall receptacle? AFI 91-203 para 6.2.10.

  Yes

  No

  N/A

• Coffee Makers: AFI 91-203 para 6.2.11.<br>- Keep coffee makers and the area around them free of combustibles.<br>- Refer to the manufacturer‘s operating instructions and consult the facility manager for approval after coffee makers placement.<br>- Unplug coffee makers at the end of the day.

  Yes

  No

  N/A

Exit/Egress

• 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 )

  Yes

  No

  N/A

• 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.

  Yes

  No

  N/A

• 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.

  Yes

  No

  N/A

• 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.

  Yes

  No

  N/A

• No lock or fastening device shall prevent escape from inside the building. AFI 91-203 para 6.3.6.

  Yes

  No

  N/A

• 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.

  Yes

  No

  N/A

Flammable Cabinets

• Does this unit have flammable cabinets?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Cabinets shall be conspicuously labeled in red letter on contrasting background FLAMMABLE--KEEP AWAY. Uniform Fire Code 79.202(c)(3)(a)

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

Required Clearance

• Aisles shall be at least 36 inches wide to permit free movement of workers, equipment and supplies. A minimum of 18 inches shall be provided for passageways formed by or between movable obstructions. AFI 91-203 para 7.2.1.1.4.

  Yes

  No

  N/A

• Sufficient access and working space shall be provided and maintained around all electrical equipment. AFI 91-203 para 7.2.1.1.5.

  Yes

  No

  N/A

Floors

• Floors, aisles and passageways shall be kept clear and in good repair, with no obstructions, free of defects that can endanger workers or interfere with handling of materials, or hinder people leaving during emergencies. AFI 91-203 para 7.2.1.2.

  Yes

  No

  N/A

• Supervisors shall ensure equipment weight and distribution comply with maximum floor loading capacity for all above grade storage areas (including areas above basements). AFI 91-203 para 7.2.1.3.

  Yes

  No

  N/A

• Guards for Floor and Wall Openings. Every floor opening, such as a hatchway, chute, pit, trap door, manhole and ladderway, shall be guarded. AFI 91-203 para 7.2.1.6.

  Yes

  No

  N/A

• All open-sided floors, platforms and runways four (4) feet or more above the ground or floor shall be guarded by a standard railing on all open sides, except at ramp entrance to a ramp, stairway or fixed ladder. AFI 91-203 para 7.2.1.7.3.

  Yes

  No

  N/A

• Dock surfaces shall be smooth and even. Where necessary, aisleways shall be marked. Edges of docks shall be marked with four-inch wide yellow lines when there is a chance of workers falling. Where the potential for serious injury exists, removable railings shall be used. AFI 91-203 para 7.2.2.1.1.

  Yes

  No

  N/A

Fluorescent Light Bulb Disposal

• All fluorescent light bulbs contain toxic materials and shall be managed IAW local disposal criteria for hazardous waste. AFI 91-203 para 7.2.1.5.

  Yes

  No

  N/A

Fixed Stairs/Ramps

• Does this unit have fixed industrial stair and ramps?

  Yes

  No

  N/A

• Every flight of fixed industrial stairs with four (4) or more risers shall have standard guardrails or standard handrails as called for below. The width of the stair shall be measured clear of all obstructions except handrails. AFI 91-203 para 7.3.2.12.1.

  Yes

  No

  N/A

• Stairs less than 44 inches wide with both sides enclosed shall have at least one handrail, preferably on the right side going down. AFI 91-203 para 7.3.2.12.1.1.

  Yes

  No

  N/A

• Stairs 88 or more inches wide shall have one handrail on each enclosed side, one guardrail on each open side and one intermediate guardrail built midway of the width. AFI 91-203 para 7.3.2.12.2.

  Yes

  No

  N/A

• Illumination. Stairs and ramps shall be lighted so all treads and landings are visible. AFI 91-203 para 7.3.2.13.

  Yes

  No

  N/A

• Vertical Clearance. Where there is less than seven (7) feet of headroom over stairs, obstructions shall be padded. When they cannot be padded, obstructions shall be color coded yellow or yellow-and-black stripes to highlight the hazards. In all cases, caution signs shall be used to warn people of low clearances. AFI 91-203 para 7.3.2.7.

  Yes

  No

  N/A

• Treads. All treads shall be slip-resistant and free of projections or lips that could cause a tripping hazard. AFI 91-203 para 7.3.2.9.

  Yes

  No

  N/A

Fixed Ladders

• Does this unit have fixed ladders?

  Yes

  No

  N/A

• Length. Ladders 20 feet or less shall be of a continuous length. AFI 91-203 para 7.4.2.2.1.

  Yes

  No

  N/A

• Landing Platforms. A landing platform is provided for a person to rest or gain access to another section of the ladder. Platforms shall be provided every 30 feet or fraction thereof. Where no cage, well or ladder safety device is provided, landing platforms shall be provided for each 20 feet of height or fraction thereof. AFI 91-203 para 7.4.2.2.1.1.

  Yes

  No

  N/A

• Where unauthorized use of a fixed ladder is a problem, the facility manager or security department shall ensure the ladders are secured from unauthorized access. Ladders available to public access require guarding to prevent unauthorized access. Typically, the bottom seven (7) feet shall be guarded. AFI 91-203 para 7.4.2.6.

  Yes

  No

  N/A

• A formal, fully documented inspection of all fixed ladders shall be accomplished upon installation and at least every three (3) years thereafter. These inspections shall be performed by the installation CE for ladders installed on real property facilities or real property installed equipment (RPIE). AFI 91-203 para 7.4.3.1.

  Yes

  No

  N/A

Portable Ladders

• Does the unit have portable ladders?

  Yes

  No

  N/A

• Ladders will be stored when not in use. On the flight line and outdoor environments, ladders shall be laid down and secured when not in use. Where possible, workers shall secure or remove the ladder to prevent unauthorized use or tripping hazards. AFI 91-203 para 7.5.2.5.17.

  Yes

  No

  N/A

• Personnel Training. Personnel who use ladders at working heights of four (4) feet or more shall be adequately trained in the care and use of different types of ladders. AFI 91-203 para 7.5.2.7.

  Yes

  No

  N/A

• Ladders not already marked with safety use instructions by the manufacturer shall be stenciled, ―DANGER — DO NOT USE AROUND ELECTRICAL EQUIPMENT,‖ in two-inch high red letters or the largest letters the surface will allow (minimum letter size is one inch). AFI 91-203 para 7.5.2.2.6.

  Yes

  No

  N/A

Common Electrical Findings

• Electrical receptacles and cover plates shall be free of cracks and securely mounted. Receptacle covers with cracks which expose the interior of the receptacle shall be replaced. AFI 91-203 para 8.2.

  Yes

  No

  N/A

• Multiple plug adapters shall not be linked to provide additional or more convenient outlets as this could overload electrical circuits. At no time shall a multiple plug adapter or strip be plugged into another multiple plug adapter or strip. AFI 91-203 para 8.2.1.

  Yes

  No

  N/A

• High wattage appliances such as heat-producing appliances, refrigerators of all types, coffee makers, etc., shall be plugged directly into a facility outlet. AFI 91-203 para 8.4.7.

  Yes

  No

  N/A

• Multi-receptacle surge protectors shall only be used to power computers and related equipment such as lights or fans. Surge protectors nor extension cords shall be used with high current items such as coffee makers, refrigerators, microwave ovens, heaters, food preparation equipment, etc. AFI 91-203 para 8.4.8.

  Yes

  No

  N/A

• Unless their purpose is evident, circuit breakers and fuse boxes shall be specifically and legibly marked to indicate their purpose. AFI 91-203 para 8.5.

  Yes

  No

  N/A

• Circuit breakers, disconnect switches and fuses shall be readily accessible to workers and building management personnel. Work space in front shall be clear and unimpeded and shall not be located where exposed to physical damage or in the vicinity of easily ignitable material. AFI 91-203 para 8.5.2.

  Yes

  No

  N/A

• Circuit breakers shall not be taped in the ―on‖ position. Breakers that trip frequently indicate electrical problems and shall be promptly reported and corrected. AFI 91-203 para 8.5.3.

  Yes

  No

  N/A

• Guarding of Live Parts. Electrical outlets, switches, junction boxes, etc., shall be in good condition and have cover plates securely installed. AFI 91-203 para 8.6.

  Yes

  No

  N/A

• Undervoltage Protection. Machines not adequately safeguarded to protect workers during undervoltage situations shall have an undervoltage protective device installed. AFI 91-203 para 8.16.

  Yes

  No

  N/A

Extension Cords & Flexible Cords

• Report, replace or dispose of worn, cracked or frayed electrical extension cords, loose or broken electrical wires and worn or broken electrical plugs. AFI 91-203 para 8.4.1.2.

  Yes

  No

  N/A

• Electrical extension cords shall be used as outlined in the NEC and not be used as a substitute for fixed wiring. AFI 91-203 para 8.4.1.3.

  Yes

  No

  N/A

• Do not run cords through holes in walls, ceilings, floors, doorways, windows, etc. AFI 91-203 para 8.4.1.4.

  Yes

  No

  N/A

• Do not tape, staple or tack extension cords to building surfaces. AFI 91-203 para 8.4.1.6.

  Yes

  No

  N/A

• Electrical extension cords shall not be walked on nor equipment allowed to run over them. If cords must be placed in travel lanes, they shall be properly protected by molded housings, bridges or other covers approved for such use. AFI 91-203 para 8.4.1.8.

  Yes

  No

  N/A

• Cords shall not be kinked, stretched or bent excessively to prevent internal wire damage. AFI 91-203 para 8.4.1.9.

  Yes

  No

  N/A

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

  Yes

  No

  N/A

Electrical Worker Safety

• Does this unit have authorized electrical workers?

  Yes

  No

  N/A

• Personnel shall not hold meters in their hand while performing measurements on energized circuits or equipment. Use non-conductive, insulated gloves or other effective PPE when necessary to hold meters or metering cables. AFI 91-203 para 8.11.3.

  Yes

  No

  N/A

• Insulating matting shall be used near electrical apparatus or circuits in high voltage maintenance areas as an additional safety measure to protect personnel. It shall be used to protect against accidental shock only and shall not be the only means of protection when handling energized wires and circuits. AFI 91-203 para 8.11.5.1.

  Yes

  No

  N/A

• Insulating matting shall be replaced when worn to one-half its original thickness or the manufacturer‘s recommended replacement requirements. AFI 91-203 para 8.11.5.4.

  Yes

  No

  N/A

• Insulating matting in front of and around electrical workbenches, high voltage cabinets, switch panels, etc., shall be one continuous length or strip. Where possible, matting shall continue 24 inches beyond the end of the equipment. AFI 91-203 para 8.11.5.5.

  Yes

  No

  N/A

• Electrical circuits and equipment shall be de-energized before being worked on. When authorized by the commander, applicable technical data or manufacturer‘s instructions, work may be performed on energized circuits and equipment as necessary to support a critical mission, prevent injury to personnel or to protect property. AFI 91-203 para 8.18.

  Yes

  No

  N/A

• Clothing made from synthetics, such as acetate, nylon, polyester or rayon, either alone or in blends, is unsafe for work on or near energized electrical circuits or equipment over 50 volts. AFI 91-203 para 8.18.2.2.

  Yes

  No

  N/A

• A flash hazard analysis (FHA) shall be performed for all Air Force operations exposing personnel to energized parts greater than 50 volts. Protective clothing required, if any, shall be based on the FHA performed. Procedures outlined in UFC 3-560-01 and AFI 32-1064 shall be followed. AFI 91-203 para 8.18.2.3.

  Yes

  No

  N/A

• Individuals required to work on or near (within 8 feet of) exposed energized equipment over 50 volts shall wear long sleeved, Arc Thermal Performance Value (ATPV) rated PPE IAW UFC 3-560-01. Long sleeves/outer garments shall be rolled down and buttoned or secured. AFI 91-203 para 8.18.2.4.

  Yes

  No

  N/A

• Are all floor areas kept clean, dry and free of refuse? AFI 91-203 para 10.2.2.1

  Yes

  No

  N/A

• Are telephone and electrical cords located where they do not pose a tripping hazard? AFI 91-203 para 10.2.2.1

  Yes

  No

  N/A

• Are all defects, such as floor tiles, broken steps, torn carpet or curled mats identified until repaired or replaced? AFI 91-203 para 10.2.2.2

  Yes

  No

  N/A

• Are office ergonomics considered when attempting to fit the job to the person? AFI 91-203 para 10.3

  Yes

  No

  N/A

• Are heavy materials stored in the bottom of file cabinets? AFI 91-203 para 10.5.5.1

  Yes

  No

  N/A

• Does this unit have hand or portable power tools?

  Yes

  No

  N/A

General Information

• Are workers well trained and familiar with the operation of the tool and the characteristics of the materials involved before being permitted to operate powder-actuated tools? AFI 91-203 para 12.6.3.1

  Yes

  No

  N/A

• Do operators wear protective goggles or face shields and other protective equipment, such as a respirator, when operations require it? AFI 91-203 para 12.7.2

  Yes

  No

  N/A

Portable Power Tools

• Are tools inspected for defects, and defective tools immediately removed from service? AFI 91-203 para 12.3.5

  Yes

  No

  N/A

• Are power tools unplugged and properly stored when not in use? AFI 91-203 para 12.3.1

  Yes

  No

  N/A

• Are portable electric tools with exposed metal parts properly grounded or double insulated? AFI 91-203 para 12.5.4

  Yes

  No

  N/A

• Are all portable circular saws with a blade diameter over two (2) inches equipped with guards above and below the base plate shoe? AFI 91-203 para 12.6.1

  Yes

  No

  N/A

• Do workers who operate chain saws wear safety footwear, snug-fitting clothing, protective gloves and eye, hearing and head protection? AFI 91-203 para 12.6.2.2

  Yes

  No

  N/A

• Does this unit require a fall protection program?

  Yes

  No

  N/A

Training/General Information

• Are workers/competent persons trained and evaluated on the fall protection/fall arrest system prior to use? AFI 91-203 para 13.6

  Yes

  No

  N/A

• Is recurring fall protection training conducted annually, when work conditions change or when new fall protection/fall arrest systems are procured? AFI 91-203 para 13.6

  Yes

  No

  N/A

• Is a rescue plan included in each fall protection plan to assure prompt rescue of fallen workers? AFI 91-203 para 13.7

  Yes

  No

  N/A

• Are workers provided fall protection when exposed to falls of four (4) feet or more? AFI 91-203 para 13.2.2

  Yes

  No

  N/A

• Are active and passive means of fall protection considered before using procedural controls? AFI 91-203 para 13.3.1.3

  Yes

  No

  N/A

• Has a JSA been performed and coordinated with the installation safety office prior to the use of procedural controls for protecting workers from falls? AFI 91-203 para 13.3.1.3

  Yes

  No

  N/A

PFAS

• Are all PFAS components marked to indicate compliance with ANSI Z359.1.? AFI 91-203 para 13.4.6.2

  Yes

  No

  N/A

• Can anchorage connectors withstand a 5000 pound load for each PFAS connected? AFI 91-203 para 13.4.6.7

  Yes

  No

  N/A

• Are wire rope, rope covered wire lanyards, plastics (such as nylon) and wet lanyards prohibited where an electrical hazard may be present? AFI 91-203 para 13.4.6.5

  Yes

  No

  N/A

• Do workers inspect their PFAS prior to each use for mildew, wear, damage and other deterioration? AFI 91-203 para 13.4.6.10.2

  Yes

  No

  N/A

• Does the supervisor ensure all PFAS components receive a thorough inspection at least quarterly and keep the record of inspection for at least one year? AFI 91-203 para 13.4.6.10.3

  Yes

  No

  N/A

Eye/Face Protection

• Does this unit use eye/face protection?

  Yes

  No

  N/A

• Protective equipment must meet the following minimum requirements: AFI 91-203 para 14.4.2.1.<br>- Provide adequate protection against the particular hazards for which they are designed.<br>- Be reasonably comfortable when worn under designated conditions.<br>- Fit snugly without interfering with movement or vision of wearer.<br>- Be durable.<br>- Be capable of being disinfected (unless disposable items are used).<br>- Be easily cleaned.<br>- Be kept clean and in good repair.

  Yes

  No

  N/A

• Eye and face protection must have the manufacturer‘s identification clearly marked on the equipment. AFI 91-203 para 14.4.2.3.

  Yes

  No

  N/A

• Face shields shall only be used as secondary eye and face protection in areas where splashing, rather than hazardous impact, is the problem. In the case of primary protection, other protective devices such as safety goggles shall be worn. Refer to 29 CFR 1910.133., for additional information. AFI 91-203 para 14.4.2.12.

  Yes

  No

  N/A

Head Protection

• Does this unit use head protection?

  Yes

  No

  N/A

• Are the safety helmets being used meeting the right job application? AFI 91-203 para 14.4.3.1.1<br>- Type I (Impact Type). Type I helmets reduce the force of impact from a blow to the top of the head.<br>- Type II (Impact Type). Type II helmets reduce the force of impact from a blow received off center or to the top of the head.<br>- Class G. (Electrical – General). Class G helmets reduce the danger of contact exposure to low voltage conductors.<br>- Class E (Electrical). Class E helmets are intended to reduce the danger of exposure to high voltage conductors.<br>- Class C (Conductive). Class C helmets do not provide protection against contact with electrical conductors.

  Yes

  No

  N/A

• Color Identification. Safety helmets shall not be painted, as certain paints may hide cracks or defects in the outer shell and destroy or degrade the insulating characteristics of the shell. AFI 91-203 para 14.4.3.1.2.

  Yes

  No

  N/A

• Keep safety helmets free of abrasions, scrapes and nicks, and do not deliberately drop, throw or otherwise abuse them because this causes them to lose their protective qualities. AFi 91-203 para 14.4.3.1.6.1.

  Yes

  No

  N/A

Hearing Protection

• Does this unit use hearing protection?

  Yes

  No

  N/A

• Mark “hazardous noise areas” and “equipment” (as identified by BE) with signs and/or decals. For potentially hazardous noise areas, signs will be located at their entrances or boundaries, including pathways leading to hazardous noise areas. AFOSH 48-20 para 2.6.3.

  Yes

  No

  N/A

• Conduct initial and annual workplace-specific hearing conservation training on shop or unit hazardous noise exposures and equipment. Consult PH for training materials. Document all training on the worker’s AF Form 55, Record of Training, or equivalent. AFOSH 48-20 para 2.6.9.

  Yes

  No

  N/A

• Personal hearing protectors are provided at no cost to all AF personnel who work in designated hazardous noise areas or operate noise-hazardous equipment. AFOSH 48-20 para 5.2.

  Yes

  No

  N/A

• Does this unit have machinery?

  Yes

  No

  N/A

Fixed Grinding Machines

• Peripheral protectors, commonly referred to as tongue guards, shall be positioned so the opening between the wheel and the guard is no more than 1/4 inch. AFI 91-203 para 18.6.2.3.2.

  Yes

  No

  N/A

• Work Rest: Adjust these devices closely to the wheel with a maximum opening of 1/8 inch to prevent the work being jammed between the wheel and rest. AFI 91-203 para 18.6.2.3.3.

  Yes

  No

  N/A

• Wheels found defective, cracked or out of balance shall be taken out of service until repaired or discarded. AFI 91-203 para 18.6.2.3.5.

  Yes

  No

  N/A

• Abrasive grinding wheels shall not be used to grind aluminum, brass, copper or other soft metals unless the wheel is specifically designed for that purpose. Soft metal wheels shall be used to grind soft metals only. AFI 91-203 para 18.6.2.3.8.

  Yes

  No

  N/A

• Special Grinding Operations. Grinding materials such as magnesium, titanium, thorium and beryllium present fire and health hazards. Supervisors of these operations shall contact the installation Ground Safety office, Fire Emergency Services (FES) Flight and BE for assistance in determining safe work practices and protective equipment needs. AFI 91-203 para 18.6.2.10.

  Yes

  No

  N/A

• Installation. Machines designed for fixed locations or that may tip over shall be securely fastened to the floor or other suitable foundation to eliminate all movement or walking. AFI 91-203 para 18.3.2.

  Yes

  No

  N/A

General Safety

• One or more methods of machine guarding shall be provided to protect the operator and other employees or patrons in the machine area from hazards such as those created by point of operation, in-running nip points, rotating parts, flying chips, power transmission apparatus and sparks. AFI 91-203 para 18.3.4.3.

  Yes

  No

  N/A

• The motor START switch shall be protected against accidental or inadvertent operation. AFI 91-203 para 18.4.2.11.

  Yes

  No

  N/A

• All machines shall incorporate one or more emergency stop controls that, upon momentary operation, shall de-energize all machine motions. AFI 91-203 para 18.5.2.18.

  Yes

  No

  N/A

• Does this unit have emergency shower or eyewash units?

  Yes

  No

  N/A

• Permanently-installed units: AFI 91-203 para 19.6.<br>- Travel distances to eyewash stations shall not exceed 100 feet and shall not take more than 10 seconds to reach.<br>- Workers should not have to open any doors or use any stairs to reach the station.<br>- Placement of the unit shall be in a central location where the need is the greatest.<br>- Units shall be connected to a supply of water free from contamination and equal in purity to potable water.<br>- Water temperature shall be between 60° F and 100° F.<br>- Fixed locations shall be identified with a highly visible sign.

  Yes

  No

  N/A

Testing/Inspection

• Permanently-installed shower and eyewash units shall be activated by the supervisor or worker weekly to verify proper operation. AFI 91-203 para 19.9.1.

  Yes

  No

  N/A

• The supervisor or worker shall inspect permanently-installed unit(s) monthly and document the inspection. AFI 91-203 para 19.9.2.<br>

  Yes

  No

  N/A

• Self-contained units shall be tested and inspected IAW the manufacturer‘s instructions. Where tap water is used, fluid shall be replaced at least monthly. AFI 91-203 para 19.9.3.

  Yes

  No

  N/A

Self-Contained Units

• Is the self-contained unit being used appropriately? AFI 91-203 para 19.4.3.<br>- As an interim fix, pending installation or repair of a permanently-installed unit.<br>- For workers exposed to irritants rather than substances that could damage the eye.<br>- In temporary locations where a permanent installation would not be economically feasible or may not be possible.<br>- In field operations, such as remote missile or communications sites, where a source of potable water is not available.

  Yes

  No

  N/A

Eyewash Bottles

• Are eyewash bottles being used appropriately? AFI 91-203 para 19.4.4.<br>- Eyewash bottles are not a replacement for other type units.<br>- An eyewash bottle may be kept in the immediate vicinity where employees are working on extremely hazardous operations.<br>- These units supply immediate flushing after which the individual may then proceed or be helped to a permanently-installed or self-contained unit to flush the eyes more thoroughly.

  Yes

  No

  N/A

Location

• Are the eyewash/showers in a proper location? AFI 91-203 para 19.5.<br>- They shall be in conspicuously identified and accessible locations.<br>- No more than 10 seconds to reach and free of obstructions that may inhibit immediate use of the equipment.<br>- The unit shall be located as close to the hazard as possible without physically causing a hazard itself.<br>- Energized circuits located within two (2) feet of emergency eyewash stations and within five (5) feet of emergency shower stations shall be protected by ground fault circuit interrupters (GFCI).

  Yes

  No

  N/A

Installation

• Findings

Finding

• Discrepancy

• Reference

• Location

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  Media