Information
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CVA Location
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Conducted on
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Prepared by
1.0 - Audit Comments
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Comments
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List of items needed from Safety Team
2.0 - Employee Interviews
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2.1 - EAP / Interviews
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2.2 - HAZCOM / Interviews
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2.3 - NH3 / Interviews
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2.4 - LOTO / Interviews
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2.5 - PRCS / Interviews
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2.6 - GAS METERS / Demonstrate
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2.7 - GRAIN / Interview
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2.8 - FALL PROTECTION / Interviews
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2.9 - DOT / Interviews
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2.10 - NEAR MISS / Interviews
3.0 - Emergency Action Plan
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3.1 - EAP / Initial and annual TRAINING documented for EAP?
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3.2 - EAP / REVIEWED and UPDATED annually?
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3.3 - EAP / VISITORS LOGS used? (except customers)
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3.4 - EAP / No additional corrective actions required?
4.0 - Lockout Tagout Safety Program
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4.1 - LOTO / Initial and annual TRAINING documented for LOTO PROGRAM?
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4.2 - LOTO / Machine specific WRITTEN PROCEDURES are complete?
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4.3 - LOTO / Annual LOTO REVIEWS current within 12 months?
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4.4 - LOTO / All LOCKS/TAGS identify authorized employees?
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4.5 - LOTO / Required LOTO EQUIPMENT is available?
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4.6 - LOTO / No additional corrective actions required?
5.0 - Grain Handling Facility Safety Program
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5.1 - GRAIN / Initial and annual TRAINING documented for GRAIN HANDLING FACILITY SAFETY PROGRAM?
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5.2 - GRAIN / HOUSEKEEPING LOGS properly documented and certified by supervisor.?
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5.3 - GRAIN / MAINTENANCE LOG properly documented and certified by supervisor?
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5.4 - GRAIN / BIN ENTRY PERMITS are completed properly and maintained for at least 12 months?
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5.5 - GRAIN / Boot pit and confined space ENTRY PERMITS completed properly and maintained for at least 12 months?
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5.6 - GRAIN / No additional corrective actions required?
6.0 - HAZ-COM Safety Program
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6.1 - HAZCOM / Initial and annual TRAINING documented for HAZCOM PROGRAM?
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6.2 - HAZCOM / Employees are TRAINED on the safe handling of the CATEGORIES OF HAZARDOUS MATERIALS they come into contact with?
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6.3 - HAZCOM / Written program includes a LIST of all onsite chemicals (except consumer products)?
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6.4 - HAZCOM / All required employees have completed GHS HAZCOM training on LMS?
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6.5 - HAZCOM / Agronomy facilities have CDMS website readily available on computer for accessing ag chemical SDS's?
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6.6 - HAZCOM / No additional corrective actions required?
7.0 - Near Miss & Unsafe Condition Reporting Safety Program
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7.1 - NEAR MISS / Initial and annual training documented for NEAR MISS REPORTING PROGRAM?
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7.2 - NEAR MISS / Report forms are readily available for employee use.
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7.3 - NEAR MISS / Proper implementation of program?
8.0 - Office Areas
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8.1 - OFFICE / FIRE EXTINGUISHERS compliant?
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8.2 - OFFICE / EGRESS routes kept clear of obstacles?
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8.3 - OFFICE / ELECTRICAL SYSTEMS compliant?
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8.4 - OFFICE / Free of SLIP or TRIP hazards?
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8.5 - OFFICE / Facility SIGNAGE compliant?
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8.6 - OFFICE / INFOTRAC contact signs/stickers are displayed.
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8.7 - OFFICE / Employee LABOR LAW POSTERS and OSHA 300 posted?
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8.8 - OFFICE / CHEMICALS properly marked and stored?
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8.9 - OFFICE / No additional corrective actions required?
9.0 - Grain Handling Areas
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9.1 - GRAIN / FIRE EXTINGUISHERS compliant?
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9.2 - GRAIN / EGRESS routes kept clear of obstacles?
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9.3 - GRAIN / ELECTRICAL SYSTEMS compliant?
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9.4 - GRAIN / MACHINE GUARDING compliant?
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9.5 - GRAIN / ORGANIZED and free of clutter, rubbish, and spilled grain?
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9.6 - GRAIN / Free of SLIP or TRIP hazards?
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9.7 - GRAIN / RAILINGS AND HOLE GUARDING compliant?
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9.8 - GRAIN / LADDERS compliant?
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9.9 - GRAIN / PERMIT SPACES properly marked?
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9.10 - GRAIN / HOUSEKEEPING performed adequately?
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9.11 - GRAIN / MAINTENANCE performed adequately?
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9.12 - GRAIN / DUST COLLECTION system is compliant?
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9.13 - GRAIN / EMERGENCY RESCUE EQUIPMENT on site and stored properly? (Rope retrieval kit, plywood coffer dams, proper harness, and lifelines)
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9.14 - GRAIN / DUMP PIT GRATES compliant?
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9.15 - GRAIN / Grain processing equipment MAGNETS are properly maintained?
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9.16 - GRAIN / All CHEMICALS are properly stored and labeled?
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9.17 - GRAIN / NO SMOKING WITHIN 50 FEET properly marked?
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9.18 - GRAIN / LOTO ENERGY ISOLATION POINTS properly marked?
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9.19 - GRAIN / EXTENSION CORDS are OSHA compliant including GFCI where required?
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9.20 - GRAIN / Adequate SECURITY at facility? (Ladders, doors, electrical, overheads, etc.)
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9.21 - GRAIN / LOADERS, skid steers etc. compliant and in safe operating condition?
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9.22 - GRAIN / No additional corrective actions required?
10.0 - Shop Areas
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10.1 - SHOP / FIRE EXTINGUISHERS compliant?
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10.2 - SHOP / EGRESS routes kept clear of obstacles?
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10.3 - SHOP / ELECTRICAL SYSTEMS compliant?
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10.4 - SHOP / MACHINE GUARDING compliant?
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10.5 - SHOP / ORGANIZED and free of clutter and rubbish?
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10.6 - SHOP / Free of SLIP or TRIP hazards?
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10.7 - SHOP / RAILINGS and HOLE GUARDING compliant?
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10.8 - SHOP / LADDERS compliant?
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10.9 - SHOP / OILY RAGS and MATERIALS are placed in covered metal containers?
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10.10 - SHOP / TOOLS are kept picked up and put away when not in use?
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10.11 - SHOP / TOOLS and equipment are all OSHA compliant?
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10.12 - SHOP / EXTENSION CORDS are OSHA compliant including GFCI where required?
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10.13 - SHOP / All JACKS and HOISTS are marked with lifting capacities?
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10.14 - SHOP / Proper PPE is available?
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10.15 - SHOP / BATTERY CHARGING stations have flushing water near by?
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10.16 - SHOP / LOTO ENERGY ISOLATION POINTS properly marked?
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10.17 - SHOP / CHEMICALS properly stored and labeled?
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10.18 - SHOP / FLAMMABLES and AEROSOLS stored away from spark and heat producing equipment?
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10.19 - SHOP / ALL FUELS are stored in OSHA compliant containers?
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10.20 - SHOP / FLAMMABLES not stored in access or egress routes?
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10.21 -SHOP / OXYGEN CYLINDERS stored properly? (Greater than 20 feet from combustibles/Flammables)
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10.22 - SHOP / All STORED CYLINDERS are capped and secured from falling over?
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10.23 - SHOP / PROPANE BOTTLES are not stored inside? (Gas grills stored indoors must have grill bottles removed)
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10.24 - SHOP / USED OIL is placed in covered containers that are marked as "USED OIL"?
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10.25 - SHOP / OVERHEAD STORAGE areas are marked with max load ratings.
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10.26 - SHOP / STORAGE RACKS are secured and in good condition.
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10.27 - SHOP / All WEED SPRAYERS are emptied and rinsed before placing or storing inside shops?
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10.28 - SHOP / Proper facility MARKINGS and SIGNS?
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10.29 - SHOP / No additional corrective actions required?
11.0 - Warehouse Areas
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11.1 - WAREHOUSE / FIRE EXTINGUISHERS compliant?
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11.2 - WAREHOUSE / EGRESS routes kept clear of obstacles?
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11.3 - WAREHOUSE / ELECTRICAL SYSTEMS compliant?
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11.4 - WAREHOUSE / MACHINE GUARDING compliant?
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11.5 - WAREHOUSE / ORGANIZED and free of clutter and rubbish?
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11.6 - WAREHOUSE / Free of SLIP or TRIP hazards?
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11.7 - WAREHOUSE / RAILINGS and HOLE GUARDING compliant?
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11.8 - WAREHOUSE / LADDERS compliant?
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11.9 - WAREHOUSE / EXTENSION CORDS are OSHA compliant including GFCI where required?
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11.10 - WAREHOUSE / STORAGE RACKS are secured and in good condition?
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11.11 - WAREHOUSE / STORAGE RACKS and STORAGE AREAS are not unsafely loaded or stacked?
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11.12 - WAREHOUSE / OVERHEAD STORAGE areas are marked with max load ratings?
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11.13 - WAREHOUSE / CHEMICAL CONTAINERS are free of leaks and stored in approved areas?
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11.14 - WAREHOUSE / Compliant with HAZCOM and DOT package marking requirements?
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11.15 - WAREHOUSE / LOTO ENERGY ISOLATION POINTS properly marked?
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11.16 - WAREHOUSE / Proper facility MARKINGS and SIGNS?
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11.17 - WAREHOUSE / Adequate SECURITY at facility? (Ladders, doors, chemicals)
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11.18 - WAREHOUSE / FORKLIFTS used and maintained in compliance with OSHA standards.
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11.19 - WAREHOUSE / No additional corrective actions required?
12.0 - Liquid Fertilizer & Chemical Areas
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12.1 - LIQ FERT / FIRE EXTINGUISHERS compliant?
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12.2 - LIQ FERT / EGRESS routes kept clear of obstacles?
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12.3 - LIQ FERT / ELECTRICAL SYSTEMS compliant?
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12.4 - LIQ FERT / MACHINE GUARDING compliant?
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12.5 - LIQ FERT / ORGANIZED and free of clutter and rubbish?
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12.6 - LIQ FERT / Free of TRIP or SLIP hazards?
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12.7 - LIQ FERT / RAILINGS and HOLE GUARDING compliant?
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12.8 - LIQ FERT / LADDERS compliant?
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12.9 - LIQ FERT / EXTENSION CORDS are OSHA compliant including GFCI where required?
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12.10 - LIQ FERT / STORAGE RACKS are secured and in good condition?
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12.11 - LIQ FERT / STORAGE RACKS and storage areas are not unsafely loaded or stacked?
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12.12 - LIQ FERT / OVERHEAD STORAGE areas are marked with max load ratings?
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12.13 - LIQ FERT / CHEMICAL containers are free of leaks and stored in approved areas?
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12.14 - LIQ FERT / LOTO ENERGY ISOLATION POINTS properly marked?
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12.15 - LIQ FERT / Proper MARKINGS and SIGNS (including "NO SMOKING")?
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12.16 - LIQ FERT / Bulk chemical tanks have SDS's readily available?
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12.17 - LIQ FERT / INFOTRAC signs posted?
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12.18 - LIQ FERT / PERMIT SPACES marked?
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12.19 - LIQ FERT / Proper PPE available?
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12.20 - LIQ FERT / EYEWASH-SHOWER STATION clear of obstacles and operational?
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12.21 - LIQ FERT / Adequate SECURITY at facility? (Ladders, doors, chemicals, etc.)
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12.22 - LIQ FERT / FORKLIFTS used and maintained in compliance with OSHA standards.
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12.23 - LIQ FERT / No additional corrective actions required?
13.0 - Dry Fertilizer Storage Areas
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13.1 - DRY FERT / FIRE EXTINGUISHERS compliant.
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13.2 - DRY FERT / EGRESS routes kept clear of obstacles?
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13.3 - DRY FERT / ELECTRICAL SYSTEMS compliant?
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13.4 - DRY FERT / MACHINE GUARDING compliant?
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13.5 - DRY FERT / ORGANIZED and free of clutter, rubbish, and spilled fertilizers?
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13.6 - DRY FERT / Free of TRIP and SLIP hazards?
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13.7 - DRY FERT / RAILINGS and HOLE GUARDING compliant?
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13.8 - DRY FERT / LADDERS compliant?
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13.9 - DRY FERT / EXTENSION CORDS are OSHA compliant including GFCI where required?
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13.10 - DRY FERT / OVERHEAD STORAGE areas are marked with max load ratings?
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13.11 - DRY FERT / CHEMICAL containers are free of leaks and stored in approved areas.
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13.12 - DRY FERT / Proper PPE available?
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13.13 - DRY FERT / LOTO ENERGY ISOLATION POINTS properly marked?
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13.14 - DRY FERT / PERMIT REQUIRED SPACE marked?
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13.15 - DRY FERT / Proper MARKINGS and SIGNS (including "NO SMOKING")?
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13.16 - DRY FERT / INFOTRAC signs posted.
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13.17 - DRY FERT / Adequate SECURITY at facility? (Ladders, doors, chemicals, etc.)
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13.18 - DRY FERT / No additional corrective actions required.
14.0 - Anhydrous Ammonia Facilities
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14.1 - NH3 / Initial and annual TRAINING documented.
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14.2 - NH3 / Load out facility compliant with NFPA standards?
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14.3 - NH3 / EMERGENCY WATER on site?
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14.4 - NH3 / Proper PPE available?
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14.5 - NH3 / INSPECTION and MAINTENANCE documented for bulk plants and nurse tanks?
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14.6 - NH3 / System free of LEAKS?
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14.7 - NH3 / MACHINE GUARDING compliant?
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14.8 - NH3 / ELECTRICAL SYSTEMS compliant?
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14.9 - NH3 / LOTO ENERGY ISOLATION POINTS properly marked?
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14.10 - NH3 / Proper SECURITY of plant?
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14.11 - NH3 / Adequate MAINTENANCE of plant and tanks. (Paint, repair, etc.)
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14.12 - NH3 / Adequate MARKINGS and SIGNS.
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14.13 - NH3 / No additional corrective actions required?
15.0 - Facility General
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15.1 - FACILITY GEN / FIRST AID adequate? (kit may be shared among multiple worksites within a facility if located in close proximity)
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15.2 - FACILITY GEN / PERSONAL FALL PROTECTION EQUIPMENT properly stored and in safe condition?
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15.3 - FACILITY GEN / RESPIRATORY PROTECTION EQUIPMENT properly stored and in safe condition?<br>
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15.4 - FACILITY GEN / Proper SIGNAGE? (free of excessive fading and damage)
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15.5 - FACILITY GEN / ORGANIZED and free of clutter and rubbish?
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15.6 - FACILITY GEN / Free of SLIP and TRIP hazards?
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15.7 - FACILITY GEN / WORKING and WALKING AREAS safe? (Impalement hazards, sharp edges, etc.)
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15.8 - FACILITY GEN / RAILING and HOLE GUARDING compliant?
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15.9 - FACILITY GEN / Adequate LIGHTING at facility?
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15.10 - FACILITY GEN / RAILROAD SIDINGS in safe condition?
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15.11 - FACILITY GEN / FALL PROTECTION SYSTEMS in safe condition? (Rail trolleys, cable systems, etc.)
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15.12 - FACILITY GEN / BULK PROPANE STORAGE compliant with NFPA standards?
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15.13 - FACILITY GEN / Other ELECTRICAL
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15.14 - FACILITY GEN / Other GUARDING
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15.15 - FACILITY GEN / Other LADDERS
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15.13 - FACILITY GEN / No additional corrective action required?
16.0 - ROLLING STOCK & EQUIPMENT
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16.1 - ROLLING STOCK & EQMT / Tractors, skid steers, loaders, and accessories compliant?
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16.2 - ROLLING STOCK & EQMT / Portable augers and conveyors compliant?
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16.3 - ROLLING STOCK & EQMT / Yard trucks and trailers in safe condition?
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16.4 - ROLLING STOCK & EQMT / Commercial trucks and trailers maintained and inspected in compliance with DOT standards?
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16.5 - ROLLING STOCK & EQMT / No additional corrective actions required?
17.0 - ALL IN SAFETY
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17.1 - ALL-IN / Safety training documented each month since last inspection?
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17.2 - ALL-IN / Representative attends company safety committee meetings?
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17.3 - ALL-IN / No workplace injuries since last inspection?
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17.4 - ALL-IN / No vehicle or machine crashes since last inspection?
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17.5 - ALL-IN / No FMCSA violations since last inspection?
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17.6 - ALL-IN / No observation reports of employees engaged in unsafe actions or in violations of any safety rules since previous inspection.
Sign Off
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Auditor's signature
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On site representative