Information

  • CVA Location

  • Conducted on

  • Prepared by

1.0 - Audit Comments

  • Comments

  • List of items needed from Safety Team

2.0 - Employee Interviews

  • 2.1 - EAP / Interviews

  • 2.2 - HAZCOM / Interviews

  • 2.3 - NH3 / Interviews

  • 2.4 - LOTO / Interviews

  • 2.5 - PRCS / Interviews

  • 2.6 - GAS METERS / Demonstrate

  • 2.7 - GRAIN / Interview

  • 2.8 - FALL PROTECTION / Interviews

  • 2.9 - DOT / Interviews

  • 2.10 - NEAR MISS / Interviews

3.0 - Emergency Action Plan

  • 3.1 - EAP / Initial and annual TRAINING documented for EAP?

  • 3.2 - EAP / REVIEWED and UPDATED annually?

  • 3.3 - EAP / VISITORS LOGS used? (except customers)

  • 3.4 - EAP / No additional corrective actions required?

4.0 - Lockout Tagout Safety Program

  • 4.1 - LOTO / Initial and annual TRAINING documented for LOTO PROGRAM?

  • 4.2 - LOTO / Machine specific WRITTEN PROCEDURES are complete?

  • 4.3 - LOTO / Annual LOTO REVIEWS current within 12 months?

  • 4.4 - LOTO / All LOCKS/TAGS identify authorized employees?

  • 4.5 - LOTO / Required LOTO EQUIPMENT is available?

  • 4.6 - LOTO / No additional corrective actions required?

5.0 - Grain Handling Facility Safety Program

  • 5.1 - GRAIN / Initial and annual TRAINING documented for GRAIN HANDLING FACILITY SAFETY PROGRAM?

  • 5.2 - GRAIN / HOUSEKEEPING LOGS properly documented and certified by supervisor.?

  • 5.3 - GRAIN / MAINTENANCE LOG properly documented and certified by supervisor?

  • 5.4 - GRAIN / BIN ENTRY PERMITS are completed properly and maintained for at least 12 months?

  • 5.5 - GRAIN / Boot pit and confined space ENTRY PERMITS completed properly and maintained for at least 12 months?

  • 5.6 - GRAIN / No additional corrective actions required?

6.0 - HAZ-COM Safety Program

  • 6.1 - HAZCOM / Initial and annual TRAINING documented for HAZCOM PROGRAM?

  • 6.2 - HAZCOM / Employees are TRAINED on the safe handling of the CATEGORIES OF HAZARDOUS MATERIALS they come into contact with?

  • 6.3 - HAZCOM / Written program includes a LIST of all onsite chemicals (except consumer products)?

  • 6.4 - HAZCOM / All required employees have completed GHS HAZCOM training on LMS?

  • 6.5 - HAZCOM / Agronomy facilities have CDMS website readily available on computer for accessing ag chemical SDS's?

  • 6.6 - HAZCOM / No additional corrective actions required?

7.0 - Near Miss & Unsafe Condition Reporting Safety Program

  • 7.1 - NEAR MISS / Initial and annual training documented for NEAR MISS REPORTING PROGRAM?

  • 7.2 - NEAR MISS / Report forms are readily available for employee use.

  • 7.3 - NEAR MISS / Proper implementation of program?

8.0 - Office Areas

  • 8.1 - OFFICE / FIRE EXTINGUISHERS compliant?

  • 8.2 - OFFICE / EGRESS routes kept clear of obstacles?

  • 8.3 - OFFICE / ELECTRICAL SYSTEMS compliant?

  • 8.4 - OFFICE / Free of SLIP or TRIP hazards?

  • 8.5 - OFFICE / Facility SIGNAGE compliant?

  • 8.6 - OFFICE / INFOTRAC contact signs/stickers are displayed.

  • 8.7 - OFFICE / Employee LABOR LAW POSTERS and OSHA 300 posted?

  • 8.8 - OFFICE / CHEMICALS properly marked and stored?

  • 8.9 - OFFICE / No additional corrective actions required?

9.0 - Grain Handling Areas

  • 9.1 - GRAIN / FIRE EXTINGUISHERS compliant?

  • 9.2 - GRAIN / EGRESS routes kept clear of obstacles?

  • 9.3 - GRAIN / ELECTRICAL SYSTEMS compliant?

  • 9.4 - GRAIN / MACHINE GUARDING compliant?

  • 9.5 - GRAIN / ORGANIZED and free of clutter, rubbish, and spilled grain?

  • 9.6 - GRAIN / Free of SLIP or TRIP hazards?

  • 9.7 - GRAIN / RAILINGS AND HOLE GUARDING compliant?

  • 9.8 - GRAIN / LADDERS compliant?

  • 9.9 - GRAIN / PERMIT SPACES properly marked?

  • 9.10 - GRAIN / HOUSEKEEPING performed adequately?

  • 9.11 - GRAIN / MAINTENANCE performed adequately?

  • 9.12 - GRAIN / DUST COLLECTION system is compliant?

  • 9.13 - GRAIN / EMERGENCY RESCUE EQUIPMENT on site and stored properly? (Rope retrieval kit, plywood coffer dams, proper harness, and lifelines)

  • 9.14 - GRAIN / DUMP PIT GRATES compliant?

  • 9.15 - GRAIN / Grain processing equipment MAGNETS are properly maintained?

  • 9.16 - GRAIN / All CHEMICALS are properly stored and labeled?

  • 9.17 - GRAIN / NO SMOKING WITHIN 50 FEET properly marked?

  • 9.18 - GRAIN / LOTO ENERGY ISOLATION POINTS properly marked?

  • 9.19 - GRAIN / EXTENSION CORDS are OSHA compliant including GFCI where required?

  • 9.20 - GRAIN / Adequate SECURITY at facility? (Ladders, doors, electrical, overheads, etc.)

  • 9.21 - GRAIN / LOADERS, skid steers etc. compliant and in safe operating condition?

  • 9.22 - GRAIN / No additional corrective actions required?

10.0 - Shop Areas

  • 10.1 - SHOP / FIRE EXTINGUISHERS compliant?

  • 10.2 - SHOP / EGRESS routes kept clear of obstacles?

  • 10.3 - SHOP / ELECTRICAL SYSTEMS compliant?

  • 10.4 - SHOP / MACHINE GUARDING compliant?

  • 10.5 - SHOP / ORGANIZED and free of clutter and rubbish?

  • 10.6 - SHOP / Free of SLIP or TRIP hazards?

  • 10.7 - SHOP / RAILINGS and HOLE GUARDING compliant?

  • 10.8 - SHOP / LADDERS compliant?

  • 10.9 - SHOP / OILY RAGS and MATERIALS are placed in covered metal containers?

  • 10.10 - SHOP / TOOLS are kept picked up and put away when not in use?

  • 10.11 - SHOP / TOOLS and equipment are all OSHA compliant?

  • 10.12 - SHOP / EXTENSION CORDS are OSHA compliant including GFCI where required?

  • 10.13 - SHOP / All JACKS and HOISTS are marked with lifting capacities?

  • 10.14 - SHOP / Proper PPE is available?

  • 10.15 - SHOP / BATTERY CHARGING stations have flushing water near by?

  • 10.16 - SHOP / LOTO ENERGY ISOLATION POINTS properly marked?

  • 10.17 - SHOP / CHEMICALS properly stored and labeled?

  • 10.18 - SHOP / FLAMMABLES and AEROSOLS stored away from spark and heat producing equipment?

  • 10.19 - SHOP / ALL FUELS are stored in OSHA compliant containers?

  • 10.20 - SHOP / FLAMMABLES not stored in access or egress routes?

  • 10.21 -SHOP / OXYGEN CYLINDERS stored properly? (Greater than 20 feet from combustibles/Flammables)

  • 10.22 - SHOP / All STORED CYLINDERS are capped and secured from falling over?

  • 10.23 - SHOP / PROPANE BOTTLES are not stored inside? (Gas grills stored indoors must have grill bottles removed)

  • 10.24 - SHOP / USED OIL is placed in covered containers that are marked as "USED OIL"?

  • 10.25 - SHOP / OVERHEAD STORAGE areas are marked with max load ratings.

  • 10.26 - SHOP / STORAGE RACKS are secured and in good condition.

  • 10.27 - SHOP / All WEED SPRAYERS are emptied and rinsed before placing or storing inside shops?

  • 10.28 - SHOP / Proper facility MARKINGS and SIGNS?

  • 10.29 - SHOP / No additional corrective actions required?

11.0 - Warehouse Areas

  • 11.1 - WAREHOUSE / FIRE EXTINGUISHERS compliant?

  • 11.2 - WAREHOUSE / EGRESS routes kept clear of obstacles?

  • 11.3 - WAREHOUSE / ELECTRICAL SYSTEMS compliant?

  • 11.4 - WAREHOUSE / MACHINE GUARDING compliant?

  • 11.5 - WAREHOUSE / ORGANIZED and free of clutter and rubbish?

  • 11.6 - WAREHOUSE / Free of SLIP or TRIP hazards?

  • 11.7 - WAREHOUSE / RAILINGS and HOLE GUARDING compliant?

  • 11.8 - WAREHOUSE / LADDERS compliant?

  • 11.9 - WAREHOUSE / EXTENSION CORDS are OSHA compliant including GFCI where required?

  • 11.10 - WAREHOUSE / STORAGE RACKS are secured and in good condition?

  • 11.11 - WAREHOUSE / STORAGE RACKS and STORAGE AREAS are not unsafely loaded or stacked?

  • 11.12 - WAREHOUSE / OVERHEAD STORAGE areas are marked with max load ratings?

  • 11.13 - WAREHOUSE / CHEMICAL CONTAINERS are free of leaks and stored in approved areas?

  • 11.14 - WAREHOUSE / Compliant with HAZCOM and DOT package marking requirements?

  • 11.15 - WAREHOUSE / LOTO ENERGY ISOLATION POINTS properly marked?

  • 11.16 - WAREHOUSE / Proper facility MARKINGS and SIGNS?

  • 11.17 - WAREHOUSE / Adequate SECURITY at facility? (Ladders, doors, chemicals)

  • 11.18 - WAREHOUSE / FORKLIFTS used and maintained in compliance with OSHA standards.

  • 11.19 - WAREHOUSE / No additional corrective actions required?

12.0 - Liquid Fertilizer & Chemical Areas

  • 12.1 - LIQ FERT / FIRE EXTINGUISHERS compliant?

  • 12.2 - LIQ FERT / EGRESS routes kept clear of obstacles?

  • 12.3 - LIQ FERT / ELECTRICAL SYSTEMS compliant?

  • 12.4 - LIQ FERT / MACHINE GUARDING compliant?

  • 12.5 - LIQ FERT / ORGANIZED and free of clutter and rubbish?

  • 12.6 - LIQ FERT / Free of TRIP or SLIP hazards?

  • 12.7 - LIQ FERT / RAILINGS and HOLE GUARDING compliant?

  • 12.8 - LIQ FERT / LADDERS compliant?

  • 12.9 - LIQ FERT / EXTENSION CORDS are OSHA compliant including GFCI where required?

  • 12.10 - LIQ FERT / STORAGE RACKS are secured and in good condition?

  • 12.11 - LIQ FERT / STORAGE RACKS and storage areas are not unsafely loaded or stacked?

  • 12.12 - LIQ FERT / OVERHEAD STORAGE areas are marked with max load ratings?

  • 12.13 - LIQ FERT / CHEMICAL containers are free of leaks and stored in approved areas?

  • 12.14 - LIQ FERT / LOTO ENERGY ISOLATION POINTS properly marked?

  • 12.15 - LIQ FERT / Proper MARKINGS and SIGNS (including "NO SMOKING")?

  • 12.16 - LIQ FERT / Bulk chemical tanks have SDS's readily available?

  • 12.17 - LIQ FERT / INFOTRAC signs posted?

  • 12.18 - LIQ FERT / PERMIT SPACES marked?

  • 12.19 - LIQ FERT / Proper PPE available?

  • 12.20 - LIQ FERT / EYEWASH-SHOWER STATION clear of obstacles and operational?

  • 12.21 - LIQ FERT / Adequate SECURITY at facility? (Ladders, doors, chemicals, etc.)

  • 12.22 - LIQ FERT / FORKLIFTS used and maintained in compliance with OSHA standards.

  • 12.23 - LIQ FERT / No additional corrective actions required?

13.0 - Dry Fertilizer Storage Areas

  • 13.1 - DRY FERT / FIRE EXTINGUISHERS compliant.

  • 13.2 - DRY FERT / EGRESS routes kept clear of obstacles?

  • 13.3 - DRY FERT / ELECTRICAL SYSTEMS compliant?

  • 13.4 - DRY FERT / MACHINE GUARDING compliant?

  • 13.5 - DRY FERT / ORGANIZED and free of clutter, rubbish, and spilled fertilizers?

  • 13.6 - DRY FERT / Free of TRIP and SLIP hazards?

  • 13.7 - DRY FERT / RAILINGS and HOLE GUARDING compliant?

  • 13.8 - DRY FERT / LADDERS compliant?

  • 13.9 - DRY FERT / EXTENSION CORDS are OSHA compliant including GFCI where required?

  • 13.10 - DRY FERT / OVERHEAD STORAGE areas are marked with max load ratings?

  • 13.11 - DRY FERT / CHEMICAL containers are free of leaks and stored in approved areas.

  • 13.12 - DRY FERT / Proper PPE available?

  • 13.13 - DRY FERT / LOTO ENERGY ISOLATION POINTS properly marked?

  • 13.14 - DRY FERT / PERMIT REQUIRED SPACE marked?

  • 13.15 - DRY FERT / Proper MARKINGS and SIGNS (including "NO SMOKING")?

  • 13.16 - DRY FERT / INFOTRAC signs posted.

  • 13.17 - DRY FERT / Adequate SECURITY at facility? (Ladders, doors, chemicals, etc.)

  • 13.18 - DRY FERT / No additional corrective actions required.

14.0 - Anhydrous Ammonia Facilities

  • 14.1 - NH3 / Initial and annual TRAINING documented.

  • 14.2 - NH3 / Load out facility compliant with NFPA standards?

  • 14.3 - NH3 / EMERGENCY WATER on site?

  • 14.4 - NH3 / Proper PPE available?

  • 14.5 - NH3 / INSPECTION and MAINTENANCE documented for bulk plants and nurse tanks?

  • 14.6 - NH3 / System free of LEAKS?

  • 14.7 - NH3 / MACHINE GUARDING compliant?

  • 14.8 - NH3 / ELECTRICAL SYSTEMS compliant?

  • 14.9 - NH3 / LOTO ENERGY ISOLATION POINTS properly marked?

  • 14.10 - NH3 / Proper SECURITY of plant?

  • 14.11 - NH3 / Adequate MAINTENANCE of plant and tanks. (Paint, repair, etc.)

  • 14.12 - NH3 / Adequate MARKINGS and SIGNS.

  • 14.13 - NH3 / No additional corrective actions required?

15.0 - Facility General

  • 15.1 - FACILITY GEN / FIRST AID adequate? (kit may be shared among multiple worksites within a facility if located in close proximity)

  • 15.2 - FACILITY GEN / PERSONAL FALL PROTECTION EQUIPMENT properly stored and in safe condition?

  • 15.3 - FACILITY GEN / RESPIRATORY PROTECTION EQUIPMENT properly stored and in safe condition?<br>

  • 15.4 - FACILITY GEN / Proper SIGNAGE? (free of excessive fading and damage)

  • 15.5 - FACILITY GEN / ORGANIZED and free of clutter and rubbish?

  • 15.6 - FACILITY GEN / Free of SLIP and TRIP hazards?

  • 15.7 - FACILITY GEN / WORKING and WALKING AREAS safe? (Impalement hazards, sharp edges, etc.)

  • 15.8 - FACILITY GEN / RAILING and HOLE GUARDING compliant?

  • 15.9 - FACILITY GEN / Adequate LIGHTING at facility?

  • 15.10 - FACILITY GEN / RAILROAD SIDINGS in safe condition?

  • 15.11 - FACILITY GEN / FALL PROTECTION SYSTEMS in safe condition? (Rail trolleys, cable systems, etc.)

  • 15.12 - FACILITY GEN / BULK PROPANE STORAGE compliant with NFPA standards?

  • 15.13 - FACILITY GEN / Other ELECTRICAL

  • 15.14 - FACILITY GEN / Other GUARDING

  • 15.15 - FACILITY GEN / Other LADDERS

  • 15.13 - FACILITY GEN / No additional corrective action required?

16.0 - ROLLING STOCK & EQUIPMENT

  • 16.1 - ROLLING STOCK & EQMT / Tractors, skid steers, loaders, and accessories compliant?

  • 16.2 - ROLLING STOCK & EQMT / Portable augers and conveyors compliant?

  • 16.3 - ROLLING STOCK & EQMT / Yard trucks and trailers in safe condition?

  • 16.4 - ROLLING STOCK & EQMT / Commercial trucks and trailers maintained and inspected in compliance with DOT standards?

  • 16.5 - ROLLING STOCK & EQMT / No additional corrective actions required?

17.0 - ALL IN SAFETY

  • 17.1 - ALL-IN / Safety training documented each month since last inspection?

  • 17.2 - ALL-IN / Representative attends company safety committee meetings?

  • 17.3 - ALL-IN / No workplace injuries since last inspection?

  • 17.4 - ALL-IN / No vehicle or machine crashes since last inspection?

  • 17.5 - ALL-IN / No FMCSA violations since last inspection?

  • 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

  • Auditor's signature

  • On site representative

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