Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
Office Area(s)
Office Area(s)
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Office Area - Clean Office, Restroom, Break Room, etc.
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Office Area - Fire Extinguishers compliant?
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Office Area - Egress routes kept clear of obstacles?
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Office Area - Electrical Systems compliant?
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Office Area - Walking working areas free of slip or trip hazards?
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Office Area - Signage compliant?
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Office Area - Contact signs and stickers up to date and compliant?
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Office Area - Employee Labor Law poster and OSHA 300 posted?
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Office Area - Chemicals properly marked and stored?
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Office Area - Additional Corrective Action?
Grain Handling Areas
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Grain Handling Area - Fire Extinguishers compliant?
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Grain Handling Area - Egress routes kept clear of obstacles?
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Grain Handling Area - Electrical Systems compliant?
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Grain Handling Area - Machine Guarding compliant?
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Grain Handling Area - Grain handling areas free of clutter, rubbish, and spilled grain?
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Grain Handling Area - Walking working areas free of slip or trip hazards?
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Grain Handling Area - Railings and hole guarding compliant?
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Grain Handling Area - Ladders compliant?
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Grain Handling Area - Permit spaces properly marked?
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Grain Handling Area - Housekeeping performed adequately?
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Grain Handling Area - Maintenance performed adequately?
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Grain Handling Area - Dust collection system compliant?
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Grain Handling Area - Emergency Rescue Equipment on site and stored properly? (rope retrieval kit, plywood coffer dams, proper harness, and lifelines)
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Grain Handling Area - Dump pit grates compliant?
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Grain Handling Area - Grain processing equipment magnets are properly maintained?
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Grain Handling Area - All chemicals are properly stored and labeled?
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Grain Handling Area - "No Smoking Within 50 ft." properly marked?
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Grain Handling Area - LOTO Energy isolation points properly marked?
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Grain Handling Area - Extension cords are OSHA compliant including GFCI where required?
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Grain Handling Area - Adequate security at facility? (Ladders, doors, electrical, overheads, etc.)
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Grain Handling Area - Loaders, skid steers, etc. compliant and in safe operation condition?
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Grain Handling Area - Additional Corrective Action?
Shop Areas
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Shop Area - Fire Extinguishers compliant?
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Shop Area - Egress routes kept clear of obstacles?
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Shop Area - Electrical Systems compliant?
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Shop Area - Machine Guarding compliant?
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Shop Area - Working areas free of clutter and rubbish?
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Shop Area - Walking working areas free of slip or trip hazards?
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Shop Area - Railings and hole guarding compliant?
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Shop Area - Ladders compliant?
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Shop Area - Oily rags and materials are placed in covered metal containers?
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Shop Area - Tools are kept picked up and put away when not in use?
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Shop Area - Tools and equipment are OSHA compliant?
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Shop Area - Extension cords are OSHA compliant including GFCI where required?
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Shop Area - All jacks and hoists are marked with lifting capacities?
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Shop Area - Proper PPE is available?
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Shop Area - Battery charging stations have flushing water near by?
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Shop Area - LOTO Energy isolation points properly marked?
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Shop Area - Chemicals properly stored and labeled?
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Shop Area - Flammables and aerosols stored away from spark and heat producing equipment?
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Shop Area - Fuels are stored in OSHA compliant containers?
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Shop Area - Flammables are not stored in access or egress routes?
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Shop Area - Oxygen cylinders are stored properly? (Greater than 20' from combustibles/flammables)
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Shop Area - Cylinders are capped and secured from falling over?
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Shop Area - Propane bottles are not stored inside? (Gas grills stored indoors must have grill bottles removed)
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Shop Area - Used oil is placed in covered containers that are marked "Used Oil"?
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Shop Area - Overhead storage areas are marked with max load ratings?
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Shop Area - Storage racks are secured and in good condition?
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Shop Area - All weed sprayers are emptied and rinsed before placing or storing inside shops?
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Shop Area - Proper facility markings and signs?
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Shop Area - Additional Corrective Actions required?
Warehouse Areas
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Warehouse Areas - Fire Extinguishers compliant?
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Warehouse Areas - Egress routes kept clear of obstacles?
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Warehouse Areas - Electrical Systems are compliant?
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Warehouse Areas - Machine Guarding Compliant?
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Warehouse Areas - Area organized and free of clutter and rubbish?
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Warehouse Areas - Area free of slip or trip hazards?
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Warehouse Areas - Railings and hole guarding compliant?
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Warehouse Areas - Ladders compliant?
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Warehouse Areas - Extension cords are OSHA compliant including GFCI where required?
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Warehouse Areas - Storage racks are secured and in good condition?
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Warehouse Areas - Storage racks and storage areas are not unsafely loaded or stacked?
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Warehouse Areas - Overhead storage areas are marked with max load ratings?
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Warehouse Areas - Chemical containers are free of leaks an stored in approved areas?
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Warehouse Areas - Compliant with Hazcom and DOT package marking requirements?
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Warehouse Areas - LOTO isolation points properly marked?
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Warehouse Areas - Proper facility markings and signs?
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Warehouse Areas - Adequate Security at facility? (Ladders, doors, chemicals)
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Warehouse Areas - Forklifts used and maintained in compliance with OSHA standards.
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Warehouse Areas - Additional Corrective Actions required?
Liquid Fertilizer & Chemical Areas
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Liquid Fertilizer & Chemical Areas - Fire Extinguishers compliant?
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Liquid Fertilizer & Chemical Areas - Egress routes kept clear of obstacles?
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Liquid Fertilizer & Chemical Areas - Electrical Systems compliant?
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Liquid Fertilizer & Chemical Areas - Machine Guarding compliant?
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Liquid Fertilizer & Chemical Areas - Area organized and free of clutter and rubbish?
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Liquid Fertilizer & Chemical Areas - Chemical containers are free of leaks and stored in approved areas?
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Liquid Fertilizer & Chemical Areas - LOTO Energy isolation points properly marked?
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Liquid Fertilizer & Chemical Areas - Proper markings ans signs (including "No Smoking")?
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Liquid Fertilizer & Chemical Areas - Bulk chemical tanks have SDS's readily available?
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Liquid Fertilizer & Chemical Areas - Infotrac signs posted?
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Liquid Fertilizer & Chemical Areas - Permit spaces marked?
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Liquid Fertilizer & Chemical Areas - Proper PPE available?
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Liquid Fertilizer & Chemical Areas - Eyewash shower station clear of obstacles and operational?
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Liquid Fertilizer & Chemical Areas - Adequate Security at facility? (ladders, doors, chemicals, etc.)
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Liquid Fertilizer & Chemical Areas - Forklifts used and maintained in compliance with OSHA standards?
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Liquid Fertilizer & Chemical Areas - Additional Corrective Actions Required?
Dry Fertilizer Storage
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Dry Fertilizer Storage - Fire Extinguishers compliant?
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Dry Fertilizer Storage - Egress routes kept clear of obstacles?
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Dry Fertilizer Storage - Electrical Systems compliant?
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Dry Fertilizer Storage - Machine Guarding compliant?
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Dry Fertilizer Storage - Area organized and free of clutter, rubbish and spilled fertilizers?
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Dry Fertilizer Storage - Area free of trip and slip hazards?
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Dry Fertilizer Storage - Railings and hole guarding compliant?
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Dry Fertilizer Storage - Ladders compliant?
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Dry Fertilizer Storage - Extension cords are OSHA compliant including GFCI where required?
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Dry Fertilizer Storage - Overhead storage areas are marked with max load ratings?
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Dry Fertilizer Storage - Chemical containers are free of leaks and stored in approved areas?
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Dry Fertilizer Storage - Proper PPE available?
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Dry Fertilizer Storage - LOTO Energy isolation points properly marked?
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Dry Fertilizer Storage - Permit required space marked?
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Dry Fertilizer Storage - Proper marking and signs (including "No Smoking")?
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Dry Fertilizer Storage - Infotrac signs posted?
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Dry Fertilizer Storage -Adequate security at facility? (ladders, doors, chemicals, etc.)
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Dry Fertilizer Storage - Additional correction actions required?
Anhydrous Ammonia Facilities
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Anhydrous Ammonia Facilities - Load out facility compliant?
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Anhydrous Ammonia Facilities - Emergency water on site?
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Anhydrous Ammonia Facilities - Proper PPE available?
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Anhydrous Ammonia Facilities - System free of leaks?
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Anhydrous Ammonia Facilities - Machine guarding compliant?
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Anhydrous Ammonia Facilities - Electrical Systems compliant?
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Anhydrous Ammonia Facilities - LOTO Energy isolation points properly marked?
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Anhydrous Ammonia Facilities - Proper security of plant?
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Anhydrous Ammonia Facilities - Adequate maintenance of plant and tanks? (paint, repair, etc.)
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Anhydrous Ammonia Facilities - Adequate markings and signs?
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Anhydrous Ammonia Facilities - Additional Correction Action required?
General Facility
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General Facility - First aid adequate? (kit may be shared among multiple work sites within a facility if located in close proximity)
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General Facility - Personal fall protection equipment properly stored and in safe condition?
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General Facility - Respiratory protection equipment properly stored and in safe condition?
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General Facility - Proper signage? (free of excessive fading and damage)
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General Facility - Organized and free of clutter and rubbish?
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General Facility - Area free of slip and trip hazards?
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General Facility - Working and walking areas safe? (impalement hazards, sharp edges, etc.)
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General Facility - Railing and hole guarding compliant?
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General Facility - Adequate lighting at facility?
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General Facility - Railroad sidings in safe condition?
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General Facility - Fall protection systems in safe condition? (Rail trolleys, cable systems, etc.)
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General Facility - Bulk propane storage compliant with NFPA standards?
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General Facility - Other Electrical?
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General Facility - Other Guarding?
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General Facility - Other Ladders?
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General Facility - Additional Corrective Action required?
Rolling Stock Equipment
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Rolling Stock Equipment - Tractors, skid steers, loaders, and accessories compliant?
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Rolling Stock Equipment - Portable augers and conveyors compliant?
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Rolling Stock Equipment - Yard trucks and trailers in safe condition?
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Rolling Stock Equipment - Commercial trucks and trailers maintained and inspected in compliance with DOT standards?
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Rolling Stock Equipment - Additional Corrective Action required?