Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Office Area(s)

Office Area(s)

  • Office Area - Clean Office, Restroom, Break Room, etc.

  • Office Area - Fire Extinguishers compliant?

  • Office Area - Egress routes kept clear of obstacles?

  • Office Area - Electrical Systems compliant?

  • Office Area - Walking working areas free of slip or trip hazards?

  • Office Area - Signage compliant?

  • Office Area - Contact signs and stickers up to date and compliant?

  • Office Area - Employee Labor Law poster and OSHA 300 posted?

  • Office Area - Chemicals properly marked and stored?

  • Office Area - Additional Corrective Action?

Grain Handling Areas

  • Grain Handling Area - Fire Extinguishers compliant?

  • Grain Handling Area - Egress routes kept clear of obstacles?

  • Grain Handling Area - Electrical Systems compliant?

  • Grain Handling Area - Machine Guarding compliant?

  • Grain Handling Area - Grain handling areas free of clutter, rubbish, and spilled grain?

  • Grain Handling Area - Walking working areas free of slip or trip hazards?

  • Grain Handling Area - Railings and hole guarding compliant?

  • Grain Handling Area - Ladders compliant?

  • Grain Handling Area - Permit spaces properly marked?

  • Grain Handling Area - Housekeeping performed adequately?

  • Grain Handling Area - Maintenance performed adequately?

  • Grain Handling Area - Dust collection system compliant?

  • Grain Handling Area - Emergency Rescue Equipment on site and stored properly? (rope retrieval kit, plywood coffer dams, proper harness, and lifelines)

  • Grain Handling Area - Dump pit grates compliant?

  • Grain Handling Area - Grain processing equipment magnets are properly maintained?

  • Grain Handling Area - All chemicals are properly stored and labeled?

  • Grain Handling Area - "No Smoking Within 50 ft." properly marked?

  • Grain Handling Area - LOTO Energy isolation points properly marked?

  • Grain Handling Area - Extension cords are OSHA compliant including GFCI where required?

  • Grain Handling Area - Adequate security at facility? (Ladders, doors, electrical, overheads, etc.)

  • Grain Handling Area - Loaders, skid steers, etc. compliant and in safe operation condition?

  • Grain Handling Area - Additional Corrective Action?

Shop Areas

  • Shop Area - Fire Extinguishers compliant?

  • Shop Area - Egress routes kept clear of obstacles?

  • Shop Area - Electrical Systems compliant?

  • Shop Area - Machine Guarding compliant?

  • Shop Area - Working areas free of clutter and rubbish?

  • Shop Area - Walking working areas free of slip or trip hazards?

  • Shop Area - Railings and hole guarding compliant?

  • Shop Area - Ladders compliant?

  • Shop Area - Oily rags and materials are placed in covered metal containers?

  • Shop Area - Tools are kept picked up and put away when not in use?

  • Shop Area - Tools and equipment are OSHA compliant?

  • Shop Area - Extension cords are OSHA compliant including GFCI where required?

  • Shop Area - All jacks and hoists are marked with lifting capacities?

  • Shop Area - Proper PPE is available?

  • Shop Area - Battery charging stations have flushing water near by?

  • Shop Area - LOTO Energy isolation points properly marked?

  • Shop Area - Chemicals properly stored and labeled?

  • Shop Area - Flammables and aerosols stored away from spark and heat producing equipment?

  • Shop Area - Fuels are stored in OSHA compliant containers?

  • Shop Area - Flammables are not stored in access or egress routes?

  • Shop Area - Oxygen cylinders are stored properly? (Greater than 20' from combustibles/flammables)

  • Shop Area - Cylinders are capped and secured from falling over?

  • Shop Area - Propane bottles are not stored inside? (Gas grills stored indoors must have grill bottles removed)

  • Shop Area - Used oil is placed in covered containers that are marked "Used Oil"?

  • Shop Area - Overhead storage areas are marked with max load ratings?

  • Shop Area - Storage racks are secured and in good condition?

  • Shop Area - All weed sprayers are emptied and rinsed before placing or storing inside shops?

  • Shop Area - Proper facility markings and signs?

  • Shop Area - Additional Corrective Actions required?

Warehouse Areas

  • Warehouse Areas - Fire Extinguishers compliant?

  • Warehouse Areas - Egress routes kept clear of obstacles?

  • Warehouse Areas - Electrical Systems are compliant?

  • Warehouse Areas - Machine Guarding Compliant?

  • Warehouse Areas - Area organized and free of clutter and rubbish?

  • Warehouse Areas - Area free of slip or trip hazards?

  • Warehouse Areas - Railings and hole guarding compliant?

  • Warehouse Areas - Ladders compliant?

  • Warehouse Areas - Extension cords are OSHA compliant including GFCI where required?

  • Warehouse Areas - Storage racks are secured and in good condition?

  • Warehouse Areas - Storage racks and storage areas are not unsafely loaded or stacked?

  • Warehouse Areas - Overhead storage areas are marked with max load ratings?

  • Warehouse Areas - Chemical containers are free of leaks an stored in approved areas?

  • Warehouse Areas - Compliant with Hazcom and DOT package marking requirements?

  • Warehouse Areas - LOTO isolation points properly marked?

  • Warehouse Areas - Proper facility markings and signs?

  • Warehouse Areas - Adequate Security at facility? (Ladders, doors, chemicals)

  • Warehouse Areas - Forklifts used and maintained in compliance with OSHA standards.

  • Warehouse Areas - Additional Corrective Actions required?

Liquid Fertilizer & Chemical Areas

  • Liquid Fertilizer & Chemical Areas - Fire Extinguishers compliant?

  • Liquid Fertilizer & Chemical Areas - Egress routes kept clear of obstacles?

  • Liquid Fertilizer & Chemical Areas - Electrical Systems compliant?

  • Liquid Fertilizer & Chemical Areas - Machine Guarding compliant?

  • Liquid Fertilizer & Chemical Areas - Area organized and free of clutter and rubbish?

  • Liquid Fertilizer & Chemical Areas - Chemical containers are free of leaks and stored in approved areas?

  • Liquid Fertilizer & Chemical Areas - LOTO Energy isolation points properly marked?

  • Liquid Fertilizer & Chemical Areas - Proper markings ans signs (including "No Smoking")?

  • Liquid Fertilizer & Chemical Areas - Bulk chemical tanks have SDS's readily available?

  • Liquid Fertilizer & Chemical Areas - Infotrac signs posted?

  • Liquid Fertilizer & Chemical Areas - Permit spaces marked?

  • Liquid Fertilizer & Chemical Areas - Proper PPE available?

  • Liquid Fertilizer & Chemical Areas - Eyewash shower station clear of obstacles and operational?

  • Liquid Fertilizer & Chemical Areas - Adequate Security at facility? (ladders, doors, chemicals, etc.)

  • Liquid Fertilizer & Chemical Areas - Forklifts used and maintained in compliance with OSHA standards?

  • Liquid Fertilizer & Chemical Areas - Additional Corrective Actions Required?

Dry Fertilizer Storage

  • Dry Fertilizer Storage - Fire Extinguishers compliant?

  • Dry Fertilizer Storage - Egress routes kept clear of obstacles?

  • Dry Fertilizer Storage - Electrical Systems compliant?

  • Dry Fertilizer Storage - Machine Guarding compliant?

  • Dry Fertilizer Storage - Area organized and free of clutter, rubbish and spilled fertilizers?

  • Dry Fertilizer Storage - Area free of trip and slip hazards?

  • Dry Fertilizer Storage - Railings and hole guarding compliant?

  • Dry Fertilizer Storage - Ladders compliant?

  • Dry Fertilizer Storage - Extension cords are OSHA compliant including GFCI where required?

  • Dry Fertilizer Storage - Overhead storage areas are marked with max load ratings?

  • Dry Fertilizer Storage - Chemical containers are free of leaks and stored in approved areas?

  • Dry Fertilizer Storage - Proper PPE available?

  • Dry Fertilizer Storage - LOTO Energy isolation points properly marked?

  • Dry Fertilizer Storage - Permit required space marked?

  • Dry Fertilizer Storage - Proper marking and signs (including "No Smoking")?

  • Dry Fertilizer Storage - Infotrac signs posted?

  • Dry Fertilizer Storage -Adequate security at facility? (ladders, doors, chemicals, etc.)

  • Dry Fertilizer Storage - Additional correction actions required?

Anhydrous Ammonia Facilities

  • Anhydrous Ammonia Facilities - Load out facility compliant?

  • Anhydrous Ammonia Facilities - Emergency water on site?

  • Anhydrous Ammonia Facilities - Proper PPE available?

  • Anhydrous Ammonia Facilities - System free of leaks?

  • Anhydrous Ammonia Facilities - Machine guarding compliant?

  • Anhydrous Ammonia Facilities - Electrical Systems compliant?

  • Anhydrous Ammonia Facilities - LOTO Energy isolation points properly marked?

  • Anhydrous Ammonia Facilities - Proper security of plant?

  • Anhydrous Ammonia Facilities - Adequate maintenance of plant and tanks? (paint, repair, etc.)

  • Anhydrous Ammonia Facilities - Adequate markings and signs?

  • Anhydrous Ammonia Facilities - Additional Correction Action required?

General Facility

  • General Facility - First aid adequate? (kit may be shared among multiple work sites within a facility if located in close proximity)

  • General Facility - Personal fall protection equipment properly stored and in safe condition?

  • General Facility - Respiratory protection equipment properly stored and in safe condition?

  • General Facility - Proper signage? (free of excessive fading and damage)

  • General Facility - Organized and free of clutter and rubbish?

  • General Facility - Area free of slip and trip hazards?

  • General Facility - Working and walking areas safe? (impalement hazards, sharp edges, etc.)

  • General Facility - Railing and hole guarding compliant?

  • General Facility - Adequate lighting at facility?

  • General Facility - Railroad sidings in safe condition?

  • General Facility - Fall protection systems in safe condition? (Rail trolleys, cable systems, etc.)

  • General Facility - Bulk propane storage compliant with NFPA standards?

  • General Facility - Other Electrical?

  • General Facility - Other Guarding?

  • General Facility - Other Ladders?

  • General Facility - Additional Corrective Action required?

Rolling Stock Equipment

  • Rolling Stock Equipment - Tractors, skid steers, loaders, and accessories compliant?

  • Rolling Stock Equipment - Portable augers and conveyors compliant?

  • Rolling Stock Equipment - Yard trucks and trailers in safe condition?

  • Rolling Stock Equipment - Commercial trucks and trailers maintained and inspected in compliance with DOT standards?

  • Rolling Stock Equipment - Additional Corrective Action required?

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