375 AMW Ground Safety Annual Assessment Checklist

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Commander Support

• Unit Safety representative appointed by commander?

  Yes

  No

  N/A

• AFI 91-202, para 1.5.20.1.

• Risk Management?

  Yes

  No

  N/A

• AFI 90-802

• Supervisor Safety Training.

  Yes

  No

  N/A

• AFI 91-202, para 2.3.2.

• ESOH Council Meeting Attendance

  Yes

  No

  N/A

• AFI 90-801, para 4.3.

USR Involvement

• USR trained?

  Yes

  No

  N/A

• AFI 91-202, para 2.2.

• Mishap Reporting

  Yes

  No

  N/A

• AFI 91-202, para 2.2.

• Spot inspections

  Yes

  No

  N/A

• AFI 91-202, para 8.5.6.

• USR Meeting Attendance

  Yes

  No

  N/A

• AFI 91-202, para 8.5.8.

• Quarterly Review with commander.

  Yes

  No

  N/A

• AFI 91-202, para 8.5.1.

• Monthly Safety Briefs?

  Yes

  No

  N/A

• AFI 91-202, para 8.5.5.

Supervisory Support

• JSTO

  Yes

  No

  N/A

• AFI 91-202, para 1.5.21.4 & Attachment 5

• Training Documentation

  Yes

  No

  N/A

• (AF Form 55) AFI 91-202, para 1.5.21.14 & A5.4.

• Spot Inspections

  Yes

  No

  N/A

• AFI 91-202' para 1.5.21.15.

• Hazard Reporting

  Yes

  No

  N/A

• AFI 91-202, para 4.3.

Programs

• Hazard Abatement Program

  Yes

  No

  N/A

• AFI 91-202, para 12.6.

• Hazard Communication

  Yes

  No

  N/A

• AFI 90-821, para 1.8.

• Confined Space

  Yes

  No

  N/A

• AFI 91-203 Chapter 23

• Lock-Out Tag-Out

  Yes

  No

  N/A

• AFI 91-203, Chapter 21

• Personal Fall Arrest

  Yes

  No

  N/A

• AFI 91-203, Chapter 13

• Personal Protective Equipment

  Yes

  No

  N/A

• AFI 91-203, Chapter 14

• Traffic Safety Program

  Yes

  No

  N/A

• AFI 91-207

• Motorcycle Safety Program

  Yes

  No

  N/A

• AFI 91-207

• Low Speed Vehicle Program

  Yes

  No

  N/A

• Federal Carrier Safety Administration, Sub B (S5)(b)

Optional Programs

• Pre Departure Breifings

  Yes

  No

  N/A

• AFI 91-202, para 1.5.21.12.

• High Risk Activities

  Yes

  No

  N/A

• AFI 91-202, para 1.5.21.9.

• Awards Program Submission

  Yes

  No

  N/A

• Wingman Checklist Brief

  Yes

  No

  N/A