Title Page

  • Document No.

  • Conducted on

  • Prepared by

  • Secteur Audité:


  • Demonstrate the cleanliness of the sector with photos


  • ACCESSIBILITY OF PASSAGES<br>- Free pedestrian crossings<br>- Free forklift passages<br>- No door or emergency exit blocked<br>- Uncluttered floor<br>- No mess on work surfaces

  • EXTENSIONS & ELECTRICAL OUTLETS<br>- No risk of tripping<br>- Well stored / rolled up<br>- Check condition: socket intact, no exposed wire<br>- Cleanliness / No water hazards nearby

  • AIR HOSES<br>- No risk of tripping<br>- Well stored / rolled up<br>- Check condition (includes small blue hoses and bigger red ones)<br>- Listen for detectable air leaks

  • LIGHTS<br>- Check condition (includes lights on ceiling, emergency exits & equipment lights)<br>- All functional / no burnt lights

  • WOODEN PALLETS<br>- 8 pallets high maximum in production<br>- No standing pallets<br>- Forklift drivers safely transport pallets<br>- Shipping: maximum storage height of 8 feet

  • WASH BAY DRAINS - In good condition, stable, does not create an obstacle that equipment can run up against


  • WARNING SIGNS<br>- Warnings in good condition on equipment (heat risk, gear, etc.)<br>- If spill on the ground: wet floor sign is installed<br>- If work in progress: perimeter is identified<br>- If equipment with safety mechanism off: safety permit on equipment with all fields filled<br>- Check that the SST communication board is up to date

  • SHADOW BOARDS & LOTO STATIONS<br>- Tools in good condition: no risk of injury <br>- Check devices in LOTO stations: present and in good condition


  • NOISES<br>- Employees wear their hearing protection properly<br>- Earmuffs worn if excessive noise in area<br>

  • SAFETY EQUIPMENT<br>- Safety equipment - Employees wear their basic PPE (helmet, net, earplugs, boots)<br>- Check PPE on the shadow boards (gloves, glasses): present and in good condition<br>- Mechanical workshop: Employees wear the PPE necessary for their task (glasses, apron, gloves, etc.)<br>- Check PPE in glue purge kits (gloves, visor, apron): present and in good condition<br>- Shipping: Check PPE at battery changing stations (gloves, visor, apron): present and in good condition<br>- Check if reflective vests are available at the entrance of the expedition

  • SAFETY HARNESSES<br>- Check condition: seams and hooks<br>- Harness available in the sector if work at height is needed<br>- If worker at height: is he/she wearing a harness?


  • EMERGENCY STOP & INTERLOCKING<br>- If in production: ask operators if any buttons are known to be defective. Test equipment if it does not affect the production<br>- If production is stopped: test the emergency buttons inspected<br>- Check condition: intact, no exposed wire, no protective guard<br>- Validate if emergency stops are accessible<br>- Validate if equipment can start with interlock disabled

  • LADDERS & STEP STOOLS<br>- Check cleanliness and stability of ladders and steps (steps have rubber tips on legs)<br>- Mobile ladder: check wheel lock mechanism

  • MACHINE GUARDS<br>- All in place on equipment<br>- No pinch points not covered by a guard<br>- Check condition: no sharp parts, no risk of broken plexiglass<br>- If welding in progress in the mechanical workshop, the barrier is placed to avoid visual contact

  • CHAIN HOISTS<br>- Verification date not expired (1 year)<br>- Hooks all intact

  • ELECTRICAL PANELS<br>- Closed and unobstructed doors at 3 feet<br>- If worker present: is he/she wearing the necessary PPE?<br>- Validate if identification readable to the panels<br>- No water leaks nearby


  • DEFIBRILLATOR<br>- Infirmary: Check cartridge expiration date

  • FIRE EXTINGUISHERS<br>- Validate if accessible<br>- Verification date not expired (1 year)<br>- Needle of the gauge in the green zone<br>- Fire extinguisher fixed to the wall<br>- Fire extinguisher identified on wall (location visible from afar)

  • GAS<br>- Canisters closed and secured with chain<br>- Laboratory: Gas inlet closed and secure<br>- Validate if gas detector is present and functional

  • CHEMICALS<br>- All identified<br>- Chemical room is locked if no employee is present<br>- MSDS are available<br>- Necessary PPE are available<br>

  • EYE-WASH STATIONS<br>- Check bottle expiration date<br>- Purge ducts from fountain stations, is the water clear?


  • FORKLIFTS & ELECTRIC PALLET TRUCKS<br>- Check condition of mirrors and lights <br>- Ask drivers if they have observations to add<br>- Check if daily checklist log is up to date<br>- Verify that a perimeter is identified when an electric pallet truck is parked in raised position

  • WHEEL LOCKING SYSTEM<br>- Shipping: Ask the shipping employee to confirm that system is functional


  • - No unsafe behavior observed<br>- No unsafe equipment detected<br>- Any point that does not fit into another category, put it here<br>- Ask employees if they have observations to add


  • Secteurs - Usine Hawkesbury - 790-INS-
    0020 http://dms.gbl/corpo_docs/dms_docs//200-PDF_Versions/790-INS-0020_fr.pdf

  • Plan d'évacuation - Usine Hawkesbury

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