Page 2

Fire Prevention and Emergency Action (General)

  • Are all exits marked with an exit sign of the proper size and illuminated by a reliable light source (electric or fluorescent are acceptable)

  • Is service center equipped with emergency lighting, is it operable?

  • Are doors and stairs that could be mistaken for an exit appropriately marked? Ex. "Not an exit", "Basement", "Storeroom", etc?

  • Are all exits kept free of obstructions, not locked?

  • Are sufficient exits available?

  • Are fire extinguishers inspected monthly by an ACT employee and annually by an authorized company?

  • Does the inspection tag provide the name, phone number and certification number of the vendor?

  • Are workplace diagrams or maps posted showing escape routes, gathering area and written instructions?

  • Are emergency telephone numbers posted in conspicuous location? (Police, Fire, Medical, and Service Center Management after hours contact numbers)

  • Is an audible alarm system available? (Require if 11 or more individuals occupy the facility at one time)

  • Is the smoke free workplace policy enforced by management and rules observed by all employees?

  • The Eyewash Station is clean, readily accessible, and inspected weekly.

  • The Eyewash fluid is not expired and changed every 6 months.

  • The Eyewash station is not blocked.

Page 3

Health and sanitation (general)

  • Are eating facilities adequate and clean?

  • Are appliances such as microwave and refrigerator kept clean?

  • Are ample trash containers available and emptied frequently?

  • Are restrooms clean?

  • Is adequate privacy afforded the users? Locks on doors, partitions, locks on individual stalls?

  • Are restrooms equipped with lined trash containers and properly stocked? Toilet paper, hand towels, soap?

  • Are first aid supplies adequately stocked not expired , readily available and accessible.

  • Can emergency response respond within 5 minutes?

  • In general, is noise level ok?

Page 4

Electrical / Utilites room or area

  • Is the area clean and free from dirt, and combustibles or other cleaning supplies, etc. that could pose a fire threat?

  • Is the area well lighted?

  • Are permanent wiring panels and breakers securely mounted and free of defects?

  • Are outlet covers,switches and receptacles securely mounted and free of defects?

  • Are extension cords in use where permanent wiring is required?

  • Are breaker or fuse boxes equipped with a cover?

  • Are all breakers or fuses labeled for use or location?

  • Are all vacant spaces in breaker or fuse boxes filled with blanks?

  • Does area in front of breaker panel have a 36 inch clearance?

  • No apparent overloading of outlets?

  • Is heating, cooling or water heating equipment clean and properly operating?

Page 5


  • Is ample work space available?

  • Are all lead persons and supervisors wearing OSHA approved safety shoes and dressed in
    a fashion that is worthy of business activity.

  • Are all movements such as walking, climbing, use of stairs done in a safe manner?

  • Are office machines, vending machines and water machines grounded and in good repair?

  • Are work stations designed with employee safety and health in mind?

  • Is office equipment clean, used properly,and in good repair?

  • Are unattended desk and file drawers kept closed?

  • Is only one file drawers opened at a time?

  • Are floors and aisle free from trash and debris?

  • Are floors and carpets and ceiling tiles dry and in good condition?no tripping or falling hazard, no water stains on ceiling tiles?

  • Are stairways in good condition and stair railing secure?

  • Are there sufficient trash containers? Are they emptied frequently?

  • Are extension cords and wires free of kinks, splices, cuts and wear?

  • Is the office well lighted, all lights working properly

  • Are work areas kept clean and neat? free of wires or other tripping hazards?

  • Are elevated storage areas or balconies posted as to maximum floor load capacity?

  • Are elevated areas or balconies equipped with guardrails, railings, or other suitable type of fall protection?

Page 6

Service Center / Yard

  • Are only authorized drivers and vehicles on the yard?

  • Is a speed limit sign posted? (Maximum 10 mph)

  • Is there a fasten seat belt sign posted at the exit gate?

  • Is there a no trespassing-right to search sign and a Smoke Free Workplace sign posted?

  • Are drivers wearing seat belts?

  • Do drivers and hostlers obey speed limits and traffic pattern?

  • Are hostlers following company procedures? (Wearing Safety Vest, Lights On,Seatbelt On, Both Airlines and Power Line Attached)

  • Are hostlers inspected on a daily basis at the beginning of each shift?

  • Do drivers and hostlers use hand holds and foot holds properly when getting in and out out tractors, trailers and hostlers?

  • Do hostlers and drivers check to assure path is clear before backing and yielding right of way?

  • Are tractors, trailers and converter gears parked in an orderly manner?

  • Are yard traffic patterns clearly communicated to drivers and hostlers?

  • Is the service center yard and employee parking area free of trash and accumulation?

  • Are trash cans placed in convenient locations and emptied frequently?

  • Is the service center yard and employee parking area free of holes, breaks,
    protrusions or other hazards?

  • Does the building appear to be in good repair

  • Do all drains have adequate covers?

  • Are both the service center yard and employee parking area adequately lighted?

  • Are all lights secure and burning?

  • Do drain gutters channel water away from a walk-ways , steps etc?

Page 7


  • Is ample workspace available?

  • Are employees wearing proper footwear (ANSI approved safety shoes)

  • Are all movements such as walking, climbing, and use of stairs and ladders done in a safe manner?

  • Are safe work practices being observed?

  • Is freight handled in such a manner to prevent injury?

  • Is freight stacked properly in vehicles?

  • Are trailer interiors clean, free of hazards, damage, holes in floor, etc?

  • Is freight stacked properly on dock? Not likely to fall over and no overflow into aisles, not stacked more than 5 feet high at corners?

  • Is material handling equipment being used properly?

  • Is material handling equipment properly stored, in good repair and free of dirt and grease?

  • Are stairs, ladders, and ramps in good repair, secure, equipped with hand holds or railings and free of trash and obstructions?

  • Ae there sufficient trash containers and are they emptied frequently?

  • Is dock and dock apron free of trash and debris?

  • Is a dock plate available at each door? Is there an adequate supply of dock plate pullers?

  • Are floors clean, with no defects and free of spilled material?

  • Are dunnage and pallets stored neatly? No fire hazards?

  • Are overhead doors operable and secure?

  • Are all permanent isles clearly defined, marked, and free of freight and trash?

  • Are loading lights available at each door?

  • Are loading lights and wiring operable and free of defects?

  • Are conduit and outlet boxes that supply power to dock free of defects? (No exposed wires - no loose connections)

  • Are "Chock on the Dock" and "Driver Pull Away" procedures being followed?
    Are chocks in use on all vehicles at the dock? (Front Wheel Chocked)

  • Is overhead lighting adequate? Are all lights burning?

  • Are all anti- tilt stands, pins and pin keepers in use on 32 FT lift gates and other vehicles as needed?

Page 8


  • Are forklifts in overall good condition?

  • Are forklifts inspected on a daily basis before each shift or at the beginning or end or each shift for 24 hour terminal?

  • Are forklift inspections maintained on file for 30 days and then destroyed?

  • Are the certifications of repair being signed off?

  • Is each forklift equipped with:

  • An operating back up alarm?

  • An overhead guard (bolted down)?

  • Are seat belts operable and being used? (no torn belt webbing)

  • Are brakes, horn, mast, blades, tires and lights free of defects and in good operating condition?

  • Are all forklifts equipped with a specification plate indicating the weight capacity?

  • Are forklifts free of water, oil or other fluid leaks?

  • Are forklifts operated in a safe manner? ( No wheel spinning - operated at a reasonable speed - horns being used)

  • Are forklifts operated by only trained, tested and certified personnel?

  • Do forklift drivers use handholds and footholds properly when getting on and off forklifts?

  • Are forklifts TURNED OFF with brakes set, blades lowered flat to the floor, and controls in neutral when operator is away from the controls or lift is parked?

  • Is forklift refueling area in good order and free of slip trip hazards?

  • Are propane tanks stored in one designated area? Is the area protected from damage?

  • Is the storage area marked "no smoking" and does it bear the NFPA or other suitable sign identifying the hazard "Flammable Gas"?

  • Are personal protective equipment (PPE) requirements being followed when refueling forklifts?

  • Is the personal protective equipment (PPE) clean and serviceable?

  • Are safe work practices observed when refueling forklifts?

Page 9

Terminal Security

  • Guards alert, require identification, know procedure for fire and or other emergency?

  • Guard house well lit, proper lights?

  • Fences in good condition, no overgrown areas, free of shadows?

  • Is the electric fence working properly?

  • Is the electric fence notification list updated with the accurate management contact information?

  • Gates in good repair, unused gates locked?

  • Are the extra truck tires secured and kept locked in a tire stand if stored outside?

  • Is there a secure cage , trailer, or area for high value items? Are all loaded trailers locked, sealed and accounted for at the end of each shift?

  • Is overall terminal security adequate?

Page 10

Fueling area ( if none leave blank)

  • Are fuel pumps attend when in operation?
    Is someone in control of the nozzle at the point of fueling?

  • Is the fuel island kept free of trash and spills?

  • Have provisions been made to prevent fuel from getting into drains in the event of a spill? (Adequate supply of non combustible absorbent, or engineering controls?)

  • Are trash containers available and emptied frequently?

  • Is lighting adequate?

  • Are pumps protected from drainage?

  • In the event of an emergency, is a cut off switch available in a location away from the pumps and clearly marked?

  • Is a properly charged and inspected fire extinguisher available near the fuel pumps? (15-25 feet)

  • Is the fuel area clearly marked as a no smoking area?

  • Are tanks checked regularly to insure no leaks?

  • Are caution fuel storage and fueling instructions signs posted?

Page 11


  • Is equipment clean and overall in good repair? (tread depth, windshield, placards, paint, etc.)

  • Is the electronic VIR completed on a daily basis?

  • Does the annual inspection plate appear on all equipment and is it properly completed?

  • Does all power equipment have a current ERG?

  • Does all power equipment have a Blank Log Book?

  • Does all power equipment have both Omnitracs DOT Quick Reference Cards and a User Manual?

  • Does all power equipment have an current insurance card?

  • Does all power equipment have a current certificate of hazardous materials registration form?

  • Does all power equipment have spare fuses?

  • Are Emergency Triangles present and secure

Page 12

Hazardous Material Handling

  • Are all personnel that are involved with the transportation of hazardous materials trained in accordance with OSHA standards, dot regulations and company policy?

  • Do all service center personnel understand what hazmat commodities ACT does not transport?

  • Do the employees know where the ACT written Hazard Communication Standard Program is located?

  • Do employees know how to find an SDS sheets when on the company internal website - MyCooper?

  • Do supervisors understand not to respond to hazardous material emergencies without the guidance of risk management personnel or Premium environmental services?

  • Is a current emergency response guidebook on hand in the office?

  • Does the service center have an adequate supply of metal and plastic salvage drums and has access to them in a reasonable amount of time?

  • Are previous markings removed for the exteriors of the over pack drums?

  • Does the service center have a spill kit and is it labeled?

  • Does service center have a spill kit contain:

  • Liquid proof gloves?

  • Tight fitting eye protection?

  • Adequate supply of non combustible absorbent?

  • Is the HAZMAT ENFORCER program used for every hazardous material load? (Both inbound and outbound shifts)

  • Are placards applied and removed as required?

  • Are loading and storage restrictions observed?

  • Are all hazmat shipments secured with straps, load bars or blocking? (Dunnage is not proper securement)

  • Are hazardous materials loaded in such a manner as to protect them from damage by other freight or handling equipment?

  • Is a hazardous material storage area clearly designated on the freight dock.

  • Are delivery receipts properly tabbed with a red hazmat sticker per ACT requirements?

  • Is the hazardous materials area free of trash and freight?

  • Are outbound hazmat bill of ladings properly tabbed with a red hazmat sticker and attached to the company travel copy per ACT requirements?

  • Are original copies of the BOL attached to travel copies ?

  • Is the hazardous materials area inspected daily for leaking containers?

  • Are all hazardous materials over packs lids fully closed?

  • Are all hazardous materials over packs properly labeled with a placard to communicate the danger of materials inside?

  • Is there an ample supply of Hazardous materials labels(small diamond stickers) and placards and a number kit?

  • Do all hazardous materials over packs have a copy of the bill of lading attached to each over pack?

Page 13

Bulletin Boards

  • Are bulletin boards kept neat, clean and free of postings unrelated to Company Business?

  • Are the following required posters and notices displayed? (These are in addition to those already mentioned in other areas of this inspection)

  • Federal 5 in 1 poster?

  • Workers Compensation information including name of insurance carrier or license if state fund, how to report injuries and panel of physicians?

  • Any posters or notices required by local or state government?

Page 14

OSHA Requirements

  • Are OSHA record keeping requirements in order?

  • Current OSHA 300 log on file?

  • Previous 5 years OSHA 300 logs on file, complete and certified by manager?

  • Injuries/illness entries made on OSHA 300 log within 6 days?

  • All first reports of injury on file, kept separate from 300 log?

  • Is the previous year OSHA 300 log displayed at the appropriate time? (Between February 1 to April 30)

General Requirements

  • Is the terminal monthly self inspection report form being completed?

  • Are the Building and Roof in good repair,

  • Additional comments:

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