AAA Cooper Transportation Annual Shop Compliance and Safety Inspection

Terminal Information

• Shop Manager

Inspection Information

• Conducted on

  Date

• Inspected by:

Equipment Information

• Instructions for form completion:
  
  Any entry marked as "NO" which requires corrective action , should be identified and a description of the necessary corrective action must be given in the "comments:" section at the end of each section.
  
  Email the inspection as an attachment to the appropriate Director and the Manager. Copy Steven Arohalt on the email. In same email, make specific mention of the items that need correcting and note in the email that you will follow up on these items in your next visit to the terminal. If an item was identified as a "NO in the previous inspection, a note should be made in the email. These items will require immediate action.
  
  Save this as a PDF attachment on the ACT Safety site on sharepoint. This will allow you to reference it before your next visit and folllow up on the items that needed correcting.

• Manager's Acknowledgement of Corrective Actions Needed: I have read and discussed the items marked as needing Corrective Action. I understand that these items require immediate attention. It is my responsibility to see that proper corrections are made so that we maintain compliance with all applicable regulations, both those Federal, State and Local agencies, as well as those set internally.

  Sign

Shop Fire Prevention and Emergency Action plan

Ingress/Egress

• Are all exits marked with an exit sign of the proper size and illuminated electrically or glows in the dark?

  Yes

  No

  N/A

• If shop is equipped with emergency lighting, is it operable?

  Yes

  No

  N/A

• Are doors and stairways that are not exits or do not lead to exits marked with "not an exit" or the name of the room such as "basement, closet, etc.)

  Yes

  No

  N/A

• Are all exits kept free from obstacles and Unlocked ?

  Yes

  No

  N/A

• Are sufficient exits available?

  Yes

  No

  N/A

Fire Safety and Fire Extinguishers

• Are fire extinguishers placed in a manner that no person is ever more than 50 ft from an extinguisher?

  Yes

  No

  N/A

• Are fire extinguishers inspected monthly by an ACT employee?

  Yes

  No

  N/A

• Are fire extinguishers tested annually by an authorized company?

  Yes

  No

  N/A

• Does the inspection tag provide the name, phone number, and certification number of the vendor and include a statement that the vendor meets the NFPA 10 requirements?

  Yes

  No

  N/A

• Have applicable shop employees been trained on the proper use of a fire extinguisher?

  Yes

  No

  N/A

• Has the smoke free workplace policy been implemented?

  Yes

  No

  N/A

Emergency Action PLan

• Is the emergency action plan for the shop current and available?

  Yes

  No

  N/A

• Are work place diagrams or maps posted showing the escape routes, emergency assembly area?

  Yes

  No

  N/A

• Are emergency telephone numbers for police, fire, medical etc. posted in a conspicuous location?

  Yes

  No

  N/A

• Is an audible alarm set up to alert shop personnel in case of an emergency?

  Yes

  No

  N/A

Health and Sanitation

Breakroom

• Are lunch/breakroom areas adequate and clean?

  Yes

  No

  N/A

• Are appliances such as microwave and refrigerator kept clean?

  Yes

  No

  N/A

• Are ample trash containers available and emptied frequently?

  Yes

  No

  N/A

Restrooms

• Are rest rooms clean?

  Yes

  No

  N/A

• Are restrooms properly stocked with trash cans equipped with liners, toilet paper hand towels and soap?

  Yes

  No

  N/A

• Is adequate privacy afforded the users? For example are locks on doors and individual stalls, are shower curtains availabe and in good condition etc.?

  Yes

  No

  N/A

First aid kits

• Are first aid kits adequately maintained and not expired?<br>

  Yes

  No

  N/A

• Is the monthly first aid checklist being done?

  Yes

  No

  N/A

Office

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

  Yes

  No

  N/A

• Are office machines free of dirt and grease?

  Yes

  No

  N/A

Shop

• Is ample work space available?

  Yes

  No

  N/A

• Are work areas kept clean and neat?

  Yes

  No

  N/A

• Are floors and aisles free from trash and debris?

  Yes

  No

  N/A

• Are floors dry and in good condition? Is Roof free of leaks or defects ?

  Yes

  No

  N/A

• Are stairways and stairs rails in good condition?

  Yes

  No

  N/A

Electrical/Utilities Room or Area Panels

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

  Yes

  No

  N/A

• Are breaker or fuse boxes equipped with a cover?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Does area in front of breaker panel have a 3 ft clearance?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• No apparent overloading of outlets? Are all outlets free of defects ?

  Yes

  No

  N/A

• Is area free of loose wires, cords or other tripping hazards?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

Shop Equipment, Work Practices and Appearance

• Are elevated storage areas or balconies posted with the maximum floor load capacity?

  Yes

  No

  N/A

• Are elevated areas or balconies equipped with guard rails, railing or other suitable fall protection?

  Yes

  No

  N/A

• Are chains for hoists or lifts inspected daily?

  Yes

  No

  N/A

General Shop Safety

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

  Yes

  No

  N/A

• Are overhead doors operable and secure?

  Yes

  No

  N/A

• Are light cords,hose reels and extension cords operable and free of defects?

  Yes

  No

  N/A

• Are Extension cords unplugged when not in use?

  Yes

  No

  N/A

• Are chocks in use on all vehicles?

  Yes

  No

  N/A

• Are all anti-tilt stands, pins and pin keepers in use on twin trailers as necessary?<br>

  Yes

  No

  N/A

• Are materials such as tires, tools, etc., stored in such a way that they are not likely to fall over or cause a tripping hazard? <br>

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Is overhead lighting adequate and operating properly, Bulbs Burning etc.?

  Yes

  No

  N/A

• Proper use of equipment guards as needed?

  Yes

  No

  N/A

• Air pressure reduction device used as required?

  Yes

  No

  N/A

• Safety procedures are followed when moving all vehicles?

  Yes

  No

  N/A

• Ventilating devices are used when engines running.

  Yes

  No

  N/A

• Is the general noise level o.k.?

  Yes

  No

  N/A

• Are the Shop Monthly Self Inspection Forms available for the last 12 months?

  Yes

  No

  N/A

• Are employees dressed properly with no loose clothing?

  Yes

  No

  N/A

• Are materials handled in such a manner to prevent injury, Are proper lifting techniques utilized?

  Yes

  No

  N/A

• Is material handling equipment being used properly?<br>

  Yes

  No

  N/A

• Are safe work practices being observed?<br><br>

  Yes

  No

  N/A

• Is personal protective equipment used as needed?

• Hearing protection?

  Yes

  No

  N/A

• Steel toed safety shoes?

  Yes

  No

  N/A

• Eye and/or face protection (safety glasses or goggles, welding hood, safety goggles, face shield)?<br>

  Yes

  No

  N/A

DRIVING

• Do shop personnel obey speed limits and traffic patterns while driving Vehicles (including forklifts) on the yard?<br>

  Yes

  No

  N/A

• Do shop employees use the three point hold when getting on and off tractors, trailers, hostlers and forklifts?<br>

  Yes

  No

  N/A

• Do shop drivers check to assure the path is clear before backing and do they yield the right of way?<br>

  Yes

  No

  N/A

• Do shop drivers observe the "no rider/passenger" rule?

  Yes

  No

  N/A

• Are safe work practices and personal protective equipment requirements <br>observed when refueling forklifts?<br>

  Yes

  No

  N/A

• Are shop forklifts inspected daily? (check records)

  Yes

  No

  N/A

FUELING AREA

• Are fuel nozzles attended when in use?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Is an adequate supply of non-combustible absorbents available on the fuel island? <br>

  Yes

  No

  N/A

• Are engineering controls in place that will prevent fuel from getting into <br>the environment in the event of a spill?<br>

  Yes

  No

  N/A

• Are trash containers available and emptied frequently?

  Yes

  No

  N/A

• Is lighting adequate on the fuel island?

  Yes

  No

  N/A

• Are pumps protected from damage by bollards or a raised concrete island?

  Yes

  No

  N/A

• In the event of an emergency, is a shutoff switch available in a location away from the pumps and clearly marked?<br>

  Yes

  No

  N/A

• Is a fire extinguisher available within 15’ to 25’ of the fuel pumps?

  Yes

  No

  N/A

• Are the fire extinguishers in good condition and properly charged?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are the Monthly Fueling Equipment Inspections being done?

  Yes

  No

  N/A

HAZARDOUS MATERIALS HANDLING

• Do employees know the AAA Cooper Transportation’s written Hazard Communication Plan is accessible through Sharepoint (mycooper.aaacooper.com)?<br>

  Yes

  No

  N/A

• Is the Hazard Communication Poster posted?

  Yes

  No

  N/A

• Do the employees know Safety Data Sheets are available during hours of operation through MSDS Online?<br>

  Yes

  No

  N/A

• Are Safety Data Sheets available for all products? Ask someone to show you the MSDS on MSDSOnline for a few shop products.<br>

  Yes

  No

  N/A

• Are the following supplies on hand?

• a) Gloves for handling corrosives and flammables

  Yes

  No

  N/A

• b) Proper eye protection

  Yes

  No

  N/A

• c) Adequate supply of noncombustible absorbent or appropriate substitute

  Yes

  No

  N/A

• Do supervisors understand they are not to respond to Hazardous Material spills without the guidance of Risk Management or Premium Environmental Services ?<br>

  Yes

  No

  N/A

• Are hazardous materials stored in undamaged containers?

  Yes

  No

  N/A

• Are all containers properly marked with the name of the product and its <br>hazard including secondary containers such as spray bottles?<br>

  Yes

  No

  N/A

• Have all shop employees received hazard communication training ?<br>

  Yes

  No

  N/A

• Are flame or spark producing operations isolated from flammable or combustible liquids and materials?<br>

  Yes

  No

  N/A

• Are containers grounded when transferring combustible/flammable liquids where appropriate?<br>

  Yes

  No

  N/A

• Are flammable products kept in a fire-proof cabinet and is cabinet<br>closed when not in use?<br>

  Yes

  No

  N/A

• If flammable cabinet doors are spring loaded, are they functioning properly?

  Yes

  No

  N/A

• Are incidental chemical spills cleaned up immediately according to the<br>Hazard Communication Program?<br>

  Yes

  No

  N/A

• Does the shop have a covered metal container used exclusively and clearly <br>labeled for shop rags?<br>

  Yes

  No

  N/A

• Are rags removed by the approved vendor in a timely manner?

  Yes

  No

  N/A

• Does the shop have a covered metal can for gasoline with a spring-lid and <br>mesh screen in the fill neck?<br>

  Yes

  No

  N/A

WELDING AND CUTTING

• Are welding and cutting operations performed safely and in the designated locations?<br>

  Yes

  No

  N/A

• The cart is not at risk of being struck by vehicles, equipment, or materials

  Yes

  No

  N/A

• Both cylinders have valves closed and protective caps or are connected <br> to a properly functioning regulator. <br>

  Yes

  No

  N/A

• Welding or cutting is not allowed to be done inside any enclosed areas such <br>as trailers with door closed, etc.?<br>

  Yes

  No

  N/A

• Appropriate PPE is being worn

  Yes

  No

  N/A

• Gauges are in good repair

  Yes

  No

  N/A

• Cylinders are secured to the cart by straps, chains, etc.

  Yes

  No

  N/A

• Backflash prevention valves are on the torch

  Yes

  No

  N/A

• There is only one acetylene and one oxygen cylinder on the cylinder cart

  Yes

  No

  N/A

• The cart is specifically designed to hold the cylinders upright

  Yes

  No

  N/A

• The cart is stored on a firm, level surface

  Yes

  No

  N/A

• Leads and hoses are in good repair

  Yes

  No

  N/A

MACHINES, EQUIPMENT, AND TOOLS:

• Electrical equipment, machines, and tools protected by ground or double insulation?<br>

  Yes

  No

  N/A

• Are moving parts within seven (7) feet of floor enclosed or provided with <br>safety guards?<br>

  Yes

  No

  N/A

• Are hoists, cranes and jacks marked for capacity or load rating, and operated <br>within specifications? <br>

  Yes

  No

  N/A

• Parts/Tool cleaning tank:

• a) Ventilation is good.

  Yes

  No

  N/A

• b) Tanks have automatic and manual closures.

  Yes

  No

  N/A

• c) Tanks are isolated from sparks and flames

  Yes

  No

  N/A

• d) Is the lid closed when tank is not in use?

  Yes

  No

  N/A

• Are safety goggles, Apron and neoprene gloves used while washing parts?

  Yes

  No

  N/A

• Have all employees received scissor lift training if applicable?

  Yes

  No

  N/A

• Does the air compressor have warning labels stating that it starts<br>Automatically?<br>

  Yes

  No

  N/A

• Are hand tools in good repair- no burrs, loose handles, etc.?

  Yes

  No

  N/A

• Do employees inspect equipment and tools for defects prior to use?

  Yes

  No

  N/A

• Are power tools in good condition?

  Yes

  No

  N/A

• Are ladders, scaffolds, and portable stairs in good repair, and properly used?

  Yes

  No

  N/A

• Are the ladders inspected for defects before each use?

  Yes

  No

  N/A

• Are the ladders rated to hold the capacity of the heaviest shop employee and<br>anything that might be carried up the ladder by him? <br>

  Yes

  No

  N/A

• Have all shop employees received Ladder Safety Training?

  Yes

  No

  N/A

• Is the grinder work rest free of excessive wear and chips?

  Yes

  No

  N/A

• Is the work rest no more than one 1/8” distance from the wheel?

  Yes

  No

  N/A

• Is the grinder wheel free of chips, cracks or foreign objects in wheel?

  Yes

  No

  N/A

• Is the grinder tongue guard in place and no more than ¼” from the wheel?

  Yes

  No

  N/A

• Is the grinder eye shield in place when used?

  Yes

  No

  N/A

Hydraulic Forklift Hoist

• If the shop is equipped with a hydraulic forklift hoist:

• a) Are the hydraulic cylinders secure, free of leaks and damage?

  Yes

  No

  N/A

• b) Are safety stands being used, secured, and operating properly?

  Yes

  No

  N/A

• c) Is the battery in the tray and secured to the frame?

  Yes

  No

  N/A

• d) Is the battery tray top secure and are the battery ends tight and secure?

  Yes

  No

  N/A

• e) is all wiring secure, in good operating condition, free from fraying?

  Yes

  No

  N/A

• f) Is the control handle in good operating condition?

  Yes

  No

  N/A

• g) Are wheel locks and safety stands secured and operating properly?

  Yes

  No

  N/A

• h) Are safety stands and wheel locks being used?

  Yes

  No

  N/A

• i) Are all anchor bolts secure and tight to the floor and frame of the lift?

  Yes

  No

  N/A

• j) Is the rack clean and free from grease and oil?

  Yes

  No

  N/A

BATTERIES

• Have applicable employees been trained on battery safety?

  Yes

  No

  N/A

• Are batteries stored properly inside? (on a rack provided by battery distributor or placed on a rubber mat or on a wooden table or shelf) <br>

  Yes

  No

  N/A

EYEWASH

• Eyewash station is available, operable, and in good repair?

  Yes

  No

  N/A

• Is the eyewash station being checked and flushed weekly?

  Yes

  No

  N/A

• The eyewash station fluid has not expired

  Yes

  No

  N/A

• The eyewash station is not blocked.

  Yes

  No

  N/A

• Is the eyewash station located a safe distance from electrical outlets or boxes?

  Yes

  No

  N/A

MAINTENANCE PITS

• Is a guard rail, or chain in place around any open pit, except inspection lane pit when in use?<br>

  Yes

  No

  N/A

• Are pits clean and free of obstructions which could create a trip or fall <br>hazard?<br>

  Yes

  No

  N/A

• Are pit stairs and stair railings free of defects?

  Yes

  No

  N/A

• Do pits have explosion proof lighting?

  Yes

  No

  N/A

• Is explosion proof lighting free of defects such as cracked lenses, damaged<br>housing, etc.?<br>

  Yes

  No

  N/A

LOCKOUT/TAGOUT

• Have all machines and equipment which will require Lockout\Tagout<br>been identified? Review Lockout\Tagout program.<br>

  Yes

  No

  N/A

• Have the Energy Control Procedures been updated at least annually to reflect <br>any machine or equipment changes due to purchases, retrofits, or upgrades?<br>

  Yes

  No

  N/A

• Does the shop have an adequate supply of locking devices with two keys?

  Yes

  No

  N/A

• Have all shop employees been trained and certified regarding the<br>Lockout\Tagout program?<br>

  Yes

  No

  N/A

• Is the Lockout\Tagout sequence being performed properly?

  Yes

  No

  N/A

• Do all supervisors understand their responsibility under the program, <br>including shift change and outside contractors performing maintenance <br>or service work?<br>

  Yes

  No

  N/A

• Is the Energy Control Procedure List located where the lockout devices <br>are stored?<br>

  Yes

  No

  N/A

• Has the Annual Inspection Report for Lockout/Tagout been completed?

  Yes

  No

  N/A

BULLETIN BOARDS

• Are bulletin boards kept neat, clean and free of postings unrelated to<br>company business? <br>

  Yes

  No

  N/A

• Are the following required posters and notices displayed?

• a) Federal Posters: (5 in 1)

  Yes

  No

  N/A

• b) Worker's compensation information, including name of insurance carrier <br> or license if state fund, how to report injuries and panel of physicians? <br> (differs from state)<br>

  Yes

  No

  N/A

• Are safety posters, safety notices, and loss prevention posters displayed?

• a) ATA Ladder poster

  Yes

  No

  N/A

• b) Eye Protection Poster

  Yes

  No

  N/A

• c) Hearing Protection Poster

  Yes

  No

  N/A

• Are appropriate posters or notices required by state or local governments?<br>posted? Local manager must call area Department of Labor to determine <br>poster needs.<br>

  Yes

  No

  N/A

ENVIRONMENTAL

• If the terminal is covered under a stormwater permit, are materials <br>stored outside (such as scrap metal, brake shoes, batteries, etc.) under cover? If no, the items must be covered or stored in such a way that they do not come in contact with stormwater. <br>

  Yes

  No

  N/A

• Are hazardous materials disposed of through the Dothan HDRM dept.?

  Yes

  No

  N/A

• Are all unusable chemicals, contaminated oil dry, etc. scheduled for <br>proper disposal or are they going through the OSD disposal process?<br>

  Yes

  No

  N/A

• Are all recyclable materials (scrap steel, shop rags, used oil, etc.) being <br>picked up on a regular basis by the recycling company?<br>

  Yes

  No

  N/A

• Additional Comments:

  Yes

  No

  N/A