Title Page

  • Document No.

  • Audit Title

  • Conducted on

  • Prepared by

  • Location

Fire Extinguishers and Exits

Fire Extinguishers and Exits

  • Are fire extinguishers checked on a monthly basis?

  • Are Fire Extinguishers marked and properly mounted?

  • Are extinguishers checked annually by a qualified technician?

  • Are paths to fire extinguishers clear of obstructions?

  • Add any pictures if needed

Emergency Exits

Emergency Exits

  • Are all exits marked properly and exit signs unobstructed?

  • Is the path to the exit free of obstruction? (36" minimum)

  • Are exit signs illuminated?

  • If winter, and needed, does the site have a supply of ice melt or rock salt?

  • Add any pictures if needed

Warehouse Review

Warehouse Review (5-S and Chemical Storage)

  • Is paint usable, stored away from heat sources, organized and properly identified?

  • Are all cleaning chemicals labeled?

  • Confirm no flammable material, i.e. propane, sterno or charcoal lighter fluid found in branch?

  • Are designated aisles marked and no product stored in those aisles?

  • Overall cleanliness of the HUB (1= Unacceptable 5= Acceptable 10=World Class)

  • Add any pictures if needed

Warehouse Electrical

Warehouse Electrical and Stair

  • Are all circuit breakers labeled?

  • Do circuit breaker boxes have ARC Flash stickers affixed?

  • Is there at least 36 inches clearance in front of electrical panels?

  • Confirm no flammable material, i.e. propane, sterno or charcoal lighter fluid found in branch?

  • If the site is equipped with a rolling stair, is it in good condition?

  • Add any pictures if needed

Warehouse Racking / Storage

Warehouse Racking / Storage

  • If building is sprinklered, is storage at least 18 inches below sprinkler head height?

  • Are there dents in the supporting legs of the warehouse racking?

  • Is the load capacity 2500lbs posted on all pallet racking?

  • Are items above "D-Level"stretch wrapped for stability?

  • Add any pictures if needed

Environmental

Environmental

  • Is there a designated staging area for battery storage?

  • Are terminals on recycled batteries taped down?

  • Is the battery recycle storage area kept inside of the building at all times?

  • Are waste batteries on a pallet or in a container that will support the weight?

  • Is the container/skid labeled "Universal Waste Recycled Batteries"? And date marked when the first battery put in?<br>(Required by EPA to keep batteries no longer in accumulation for >1 year)

  • Is the shipping paperwork current? (Sites should be able to pull up prior shipments via the web or Bill of Lading)

  • Is there documentation of a Storm Water No Exposure certification or similar Storm water compliance document?

  • Add any pictures if needed

Powered Industrial Trucks (Forklifts and Powered Pallet Jacks)

Powered Industrial Truck (Excludes Pallet Jacks that are only powered for lifting)

  • Does the site have powered industrial trucks such as Forklifts and Pallet Jacks. (Pallet Jacks that are only powered for up and down movement do not apply)

  • Is the eyewash station clean?

  • Is the eyewash station inspected on a monthly basis?

  • If the site has a powered industrial truck, does the site have an eyewash station?

  • Is there a daily documented inspection program with appropriate corrective action follow-up?

  • Is there a current Manager's Evaluation Form for all employees operating powered industrial equipment?

  • Are annual certifications (driver tests) in place for all employees who operate a lift truck or other industrial vehicle?

  • Are truck wheels chocked, stops, or other means to prevent movement and is the driver out of the cab during truck loading / unloading operations? (any truck applies)

  • Add any pictures if needed

Office / Records Review

Office / Record Review

  • 5 HSE postings required as shown in reference. (Copies can be found in SSS-001)

  • See reference

    BSS 001.PNG
  • Is the "SDS Available upon Request" sign posted and visible?

  • Has site conducted an evacuation drill during the calendar year and can provide a critique form as evidence?

  • Does the site conduct weekly safety inspections and are copies retained for 1 year?

  • Does the site conduct documented monthly safety talks? Retain 1 yr

  • Verify video surveillance system: recording? Capacity? Cameras down? Blind spots?

  • Add any pictures if needed

Employee Interview Quetions

Questions anyone should know in the branch...ask the following:

  • When questioned, do employees know how to report an incident or share safety observations?

  • Do employees know where HSE issues are posted and/or tracked to closure?

  • Do the employees know how to get a SDS?

  • Do the employees know where to go during an evacuation and shelter-in-place?

  • Add any pictures if needed

Breakroom / Common Area Review

General HSE / Breakroom and Common Area

  • Refrigerator, microwave, toaster and other breakroom appliances appear to be cleaned on a regular basis?

  • Is there a separation between storage of food and chemicals?

  • Add media

General Electrical Safety

General Electrical Safety

  • Are GFCI used for electrical outlets at sinks? Check Restrooms, Breakroom, Hospitality, or any locations within 8ft of a water source.

  • Did you validate no extension cords are used for permanent wiring?

  • Are surge protectors used correctly? (No daisy chaining)

  • Did you validate there were no exposed wiring?

  • Add media

First Aid Cabinet

First Aid Cabinet

  • Is the first aid kit being checked for expired medications? Are all inside the kit within the expiration date?

  • Is a log being used for the first aid kit to determine if event/injury is work related? And is the log current

  • Add media

Miscellaneous Pictures (As needed)

  • Upload picture(s) for items found as best practices

  • Upload picture(s) for items found as UNSAFE conditions or Practices. Add actions as necessary.

  • Add signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.