ADI HUB Monthly Assessment

• Document No.

• Select Atlanta Chicago Louisville Return Center Albany (Northeast) Reno Toronto Virginia Vancouver

  • Atlanta
  • Chicago
  • Louisville
  • Return Center
  • Albany (Northeast)
  • Reno
  • Toronto
  • Virginia
  • Vancouver

• Audit Title

• Conducted on

  Date

• Prepared by

• Location
  Address

Fire Extinguishers and Exits

• Are fire extinguishers checked on a monthly basis?

  Safe

  At Risk

  N/A

• Are Fire Extinguishers marked and properly mounted?

  Safe

  At Risk

  N/A

• Are extinguishers checked annually by a qualified technician?

  Safe

  At Risk

  N/A

• Are paths to fire extinguishers clear of obstructions?

  Safe

  At Risk

  N/A

• Add any pictures if needed

  Media

Emergency Exits

• Are all exits marked properly and exit signs unobstructed?

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

• Are exit signs illuminated?

  Safe

  At Risk

  N/A

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

  Yes

  No

  N/A

• Add any pictures if needed

  Media

Warehouse Review (5-S and Chemical Storage)

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

  Safe

  At Risk

  N/A

• Are all cleaning chemicals labeled?

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

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

  Yes

  No

  N/A

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

• Add any pictures if needed

  Media

Warehouse Electrical and Stair

• Are all circuit breakers labeled?

  Safe

  At Risk

  N/A

• Do circuit breaker boxes have ARC Flash stickers affixed?

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

• Add any pictures if needed

  Media

Warehouse Racking / Storage

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

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

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

  Yes

  No

  N/A

• Add any pictures if needed

  Media

Environmental

• Is there a designated staging area for battery storage?

  Safe

  At Risk

  N/A

• Are terminals on recycled batteries taped down?

  Safe

  At Risk

  N/A

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

  Yes

  No

  N/A

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

  Safe

  At Risk

  N/A

• 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)

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

• Add any pictures if needed

  Media

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)

  Yes

  No

• Is the eyewash station clean?

  Safe

  At Risk

  N/A

• Is the eyewash station inspected on a monthly basis?

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 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)

  Safe

  At Risk

  N/A

• Add any pictures if needed

  Media

Office / Record Review

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

  Yes

  No

  N/A

• See reference

  

• Is the "SDS Available upon Request" sign posted and visible?

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

• Add any pictures if needed

  Media

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

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

  Safe

  At Risk

  N/A

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

  Yes

  No

  N/A

• Do the employees know how to get a SDS?

  Safe

  At Risk

  N/A

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

  Yes

  No

  N/A

• Add any pictures if needed

  Media

General HSE / Breakroom and Common Area

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

  Safe

  At Risk

  N/A

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

  Safe

  At Risk

  N/A

• Add media

  Media

General Electrical Safety

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

  Safe

  At Risk

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Did you validate there were no exposed wiring?

  Yes

  No

  N/A

• Add media

  Media

First Aid Cabinet

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Add media

  Media

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

  Media

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

  Media

• Add signature

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