Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by Scott Murray

  • Location
  • Personnel Mike A Doug E James W Jody P Riley D Dakota B

1.0 Previous Inspection

  • 1.1 Was last Inspection Reviewed?

  • 1.2 Were issues from last Inspection resolved and corrected?

  • 1.3 Are all records in place and up to date (house keeping, daily leg inspection, maintenance, pits and CMVs)

2.0 Emergency Plan

  • 2.1 Are evacuation plans and facility emergency route map, displayed throughout the facility and understood by employees ?

  • 2.2 Are Emergency Drills completed at least once per year, and Documented in the Emergency Program.

  • 2.3 Has the Fire Department tour been completed for the current year?<br>

  • 2.4 Are fire extinguishers in place, clearly marked and free of obstruction to immediate access?

  • 2.5 Are extinguishers checked monthly by employees?

  • 2.6 Have Annual extinguisher inspections been done, by a qualified inspector?

  • 2.7 Are extinguisher location signage visible and 6' above floor level?

  • 2.8 Are fire extinguishers placed at between 3' and 5' above the floor level?

  • 2.9 Exits are clearly marked and free of obstructions?

  • 2.10 Exit doors are unlocked during business hours and easily open from inside?

  • 2.11 Does facility have a fire alarm system?

  • Fire Alarm System<br>Air Horn<br>Other

3.0 Housekeeping

Interior 3.1

3.1-1 Office

  • Work areas are clean and free of clutter?

  • Desks chairs and computers allow for correct ergonomics?

  • Heating and cooling adequate and comfortable for space?

3.1-2Driveway

  • Driveway is clean ( less than 1/8 inch of dust and debris) fertilizer ?

  • Driveway clear of debris and unnecessary materials (tools etc picked up and properly stored?

3.1-3 Main Plant

  • Ledges floors / working surfaces clean ( less than 1/8 " of dust or fertilizer?

  • Boot Pit clean ( dust less than 1/8" , no standing water) ? No unusual odors or conditions?

3.1-4 Bins

  • Working surfaces floors ledges clean and free of less than 1/8" dust?

  • Walkways and exit points are clear and free of clutter?

3.1-5 Distributor / Blenders

  • Working surfaces floors ledges clean and free of less than 1/8" dust ?

  • Walkways and exit points are clear and free of clutter?

4.0 Exterior

  • 4.1 Exterior of facility is clean and free of clutter,no piles etc?

  • 4.2 Exterior tanks have proper containment?

5.0 Electrical

  • 5.1 Electrical Room is clean free of clutter and has no materials within 36" of front of electrical panels?

  • 5.2 No extension cords used as permanent wiring?

  • 5.3 Extension cords are in good shape ( no damage or missing prongs) ?

6.0 Fall Protection

6.1 Ladders

  • 6.1-1 Are all ladders approved (type 1 or 2) No type 3?

  • 6.1-2 Ladders are inspected and are determined in good condition?

  • 6.1-3 Ladders are stored properly when not in use?

  • 6.1-4 Fixed Ladders have proper cages and runs do not exceed 20' with step off?<br>

6.2 Docks / Platforms / Walkways

  • 6.2-1 All docks, platforms and walkways over 4' from ground have proper guarding?

  • 6.2-2 All top rails are 42" high mid rails are 21" and a toe board on all that are over 6'?

6.3 Harness/Lanyards

  • 6.3-1 Where there are no cages on fixed ladders or runs exceed the 20' maximum, harnesses and cable grabs or crab claws are provided?

  • 6.3-2 All facilities that have rail car access have have fall protection systems in place, or have No climb policy in place?

7.0 Maintenance

  • 7.1 Facility has a LOTO Program in place for all employees who may work on any equipment that has a potential to cause harm from hazardous energy?

  • 7.2 Maintenance is scheduled and performed per a routine and documented when completed?

  • 7.3 Inspection of equipment is routine and completed on a scheduled basis?

  • 7.4 Leg inspections are completed daily and documented?

8.0 Vehicles and Power Industrial Trucks

  • 8.1 All vehicles and PITs are maintained in working condition?

  • 8.2 Prior to operation of any vehicle or PIT a proper inspection is completed and documented?

  • 8.3 All operators have proper license and or certification?

  • 8.4 All hazardous areas have been identified and proper signage is in place?

9.0 CMV (Commercial Motor Vehicles)

  • 9.1 All CMVs are inspected prior to use and documented on Pre Trip Inspection Sheets? (DVIR)

  • 9.2 Annual Inspections on all CMVs are documented and complete?

  • 9.3 All CMVs have proper signage and DOT # etc in place?

  • 9.4 Vehicle exterior and interior are clean and presentable?

10.0 Chemicals

  • 10.1 Hazardous Material Inventory completed and accessible to all employees?

  • 10.2 SDS ( Safety Data Sheets) are available for each substance on hand?

  • 10.3 Risk Assessment completed for hazardous substances?

  • 10.4 All containers are properly labeled?

11.0 Shop / Garage

  • 11.1 Is Shop clean and free of clutter?

  • 11.2 Does the Shop have flammable liquid or canisters that contain flammable material, and do they have a proper storage cabinet?

General Information & Comments

  • Manager/ Supervisor

  • Inspector/ Auditor

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