Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
IM Office
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Lobby (5S, Lighting, etc)
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Hazard Class
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Safety Data Sheets (Located outside office)
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Hazard Class
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Comments
Restrooms
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5S
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Hazard Class
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Lighting
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Hazard Class
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Comments
First Aid
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AED System Check (Green button. Sign & Date.)
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Hazard Class
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AED Battery Expiration Date (Remove battery cover)
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Hazard Class
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AED Supply Contents (List in cabinet. Supplies in AED case.)
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Hazard Class
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Latex Gloves (2)
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Antiseptic Wipes (20)
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Triple Antibiotic Ointment (25)
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Finger Tip Bandage (40)
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Cold Compress (1)
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Ammonia Wipes (10)
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3"x3" Sterile Pads (25)
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2" x 3" non-adherent sterile pads (10)
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Band Aid (100)
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7/8" x 3" adhesive bandages (50)
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Bloodstopper Compress Dressing (1)
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1/2" x 5 yard adhesive tape (1)
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Antacid (100)
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Pain Relief (100)
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Eye Wash (4oz)
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Burn Spray (3oz)
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Cotton Tip Applicators (20)
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Scissors (1)
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Tweezers (1)
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Burn Aid Jel (1)
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Comments
Docks
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5S (Floor, Lights, etc)
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Hazard Class
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Dock Doors/Plates (Good Condition. Gates locked. Etc)
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Hazard Class
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Trailer Jacks (Proper position)
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Hazard Class
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Wheel Chocks ( TWO used per trailer)
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Hazard Class
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Comments
Material Staging
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5S (Floors, Material, etc)
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Hazard Class
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Lighting
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Hazard Class
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Comments
Tool Room
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5S (Material, Floors, Lighting, etc)
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Hazard Class
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Eye Wash (Sign & Date. Change every 4 months)
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Hazard Class
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Equipment/Tools
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Hazard Class
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Chemicals in Proper Containers/Cabinets
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Hazard Class
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Comments
Material
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5S (Floor, Lighting, etc)
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Hazard Class
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Stacking
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Hazard Class
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Comments
Press 1
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5S (Pits, Workstations, Floor, Lights, Etc)
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Hazard Class
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Comments
Press 2
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5S (Pits, Workstations, Floor, Lights, Etc)
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Hazard Class
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Comments
Press 3
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5S (Pits, Workstations, Floor, Lights, Etc)
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Hazard Class
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Comments
Press 4
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5S (Pits, Workstations, Floor, Lights, Etc)
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Hazard Class
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Comments
Press 5
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5S (Pits, Workstations, Floor, Lights, Etc)
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Hazard Class
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Comments
Used Oil Storage
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5S (Floor, Lighting, etc)
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Hazard Class
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Drums (Condition)
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Hazard Class
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Drums Labelled & Properly Closed
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Hazard Class
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Secondary Containment (Leaks/Spills evident. Clean)
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Hazard Class
Resin Storage
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Shelving Units
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Hazard Class
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Material Storage
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Hazard Class
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Comments
New Oil Storage/Pump System
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5S (Lighting, Floors, etc)
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Hazard Class
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Barriers in Place
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Hazard Class
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Oil Tote Condition
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Hazard Class
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Secondary Containment (Clean, Clear, No leaks)
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Hazard Class
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Pump System/Chemical Additives (No leaks)
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Hazard Class
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Comments
