Information
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Month/Year
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Prepared by
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Conducted on
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Hazard Classification:
Class (A) - Major - To be corrected Immediately
A condition or practice likely to cause permanent disability, loss of life or body and/or extensive loss of structure, equipment or material -
Class (B) - Serious - To be corrected within 24 hours
A condition or practice likely to cause injury or illness, resulting in temporary disability or property damage that is disruptive but not excessive -
Class (C) - Minor - To be placed on action plan
A condition or practice likely to cause minor, non-disabling injury or illness or non-disruptive property damage -
Fire Extinguisher Map
Office
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Floor
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Hazard Class
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Rugs (trip hazard)
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Hazard Class
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Furniture
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Hazard Class
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Kitchen
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Hazard Class
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AED System (green light)
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Hazard Class
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AED Battery Expiration Date (list date)
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Hazard Class
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AED Supply Contents (list inside)
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Hazard Class
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Conference Rooms (2)
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Hazard Class
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Training Room
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Hazard Class
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Washrooms
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Hazard Class
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Housekeeping (5S)
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Hazard Class
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Lighting
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Hazard Class
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20
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21
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22
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24
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25
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30
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27 (Training Room)
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28 (Training Room Stairs)
Office First Aid Kit
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Latex Gloves - 1
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Triangular Bandage - 1
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Antihistamine Tablets - 10
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Splinter Out/Tweezers - 1
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Scissors - 1
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Resuscitation Barrier - 1
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Gauze Roll 3in - 2
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Ice Pack - 2
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Flex Wrap Roll - 2
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Hydrocortisone Cream - 10
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Antacid - 25
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Adhesive Bandages - 50
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Antiseptic Wipes - 20
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Burn Treatment - 1
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Adhesive Tape - 1
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Eye Covering - 1
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Eye Wash - 1
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Triple Antibiotic Ointment - 10
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Gauze Pads 4x4 - 10 More pads (all sizes) in production first aid office
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Gauze Pads 3x3 - 10
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Tylenol - 50
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Advil/Ibuprofen - 50
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AED (check contents, exp date, working)
Office Janitor's Closet
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Housekeeping (5S)
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Hazard Class
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Lights
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Hazard Class
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MSDS Sheets
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Hazard Class
Quality Cage
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Housekeeping (5S)
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Hazard Class
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Lights
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Hazard Class
Warehouse/Materials
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Housekeeping (5S)
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Hazard Class
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Lights
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Hazard Class
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Aisles
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Hazard Class
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Racking
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Hazard Class
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Stacking
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Hazard Class
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7
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23
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6 (Inside Squash Court)
Production Lunchroom
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Housekeeping (5S)
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Hazard Class
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Lights
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Hazard Class
Maintenance PM Logs
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Emergency Lighting (verify completion by maintenance)
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Hazard Class
Comments
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Addition Comments
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Name & Initials