American Fence & Security Company Inc.

• Document No.

• Conducted on

  Date

• Prepared by

• Location
  Address

RISK ASSESSMENT AREAS

EQUIPMENT/MACHINERY/POWERTOOL

• Are all guards on equipment/machinery/powertool working properly?

  Yes

  No

  N/A

• If your answer was no, then lock out equipment/machine/powertool until the guards are properly installed. Date corrected

  Date

• Are all equipment/machinery/powertool fluid levels properly maintained?

  Yes

  No

  N/A

• If necessary add the required fluid. Date corrected

  Date

• Equipment/machinery/powertool are in proper working condition (no leaking fluids)?

  Yes

  No

  N/A

• If your answer is no, have equipment/machinery/powertool repaired. Date corrected

  Date

WALKING AND WORKING SURFACES

• Are all materials properly stacked?

  Yes

  No

  N/A

• If your answer is no, organize and stack materials properly. Date corrected

  Date

• Are walkways and floors in good condition, clean, dry, and clear of obstructions?

  Yes

  No

  N/A

• If your answer is no, clean up and reorganize the area. Date corrected

  Date

PERSONAL PROTECTIVE EQUIPMENT

• Do have all of the required personal protective equipment to be issued to workers on hand and all workers have been trained in the use and maintenance of all personal protective equipment?

  Yes

  No

  N/A

• If your answer is no, provide all required training on personal protective equipment. Order the required personal protective equipment in sufficient supply to be on hand. Date corrected

  Date

ELECTRICAL WIRING & EQUIPMENT

• Are your electrical cords, receptacles, and plugs in proper working condtion?

  Yes

  No

  N/A

• I you answered no, repair or replace all worn, patched, or cut electrical cords. Replace all broken receptacle covers. Date corrected

  Date

• Electrical cords are disconnected from equipment daily?

  Yes

  No

  N/A

• I you answered no, then start disconnecting electrical cords from equipment daily. Date corrected

  Date

• Is all of your electrical equipment working properly?

  Yes

  No

  N/A

• I you answered no, repair or replace equipment. Date corrected

  Date

• Is all equipment grounded properly?

  Yes

  No

  N/A

• If you answered no, call an electrician and have the equipment repaired. Date corrected

  Date

• Do you have a clear access (36" wide) area to all electrical panel areas?

  Yes

  No

  N/A

• If you answered no, clear a 36" pathway to all electrical panels? Date corrected

  Date

• Are electrical panels in proper condition (no missing, or broken breakers)?

  Yes

  No

  N/A

• If you answered no, then call electrician to repair or replace breakers and/or blanks inserted into panels. Date corrected

  Date

FIRE EXTINGUISHER

• Have you inspected the fire extinguisher and initialed the fire extinguisher this month?

  Yes

  No

  N/A

• If you answered no, inspect all fire extinguishers and initial each one. Any fire extinguisher failing inspection is to be replaced. Date corrected

  Date

• Are all fire extinguishers properly mounted (not sitting on the floor or on top of something) and it's signage indicating location in place?

  Yes

  No

  N/A

• If you answered no, have the fire extinguisher mounted properly and missing signage indicating each extinguisher location replaced. Date corrected

  Date

WELDING, CUTTING, AND BRAZING

• Gas and Arc equipment is in properly working condition?

  Yes

  No

  N/A

• If you answered no, have the equipment repaired or replaced. Date corrected

  Date

• Fuel gas, Oxygen cylinders and gauges are in properly working condtion?

  Yes

  No

  N/A

• If you answered no, have the equipment repaired or replaced. Date corrected

  Date

• Ventilation for fumes is working properly?

  Yes

  No

  N/A

• If you answered no, have the equipment repaired or replaced. Date corrected

  Date

• Is customer observation of welding area obstructed?

  Yes

  No

  N/A

• If you answered no, install welding screens to obscure customer visibility of welding area. Date corrected

  Date

• Are your stored compressed gas and oxygen cylinders separated by at least 25'?

  Yes

  No

  N/A

• If you answered no, separate the compressed gas and oxygen cylinders by at least 25'. Date corrected

  Date

ILLUMINATION

• All lights at the facility are working properly?

  Yes

  No

  N/A

• If you answered no, have lights repaired or replaced. Date corrected

  Date

COMMENTS

• Comments or Concerns

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