Title Page
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Building/Facility Name
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Room number, adjacent to. etc
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Inspector's Name
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Inspection Date
Instructions: Complete this inspection and enter any findings that need to be addressed in WebTMA. If you fixed an item during the inspection, please note that you took corrective action. "Yes" items that cannot be corrected in the field require a WO request.
Electrical
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Is electrical equipment free from hazards, such as breakage, damage, frayed/damaged wiring, corrosion, chemical exposure or excessive heat, missing ground plugs?
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Are outlets in wet or potentially wet areas equipped with a ground-fault-circuit-interrupter (GFCI) (e.g., outdoors use or less than 6 ft from sink)?
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Is the equipment in the workspace unobstructed and ready for use (e.g., electrical panels, transformer, and/or eye wash/emergency shower)?
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Are power strips plugged directly into outlets, rather than "daisy chained" (plugged in a series)?
Emergency
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Are eye wash stations and/or safety showers available, maintained and inspected in areas where corrosive or hazardous materials are used?
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Are eye wash stations and/or safety showers available, maintained and inspected in areas where corrosive or hazardous materials are used?
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Are first aid kits in their designated location and fully supplied?
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Are first aid supplies up to date (no expired items)?
Environmental
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Are used oil drums being stored outside of secondary spill containment?
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Are universal wastes (e.g., spent fluorescent lamps or batteries) being stored in open containers, not labeled with the words “Universal Waste Lamps” or “Universal Waste Batteries”, and/or on-site for over a year?
Fire – Protection
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Are portable fire extinguishers in place, unobstructed, properly positioned, charged, and equipped with monthly and annual inspection tags?
General Safety
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Is the work area free from slip, trip or fall hazards (on grounds, walking-working surfaces gardens, etc.)?
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Are hazardous areas such as moving or rotating parts of machines/equipment protected by guards or covers?
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Is the work area free from low hanging branches or limbs encroaching on walkways?
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Is safety gear and PPE readily available, restocked, and properly stored?
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Are fertilizers, chemicals, pesticides, fuel, etc., being stored correctly?
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Are pallets of materials and other items store correctly on shelving or on other structures?
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Are chemicals being stored in correct locations?
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Are heavier items stored in the bottom file cabinet drawers to prevent the cabinet from tipping over?
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Are Safety Data Sheets (SDS) available for chemicals used in the work area?
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Are any available step stools or ladders free from damage?
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Are containers of hazardous chemicals labeled with the name of the chemical and hazard warnings (e.g. corrosive, flammable, etc.)?
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Are keys for vehicles secured (e.g., not left in ignition or where accessible)?
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Are materials, tools or items that can be improvised as weapons secured (in vehicles or attended to)?
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Have vehicle liftgates been checked for issues (e.g., fluid leaks; spring assemblies)?
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Is the workspace clear of signs of vandalism? E.g., broken glass or trash.
Remarks/Recommendations
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