ASAP M&W Monthly Physical Condition Checklist HSE Audit

• Document No.

• Inspector Name

• Facility

• Location within Facitlity

• Period

• Conducted on

  Date

• Inspector completes observations of the physical condition listed. For each physical condition that is inadequate or requires a corrective action a note should be made.

Required Postings

• OSHA Poster - Posted and visible

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• State specific WC poster - Posted and visible

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• PepsiCo Occ. Health and Safety Policy - Posted, visible, and signed by senior management

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Fire Suppression System

• Fire Extinguisher NOT blocked - 36 inch clearance

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Fire Extinguisher tagged and inspected monthly

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Fire equipment marked with signage/red paint

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Fire rinsers unobstructed

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Plastic and wood pallets stored properly

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Emergency Preparedness

• Emergency maps posted

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All shut off valves are clearly marked on equipment

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Windsock - Present, visible, and in good condition

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Exit doors marked and NOT block - 36" pathway

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Emergency lighting operational and positioned to eliminate walkway to exit

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Aisles/pathways marked and NOT blocked

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Hazard Communication

• All chemicals (Original and secondary containers) are labeled including: Name, hazard warning, name and address of manufacturer

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• 3E poster (MSDS Vendor) posted, phone stickers in place

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Spill containment in place and adequate

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All labels removed from EMPTY concentrate drums

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Compressed Gas

• Incompatible materials separated by 20' (Caustics from acids, flammables from oxidizers, Acetylene from Oxygen tanks)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All tanks are secured from falling by chains or strap

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All tanks are free from dents and corrosion

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All tanks are stored in designated areas

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All protective caps are in place

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Hot Works

• Proper equipment available for hot works (i.e.: curtains, fire extinguishers and PPE)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Flammable Cabinets

• All flammables are stored in fire rated cabinets

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Cabinet is grounded and doors close automatically

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Vents are closed it cabinet is not vented outside facility

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• No paper, cardboard, or combustible items are located within or on top of cabinet

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Eyewash/Shower Stations

• Present near chemical sites (i.e.: Battery recharging, fleet, chemical storage)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Must be plumbed (No temporary construction stations)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Located within 10 seconds of unimpeded travel distance from the hazard (Approximately 55 feet)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• NOT blocked - 30 inch clearance

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Condition checked monthly and inspection tag signed (Water flow, cleanliness, caps in place, etc.)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Confined Space

• Confined spaces are identified and labeled properly

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Lockout/Tagout

• Lockout procedures exist for all equipment observed

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All equipment currently being worked on is locked out and all authorized employees have their own red locks

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Electrical and Arc Flash

• Electrical panels and main shutoffs are labeled (Panel name, sticker and voltage)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• NOT blocked - 36 inch clearance around all panels

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• No exposed, empty, uncovered or broken panels (Knockouts and breakers)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All cords are free from slices or frays – no exposed wires

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Cords not pulling away from plug end, including power tools

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All grounding prongs are present

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Extension cords/surge protectors not linked together (Daisy-chained)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Arc flash stickers are present (Electrical panels, motor control centers and equipment control panels)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Proper PPE exist for performing Arc flash work

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Ladder Safety

• Ladders are in good repair, feet in place, all TYPE 1 (No wood, weight capacity must be listed)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Ladders are not used as permanent stairs

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Ladders are secured when used

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Ladders are stored safely when not in use (Ladder rack or chain system)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Aerial Lifts (Scissor Lift and Boom Lift)

• Pre-use/shift inspections are performed on lifts

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Pre-use inspections are performed on fall protection equipment

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Personal fall arrest system (Full harness and SRL/lanyard) is worn when working on aerial lift equipment

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Lanyard is attached to approved anchorage point within lift

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Sugar Tanker (Carbis) Platform

• Carbis platform is present (Contact HQ safety if platform is needed)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Platform is used when sugar is delivered

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Platform is maintained in good condition, free of debris

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Gaps are not present between cage and tanker or platform bridge and platform

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Rack Safety

• Racks are not dented, twisted or damaged, no deflection or sagging in the beam

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Racks are bolted to the floor and to other racks/walls to provide support with at least one bolt per leg or to manufacturers specifications

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All pallets on upper racks are stretch wrapped

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Mezzanine

• Mezzanines have posted load limit signs (Load rating without an engineering review is 100 pounds per square foot)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Mezzanines on top of 2 x 4 joist are not used for storage or pedestrian traffic

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• 4 inch toeboards are present

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Mid rails and top rails are present for mezzanines above 4 feet

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

PPE

• Proper PPE available where needed (Gloves, safety glasses, goggles, hearing protection)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Are employees using proper PPE

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• PPE is maintained in good/clean condition

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Signage posted where PPE is required

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Machine Guarding

• Fixed guards are secured in position and well maintained

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Pinch and nip points, shafts and pulleys are guard

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Pinch points on conveyor belts are guarded to prevent access

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Emergency stop buttons clearly labeled and situated close to operators

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Mechanical power transmission is guarded

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Interlock guards are in place and operating properly

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Shafts must be smooth and do not protrude more than 1/2 their diameter unless guarded capped

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Unguarded shafts do not have keyways, bolts, screws or fasteners protruding on them

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Shaft openings are guarded so chains/belts are not exposed

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Internal rotating shafts are guarded to prevent snagging items

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All accordion lift tables have skirts around the scissor

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Underside of conveyors are covered where in reach of persons

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Proper signage is present for low clearance

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Caution tape is not used as a means of guarding

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Machine Guarding - Portable Tools

• Air nozzles are limited to 30 PSI or below

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All fan guards are fastened with no gaps

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All grinders are adjusted properly with guards in place (tool rest 1/8" from wheel, tongue guard adjusted to 1/4")

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All grinders are securely mounted to table

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Proper PPE is available for grinders (i.e: face shield or safety goggles)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All drill presses are clean and guards and shields present

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Proper PPE is available for lathes and Mills (i.e.: Face shields or safety goggles)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All lathes and mills are guarded and in good condition

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Pedestal equipment like grinders, bandsaws, lathes and mills bolted to the floor

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Tablesaws are guarded and in good condition

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Blades are properly secured

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• All machine labels are in place

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Hoists, Cranes, and Slings

• Maximum load limits are posted on all hoists

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Hoist, cranes and slings are inspected annually (Inspection form located in the safety library under regulatory)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Equipment is in good condition (All chains, steel cables, straps, etc. are free of cracks, kinks or breaks and all clasps and springs must be intact and fully functioning)

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Dock Safety

• Dock locks are present for all docks and are in good condition (Functioning, lights working) with procedures posted

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Wheel chocks are present and in good repair in the absence of dock locks with procedures posted

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Overhead doors are shut or openings are chained off when trailer is out

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

Powered Industrial Truck Safety

• Forklifts and pallet jacks are operated by qualified employees who have their license on their person

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Preshift inspections are being performed

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Static straps/chains are in place and locator pins are in place on propane forklift

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Drivers do not operate the forklift while walking next to them

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Drivers are traveling at or below a brisk walk

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Drivers are sounding the horn when pedestrians are present

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Drivers slow down and sound horns at intersections and when changing direction

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Drivers look in direction of travel and travel in reverse with an obstructing load

  Safe

  At Risk

  N/A

• Action Plan

  No Action Plan

• Corrective Action

• Responsible

• Planned completion date

  Date

• Auditor Signature

  Sign