ATMI-Indy

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by: Vince Plank, CSP

• 6324 W. Stoner Drive Greenfield, IN 46140
  Address

Housekeeping/Aisles

• General orderliness and cleanliness

  Safe

  At Risk

  N/A

• Disposal of trash

  Safe

  At Risk

  N/A

• Material stored properly

  Safe

  At Risk

  N/A

• Trip hazards are removed from aisle(s)

  Safe

  At Risk

  N/A

• Slip hazards (mud, snow, ice, etc.) have been removed

  Safe

  At Risk

  N/A

Fire Protection/Prevention

• Flammable liquids stored properly

  Safe

  At Risk

  N/A

• Compressed gas cylinders stored properly

  Safe

  At Risk

  N/A

• Fire extinguisher locations are clearly marked

  Safe

  At Risk

  N/A

• Fire extinguishers are not obstructed

  Safe

  At Risk

  N/A

• Monthly fire extinguisher inspection is current

  Safe

  At Risk

  N/A

• Annual fire extinguisher certification is current

  Safe

  At Risk

  N/A

Hazard Communication

• Original and workplace chemicals containers are labeled properly

  Safe

  At Risk

  N/A

• Spill kit contents are sufficient/full

  Safe

  At Risk

  N/A

Electrical

• GFCI's are utilized in wet area(s)

  Safe

  At Risk

  N/A

• Extension cords are used temporarily (not permanently used)

  Safe

  At Risk

  N/A

• Insulation on flexible cords is intact

  Safe

  At Risk

  N/A

• Power tools are double insulated or grounded (ground pin present)

  Safe

  At Risk

  N/A

Machine Guarding

• Pedestal grinder guards compliant (work rest 1/8", tongue guard 1/4")

  Safe

  At Risk

  N/A

• Machinery is anchored to prevent vibratory walking

  Safe

  At Risk

  N/A

• Saw guards a compliant

  Safe

  At Risk

  N/A

• Compressed air hose(s) are secure

  Safe

  At Risk

  N/A

• Compressed air cleaning tools meet 30psi requirement

  Safe

  At Risk

  N/A

• Compressed air is not used to clean personnel

  Safe

  At Risk

  N/A

Personal Protective Equipment

• Appropriate safety glasses are worn (no street/Rx glasses)

  Safe

  At Risk

  N/A

• Hearing protection is worn (ear buds with music is not hearing protection)

  Safe

  At Risk

  N/A

• Safety boots are worn (no tennis shoes)

  Safe

  At Risk

  N/A

• Personnel are protected from flying hazards (welding, cutting)

  Safe

  At Risk

  N/A

• Personnel are protected from UV/IR hazards from cutting and welding

  Safe

  At Risk

  N/A

• Task specific PPE is worn (i.e. respiratory, etc.)

  Safe

  At Risk

  N/A

Equipment Inspections

• Frequent (Daily) Crane Inspection

  Safe

  At Risk

  N/A

• Periodic (Monthly) Crane Inspection

  Safe

  At Risk

  N/A

• Daily Forklift Inspection

  Safe

  At Risk

  N/A

Other Safety Observations

• Other safety observations / Comments

  Safe

  At Risk

  N/A

Score

• Score Outstanding (95-100%) Above Average (90-95%) Average (70-90%) Below Average (<70%)

Foreman Review

• Signature of Foreman:

  Sign