Block Small Group Inspection

• Audit Title

• Department / Area Inspected

• Conducted on

  Date
• Plant Location
  Address

• Personnel

• Prepared by

  Sign

Housekeeping

• Are all conveyors free from buildup and debris?

  Yes

  No

  N/A

• Are all aisles/pathways clear?

  Yes

  No

  N/A

• Equipment access clear of obstructions such as trash, tools, etc?

  Yes

  No

  N/A

• Work areas/catwalks/stairs clean?

  Yes

  No

  N/A

• Are trash bins not running over with trash?

  Yes

  No

  N/A

• Is the landscaping being done where it is required?

  Yes

  No

  N/A

• Are the break room appliances clean and working?

  Yes

  No

  N/A

• Are the breakroom and bathroom areas clean and orderly?

  Yes

  No

  N/A

• Are the office work areas clean and orderly?

  Yes

  No

  N/A

Additional items of Concern - Housekeeping

• Are there any other items that require attention?

  Yes

  No

  N/A

Electrical Items

• Are all pull cords working properly?

  Yes

  No

  N/A

• Are the floor and pathways clear?

  Yes

  No

  N/A

• Is all plant lighting working properly? Compressor room, parts room, MCC room, etc.

  Yes

  No

  N/A

• Wiring/extension cords in good shape?

  Yes

  No

  N/A

• Are bin indicator lights and horns working?

  Yes

  No

  N/A

• Are junction boxes and switches in good shape?

  Yes

  No

  N/A

• Power panels accessible and labeled ?

  Yes

  No

  N/A

• Conduit or connections are free from exposed wires or damage?

  Yes

  No

  N/A

• All cords have the required ground prong?

  Yes

  No

  N/A

• Are all outlets wired properly? (No loose ground, hot/neutral not reversed)

  Yes

  No

  N/A

• Are all exit signs and emergency lighting working properly?

  Yes

  No

  N/A

Additional items of Concern - Electrical

• Are there any other items that require attention?

  Yes

  No

  N/A

Block Machine and Equipment

• Are all area guards in place?

  Yes

  No

  N/A

• Are all flywheels, pulleys, chain / sprockets- including backside guarded?

  Yes

  No

  N/A

• Are all return idlers properly guarded?

  Yes

  No

  N/A

• All safety devices (E-stops, pull cords) fully operational when testing?

  Yes

  No

  N/A

• Are all tail pulleys and belt take-up areas cleaned under conveyors?

  Yes

  No

  N/A

• Are the Dust collectors functioning?

  Yes

  No

  N/A

• All start / stop devices functioning?

  Yes

  No

  N/A

Additional Items of Concern - Block Machine and Equipment

• Are there any other items that require attention?

  Yes

  No

  N/A

LOTOTO

• Are LOTOTO procedures posted as appropriate?

  Yes

  No

  N/A

• Is LOTOTO being applied for maintenance activities observed?

  Yes

  No

  N/A

• For group LOTOTO (more than one employee in the machine,) is each employee applying their own lock?

  Yes

  No

  N/A

• Do the locks / tags identify the employee(s) involved?

  Yes

  No

  N/A

Stairs / Steps / Ladders

• Stairs / access / rungs safe and secure?

  Yes

  No

  N/A

• Handrails in place where required?

  Yes

  No

  N/A

• Are all hand rails in good shape (secured and stable)?

  Yes

  No

  N/A

• Have all ladders been inspected and in safe usable condition?

  Yes

  No

  N/A

• Are ladders stored correctly?

  Yes

  No

  N/A

• Fall Protection adequate for elevated maintenance activities (if observed)?

  Yes

  No

  N/A

Exits

• Access to exits clear and unobstructed? (No exit doors blocked)

  Yes

  No

  N/A

• Exits adequately marked / lighted?

  Yes

  No

  N/A

• Emergency lights all working properly and tested?

  Yes

  No

  N/A

• Emergency evacuation plan posted?

  Yes

  No

  N/A

Material Storage

• Are aisles (means of egress) free of materials?

  Yes

  No

  N/A

• Is material stacked at an appropriate height?

  Yes

  No

  N/A

• Is stacked material level and stable?

  Yes

  No

  N/A

• Material stored for safe access / retrieval?

  Yes

  No

  N/A

Equipment / Tools / Welding / Cutting

• Are tools being properly stored?

  Yes

  No

  N/A

• Tools in safe condition?

  Yes

  No

  N/A

• Tools being used as intended?

  Yes

  No

  N/A

• Hazardous and/or flammable materials stored / used safely?

  Yes

  No

  N/A

• Gas / oxygen cylinders handled and/or stored safely? (Chained and separated)

  Yes

  No

  N/A

• Hot work permits used for non routine welding (ie. outside the maintenance shop, near flammables, in production near employees, etc)?

  Yes

  No

  N/A

Forklift / FEL Operations

• Is all equipment begin greased?

  Yes

  No

  N/A

• Daily safety checks completed with defects noted (forklifts)?

  Yes

  No

  N/A

• Daily safety checks completed with defects noted (front end loader)?

  Yes

  No

  N/A

• Brakes / handbrakes fully operational and safe?

  Yes

  No

  N/A

• Dock plates / chocks used when needed?

  Yes

  No

  N/A

• Horns fully operational and used?

  Yes

  No

  N/A

• Traveling at safe speeds / safely?

  Yes

  No

  N/A

• Unattended forklifts properly set (brake set, forks lowered, engine off)?

  Yes

  No

  N/A

• Loading of trailers/Dump trucks safely / properly?

  Yes

  No

  N/A

• Do all forklifts have working blue spotlights?

  Yes

  No

  N/A

• Data plates legible?

  Yes

  No

  N/A

• Mirrors cleaned and adjusted for blind corners?

  Yes

  No

  N/A

Material Handling

• Are tail pulleys and head pulleys being greased?

  Yes

  No

  N/A

• Are the wireless remotes functioning properly?

  Yes

  No

  N/A

• Are proper lifting practices being observed?

  Yes

  No

  N/A

• Hoists / Chains / hooks / harness in good condition and inspected regularly?

  Yes

  No

  N/A

Chemicals

• Are all chemicals properly labeled?

  Yes

  No

  N/A

• All drums / containers of chemicals properly labeled?

  Yes

  No

  N/A

• Good ventilation where chemicals are used / stored?

  Yes

  No

  N/A

• Are SDS sheets available and accessible to employees?

  Yes

  No

  N/A

• Are all eye wash stations working / accessible?

  Yes

  No

  N/A

Environment

• Are all environmental books being done?

  Yes

  No

  N/A

• NO SMOKING policy enforced?

  Yes

  No

  N/A

• There is no unusual amount of fugitive dust?

  Yes

  No

  N/A

• Local exhaust ventilation, (duct work) attached and functioning?

  Yes

  No

  N/A

• Is lighting adequate in the Plant?

  Yes

  No

  N/A

• Are runoff ponds clean ?

  Yes

  No

  N/A

• Are all environment permits in place?

  Yes

  No

  N/A

Inventory Files

• Is the material calculator being used?

  Yes

  No

  N/A

• Are the physical inventory count sheets being used (Bin sizes)?

  Yes

  No

  N/A

• Are the Loader Operator reclaimer material Sheet being used ?

  Yes

  No

  N/A

• Are the Admix count sheet being used?

  Yes

  No

  N/A

• Stamp clock is in a secure location and has the correct time?

  Yes

  No

  N/A

• Are the fuel count sheet being used?

  Yes

  No

  N/A

• Are Signature Stamp for Plant location is in place?

  Yes

  No

  N/A

• Are the inventory count sheets being sign off on?

  Yes

  No

  N/A

Attach any additional finds......

• Are there any items that require attention that has not been marked above?

  Yes

  No

  N/A

• Inspector Name

  Sign

• Inspector Name

  Sign

• Reviewer Signature

  Sign

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