Title Page
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Conducted on
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Dale Laney
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Location
* 1 Work site General 9/9
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1.2) Is a first aid kit available and adequately stocked?
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1.3) Is the Summary of Occupational Illnesses posted? example from 2/1-4/30?
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1.4) Are emergency evacuation traffic routes identified and free of hazards?
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1.5) Area all work ares clean and orderly?
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1.6) Are combustible scrap, debris and waste stored safely and remove from the work ares promptly?
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1.7) Is there a work site specific Emergency Action Plan?
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1.8) Is there a site specific Fire Prevention Plan?
* 2 Record Keeping 5/5
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2.1) Are OSHA 300/301 Logs Maintained as required for the current year and past 5 years?
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2.2) Are training records maintained in accordance with OSHA requirements?
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2.5) Are procedures in place to maintain records and logs?
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2.5 a) Safety inspections
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2.5 b) Safety meeting minutes
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2.5 c) Accident investigations
* 3 Medical Services/First-Aid 3/3
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3.1) Are emergency telephone numbers posted where they can be<br>readily found in case of emergency?
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3.2) Sharps containers are required if an employee uses needles for medical application. Are medically approved first-aid kit and sharps container adequately supplied.
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3.3) First aid kit in vehicle and serviceable?
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3.4) Fire extinguisher mounted in vehicle and serviceable?
* 4 Health & Safety Training 5/5
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4.1) Have all new employees received safety orientation training on day one or before their first job?
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4.2) Do employees participate in regularly scheduled safety training?
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4.3 a) Work area hazards.
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4.3 b) Emergency action and Fire prevention plan.
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4.3 c) Equipment operation.
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4.3 d) Personal protective equipment.
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4.3 e) Location and use of emergency equipment.
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4.3 f) Hazard communication/Safety Data Sheet (SDS)
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4.3 g) Hearing conservation
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4.4) Do all employees receive refresher training at least annually?
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4.5) Have employees received instruction on procedures to report unsafe conditions, defective equipment, and unsafe acts?
* 5 Fire Protection 3/3
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5.1) Is the local fire department acquainted with the facility and its specific hazards?
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5.2) Are fire extinguishers provided in adequate number, type, and are they in readily accessible locations, no greater than 75' ABC5 showroom and warehouse areas.
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5.3) Are employees periodically trained in use of fire suppression and protection procedures?
* 6 Exit Routes 2/2
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6.1) Are all exits routes marked and illuminated by reliable light sources?
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6.2) Are all doors, passageways or stairways that are not exits, or accessible to exits appropriately marked as "Not an Exit " or with an indication of its actual use?
* 7 Walkways 3/3
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7.1) Are aisles and passageways kept clear and clean?
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7.2) Are wet surfaces covered with non-slip materials?
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7.3) Toe boards installed around edges of permanent floor opening?
* 8 Stairs and Stairways 3/3
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8.1) Are standard stair rails or handrails on all stairways with four or more risers?
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8.2) Are stairways at lease 22 inches wide?
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8.3) Are stair landing platforms not less than 30 inches in the direction of travel?
* 9 Elevated Surfaces 2/2
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9.1) Are signs posted showing the surface load capacity?
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9.2) Is material on elevated surface piled, stacked or racked in a manner to prevent it from tipping, falling , collapsing, rolling, or spreading?
* 10 Personal Protective Equipment (PPE) 7/7
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10.1) Are protective goggles or face shields provided and worn where there is a danger of flying particles or corrosive materials?
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10.2) Are approved safety glasses worn at all times in areas where there is a risk of eye injuries?
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10.3) Are protective gloves, aprons, shields or other means provided where employees could be cut or where there is a reasonably anticipated exposure?
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10.4) Is appropriate foot protection provided as required?
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10.5) Is PPE maintained in a sanitary condition and ready for use?
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10.6) Are adequate work procedures and PPE provided and used when cleaning up spills toxic or hazardous materials or liquids?
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10.7) Are employees trained in use, limitations, maintenance, storage, and inspection requirments of PPE?
* 11 Ladders 11/11
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11.1) Are ladders inspected and maintained in good condition?
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11.2) Are non-slip feet provided on each ladder?
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11.3) Are ladder rungs and steps free from grease and oil?
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11.4) Are employees trained in the proper use and operation of ladders?
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11.5) Are ladders with broken, missing steps rungs, or cleats, broken side rails or faulty equipment removed from service?
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11.6) Are ladders not in use strapped down to prevent them from falling?
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11.7) Are metal ladders legibly marked with signs cautioning against using them around electrical power sources?
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11.8) Is use of ladders prohibited in areas where the ladder or the person using the ladder could come in contact with energized parts of equipment , fixtures or circuit conductors?
* 12 Compressors and Compressed Air 5/5
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12.1) Are all compressors equipped with pressure relief valves, and pressure gauges?
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12.2) Are compressors safety devices checked frequently?
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12.3) Before repairing work is done on the pressure system, is all pressure bled off and the system locked-out?
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12.4) Is it strictly prohibited to direct compressed air toward a person?
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12.5) Are all safety valves tested frequently and at regular intervals to determine whether they are in good operating condition?
* 13 Flammable/Combustible Materials 6/6
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13.1) Are flammable kept in closed containers (Flamable Storage Cabinets) when not in use and are they grounded?
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13.2) Are employees trained in the safe use of hazardous chemicals and materials?
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13.3) Are chemical containers labeled?
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13.4) Are flammable and toxic chemicals kept in closed containers when not in use?
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13.5) Are adequate means readily available for containing spills or overflows properly and safely?
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13.6) Are standard operating procedures established and being followed when cleaning up chemical spills?
* 14 Hazard Communication 14/14
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14.1) Is there a list of hazardous substance that are used in your workplace?
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14.2) Do you have a written hazardous communication program dealing with Safety Data Sheets (SDSs), labeling, employee training etc., that meets the OSHA standard?
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14.3) Are all containers for a hazard substance ( i.e.bottles and ect.) labeled with product identity and a hazard warning (communication of the specific health hazard and physical hazards)?
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14.4) Are SDSs readily avaliable for each hazardous substance used?
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14.5) Is there an employee training program for hazardous substances?
* 15 Electrical 9/9
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15.1) Are portable electrical tools and equipment grounding or have double insulation?
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15.2) Do all extension cords on site have a grounding conductor?
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15.3) Are multiple plug adapters prohibited?
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15.4) Are exposed wiring and cords with frayed or deteriorated insulation repaired/replaced properly?
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15.5) Are all flexible cords and cables free of splices and taps?
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15.6) Are cord, cable and raceway connections intact and secure?
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15.7) Are disconnecting switches and circuit breakers labeled to indicate their use or equipment served?
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15.8) Is sufficient access and working space provided and maintained around all electrical equipment to permit safe operations and maintenance?
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15.9) Are unused openings (including conduit knockouts) in electrical enclosures and fittings protected with appropraite covers, plugs, or plates.
* 16 Hand Tools and Equipment 8/8
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16.1) Are all tools and equipment maintained in good condition?
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16.2) Are broken or fractured handles on hammers, axes, and similar equipment replaced promptly?
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16.3) Are worn or bent wrenches replaced regularly?
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16.4) Are appropriate handles used on files and similar tools?
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16.5) Are employees made aware of the hazards caused by faulty or improperly used hand tools?
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16.6) Are safety glasses, face shields, etc. used while using hand tools or equipment that might produce flying materials or be subject to breakage?
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16.7) Are tool handles wedged tightly in the head of all tools?
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16.8) Are tools cutting edges kept sharp so the tool will move smoothly without binding or skipping?
* 17 Portable Power Tools and Equipment 5/5
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17.1) Are grinding, saws and similar equipment provided with appropriate safety guards and are they used as recommended by the manufacturer?
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17.2) Are effective guards in place over belts, pulleys, chains, and sprockets?
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17.3) Are portable fans provided with full guards or screens having openings of 1/2 inch or less?
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17.4) Are ground fault circuits interrupters provided on all temporary electrical 15 and 20 amp circuits, used during periods of construction?
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17.5) Are pneumatic and hydraulic hoses on power-operated tools checked regularly for deterioration or damage?
*18 Grinders and Diamond Wheel Equipment 11/11
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18.1) Are work rests installed and kept adjusted to within 1/8 inch of the wheel?
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18.3) Do side guards cover the spindle, nut, and flange and 75 percent of the wheel diameter?
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18.4) Are bench and pedestal grinders permanently mounted?
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18.5) Are goggles or face shields always worn when grinding?
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18.6) Is the maximum RPM rating on each abrasive wheel compatible with the RPM rating of the grinding motor?
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18.7) Are fixed or permanently mounted grinders connected to their electrical supply system with metallic conduit or other permanent wiring methods?
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18.8) Does each grinder have an individual on/off control switch?
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18.9) Is each electrically operated grinder effectively grounded?
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18.10) Before new diamond wheels are mounted, are they visually inspected and ring tested?
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18.11) Is cleanliness maintained around grinder?
*19 industrial Trucks 10/10
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19.1 Are employees properly trained in the use of the type of industrial<br>truck they operate?
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19.2 Are only trained personnel allowed to operate industrial trucks?
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19.3 Is substantial overhead protective equipment provided on high<br>lift rider equipment?
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19.4 Are the required lift truck operating rules posted and enforced?
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19.5 Is directional lighting provided on each industrial truck that<br>operates in an area with less than 2 foot candles per square foot of<br>general lighting?
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19.6 Does each industrial truck have a warning horn, whistle, gong, or<br>other device that can be clearly heard above normal noise in the areas<br>where it is operated?
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19.7 Are the brakes on each industrial truck capable of bringing the<br>vehicle to a complete and safe stop when fully loaded?
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19.8 Does the parking brake of the industrial truck prevent the vehicle<br>from moving when unattended?
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19.9 Are industrial trucks that operate where flammable gases,<br>vapors, combustible dust, or ignitable fibers may be present approved<br>for such locations?
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19.10 Are industrial trucks with internal combustion engines that are<br>operated in buildings or enclosed areas carefully checked to ensure<br>that such operations do not cause harmful concentrations of<br>dangerous gases or fumes?
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19.11 Are safe distances maintained from the edges of elevated<br>ramps and platforms?
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19.12 Are employees prohibited from standing or passing under<br>elevated portions of trucks, whether loaded or empty?
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19.13 Are unauthorized employees prohibited from riding on trucks?
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19.14 Are operators prohibited from driving up to anyone standing in<br>front of a fixed object?
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19.15 Are arms and legs kept inside the running lines of the truck?
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19.16 Are loads handled only within the rated capacity of the truck?
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19.17 Are industrial trucks inspected and maintained on an annual bases?
Areas of the Safety Program that need improvement.
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Area of the Safety Program that need improvement.
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Area of the Safety Program that need immediate attention.
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Notes;
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Notes;
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Notes;
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Notes;
Sign - Off
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Division Manager
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Install Manager
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Install Supervisor
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Other