Charlotte-Mecklenburg Risk Management

• Charlotte-Mecklenburg Risk Management Facility Safety Audit

• Audit Title

• Organization / Department Name / Site Name

• Location
  Address

Marshall & Swift Valuation

• Year Built

• Number of Employees / Occupants

• Number of Buildings

• Number of Floors or Stories

• Story Height in Feet

• Occupancy Type

• Facility Square Footage

• Passenger Elevators / How Many?

  Yes

  No

  N/A

• Freight Elevators / How Many?

  Yes

  No

  N/A

• Basement / Square Footage

  Yes

  No

  N/A

• Is Basement Finished?

  Yes

  No

  N/A

• Type and Location of HVAC System

• Construction Type

  Select ISO 1- Frame ISO 2- Joisted Masonary ISO 3- Pre-Engineered Metal ISO 4- Masonry Non-Combust. ISO 5- Modified Fire Resist. ISO 6- Fire Resistive

  • ISO 1- Frame
  • ISO 2- Joisted Masonary
  • ISO 3- Pre-Engineered Metal
  • ISO 4- Masonry Non-Combust.
  • ISO 5- Modified Fire Resist.
  • ISO 6- Fire Resistive

• Wall Construction

  Select Metal Concrete Block Tilt-up Pre-cast Concrete Wood/Frame Brick EFIS Unknown Other

  • Metal
  • Concrete Block
  • Tilt-up Pre-cast Concrete
  • Wood/Frame
  • Brick
  • EFIS
  • Unknown
  • Other

• Roof Construction

  Select Metal Asphalt Shingle Fiberglass Shingle Wood/Frame Gravel Rubber Unknown Other

  • Metal
  • Asphalt Shingle
  • Fiberglass Shingle
  • Wood/Frame
  • Gravel
  • Rubber
  • Unknown
  • Other

• Roof Support

  Select Unprotected Steel Column Steel Column Masonry Encapsulated Steel Column Sheetrock Encapsulated Masonary Wood/Frame Unknown Other

  • Unprotected Steel Column
  • Steel Column Masonry Encapsulated
  • Steel Column Sheetrock Encapsulated
  • Masonary
  • Wood/Frame
  • Unknown
  • Other

• Floor Construction

  Select Dirt Poured Concrete Wood/Frame Block/Brick Unknown Other

  • Dirt
  • Poured Concrete
  • Wood/Frame
  • Block/Brick
  • Unknown
  • Other

• Automatic Fire Alarm System?

  Yes

  No

  N/A

• Sprinkler System?

  Yes

  No

  N/A

• Audit completed on:

  Date

• Auditor

• Auditors Comments

• Auditors summary

• Disclaimer: While Charlotte-Mecklenburg Risk Management makes every attempt to observe and locate hazards at the time of this inspection we do not warrant or guarantee that all hazards were discovered or observed during this inspection. We recommend and it is required to conduct ongoing periodic safety inspections on an ongoing basis as new or previously uncovered hazards can develop at any time. Should you or your department seek further clarification or assistance please contact Risk Management.

Manager Safety Awareness

• Manager - Supervisor - Worker safety awareness and involvement.

• Overall management understanding of OSHA regulations and requirments.

  Yes

  No

  N/A

• Overall Readiness for an OSHA Inspectiion

  Yes

  No

  N/A

• Supervisors assist in worksite hazard analysis, ensure physical protections, reinforce training, enforce discipline, and can explain work procedures based on the training provided to them?

  Yes

  No

  N/A

• Managers verify employees are applying their safety training and following procedures?

  Yes

  No

  N/A

• Management follows the rules and usually addresses the safety behavior of others?

  Yes

  No

  N/A

• Employees feel they have a positive impact on identifying and resolving safety and health issues?

  Yes

  No

  N/A

• Visitors, contractors and vendors are provided safety rules and procedures while on site.

  Yes

  No

  N/A

• Overall Safety Awareness of the management and workers.

  Yes

  No

  N/A

• Overall Safety Culture in facility - Based on observations and worker feedback

  Yes

  No

  N/A

Other Hazards Observed (General Duty Safety Clause 5(a)(1))

• OSHA general duty clause hazards observed

• There were no OSHA general duty or other unclassified hazards observed during this inspection.

• General hazards observed that could cause injury

  Yes

  No

  N/A

• General hazards observed that could cause injury

  Yes

  No

  N/A

• General hazards observed that could cause injury

  Yes

  No

  N/A

• General hazards observed that could cause injury

  Yes

  No

  N/A

• General hazards observed that could cause injury

  Yes

  No

  N/A

Chemical - RTK and GHS compliance - MSDS 1910.1200

• Chemical Hazards Were Observed by the Auditor (You Must Correct Severe Issues immediately)

• There were no RTK or GHS compliance issues observed during this inspection.

• Are secondary bottles labeled to meet HMIS or GHS compliance? Do they contain HMIS information or pictograms to indicate hazards along with first aid and specific hazard warning instructions.

  Yes

  No

  N/A

• Is there an updated chemical inventory available with maximum quantity on hand and location?

  Yes

  No

  N/A

• Is there an SDS binder available where chemicals are used and has it been updated in the last 12 months?

  Yes

  No

  N/A

• Is there an employee training program for hazardous substances that includes an overview of the Right To Know program, chemical hazards, how to protect against chemical exposure, proper use of chemicals, and MSDS / SDS information?

  Yes

  No

  N/A

Chemical Handling and Storage 1910.120

• Chemical hazards observed

• There were no chemical handling and storage hazards observed during this inspection.

• Are open drums and containers stored on spill containment pallets or pans?

  Yes

  No

  N/A

• Are quantities of more than a quart of flammable liquid stored in an approved flammable cabinet?

  Yes

  No

  N/A

• Are metal flammable storage drums grounded properly to prevent sparks and fire?

  Yes

  No

  N/A

• Are approved secondary containers utilized, are they labeled properly and are they compatible with its contents?

  Yes

  No

  N/A

• Are any chemicals stored or being handled in an unsafe manner?

  Yes

  No

  N/A

• Are chemical piping systems clearly marked as to their content?

  Yes

  No

  N/A

• Have appropriate control procedures been instituted for hazardous materials including safe handling practices and the use of respirators, ventilation systems, and PPE?

  Yes

  No

  N/A

• Do you use general dilution or local exhaust ventilation systems to control dusts, vapors, gases, fumes, smoke, solvents, or mists that may be generated in your workplace?

  Yes

  No

  N/A

• Is operational ventilation equipment provided for removal of contaminants for production grinding, buffing, spray painting, and/or vapor degreasing?

  Yes

  No

  N/A

• Do employees complain about dizziness, headaches, nausea, irritation, or other factors of discomfort when they use solvents or other chemicals?

  Yes

  No

  N/A

• Is there a dermatitis problem? Do employees complain about dryness, irritation, or sensitization of the skin?

  Yes

  No

  N/A

Compressed Gasses 1910 Subpart M

• Do you have compressed gas cylinders stored or used onsite?

• There were no compressed gas hazards observed during this inspection.

• Are compressed gas cylinders capped with a metal protective cover when not in use?

  Yes

  No

  N/A

• Do empty cylinders have their valves closed? 1910.253(b)(2)(iii)

  Yes

  No

  N/A

• Are compressed gas cylinders stored to prevent tipping or falling?

  Yes

  No

  N/A

• Are fuel gas cylinders stored separately from O2 cylinders?

  Yes

  No

  N/A

Confined Space 1910.146

• Do you have confined spaces that have potentially hazardous conditions? Confined Space (Has limited or restricted means of entry or exit (Tanks, vessels, silos, storage bins, hoppers, vaults, pits, and space with limited means of entry)

• There were no confined space hazards observed during this inspection.

• Are only trained personnel permitted to enter confined spaces? Do they have the appropriate equipment to enter the space safely?

  Yes

  No

  N/A

• Do you have permit required or non permit required confined space posted properly?

  Yes

  No

  N/A

• Safe Entry procedures are established for permit required or non permit required confined space for employees and contractors?

  Yes

  No

  N/A

• Emergency and protective equipment and materials provided and available?

  Yes

  No

  N/A

• Is air sampling equipment provided and are the calibrations current and records retained?

  Yes

  No

  N/A

• Are there procedures to ensure that all physical hazards are locked out prior to entry?

  Yes

  No

  N/A

Electrical Safety 1910 Subpart S

• Electrical hazards observed

• There were no electrical hazards observed during this inspection.

• Do electrical panels and disconnects have 36" radial clearance for emergency access?

  Yes

  No

  N/A

• Is electrical equipment being used as listed, labeled, and designed?

  Yes

  No

  N/A

• Are there any electrical cords that are supplying equipment not considered temporary that should be hard wired?

  Yes

  No

  N/A

• Were there excessive extension cords, surge protectors or overloaded circuits observed?

  Yes

  No

  N/A

• Are all extension chords it good condition with no cuts, nicks, repairs, or missing grounding pins?

  Yes

  No

  N/A

• Are electrical panels, disconnects and breakers labeled as to what they control?

  Yes

  No

  N/A

• Observed electrical panels and disconnects or junction boxes with open slots, uncapped conduit holes, discontinued circuits or uncovered wiring.

  Yes

  No

  N/A

• Are there any missing panel covers, missing or damaged outlet covers, or others exposed live electrical parts?

  Yes

  No

  N/A

• Are electrical panels and disconnects labeled with amperage and voltage?

  Yes

  No

  N/A

• Are GFCI outlets or devices used near sinks or in wet or damp locations?

  Yes

  No

  N/A

• Are the facilities maintenance employees trained and using safe Arc Flash 70E and electrical safety procedures when working on HOT circuits?

  Yes

  No

  N/A

• Is there a Safe Electrical Work Practices policy in place outlining who is authorized to work on electrical equipment etc.?

  Yes

  No

  N/A

Emergency Equipment 1910.157 and 120

• Emergency equipment issues

• There were no emergency equipment issues observed during this inspection.

• Spill kits available where required, inspected and adequate for amount and type of chemicals on site?

  Yes

  No

  N/A

• Are eyewash stations, showers and fire blankets available, inspected and working properly?

  Yes

  No

  N/A

• Are first aid kits available, applicable for the facility, stocked and readily available?

  Yes

  No

  N/A

• Are eyewash stations, showers, and other emergency equipment properly labeled and clearly accessible?

  Yes

  No

  N/A

Emergency Preparedness 1910.38

• Emergency preparedness issues observed

• There were no emergency preparedness issues observed during this inspection.

• Evacuation plan and maps displayed and understood by all employees?

  Yes

  No

  N/A

• Do employees know where to go (assembly point) and do you have roll call procedures in place?

  Yes

  No

  N/A

• Do you conduct mock drills annually to prepare workers and staff for an emergency?

  Yes

  No

  N/A

• Are emergency numbers posted and up to date in a conspicuous location?

  Yes

  No

  N/A

• Does the emergency plan include weather emergencies or other All Hazards emergencies?

  Yes

  No

  N/A

Fire Prevention 29 CFR 1910.39

• Fire prevention hazards observed

• There were no fire prevention issues or hazards observed during this inspection.
  
  
  
  

• Oily rags and combustible refuse stored in covered metal containers?

  Yes

  No

  N/A

• Yes

  No

  N/A

• If welding, cutting or brazing is performed is there a Hot Work Permit a program?

  Yes

  No

  N/A

• Fire alarm system functioning correctly?

  Yes

  No

  N/A

• Are automatic sprinkler system water control valves, air and water pressure, and fire pump operation checked periodically as required?.

  Yes

  No

  N/A

• Is the proper clearance maintained between stored items and the ceiling ( 24 inches for non-sprinklered locations, 18 inches for sprinklered locations)

  Yes

  No

  N/A

• Have automated sprinkler systems and risers been certified within the last 5 years and are they clear of materials?

  Yes

  No

  N/A

• Are Fire Extinguishers inspected monthly, documented and clear of obstructions?

  Yes

  No

  N/A

• Are Fire hoses inspected annually and clear of obstructions?

  Yes

  No

  N/A

• Is paper, trash and flammable material stored away from potential fire or combustion hazards?

  Yes

  No

  N/A

Environmental Hazards

• Environmental issues were observed!

• There were no environmental hazards or issues observed during this inspection.

• Do you conduct weekly documented hazardous waste area inspections?

  Yes

  No

  N/A

• Is hazardous waste labeled legibly and properly with contents, accumulation start date and EPA I.D.?

  Yes

  No

  N/A

• Is hazardous waste routinely removed by qualified contractors for disposal and not allowed to accumulate?

  Yes

  No

  N/A

• Observed potential sewer or storm drain pollution.

  Yes

  No

  N/A

• Have employees that handle hazardous waste been trained on spill and leak procedures?

  Yes

  No

  N/A

• Are there any underground storage tanks and are these tanks permitted and monitored as required?

  Yes

  No

  N/A

• Are any above ground storage tanks properly installed and have appropriate spill containment and prevention systems in place?

  Yes

  No

  N/A

• Storm Water Pollution Prevention Plan (SWPPP) is in place if required.

  Yes

  No

  N/A

• Spill Prevention, Control, and Countermeasure Plan is in place if required.

  Yes

  No

  N/A

Exits 1910 Subpart E

• Means of egress deficiencies observed

• There were no means of egress or exit issues or hazards observed during this inspection.

• Are all exits and exit routes marked and visible?

  Yes

  No

  N/A

• Where exits are not visible are directional signs provided?

  Yes

  No

  N/A

• Emergency exit lighting and illuminated exits in place and operable?

  Yes

  No

  N/A

• Exits clear of obstructions?

  Yes

  No

  N/A

• Are all exits and exit routes of sufficient width at all points along the exit route ( minimum of 28 inches)?

  Yes

  No

  N/A

• Are doors on cold-storage rooms provided with inside release mechanisms that release the latches and open the doors?

  Yes

  No

  N/A

• Where exit doors open directly onto a street, alley, or other area where vehicles may be operated, are adequate barriers and warnings provided to prevent employees from stepping directly into traffic?

  Yes

  No

  N/A

• Are doors, passageways or stairways that are neither exits nor access to exits, but could be mistaken for exits, appropriately marked "NOT AN EXIT," "TO BASEMENT," "STOREROOM" etc.?

  Yes

  No

  N/A

• Are exit doors able to open from the direction of exit travel without the use of a key or special knowledge or effort?

  Yes

  No

  N/A

Machine Guarding 1910 Subpart O

• Machine Guarding Hazards Observed

• There were no machine guarding hazards observed during this inspection.

• Are all machines and guards inspected regularly and properly maintained?

  Yes

  No

  N/A

• Guards firmly secured and not easily removable?

  Yes

  No

  N/A

• Observed removed or damaged machine guards. SERIOUS HAZARDObserved removed or damaged machine guards. SERIOUS HAZARD

  Yes

  No

  N/A

• Guards prevent workers from reaching under, around or behind guarded area?

  Yes

  No

  N/A

• Foot trundle or foot pedal safety guards are in place?

  Yes

  No

  N/A

• Point-of-operation guards provided and in place?

  Yes

  No

  N/A

• Observed bypassed safety switches or interlocks. SERIOUS HAZARD<br>

  Yes

  No

  N/A

• Pinch points and inward running rollers are properly guarded?

  Yes

  No

  N/A

• Belts, chains, gears, sprockets, pulleys and flywheels guarded?

  Yes

  No

  N/A

• Are fan blades protected with a guard having openings no larger than 1/2 inch when operating within 7 feet of the floor?

  Yes

  No

  N/A

• Machine controls within easy reach of the operator?

  Yes

  No

  N/A

• Guards provided for any other hazardous moving part of the machine?

  Yes

  No

  N/A

Lockout Tagout (Control of Hazardous Energy) 29CFR 1910.147

• Control of hazardous energy (LOTO) issues observed

• There were no lock out tag out issues or hazard observed during this inspection.

• Have written Lockout/Tagout procedures been developed for all hazardous equipment?

  Yes

  No

  N/A

• Have the required periodic audits of energy control procedures been performed and documented? 1910.147(c)(6)(ii)

  Yes

  No

  N/A

• Do the energy control procedures account for all energy hazards, order of equipment shut down, and verification of lockout ( attempt to run prior to work)?

  Yes

  No

  N/A

• Is Lockout/Tagout equipment available? Are all lockouts documented?

  Yes

  No

  N/A

• If using a single user key procedure, does the employee control the key during work?

  Yes

  No

  N/A

• If using a Gang lock procedure, is the procedure adequate and are all employees trained on the procedure?

  Yes

  No

  N/A

• Have employees performing lockout tagout been effectively trained?

  Yes

  No

  N/A

Housekeeping 1910.22

• Housekeeping hazards observed

• There were no housekeeping issues or hazards observed during this inspection.

• Entry and walkways kept clear of materials and blockage?

  Yes

  No

  N/A

• Walkways adequately and clearly marked?

  Yes

  No

  N/A

• Floor surfaces even and uncluttered?

  Yes

  No

  N/A

• Are footpaths in good condition?

  Yes

  No

  N/A

• Are railings in good condition?

  Yes

  No

  N/A

• Are fall preventive measures in place and used where gaps occur in railings?

  Yes

  No

  N/A

• Stairs and risers kept clear?

  Yes

  No

  N/A

• Are liquid spills removed quickly?

  Yes

  No

  N/A

• Intersections kept clear of boxes, pallets, etc?

  Yes

  No

  N/A

Inspections and Procedures 5(a)(1) (GDC)

• Workplace inspection issues observed

• There were no workplace inspection issues observed during this inspection.

• Are weekly hazardous waste inspections performed if applicable?

  Yes

  No

  N/A

• Do you inspect eyewash stations, emergency lighting, fire extinguishers and any other emergency equipment regularly?

  Yes

  No

  N/A

• Are you conducting monthly period safety inspections to document a safe work environment?

  Yes

  No

  N/A

Machine Shop and Maintenance Areas 1910.215, Subpart P,Q,O

• Machine shop was inspected

• There were no machine shop related issues or hazards observed during this inspection.

• When welding is the proper ventilation in place, is there a shield to protect other workers and are employees trained on safe welding and hot work procedures?

  Yes

  No

  N/A

• Are maintenance records kept to show PM or other regular maintenance on equipment and to verify equipment in facility is kept in safe working condition?

  Yes

  No

  N/A

• Bench Grinders - Shields in place, tool rest adjusted within 1/16", grinder securely mounted, no non-ferrous material in wheel? 1910.215(b)(1)(iii)

  Yes

  No

  N/A

• Table Saws - Are table saw and portable saw blades properly guarded to prevent injury?

  Yes

  No

  N/A

• Are ladders over 6' and other equipment safely secured to prevent falling?

  Yes

  No

  N/A

• Are hand tools in safe working order? Are electrical cords in good condition?

  Yes

  No

  N/A

Noise Exposure 1910.95

• Noise from equipment or process was found to exceed safe Decibel levels of 85 DB

• There were no noise exposure hazards or issues observed during this inspection.

• Are noise levels in any areas at or above 90 decibels for an 8 hour period?

  Yes

  No

  N/A

• If yes have noise controls been evaluated and implemented such as engineering controls, work practices controls, and administrative controls?

  Yes

  No

  N/A

• If yes are employees required to wear hearing protection and is it well stocked and readily available?

  Yes

  No

  N/A

• Do you have a written Hearing Conservation Program?

  Yes

  No

  N/A

• Are employees trained about noise and it's effects on their hearing as well as how to properly use hearing protection?

  Yes

  No

  N/A

• Do you conduct annual audiometric testing for workers exposed to excessive noise?

  Yes

  No

  N/A

• Are areas posted where hearing protection is required?

  Yes

  No

  N/A

Personal Protective Equipment -PPE 1910.132

• PPE hazards

• There were no PPE hazards or issues observed during this inspection.

• Has a Job Hazard Analysis been performed on each job function to evaluate the need for and type of PPE required?

  Yes

  No

  N/A

• Personal protective equipment is well stocked and available for the hazards present at this facility?

  Yes

  No

  N/A

• Fall protection PPE is available where applicable and areas where required are posted to restrict access to trained personnel only?

  Yes

  No

  N/A

• Are respirators or dust masks being utilized properly where applicable?

  Yes

  No

  N/A

• Are respirators or dust masks required or voluntarily used by employees?

  Yes

  No

  N/A

• Do you have a written Respiratory Program if respirator use is required? Are all employees using respirators trained?

  Yes

  No

  N/A

• Have all workers using PPE been trained on the proper use, fit and limitations of the PPE?

  Yes

  No

  N/A

• Are engineering controls in place to protect workers before PPE is utilized?

  Yes

  No

  N/A

Employee Training 29CFR part 128

• Employee training issues observed

• There were no employee training issues observed during this inspection.

• Facility conducts comprehensive employee hazard training and ensures all participate; in addition, employees can demonstrate proficiency in, and support of areas covered by training?

  Yes

  No

  N/A

• Facility ensures workers receive documented safety training for the equipment they will be operating. <br>Workers are informed of the hazards of the equipment, PPE required, engineering controls and safe operating procedures utilizing operators manuals or safe work procedures.

  Yes

  No

  N/A

• Basic First Aid training

  Yes

  No

  N/A

• Blood Borne Pathogens - Does the employer have documentation of training, including the contents of the training sessions, names and qualifications of trainers, names and job titles of those trained? (Note: Documentation must be kept for three years.) 1910.1030(h)(2)(ii)

  Yes

  No

  N/A

• Confined Space - Does the employer have documentation of each employee’s name, the signatures or initials of trainers and the dates of the train- ing? 1910.146(g)(4)

  Yes

  No

  N/A

• Hazard Communication GHS - Does the employer maintain documentation of the employee name and contents of haz- ardous communication training? 1910.1200(h)(3)

  Yes

  No

  N/A

• HAZWOPER Level 1-5 training

  Yes

  No

  N/A

• Lockout Tagout - Does the employer have certification that training has been accomplished and kept up to date including each employees name and training dates? 1910. 147(c)(7)(iv)

  Yes

  No

  N/A

• New Employee Training: are all employees being trained properly before beginning work for specific hazards associated with their task and general hazards in the facility. Additionally are they trained where emergency equipment and supplies are located and what to do in an emergency or spill of a chemical?

  Yes

  No

  N/A

• Personal Protective Equipment - Does the employer have certification with employee’s name, date and subject for personal protective equipment training? 1910.132(f)(4)

  Yes

  No

  N/A

• Eye safety for hazards present

  Yes

  No

  N/A

• Emergency Preparedness

  Yes

  No

  N/A

• Respirator training, fit testing and medical evaluations are completed when required?

  Yes

  No

  N/A

• Slips Trips and Falls training

  Yes

  No

  N/A

• Safe lift or Industrial Ergonomics

  Yes

  No

  N/A

• Other site specific training deficiencies noted where applicable?

  Yes

  No

  N/A

Office Areas

• Office areas were inspected and hazards were found.

• There were no office area hazards observed during this inspection.

• Exit paths are free of boxes/materials at all times?

  Yes

  No

  N/A

• Aisles, walkways, and work areas are free of trip and fall hazards (i.e. torn carpets, turned up edges of door mats, boxes etc.)

  Yes

  No

  N/A

• Illuminated exit and emergency lighting working properly?

  Yes

  No

  N/A

• First aid kits and fire extinguishers available and inspected regularly?

  Yes

  No

  N/A

• 36” clearance is maintained in front of all electrical panels and fire extinguishers?

  Yes

  No

  N/A

• Electrical cords and plugs are in good condition: not frayed, taped, spliced, covered with carpet or the ground prong missing?

  Yes

  No

  N/A

• Work and storage areas are free of improper storage (e.g., heavy, high and/or unstable storage)

  Yes

  No

  N/A

• Shelf and wall units over 6' or by exit aisles are secured to prevent tip over?

  Yes

  No

  N/A

• Computer work stations and work areas are ergonomically correct and workers are working safely?

  Yes

  No

  N/A

• The use of space heaters is kept to a minimum and the area around them kept clear of combustible materials?

  Yes

  No

  N/A

Postings: State and Federal - Department of Labor and State required.

• State and federal required posting

• There were no issues with State and Federal postings observed during this inspection.

• State and federal posters are current and the information that is required to be filled out by the employer is up to date?

  Yes

  No

  N/A

Warning Signs and Labels 1910.16

• Warning signs, labels and postings

• Warning signs, stickers or labels were placed in areas or on equipment to notify or warn employees of specific hazards.

  Yes

  No

  N/A

• Are areas where PPE is critical and hazards are prevalent posted to remind workers to wear their assigned PPE?

  Yes

  No

  N/A

• There were no issues observed with warning signs and labels during this inspection.

Dock and Warehouse Safety 1910 Subpart N

• Dock and warehouse hazards observed

• There were no dock and warehouse hazards or issues observed during this inspection.

• Loading area is clean and uncluttered to prevent falling objects, slips, trips or fall hazards?

  Yes

  No

  N/A

• Are roll up doors functioning properly?

  Yes

  No

  N/A

• Are heavy or bulky objects stored on lower shelves?

  Yes

  No

  N/A

• Pallets must be in good condition. Empty pallets must be stored flat or in a contained area to prevent injury. No broken or protruding wood or nails. No pallets on edge. Avoid storing empty pallets in quantities or densities in excess of O.H. fire sprinkler combustible load ratings.

  Yes

  No

  N/A

• Are rack uprights and beams in good condition? Bent racks and beams must be repaired or replaced.

  Yes

  No

  N/A

• All rack uprights over 6' should be bolted down to prevent tipping or falling?

  Yes

  No

  N/A

• Guardrails and/or covers are provided to protect personnel from the hazards of open sides of stairs, platforms, floor openings, floor holes, mezzanines, equipment pits, and other possible fall hazards.

  Yes

  No

  N/A

• Aisles and forklift zones are indicated to protect pedestrians?

  Yes

  No

  N/A

• If propane or gasoline powered forklifts are used is the area monitored for CO and properly ventilated?

  Yes

  No

  N/A

• Fall hazards are protected with restraint and signage?

  Yes

  No

  N/A

• Wheel chock required and utilized when loading or unloading trailers with forklifts?

  Yes

  No

  N/A

• Are open docks with a fall hazard that exceeds 36" protected with a restraint and warning signage?

  Yes

  No

  N/A

Forklifts and Pallet Jacks 1910.178

• Forklift hazards observed

• There were no forklift and pallet jack hazards or issues observed during this inspection.

• Are the proper lifts being used for the location and intended use?

  Yes

  No

  N/A

• Do forklift and lift operators have current training certifications and are they trained on the specific type of equipment that they are using?

  Yes

  No

  N/A

• Are forklifts and material lifts being operated safely? I.e. Seat belts being worn.

  Yes

  No

  N/A

• Have electric pallet jack operators been trained and certified on their use?

  Yes

  No

  N/A

• If electric lifts are used are the charging areas clean and safe with access to an eye wash station?

  Yes

  No

  N/A

• Forklifts - Are daily or pre-shift industrial truck inspections being done and documented? 1910.178(g)(7)

  Yes

  No

  N/A

• Are forklifts in safe working condition? Tires good, horn works, backup alarm operational, no cracks in hoses, chains even and greased, etc.

  Yes

  No

  N/A

• Are current forklift safety rules posted in areas where forklifts are used?

  Yes

  No

  N/A

Written Plans and Procedures. Title 8 3203 and OSH act

• Written plans and procedures were checked.

• There were no issues with written plans and procedures observed during this inspection.

• Is your company's General Safety or IIPP written program up to date and being applied? Has it been reviewed and signed by an officer of the company in the last year?

  Yes

  No

  N/A

• Do you have required written plans such as a respiratory protection program , a chemical hygiene plan, a lockout tagout program or noise exposure program in place and being applied per the plan?

  Yes

  No

  N/A

• Do you have a written emergency preparedness program or fire safety program and is it complied with?

  Yes

  No

  N/A

• Do you have documented employee accountability program in place with progressive discipline for safety violations?

  Yes

  No

  N/A

• Do you have a Heat Illness Prevention Program that applies to all employees that may be at risk of heat illness and applies to all indoor and outdoor places of employment where environmental risk factors for heat illness are present.

  Yes

  No

  N/A

• Do you have a comprehensive HMBEP with chemical Qty on hand, hazard ratings, control and mitigation procedures.

  Yes

  No

  N/A

• Fire prevention plan

  Yes

  No

  N/A

• NFPA 654: Standard for the Prevention of Fire and Dust Explosions - is there a plan in place to reduce the threat of combustible dust?

  Yes

  No

  N/A

Walking Work Surfaces and stairs 1910.22

• Walking work surface hazards observed.

• There were no walking working surface hazards observed during this inspection.

• Catwalks, walkways and coverings must be free from hazardous openings, fall hazards or trip hazards

  Yes

  No

  N/A

• Aisles and passageways are kept clear of obstruction causing a hazard, sufficiently wide for equipment to operate and permanent Aisles are marked clearly to indicate the path.

  Yes

  No

  N/A

• Open pits, tanks, vats, ditches and vaults must be safely covered and or have protective guardrails to protect workers from fall hazards.

  Yes

  No

  N/A

• Load rating plates must be posted for mezzanine and storage areas

  Yes

  No

  N/A

• Stairs with 4 or more risers must have railings or hand rails. Stairs min width 22" , with slip resistant surface recommended

  Yes

  No

  N/A

Ladders, step stools and platforms. 1926.1053

• Ladders safety violations observed.

• There were no ladder, step stool, or platform hazards observed during this inspection.

• Are ladders are being used in the manner for which they were designed?

  Yes

  No

  N/A

• Ladders must support 4 Times the intended load.

  Yes

  No

  N/A

• Are the appropriate ladders being used for the work being performed? (Fiberglass ladders near electricity)

  Yes

  No

  N/A

• Ladders are secured when not in use

  Yes

  No

  N/A

• Ladders and step stools are used safely. not standing on top step, fully opened, on a flat safe surface with employees maintaining three points of contact. Ladders are set up properly using the 4:1 rule.

  Yes

  No

  N/A

• Step stools are designed with handles to support workers when reaching or stacking items.

  Yes

  No

  N/A

• Fixed ladders are in safe operating condition and do not put workers in an unsafe hazardous position.

  Yes

  No

  N/A

• Reviewed audit items with staff

• Reviewed with:

• Risk Management Representative Signature

  Sign

• Supervisor Or Manager Signature

  Sign

• Select date

  Date