CM Boiler/Maint./Dry house

• Conducted on

  Date

• Prepared by

Machinery and Equipment

• Drill, Grinder and Press guards in place and in good condition

  Yes

  No

• Machine guards in place and in good condition?

  Yes

  No

• Observed Ladders in Safe condition

  Yes

  No

Safety Equipment

• MSDS/SDS Manual in Boiler Control room

  Yes

  No

• Emergency Response Manual in Control Room

  Yes

  No

• Emergency Response Manual in Maintenance Ship

  Yes

  No

Eye Wash Stations

• Eye Wash Stations clean and operational

• Eyewash #7

  Yes

  No

• Eyewash #8

  Yes

  No

• Eyewash #10

  Yes

  No

First Aid Kits

• First Aid Kits present and stocked

• Boiler Room

  Yes

  No

• Last inspected

  Date

• Maintenance Shop

  Yes

  No

• Last inspected

  Date

Fire Extinguishers

• 26

• 27

• 11

• 12

AED

• 1. Open the AED lid
  2. Wait for the AED to indicate status: Observe the change of the status indicator from green to red.

• After approximately 5 seconds, verify that the status indicator returns to green

  Yes

  No

• Expiration date of electrodes

  Date

• Audible voice prompts

  Yes

  No

• 3. Close the lid and observe the change of the status indicator to red.

• After approximately 5 seconds verify that the indicator status returns to green.

  Yes

  No

Housekeeping / 5S

• All Materials Stored Neatly and Safely

  Yes

  No

• Furniture Safe and in good repair

  Yes

  No

Fire Doors

• Check that all fire doors are operative (open man doors 90 deg to wall and let go. The Door should close completely

• 1

• 2

• 15

• 16

• 17

• 22

• 23

• 25

• 26

• 27

• 33

• 34

• 38

• 39

• 40

• 41

• 43