Comprehensive Hazard Assessment Checklist

• Member / Site

• Location
  Address

• Conducted on

  Date

• Prepared by

  Select

GENERAL WORK ENVIRONMENT

• Are all worksites clean and orderly?

  Yes

  No

  N/A

• Are work surfaces kept dry or appropriate means taken to assure the surfaces are slip-resistant?

  Yes

  No

  N/A

• Are all spilled materials or liquids cleaned up immediately?

  Yes

  No

  N/A

• Are combustible scrap, debris, and waste stored safely and removed from the worksite promptly?

  Yes

  No

  N/A

• Are covered metal waste cans used for oily and paint-soaked waste?

  Yes

  No

  N/A

• Are all toilets and washing facilities clean and sanitary?

  Yes

  No

  N/A

• Are all work areas adequately illuminated?

  Yes

  No

  N/A

• Are pits and floor openings covered or otherwise guarded?

  Yes

  No

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Are protective goggles or face shields provided and worn where there is any danger of flying particles or corrosive materials?

  Yes

  No

  N/A

• Are approved safety glasses required to be worn at all times in areas where there is a risk of eye injuries such as punctures, abrasions, contusions or burns?

  Yes

  No

  N/A

• Are employees who need corrective lenses (glasses or contacts lenses) in working environments with harmful exposures, required to wear only approved safety glasses, protective goggles, or use other medically approved precautionary procedures?

  Yes

  No

  N/A

• Are protective gloves, aprons, shields, or other means provided against cuts, corrosive liquids, and chemicals?

  Yes

  No

  N/A

• Are hard hats provided and worn where danger of falling objects exists?

  Yes

  No

  N/A

• Are hard hats inspected periodically for damage to the shell and suspension system?

  Yes

  No

  N/A

• Is appropriate foot protection required where there is the risk of foot injuries from hot, corrosive, poisonous substances, falling objects, crushing or penetrating actions?

  Yes

  No

  N/A

• Are approved respirators provided for regular or emergency use where needed?

  Yes

  No

  N/A

• Is all protective equipment maintained in a sanitary condition and ready for use?

  Yes

  No

  N/A

• Where special equipment is needed for electrical workers, is it available?

  Yes

  No

  N/A

• When lunches are eaten on the premises, are they eaten in areas where there is no exposure to toxic materials or other health hazards?

  Yes

  No

  N/A

• Is protection against the effects of occupational noise exposure provided when sound levels exceed those of the noise standard?

  Yes

  No

  N/A

WALKWAYS

• Are aisles and passageways kept clear?

  Yes

  No

  N/A

• Are aisles and walkways marked as appropriate?

  Yes

  No

  N/A

• Are wet surfaces covered with non-slip materials?

  Yes

  No

  N/A

• Are holes in the floor, sidewalk or other walking surface repaired properly, covered or otherwise made safe?

  Yes

  No

  N/A

• Is there safe clearance for walking in aisles where motorized or mechanical handling equipment is operating.

  Yes

  No

  N/A

• Are spilled materials cleaned up immediately?

  Yes

  No

  N/A

• Are materials or equipment stored in such a way that sharp projectiles will not interfere with the walkway?

  Yes

  No

  N/A

• Are changes of direction or elevations readily identifiable?

  Yes

  No

  N/A

• Are aisles or walkways that pass near moving or operating machinery, welding operations or similar operations arranged so employees will not be subjected to potential hazards?

  Yes

  No

  N/A

• Is adequate headroom provided for the entire length of any aisle or walkway?

  Yes

  No

  N/A

• Are standard guardrails provided wherever aisle or walkway surfaces are elevated more than 30 inches above any adjacent floor or the ground?

  Yes

  No

  N/A

• Are bridges provided over conveyors and similar hazards?

  Yes

  No

  N/A

FLOOR AND WALL STAIRWAYS

• Are floor openings guarded by a cover, guardrail, or equivalent on all sides (except at entrance to stairways or ladders)?

  Yes

  No

  N/A

• Are toeboards installed around the edges of a permanent floor opening (where persons may pass below the opening)?

  Yes

  No

  N/A

• Are skylight screens of such construction and mounting that they will withstand a load of at least 200 pounds?

  Yes

  No

  N/A

• Is the glass in windows, doors, glass walls that are subject to human impact, of sufficient thickness and type for the condition of use?

  Yes

  No

  N/A

• Are grates or similar type covers over floor openings such as floor drains, of such design that foot traffic or rolling equipment will not be affected by the grate spacing?

  Yes

  No

  N/A

• Are unused portions of service pits and pits not actually in use either covered or protected by guardrails or equivalent?

  Yes

  No

  N/A

• Are manhole covers, trench covers and similar covers, plus their supports, designed to carry a truck rear axle load of at least 20,000 pounds when located in roadways and subject to vehicle traffic?

  Yes

  No

  N/A

• Are floor or wall openings in fire resistive construction provided with doors or covers compatible with the fire rating of the structure and provided with self-closing feature when appropriate?

  Yes

  No

  N/A

• Are there Stairs in the Facility?

  Yes

  No

STAIRS & STAIRWAYS

• Are standard stair rails or handrails on all stairways having four or more risers?

  Yes

  No

  N/A

• Do stairs have at least a 6'6" overhead clearance?

  Yes

  No

  N/A

• Do stairs angle no more than 50 and no less than 30 degrees?

  Yes

  No

  N/A

• Are step risers on stairs uniform from top to bottom, with no riser spacing greater than 7-1/2 inches?

  Yes

  No

  N/A

• Are steps on stairs and stairways designed or provided with a surface that renders them slip resistant?

  Yes

  No

  N/A

• Are stairway handrails located between 30 and 34 inches above the leading edge of stair treads?

  Yes

  No

  N/A

• Do stairway handrails have a least 1-1/2 inches of clearance between the handrails and the wall or surface they are mounted on?

  Yes

  No

  N/A

• Are stairway handrails capable of withstanding a load of 200 pounds, applied in any direction?

  Yes

  No

  N/A

• Where stairs or stairways exit directly into any area where vehicles may be operated, are adequate barriers and warnings provided to prevent employees stepping into the path of traffic?

  Yes

  No

  N/A

• Do stairway landings have a dimension measured in the direction of travel, at least equal to width of the stairway?

  Yes

  No

  N/A

• Is the vertical distance between stairway landings limited to 12 feet or less?

  Yes

  No

  N/A

ELEVATED SURFACES

• Are there Elevated Surfaces on the site?

  Yes

  No

• Are signs posted, when appropriate, showing the elevated surface load capacity?

  Yes

  No

  N/A

• Are surfaces elevated more than 30 inches above the floor or ground provided with standard guardrails?

  Yes

  No

  N/A

• Are all elevated surfaces (beneath which people or machinery could be exposed to falling objects) provided with standard 4-inch toeboards?

  Yes

  No

  N/A

• Is a permanent means of access and egress provided to elevated storage and work surfaces?

  Yes

  No

  N/A

• Is required headroom provided where necessary?

  Yes

  No

  N/A

• Is material on elevated surfaces piled, stacked or racked in a manner to prevent it from tipping, falling, collapsing, rolling or spreading?

  Yes

  No

  N/A

• Are dock boards or bridge plates used when transferring materials between docks and trucks or rail cars?

  Yes

  No

  N/A

EXITING OR EGRESS

• Are all exits marked with an exit sign and illuminated by a reliable light source?

  Yes

  No

  N/A

• Are the directions to exits, when not immediately apparent, marked with visible signs?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are exit signs provided with the word "EXIT" in lettering at least 5 inches high and the stroke of the lettering at least 1/2 inch wide?

  Yes

  No

  N/A

• Are all exits kept free of obstructions?

  Yes

  No

  N/A

• Are at least two means of egress provided from elevated platforms, pits or rooms where the absence of a second exit would increase the risk of injury from hot, poisonous, corrosive, suffocating, flammable, or explosive substances?

  Yes

  No

  N/A

• Are there sufficient exits to permit prompt escape in case of emergency?

  Yes

  No

  N/A

• Are special precautions taken to protect employees during construction and repair operations?

  Yes

  No

  N/A

• Is the number of exits from each floor of a building, and the number of exits from the building itself, appropriate for the building occupancy load?

  Yes

  No

  N/A

• Are exit stairways which are required to be separated from other parts of a building enclosed by at least two-hour fire-resistive construction in buildings more than four stories in height, and not less than one-hour fire-resistive construction elsewhere?

  Yes

  No

  N/A

• When ramps are used as part of required exiting from a building, is the ramp slope limited to 1- foot vertical and 12 feet horizontal?

  Yes

  No

  N/A

• Will exiting be through frameless glass doors, glass exit doors, storm doors, and such are the doors fully tempered and meet the safety requirements for human impact?

  Yes

  No

  N/A

EXIT DOORS

• Are doors that are required to serve as exits designed and constructed so that the way of exit travel is obvious and direct?

  Yes

  No

  N/A

• Are windows that could be mistaken for exit doors, made inaccessible by means of barriers or railings?

  Yes

  No

  N/A

• Are exit doors side-hinged?

  Yes

  No

  N/A

• Are exit doors openable from the direction of exit travel without the use of a key or any special knowledge or effort, when the building is occupied?

  Yes

  No

  N/A

• Is a revolving, sliding or overhead door prohibited from serving as a required exit door?

  Yes

  No

  N/A

• Where panic hardware is installed on a required exit door, will it allow the door to open by applying a force of 15 pounds or less in the direction of the exit traffic?

  Yes

  No

  N/A

• Are doors on cold storage rooms provided with an inside release mechanism that will release the latch and open the door even if it's padlocked or otherwise locked on the outside?

  Yes

  No

  N/A

• Where exit doors open directly onto any street, alley or other areas where vehicles may be operated, are adequate barriers and warnings provided to prevent employees stepping into the path of traffic?

  Yes

  No

  N/A

• Are doors that swing in both directions and are located between rooms where there is frequent traffic, provided with viewing panels in each door?

  Yes

  No

  N/A

PORTABLE LADDERS

• Yes

  No

  N/A

• Are Portable ladders used at the site?

  Yes

  No

• Are all ladders maintained in good condition, joints between steps and side rails tight, all hardware and fittings securely attached, and moveable parts operating freely without binding or undue play?

  Yes

  No

  N/A

• Are non-slip safety feet provided on each ladder?

  Yes

  No

  N/A

• Are non-slip safety feet provided on each metal or rung ladder?

  Yes

  No

  N/A

• Are ladder rungs and steps free of grease and oil?

  Yes

  No

  N/A

• Is it prohibited to place a ladder in front of doors opening toward the ladder except when the door is blocked open, locked or guarded?

  Yes

  No

  N/A

• Is it prohibited to place ladders on boxes, barrels, or other unstable bases to obtain additional height?

  Yes

  No

  N/A

• Are employees instructed to face the ladder when ascending or descending?

  Yes

  No

  N/A

• Are employees prohibited from using ladders that are broken, missing steps, rungs, or cleats, broken side rails or other faulty equipment?

  Yes

  No

  N/A

• Are employees instructed not to use the top 2 steps of ordinary stepladders as a step?

  Yes

  No

  N/A

• When portable rung ladders are used to gain access to elevated platforms, roofs, and the like does the ladder always extend at least 3 feet above the elevated surface?

  Yes

  No

  N/A

• Is it required that when portable rung or cleat type ladders are used the base is so placed that slipping will not occur, or it is lashed or otherwise held in place?

  Yes

  No

  N/A

• Are portable metal ladders legibly marked with signs reading "CAUTION" "Do Not Use Around Electrical Equipment" or equivalent wording?

  Yes

  No

  N/A

• Are employees prohibited from using ladders as guys, braces, skids, gin poles, or for other than their intended purposes?

  Yes

  No

  N/A

• Are employees instructed to only adjust extension ladders while standing at a base (not while standing on the ladder or from a position above the ladder)?

  Yes

  No

  N/A

• Are metal ladders inspected for damage?

  Yes

  No

  N/A

• Are the rungs of ladders uniformly spaced at 12 inches, center to center?

  Yes

  No

  N/A

• Are all tools and equipment (both, company and employee-owned) used by employees at their workplace in good condition?

  Yes

  No

  N/A

HAND TOOLS & EQUIPMENT

• Are all tools and equipment (both, company and employee-owned) used by employees at their workplace in good condition?

  Yes

  No

  N/A

• Are hand tools such as chisels, punches, which develop mushroomed heads during use, reconditioned or replaced as necessary?

  Yes

  No

  N/A

• Are broken or fractured handles on hammers, axes and similar equipment replaced promptly?

  Yes

  No

  N/A

• Are worn or bent wrenches replaced regularly?

  Yes

  No

  N/A

• Are appropriate handles used on files and similar tools?

  Yes

  No

  N/A

• Are employees made aware of the hazards caused by faulty or improperly used hand tools?

  Yes

  No

  N/A

• Are appropriate safety glasses, face shields, and similar equipment used while using hand tools or equipment that might produce flying materials or be subject to breakage?

  Yes

  No

  N/A

• Are jacks checked periodically to assure they are in good operating condition?

  Yes

  No

  N/A

• Are tool handles wedged tightly in the head of all tools?

  Yes

  No

  N/A

• Are tool cutting edges kept sharp so the tool will move smoothly without binding or skipping?

  Yes

  No

  N/A

• Are tools stored in dry, secure location where they won't be tampered with?

  Yes

  No

  N/A

• Is eye and face protection used when driving hardened or tempered spuds or nails?

  Yes

  No

  N/A

• Are Portable Power Tools and Equipment used at this Site

  Yes

  No

PORTABLE (POWER OPERATED) TOOLS & EQUIPMENT

• Are grinders, saws, and similar equipment provided with appropriate safety guards?

  Yes

  No

  N/A

• Are power tools used with the correct shield, guard or attachment recommended by the manufacturer?

  Yes

  No

  N/A

• Are portable circular saws equipped with guards above and below the base shoe?

  Yes

  No

  N/A

• Are circular saw guards checked to assure they are not wedged up, thus leaving the lower portion of the blade unguarded?

  Yes

  No

  N/A

• Are rotating or moving parts of equipment guarded to prevent physical contact?

  Yes

  No

  N/A

• Are all cord-connected, electrically operated tools and equipment effectively grounded or of the approved double insulated type?

  Yes

  No

  N/A

• Are effective guards in place over belts, pulleys, chains, and sprockets, on equipment such as concrete mixers, air compressors, and the like?

  Yes

  No

  N/A

• Are portable fans provided with full guards or screens having openings 1/2 inch or less?

  Yes

  No

  N/A

• Is hoisting equipment available and used for lifting heavy objects, and are hoist ratings and characteristics appropriate for the task?

  Yes

  No

  N/A

• Are ground-fault circuit interrupters provided on all temporary electrical 15 and 20 ampere circuits, used during periods of construction?

  Yes

  No

  N/A

• Are pneumatic and hydraulic hoses on power-operated tools checked regularly for deterioration or damage?

  Yes

  No

  N/A

• Abrasive Wheel Equipment & Grinders used at this site?

  Yes

  No

ABRASIVE WHEEL EQUIPMENT & GRINDERS

• Is the work rest used and kept adjusted to within 1/8 inch of the wheel?

  Yes

  No

  N/A

• Is the adjustable tongue on the top side of the grinder used and kept adjusted to within 1/4 inch of the wheel?

  Yes

  No

  N/A

• Do side guards cover the spindle, nut, and flange and 75 percent of the wheel diameter?

  Yes

  No

  N/A

• Are bench and pedestal grinders permanently mounted?

  Yes

  No

  N/A

• Are goggles or face shields always worn when grinding?

  Yes

  No

  N/A

• Is the maximum RPM rating of each abrasive wheel compatible with the RPM rating of the grinder motor?

  Yes

  No

  N/A

• Are fixed or permanently mounted grinders connected to their electrical supply system with metallic conduit or other permanent wiring method?

  Yes

  No

  N/A

• Does each grinder have an individual on and off control switch?

  Yes

  No

  N/A

• Is each electrically operated grinder effectively grounded?

  Yes

  No

  N/A

• Before new abrasive wheels are mounted, are they visually inspected and ring tested?

  Yes

  No

  N/A

• Are dust collectors and powered exhausts provided on grinders used in operations that produce large amounts of dust?

  Yes

  No

  N/A

• Are splashguards mounted on grinders that use coolant, to prevent the coolant reaching employees?

  Yes

  No

  N/A

• Is cleanliness maintained around grinder?

  Yes

  No

  N/A

MACHINE GUARDING

• Is there a training program to instruct employees on safe methods of machine operation?

  Yes

  No

  N/A

• Is there adequate supervision to ensure that employees are following safe machine operating procedures?

  Yes

  No

  N/A

• Is there a regular program of safety inspection of machinery and equipment?

  Yes

  No

  N/A

• Is all machinery and equipment kept clean and properly maintained?

  Yes

  No

  N/A

• Is sufficient clearance provided around and between machines to allow for safe operations, set up and servicing, material handling and waste removal?

  Yes

  No

  N/A

• Is equipment and machinery securely placed and anchored, when necessary to prevent tipping or other movement that could result in personal injury?

  Yes

  No

  N/A

• Is there a power shut-off switch within reach of the operator's position at each machine?

  Yes

  No

  N/A

• Can electric power to each machine be locked out for maintenance, repair, or security?

  Yes

  No

  N/A

• Are the noncurrent-carrying metal parts of electrically operated machines bonded and grounded?

  Yes

  No

  N/A

• Are foot-operated switches guarded or arranged to prevent accidental actuation by personnel or falling

  Yes

  No

  N/A

• Are manually operated valves and switches controlling the operation of equipment and machines clearly identified and readily accessible?

  Yes

  No

  N/A

• Are all emergency stop buttons colored red?

  Yes

  No

  N/A

• Are all pulleys and belts that are within 7 feet of the floor or working level properly guarded?

  Yes

  No

  N/A

• Are all moving chains and gears properly guarded?

  Yes

  No

  N/A

• Are splashguards mounted on machines that use coolant, to prevent the coolant from reaching employees?

  Yes

  No

  N/A

• Are methods provided to protect the operator and other employees in the machine area from hazards created at the point of operation, ingoing nip points, rotating parts, flying chips, and sparks?

  Yes

  No

  N/A

• Are machinery guards secure and so arranged that they do not offer a hazard in their use?

  Yes

  No

  N/A

• If special hand tools are used for placing and removing material, do they protect the operator's hands?

  Yes

  No

  N/A

• Are revolving drums, barrels, and containers required to be guarded by an enclosure that is interlocked with the drive mechanism, so that revolution cannot occur unless the guard enclosure is in place, so guarded?

  Yes

  No

  N/A

• Do arbors and mandrels have firm and secure bearings and are they free from play?

  Yes

  No

  N/A

• Are provisions made to prevent machines from automatically starting when power is restored after a power failure or shutdown?

  Yes

  No

  N/A

• Are machines constructed so as to be free from excessive vibration when the largest size tool is mounted and run at full speed?

  Yes

  No

  N/A

• If machinery is cleaned with compressed air, is air pressure controlled and personal protective equipment or other safeguards used to protect operators and other workers from eye and body injury?

  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

• Are saws used for ripping, equipped with anti-kick back devices and spreaders?

  Yes

  No

  N/A

• Are radial arm saws so arranged that the cutting head will gently return to the back of the table when released?

  Yes

  No

  N/A

LOCKOUT TAGOUT PROCEDURES

• Is all machinery or equipment capable of movement, required to be de-energized or disengaged and blocked or locked out during cleaning, servicing, adjusting or setting up operations, whenever required?

  Yes

  No

  N/A

• Is the locking-out of control circuits in lieu of locking-out main power disconnects prohibited?

  Yes

  No

  N/A

• Are all equipment control valve handles provided with a means for locking-out?

  Yes

  No

  N/A

• Does the lockout procedure require that stored energy (i.e. mechanical, hydraulic, air,) be released or blocked before equipment is locked-out for repairs?

  Yes

  No

  N/A

• Are appropriate employees provided with individually keyed personal safety locks?

  Yes

  No

  N/A

• Are employees required to keep personal control of their key(s) while they have safety locks in use?

  Yes

  No

  N/A

• Is it required that employees check the safety of the lock out by attempting a start up after making sure no one is exposed? (Try Step)

  Yes

  No

  N/A

• Are the appropriate electrical enclosures identified? (Are electrical panel ratings posted?)

  Yes

  No

  N/A

• Are all LOTO points identified at the lock out point, and correlate to posted procedures?

  Yes

  No

  N/A

• Is means provide to assure the control circuit can also be disconnected and locked out?

  Yes

  No

  N/A

• Is Welding, Cutting or Brazing performed at the site?

  Yes

  No

WELDING, CUTTING & BRAZING

• Are only authorized and trained personnel permitted to use welding, cutting or brazing equipment?

  Yes

  No

  N/A

• Do all operator have a copy of the appropriate operating instructions and are they directed to follow them?

  Yes

  No

  N/A

• Are compressed gas cylinders regularly examined for obvious signs of defects, deep rusting, or leakage?

  Yes

  No

  N/A

• Is care used in handling and storage of cylinders, safety valves, relief valves, and the like, to prevent damage?

  Yes

  No

  N/A

• Are precautions taken to prevent the mixture of air or oxygen with flammable gases, except at a burner or in a standard torch?

  Yes

  No

  N/A

• Are only approved apparatus (torches, regulators, pressure-reducing valves, acetylene generators, manifolds) used?

  Yes

  No

  N/A

• Are cylinders kept away from sources of heat?

  Yes

  No

  N/A

• Is it prohibited to use cylinders as rollers or supports?

  Yes

  No

  N/A

• Are empty cylinders appropriately marked their valves closed and valve-protection caps on?

  Yes

  No

  N/A

• Are signs reading: DANGER NO-SMOKING, MATCHES, OR OPEN LIGHTS, or the equivalent posted?

  Yes

  No

  N/A

• Are cylinders, cylinder valves, couplings, regulators, hoses, and apparatus keep free of oily or greasy substances?

  Yes

  No

  N/A

• Is care taken not to drop or strike cylinders?

  Yes

  No

  N/A

• Unless secured on special trucks, are regulators removed and valve-protection caps put in place before moving cylinders?

  Yes

  No

  N/A

• Do cylinders without fixed hand wheels have keys, handles, or non-adjustable wrenches on stem valves when in service?

  Yes

  No

  N/A

• Are liquefied gases stored and shipped valve-end up with valve covers in place?

  Yes

  No

  N/A

• Are employees instructed to never crack a fuel-gas cylinder valve near sources of ignition?

  Yes

  No

  N/A

• Before a regulator is removed, is the valve closed and gas released form the regulator?

  Yes

  No

  N/A

• Is red used to identify the acetylene (and other fuel-gas) hose, green for oxygen hose, and black for inert gas and air hose?

  Yes

  No

  N/A

• Are pressure-reducing regulators used only for the gas and pressures for which they are intended?

  Yes

  No

  N/A

• Is open circuit (No Load) voltage of arc welding and cutting machines as low as possible and not in excess of the recommended limits?

  Yes

  No

  N/A

• Under wet conditions, are automatic controls for reducing no-load voltage used?

  Yes

  No

  N/A

• Is grounding of the machine frame and safety ground connections of portable machines checked periodically?

  Yes

  No

  N/A

• Are electrodes removed from the holders when not in use?

  Yes

  No

  N/A

• Is it required that electric power to the welder be shut off when no one is in attendance?

  Yes

  No

  N/A

• Is suitable fire extinguishing equipment available for immediate use?

  Yes

  No

  N/A

• Is the welder forbidden to coil or loop welding electrode cable around his body?

  Yes

  No

  N/A

• Are wet machines thoroughly dried and tested before being used?

  Yes

  No

  N/A

• Are work and electrode lead cables frequently inspected for wear and damage, and replaced when needed?

  Yes

  No

  N/A

• Do means for connecting cables' lengths have adequate insulation?

  Yes

  No

  N/A

• When the object to be welded cannot be moved and fire hazards cannot be removed, are shields used to confine heat, sparks, and slag?

  Yes

  No

  N/A

• Are firewatchers assigned when welding or cutting is performed, in locations where a serious fire might develop?

  Yes

  No

  N/A

• Are combustible floors kept wet, covered by damp sand, or protected by fire-resistant shields?

  Yes

  No

  N/A

• When floors are wet down, are personnel protected from possible electrical shock?

  Yes

  No

  N/A

• When welding is done on metal walls, are precautions taken to protect combustibles on the other side?

  Yes

  No

  N/A

• Before hot work is begun, are used drums, barrels, tanks, and other containers so thoroughly cleaned that no substances remain that could explode, ignite, or produce toxic vapors?

  Yes

  No

  N/A

• Is it required that eye protection helmets, hand shields and goggles meet appropriate standards?

  Yes

  No

  N/A

• Are employees exposed to the hazards created by welding, cutting, or bracing operations protected with personal protective equipment and clothing?

  Yes

  No

  N/A

• Is a check made for adequate ventilation in and where welding or cutting is preformed?

  Yes

  No

  N/A

• When working in confined places are environmental monitoring tests taken and means provided for quick removal of welders in case of an emergency?

  Yes

  No

  N/A

• Is Compressed Air used at the site?

  Yes

  No

COMPRESSORS & COMPRESSED AIR

• Are compressors equipped with pressure relief valves, and pressure gauges?

  Yes

  No

  N/A

• Are compressor air intakes installed and equipped to ensure that only clean uncontaminated air enters the compressor?

  Yes

  No

  N/A

• Are air filters installed on the compressor intake?

  Yes

  No

  N/A

• Are compressors operated and lubricated in accordance with the manufacturer's recommendations?

  Yes

  No

  N/A

• Are safety devices on compressed air systems checked frequently?

  Yes

  No

  N/A

• Before any repair work is done on the pressure system of a compressor, is the pressure bled off and the system locked-out?

  Yes

  No

  N/A

• Are signs posted to warn of the automatic starting feature of the compressors?

  Yes

  No

  N/A

• Is the belt drive system totally enclosed to provide protection for the front, back, top, and sides?

  Yes

  No

  N/A

• Is it strictly prohibited to direct compressed air towards a person?

  Yes

  No

  N/A

• Are employees prohibited from using highly compressed air for cleaning purposes?

  Yes

  No

  N/A

• If compressed air is used for cleaning off clothing, is the pressure reduced to less than 10 psi?

  Yes

  No

  N/A

• When using compressed air for cleaning, do employees use personal protective equipment?

  Yes

  No

  N/A

• Are safety chains or other suitable locking devices used at couplings of high pressure hose lines where a connection failure would create a hazard?

  Yes

  No

  N/A

• Before compressed air is used to empty containers of liquid, is the safe working pressure of the container checked?

  Yes

  No

  N/A

• When compressed air is used with abrasive blast cleaning equipment, is the operating valve a type that must be held open manually?

  Yes

  No

  N/A

• When compressed air is used to inflate auto tires, is a clip-on chuck and an inline regulator preset to 40 psi required?

  Yes

  No

  N/A

• Is it prohibited to use compressed air to clean up or move combustible dust if such action could cause the dust to be suspended in the air and cause a fire or explosion hazard?

  Yes

  No

  N/A

• Are there compressed air receivers on site?

  Yes

  No

COMPRESSED AIR RECEIVERS

• Is every receiver equipped with a pressure gauge and with one or more automatic, spring-loaded safety valves?

  Yes

  No

  N/A

• Is the total relieving capacity of the safety valve capable of preventing pressure in the receiver from exceeding the maximum allowable working pressure of the receiver by more than 10 percent?

  Yes

  No

  N/A

• Is every air receiver provided with a drainpipe and valve at the lowest point for the removal of accumulated oil and water?

  Yes

  No

  N/A

• Are compressed air receivers periodically drained of moisture and oil?

  Yes

  No

  N/A

• Are all safety valves tested frequently and at regular intervals to determine whether they are in good operating condition?

  Yes

  No

  N/A

• Is the inlet of air receivers and piping systems kept free of accumulated oil and carbonaceous materials?

  Yes

  No

  N/A

• Are there compressed gas cylinders present on site

  Yes

  No

COMPRESSED GAS & CYLINDERS

• Are cylinders with a water weight capacity over 30 pounds equipped with means for connecting a valve

  Yes

  No

  N/A

• protector device, or with a collar or recess to protect the valve?

  Yes

  No

  N/A

• Are cylinders legibly marked to clearly identify the gas contained?

  Yes

  No

  N/A

• Are compressed gas cylinders stored in areas which are protected from external heat sources such as flame impingement, intense radiant heat, electric arcs, or high temperature lines?

  Yes

  No

  N/A

• Are cylinders located or stored in areas where they will not be damaged by passing or falling objects, or subject to tampering by unauthorized persons?

  Yes

  No

  N/A

• Are cylinders stored or transported in a manner to prevent them creating a hazard by tipping, falling or rolling?

  Yes

  No

  N/A

• Are cylinders containing liquefied fuel gas, stored or transported in a position so that the safety relief device is always in direct contact with the vapor space in the cylinder?

  Yes

  No

  N/A

• Are valve protectors always placed on cylinders when the cylinders are not in use or connected for use?

  Yes

  No

  N/A

• Are all valves closed off before a cylinder is moved, when the cylinder is empty, and at the completion of each job?

  Yes

  No

  N/A

• Are low pressure fuel-gas cylinders checked periodically for corrosion, general distortion, cracks, or any other defect that might indicate a weakness or render it unfit for service?

  Yes

  No

  N/A

• Does the periodic check of low pressure fuel-gas cylinders include a close inspection of the cylinders' bottom?

  Yes

  No

  N/A

HOIST & AUXILIARY EQUIPMENT

• Is each overhead electric hoist equipped with a limit device to stop the hook travel at its highest and lowest point of safe travel?

  Yes

  No

  N/A

• Is the rated load of each hoist legibly marked and visible to the operator?

  Yes

  No

  N/A

• Are stops provided at the safe limits of travel for trolley hoist?

  Yes

  No

  N/A

• Are the controls of hoists plainly marked to indicate the direction of travel or motion?

  Yes

  No

  N/A

• Is each cage-controlled hoist equipped with an effective warning device?

  Yes

  No

  N/A

• Are close-fitting guards or other suitable devices installed on hoist to assure hoist ropes will be maintained in the sheave groves?

  Yes

  No

  N/A

• Are all hoist chains or ropes of sufficient length to handle the full range of movement for the application while still maintaining two full wraps on the drum at all times?

  Yes

  No

  N/A

• Are nip points or contact points between hoist ropes and sheaves which are permanently located within 7 feet of the floor, ground or working platform, guarded?

  Yes

  No

  N/A

• Is it prohibited to use chains or rope slings that are kinked or twisted?

  Yes

  No

  N/A

• Is it prohibited to use the hoist rope or chain wrapped around the load as a substitute, for a sling?

  Yes

  No

  N/A

• Is the operator instructed to avoid carrying loads over people?

  Yes

  No

  N/A

• Are only employees who have been trained in the proper use of hoists allowed to operate them?

  Yes

  No

  N/A

• Are PIVs (Forklifts) used at this site?

  Yes

  No

POWERED INDUSTRIAL TRUCKS - FORKLIFTS

• Are only trained personnel allowed to operate industrial trucks?

  Yes

  No

  N/A

• Is substantial overhead protective equipment provided on high lift rider equipment?

  Yes

  No

  N/A

• Are the required lift truck operating rules posted and enforced?

  Yes

  No

  N/A

• Is directional lighting provided on each industrial truck that operates in an area with less than 2 foot candles per square foot of general lighting?

  Yes

  No

  N/A

• Does each industrial truck have a warning horn, whistle, gong or other device which can be clearly heard above the normal noise in the areas where operated?

  Yes

  No

  N/A

• Are the brakes on each industrial truck capable of bringing the vehicle to a complete and safe stop when fully loaded?

  Yes

  No

  N/A

• Will the industrial truck's parking brake effectively prevent the vehicle from moving when unattended?

  Yes

  No

  N/A

• Are industrial trucks operating in areas where flammable gases or vapors, or combustible dust or ignitable fibers may be present in the atmosphere, approved for such locations?

  Yes

  No

  N/A

• Are motorized hand and hand/rider trucks so designed that the brakes are applied, and power to the drive motor shuts off when the operator releases his/her grip on the device that controls the travel?

  Yes

  No

  N/A

• Are industrial trucks with internal combustion engine operated in buildings or enclosed areas, carefully checked to ensure such operations do not cause harmful concentration of dangerous gases or fumes?

  Yes

  No

  N/A

• Are Spraying Operations conducted at this site?

  Yes

  No

  N/A

SPRAYING OPERATIONS

• Is adequate ventilation assured before spray operations are started?

  Yes

  No

  N/A

• Is mechanical ventilation provided when spraying operation is done in enclosed areas?

  Yes

  No

  N/A

• When mechanical ventilation is provided during spraying operations, is it so arranged that it will not circulate the contaminated air?

  Yes

  No

  N/A

• Is the spray area free of hot surfaces?

  Yes

  No

  N/A

• Is the spray area at least 20 feet from flames, sparks, operating electrical motors and other ignition sources?

  Yes

  No

  N/A

• Are portable lamps used to illuminate spray areas suitable for use in a hazardous location?

  Yes

  No

  N/A

• Is approved respiratory equipment provided and used when appropriate during spraying operations?

  Yes

  No

  N/A

• Do solvents used for cleaning have a flash point of 100E F or more?

  Yes

  No

  N/A

• Are fire control sprinkler heads kept clean?

  Yes

  No

  N/A

• Are "NO SMOKING" signs posted in spray areas, paint rooms, paint booths, and paint storage areas?

  Yes

  No

  N/A

• Is the spray area kept clean of combustible residue?

  Yes

  No

  N/A

• Are spray booths constructed of metal, masonry, or other substantial noncombustible material?

  Yes

  No

  N/A

• Are spray booth floors and baffles noncombustible and easily cleaned?

  Yes

  No

  N/A

• Is infrared drying apparatus kept out of the spray area during spraying operations?

  Yes

  No

  N/A

• Is the spray booth completely ventilated before using the drying apparatus?

  Yes

  No

  N/A

• Is the electric drying apparatus properly grounded?

  Yes

  No

  N/A

• Are lighting fixtures for spray booths located outside of the booth and the interior lighted through sealed clear panels?

  Yes

  No

  N/A

• Are the electric motors for exhaust fans placed outside booths or ducts?

  Yes

  No

  N/A

• Are belts and pulleys inside the booth fully enclosed?

  Yes

  No

  N/A

• Do ducts have access doors to allow cleaning?

  Yes

  No

  N/A

• Do all drying spaces have adequate ventilation?

  Yes

  No

  N/A

• Are there Confined Spaces on the site property?

  Yes

  No

ENTERING CONFINED SPACES

• Are confined spaces thoroughly emptied of any corrosive or hazardous substances, such as acids or caustics, before entry?

  Yes

  No

  N/A

• Before entry, are all lines to a confined space, containing inert, toxic, flammable, or corrosive materials valved off and blanked or disconnected and separated?

  Yes

  No

  N/A

• Is it required that all impellers, agitators, or other moving equipment inside confined spaces be locked-out if they present a hazard?

  Yes

  No

  N/A

• Is either natural or mechanical ventilation provided prior to confined space entry?

  Yes

  No

  N/A

• Before entry, are appropriate atmospheric tests performed to check for oxygen deficiency, toxic substance and explosive concentrations in the confined space before entry?

  Yes

  No

  N/A

• Is adequate illumination provided for the work to be performed in the confined space?

  Yes

  No

  N/A

• Is the atmosphere inside the confined space frequently tested or continuously monitor during conduct of work?

  Yes

  No

  N/A

• Is there an assigned safety standby employee outside of the confined space, whose sole responsibility is to watch the work in progress, sound an alarm if necessary, and render assistance?

  Yes

  No

  N/A

• Is the standby employee or other employees prohibited from entering the confined space without lifelines and respiratory equipment if there is any questions as to the cause of an emergency?

  Yes

  No

  N/A

• In addition to the standby employee, is there at least one other trained rescuer in the vicinity?

  Yes

  No

  N/A

• Are all rescuers appropriately trained and using approved, recently inspected equipment?

  Yes

  No

  N/A

• Does all rescue equipment allow for lifting employees vertically from a top opening?

  Yes

  No

  N/A

• Are there trained personnel in First Aid and CPR immediately available?

  Yes

  No

  N/A

• Is there an effective communication system in place whenever respiratory equipment is used and the employee in the confined space is out of sight of the standby person?

  Yes

  No

  N/A

• Is approved respiratory equipment required if the atmosphere inside the confined space cannot be made acceptable?

  Yes

  No

  N/A

• Is all portable electrical equipment used inside confined spaces either grounded and insulated, or equipped with ground fault protection?

  Yes

  No

  N/A

• Before gas welding or burning is started in a confined space, are hoses checked for leaks, compressed gas bottles forbidden inside of the confined space, torches lighted only outside of the confined area and the confined area tested for an explosive atmosphere each time before a lighted torch is to be taken into the confined space?

  Yes

  No

  N/A

• If employees will be using oxygen-consuming equipment such as salamanders, torches, furnaces, in a confined space, is sufficient air provided to assure combustion without reducing the oxygen concentration of the atmosphere below 19.5 percent by volume?

  Yes

  No

  N/A

• Whenever combustion-type equipment is used in confined space, are provisions made to ensure the exhaust gases are vented outside of the enclosure?

  Yes

  No

  N/A

• Is each confined space checked for decaying vegetation or animal matter, which may produce methane?

  Yes

  No

  N/A

• Is the confined space checked for possible industrial waste, which could contain toxic properties?

  Yes

  No

  N/A

• If the confined space is below the ground and near areas where motor vehicles will be operating, is it possible for vehicle exhaust or carbon monoxide to enter the space?

  Yes

  No

  N/A

ENVIRONMENTAL CONTROLS

• Are all work areas properly illuminated?

  Yes

  No

  N/A

• Are employees instructed in proper first aid and other emergency procedures?

  Yes

  No

  N/A

• Are hazardous substances identified which may cause harm by inhalation, ingestion, skin absorption or contact?

  Yes

  No

  N/A

• Are employees aware of the hazards involved with the various chemicals they may be exposed to in their work environment, such as ammonia, chlorine, epoxies, and caustics?

  Yes

  No

  N/A

• Is employee exposure to chemicals in the workplace kept within acceptable levels?

  Yes

  No

  N/A

• Can a less harmful method or product be used?

  Yes

  No

  N/A

• Is the work area's ventilation system appropriate for the work being performed?

  Yes

  No

  N/A

• Are spray painting operations done in spray rooms or booths equipped with an appropriate exhaust system?

  Yes

  No

  N/A

• Is employee exposure to welding fumes controlled by ventilation, use of respirators, exposure time, or other means?

  Yes

  No

  N/A

• Are welders and other workers nearby provided with flash shields during welding operations?

  Yes

  No

  N/A

• If forklifts and other vehicles are used in buildings or other enclosed areas, are the carbon monoxide levels kept below maximum acceptable concentration?

  Yes

  No

  N/A

• Has there been a determination that noise levels in the facilities are within acceptable levels?

  Yes

  No

  N/A

• Are steps being taken to use engineering controls to reduce excessive noise levels?

  Yes

  No

  N/A

• Are proper precautions being taken when handling asbestos and other fibrous materials?

  Yes

  No

  N/A

• Are caution labels and signs used to warn of asbestos?

  Yes

  No

  N/A

• Are wet methods used, when practicable, to prevent the emission of airborne asbestos fibers, silica dust and similar hazardous materials?

  Yes

  No

  N/A

• Is vacuuming with appropriate equipment used whenever possible rather than blowing or sweeping dust?

  Yes

  No

  N/A

• Are grinders, saws, and other machines that produce respirable dusts vented to an industrial collector or central exhaust system?

  Yes

  No

  N/A

• Are all local exhaust ventilation systems designed and operating properly such as airflow and volume necessary for the application? Are the ducts free of obstructions or the belts slipping?

  Yes

  No

  N/A

• Is personal protective equipment provided, used and maintained wherever required?

  Yes

  No

  N/A

• Are there written standard operating procedures for the selection and use of respirators where needed?

  Yes

  No

  N/A

• Are restrooms and washrooms kept clean and sanitary?

  Yes

  No

  N/A

• Is all water provided for drinking, washing, and cooking potable?

  Yes

  No

  N/A

• Are all outlets for water not suitable for drinking clearly identified?

  Yes

  No

  N/A

• Are employees' physical capacities assessed before being assigned to jobs requiring heavy work?

  Yes

  No

  N/A

• Are employees instructed in the proper manner of lifting heavy objects?

  Yes

  No

  N/A

• Where heat is a problem, have all fixed work areas been provided with spot cooling or air conditioning?

  Yes

  No

  N/A

• Are employees screened before assignment to areas of high heat to determine if their health condition might make them more susceptible to having an adverse reaction?

  Yes

  No

  N/A

• Are employees working on streets and roadways where they are exposed to the hazards of traffic, required to wear bright colored (traffic orange) warning vest?

  Yes

  No

  N/A

• Are exhaust stacks and air intakes located that contaminated air will not be recirculated within a building or other enclosed area?

  Yes

  No

  N/A

• Is equipment producing ultra-violet radiation properly shielded?

  Yes

  No

  N/A

FLAMMABLE & COMBUSTIBLE MATERIALS

• Are combustible scrap, debris and waste materials (i.e. oily rags) stored in covered metal receptacles and removed from the worksite promptly?

  Yes

  No

  N/A

• Is proper storage practiced to minimize the risk of fire including spontaneous combustion?

  Yes

  No

  N/A

• Are approved containers and tanks used for the storage and handling of flammable and combustible liquids?

  Yes

  No

  N/A

• Are all connections on drums and combustible liquid piping, vapor and liquid tight?

  Yes

  No

  N/A

• Are all flammable liquids kept in closed containers when not in use (e.g. parts cleaning tanks, pans)?

  Yes

  No

  N/A

• Are bulk drums of flammable liquids grounded and bonded to containers during dispensing?

  Yes

  No

  N/A

• Do storage rooms for flammable and combustible liquids have explosion-proof lights?

  Yes

  No

  N/A

• Do storage rooms for flammable and combustible liquids have mechanical or gravity ventilation?

  Yes

  No

  N/A

• Is liquefied petroleum gas stored, handled, and used in accordance with safe practices and standards?

  Yes

  No

  N/A

• Are liquefied petroleum storage tanks guarded to prevent damage from vehicles?

  Yes

  No

  N/A

• Are all solvent wastes and flammable liquids kept in fire-resistant covered containers until they are removed from the worksite?

  Yes

  No

  N/A

• Is vacuuming used whenever possible rather than blowing or sweeping combustible dust?

  Yes

  No

  N/A

• Are fire separators placed between containers of combustibles or flammables, when stacked one upon another, to assure their support and stability?

  Yes

  No

  N/A

• Are fuel gas cylinders and oxygen cylinders separated by distance, fire resistant barriers or other means while in storage?

  Yes

  No

  N/A

• Are fire extinguishers selected and provided for the types of materials in areas where they are to be used?

  Yes

  No

  N/A

• Class A: Ordinary combustible material fires.

  Yes

  No

  N/A

• Class B: Flammable liquid, gas or grease fires.

  Yes

  No

  N/A

• Class C: Energized-electrical equipment fires.

  Yes

  No

  N/A

• If a Halon 1301 fire extinguisher is used, can employees evacuate within the specified time for that extinguisher?

  Yes

  No

  N/A

• Are appropriate fire extinguishers mounted within 75 feet of outside areas containing flammable liquids, and within 10 feet of any inside storage area for such materials?

  Yes

  No

  N/A

• Is the transfer/withdrawal of flammable or combustible liquids performed by trained personnel?

  Yes

  No

  N/A

• Are fire extinguishers mounted so that employees do not have to travel more than 75 feet for a class "A" fire or 50 feet for a class "B" fire?

  Yes

  No

  N/A

• Are employees trained in the use of fire extinguishers?

  Yes

  No

  N/A

• Are extinguishers free from obstructions or blockage?

  Yes

  No

  N/A

• Are all extinguishers serviced, maintained and tagged at intervals not to exceed one year?

  Yes

  No

  N/A

• Are all extinguishers fully charged and in their designated places?

  Yes

  No

  N/A

• Is a record maintained of required monthly checks of extinguishers?

  Yes

  No

  N/A

• Where sprinkler systems are permanently installed, are the nozzle heads directed or arranged so that water will not be sprayed into operating electrical switchboards and equipment?

  Yes

  No

  N/A

• Are "NO SMOKING" signs posted where appropriate in areas where flammable or combustible materials are used or stored?

  Yes

  No

  N/A

• Are "NO SMOKING" signs posted on liquefied petroleum gas tanks?

  Yes

  No

  N/A

• Are "NO SMOKING" rules enforced in areas involving storage and use of flammable materials?

  Yes

  No

  N/A

• Are safety cans used for dispensing flammable or combustible liquids at a point of use?

  Yes

  No

  N/A

• Are all spills of flammable or combustible liquids cleaned up promptly?

  Yes

  No

  N/A

• Are storage tanks adequately vented to prevent the development of excessive vacuum or pressure as a result of filling, emptying, or atmosphere temperature changes?

  Yes

  No

  N/A

• Are storage tanks equipped with emergency venting that will relieve excessive internal pressure caused by fire exposure?

  Yes

  No

  N/A

• Are spare portable or butane tanks, which are sued by industrial trucks stored in accord with regulations?

  Yes

  No

  N/A

FIRE PROTECTION

• Do you have a fire prevention plan?

  Yes

  No

  N/A

• Does your plan describe the type of fire protection equipment and/or systems?

  Yes

  No

  N/A

• Have you established practices and procedures to control potential fire hazards and ignition sources?

  Yes

  No

  N/A

• Are employees aware of the fire hazards of the material and processes to which they are exposed?

  Yes

  No

  N/A

• Is your local fire department well acquainted with your facilities, location and specific hazards?

  Yes

  No

  N/A

• If you have a fire alarm system, is it tested at least annually?

  Yes

  No

  N/A

• If you have a fire alarm system, is it certified as required?

  Yes

  No

  N/A

• If you have interior standpipes and valves, are they inspected regularly?

  Yes

  No

  N/A

• If you have outside private fire hydrants, are they flushed at least once a year and on a routine preventive maintenance schedule?

  Yes

  No

  N/A

• Are fire doors and shutters in good operating condition?

  Yes

  No

  N/A

• Are fire doors and shutters unobstructed and protected against obstructions, including their counterweights?

  Yes

  No

  N/A

• Are fire door and shutter fusible links in place?

  Yes

  No

  N/A

• Are automatic sprinkler system water control valves, air and water pressures checked weekly/periodically as required?

  Yes

  No

  N/A

• Is maintenance of automatic sprinkler system assigned to responsible persons or to a sprinkler contractor?

  Yes

  No

  N/A

• Are sprinkler heads protected by metal guards, when exposed to physical damage?

  Yes

  No

  N/A

• Is proper clearance maintained below sprinkler heads?

  Yes

  No

  N/A

• Are portable fire extinguishers provided in adequate number and type?

  Yes

  No

  N/A

• Are fire extinguishers mounted in readily accessible locations?

  Yes

  No

  N/A

• Are fire extinguishers recharged regularly and noted on the inspection tag?

  Yes

  No

  N/A

• Are employees periodically instructed in the use of extinguishers and fire protection procedures?

  Yes

  No

  N/A

• Are Hazardous Chemicals used at this site?

  Yes

  No

HAZARDOUS CHEMICAL EXPOSURE

• Are employees trained in the safe handling practices of hazardous chemicals such as acids, caustics, and the like?

  Yes

  No

  N/A

• Are employees aware of the potential hazards involving various chemicals stored or used in the workplace-- such as acids, bases, caustics, epoxies, and phenols?

  Yes

  No

  N/A

• Is employee exposure to chemicals kept within acceptable levels?

  Yes

  No

  N/A

• Are eye wash fountains and safety showers provided in areas where corrosive chemicals are handled?

  Yes

  No

  N/A

• Are all employees required to use personal protective clothing and equipment when handling chemicals (i.e. gloves, eye protection, and respirators)?

  Yes

  No

  N/A

• Are flammable or toxic chemicals kept in closed containers when not in use?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Where corrosive liquids are frequently handled in open containers or drawn from storage vessels or pipelines,

  Yes

  No

  N/A

• are adequate means readily available for neutralizing or disposing of spills or overflows properly and safely?

  Yes

  No

  N/A

• Have standard operating procedures been established and are they being followed when cleaning up chemical spills?

  Yes

  No

  N/A

• Where needed for emergency use, are respirators stored in a convenient, clean and sanitary location?

  Yes

  No

  N/A

• Are respirators intended for emergency use adequate for the various uses for which they may be needed?

  Yes

  No

  N/A

• Are employees prohibited from eating in areas where hazardous chemicals are present?

  Yes

  No

  N/A

• Is personal protective equipment provided, used and maintained whenever necessary?

  Yes

  No

  N/A

• Are there written standard operating procedures for the selection and use of respirators where needed?

  Yes

  No

  N/A

• If you have a respirator protection program, are your employees instructed on the correct usage and limitations of the respirators?

  Yes

  No

  N/A

• Are the respirators NIOSH approved for this particular application?

  Yes

  No

  N/A

• Are they regularly inspected and cleaned sanitized and maintained?

  Yes

  No

  N/A

• If hazardous substances are used in your processes, do you have a medical or biological monitoring system in operation?

  Yes

  No

  N/A

• Are you familiar with the Threshold Limit Values or Permissible Exposure Limits of airborne contaminants and physical agents used in your workplace?

  Yes

  No

  N/A

• Have control procedures been instituted for hazardous materials, where appropriate, such as respirators, ventilation systems, handling practices, and the like?

  Yes

  No

  N/A

• Whenever possible, are hazardous substances handled in properly designed and exhausted booths or similar locations?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Is ventilation equipment provided for removal of contaminants from such operations as production grinding, buffing, spray painting, and/or vapor decreasing, and is it operating properly?

  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 skin dryness, irritation, or sensitization?

  Yes

  No

  N/A

• Have you considered the use of an industrial hygienist or environmental health specialist to evaluate your operation?

  Yes

  No

  N/A

• If internal combustion engines are used, is carbon monoxide kept within acceptable levels?

  Yes

  No

  N/A

• Is vacuuming used, rather than blowing or sweeping dusts whenever possible for clean up?

  Yes

  No

  N/A

• Are materials, which give off toxic asphyxiant, suffocating or anesthetic fumes, stored in remote or isolated locations when not in use?

  Yes

  No

  N/A

HAZARDOUS SUBSTANCES COMMUNICATION

• Is there a list of hazardous substances used in your workplace?

  Yes

  No

  N/A

• Is there a written hazard communication program dealing with Material Safety Data Sheets (MSDS) labeling, and employee training?

  Yes

  No

  N/A

• Is each container for a hazardous substance (i.e. vats, bottles, storage tanks,) labeled with product identity and a hazard warning (communication of the specific health hazards and physical hazards)?

  Yes

  No

  N/A

• Is there a Material Safety Data Sheet readily available for each hazardous substance used?

  Yes

  No

  N/A

• How will you inform other employers whose employees share the same work area where the hazardous substances are used?

  Yes

  No

  N/A

• Is there an employee training program for hazardous substances?

  Yes

  No

  N/A

• Does this program include:

• An explanation of what an MSDS is and how to use and obtain one?

  Yes

  No

  N/A

• MSDS contents for each hazardous substance or class of substances?

  Yes

  No

  N/A

• Explanation of "Right to Know"?

  Yes

  No

  N/A

• Identification of where employees can see the employer's written hazard communication program and where hazardous substances are present in their work area?

  Yes

  No

  N/A

• The physical and health hazards of substances in the work area, how to detect their presence, and specific protective measures to be used?

  Yes

  No

  N/A

• Details of the hazard communication program, including how to use the labeling system and MSDSs?

  Yes

  No

  N/A

• How employees will be informed of hazards of non-routine tasks, and hazards of unlabeled pipes?

  Yes

  No

  N/A

ELECTRICAL SAFETY

• Are all employees required to report as soon as practicable any obvious hazard to life or property observed in connection with electrical equipment or lines?

  Yes

  No

  N/A

• Are employees instructed to make preliminary inspections and/or appropriate tests to determine what conditions exist before starting work on electrical equipment or lines?

  Yes

  No

  N/A

• When electrical equipment or lines are to be serviced, maintained or adjusted, are necessary switches opened, locked-out and tagged whenever possible?

  Yes

  No

  N/A

• Are portable electrical tools and equipment grounded or of the double insulated type?

  Yes

  No

  N/A

• Are electrical appliances such as vacuum cleaners, polishers, vending machines grounded?

  Yes

  No

  N/A

• Do extension cords being used have a grounding conductor?

  Yes

  No

  N/A

• Are multiple plug adapters prohibited?

  Yes

  No

  N/A

• Are ground-fault circuit interrupters installed on each temporary 15 or 20 ampere, 120 volt AC circuit at locations where construction, demolition, modifications, alterations or excavations are being performed?

  Yes

  No

  N/A

• Are all temporary circuits protected by suitable disconnecting switches or plug connectors at the junction with permanent wiring?

  Yes

  No

  N/A

• Is exposed wiring and cords with frayed or deteriorated insulation repaired or replaced promptly?

  Yes

  No

  N/A

• Are flexible cords and cables free of splices or taps?

  Yes

  No

  N/A

• Are clamps or other securing means provided on flexible cords or cables at plugs, receptacles, tools, and equipment and is the cord jacket securely held in place?

  Yes

  No

  N/A

• Are all cord, cable and raceway connections intact and secure?

  Yes

  No

  N/A

• In wet or damp locations, are electrical tools and equipment appropriate for the use or location or otherwise protected?

  Yes

  No

  N/A

• Is the location of electrical power lines and cables (overhead, underground, underfloor, other side of walls) determined before digging, drilling or similar work is begun?

  Yes

  No

  N/A

• Is the use of metal ladders prohibited in area where the ladder or the person using the ladder could come in contact with energized parts of equipment, fixtures or circuit conductors?

  Yes

  No

  N/A

• Are all disconnecting switches and circuit breakers labeled to indicate their use or equipment served?

  Yes

  No

  N/A

• Are disconnecting means always opened before fuses are replaced?

  Yes

  No

  N/A

• Do all interior wiring systems include provisions for grounding metal parts of electrical raceways, equipment, and enclosures?

  Yes

  No

  N/A

• Are all electrical raceways and enclosures securely fastened in place?

  Yes

  No

  N/A

• Are all energized parts of electrical circuits and equipment guarded against accidental contact by approved cabinets or enclosures?

  Yes

  No

  N/A

• Is sufficient access and working space provided and maintained about all electrical equipment to permit ready and safe operations and maintenance?

  Yes

  No

  N/A

• Are all unused openings (including conduit knockouts) in electrical enclosures and fittings closed with appropriate covers, plugs or plates?

  Yes

  No

  N/A

• Are electrical enclosures such as switches, receptacles, junction boxes, etc., provided with tight-fitting covers or plates?

  Yes

  No

  N/A

• Are disconnecting switches for electrical motors in excess of two horsepower, capable of opening the circuit when the motor is in a stalled condition, without exploding? (Switches must be horsepower rated equal to or in excess of the motor hp rating).

  Yes

  No

  N/A

• Is low voltage protection provided in the control device of motors driving machines or equipment, which could cause probably injury from inadvertent starting?

  Yes

  No

  N/A

• Is each motor disconnecting switch or circuit breaker located within sight of the motor control device?

  Yes

  No

  N/A

• Is each motor located within sight of its controller or the controller disconnecting means capable of being locked in the open position or is a separate disconnecting means installed in the circuit within sight of the motor?

  Yes

  No

  N/A

• Is the controller for each motor in excess of two horsepower, rated in horsepower equal to or in excess of the rating of the motor is serves?

  Yes

  No

  N/A

• Are employees who regularly work on or around energized electrical equipment or lines instructed in the cardiopulmonary resuscitation (CPR) methods?

  Yes

  No

  N/A

• Are employees prohibited from working alone on energized lines or equipment over 600 volts?

  Yes

  No

  N/A

• Is noise levels in any part of the operation in excess of 82 dBA for 10hr shifts or 85 dBA for a 12hr shift?

  Yes

  No

NOISE

• Are there areas in the workplace where continuous noise levels exceed 85 dBA?

  Yes

  No

  N/A

• Are noise levels being measured using a sound level meter or an octave band analyzer and records being kept?

  Yes

  No

  N/A

• Have you tried isolating noisy machinery from the rest of your operation?

  Yes

  No

  N/A

• Have engineering controls been used to reduce excessive noise levels?

  Yes

  No

  N/A

• Where engineering controls are determined not feasible, are administrative controls (i.e. worker rotation) being used to minimize individual employee exposure to noise?

  Yes

  No

  N/A

• Is there an ongoing preventive health program to educate employees in safe levels of noise and exposure, effects of noise on their health, and use of personal protection?

  Yes

  No

  N/A

• Is the training repeated annually for employees exposed to continuous noise above 85 dBA?

  Yes

  No

  N/A

• Have work areas where noise levels make voice communication between employees difficult been identified and posted?

  Yes

  No

  N/A

• Is approved hearing protective equipment (noise attenuating devices) available to every employee working in areas where continuous noise levels exceed 85 dBA?

  Yes

  No

  N/A

• If you use ear protectors, are employees properly fitted and instructed in their use and care?

  Yes

  No

  N/A

• Are employees exposed to continuous noise above 85 dBA given periodic audiometric testing to ensure that you have an effective hearing protection system?

  Yes

  No

  N/A

• Are any fueling tasks conducted on site?

  Yes

  No

FUELING

• Is it prohibited to fuel an internal combustion engine with a flammable liquid while the engine is running?

  Yes

  No

  N/A

• Are fueling operations done in such a manner that likelihood of spillage will be minimal?

  Yes

  No

  N/A

• When spillage occurs during fueling operations, is the spilled fuel cleaned up completely, evaporated, or other measures taken to control vapors before restarting the engine?

  Yes

  No

  N/A

• Are fuel tank caps replaced and secured before starting the engine?

  Yes

  No

  N/A

• In fueling operations is there always metal contact between the container and fuel tank?

  Yes

  No

  N/A

• Are fueling hoses of a type designed to handle the specific type of fuel?

  Yes

  No

  N/A

• Is it prohibited to handle or transfer gasoline in open containers?

  Yes

  No

  N/A

• Are open lights, open flames, or sparking or arcing equipment prohibited near fueling or transfer of fuel operations?

  Yes

  No

  N/A

• Is smoking prohibited in the vicinity of fueling operations?

  Yes

  No

  N/A

• Are fueling operations prohibited in building or other enclosed areas that are not specifically ventilated for this purpose?

  Yes

  No

  N/A

• Where fueling or transfer of fuel is done through a gravity flow system, are the nozzles of the self-closing type?

  Yes

  No

  N/A

IDENTIFICATION OF PIPING SYSTEMS

• When nonpotable water is piped through a facility, are outlets or taps posted to alert employees that it is unsafe and not to be used for drinking, washing or other personal use?

  Yes

  No

  N/A

• When hazardous substances are transported through above ground piping, is each pipeline identified at points where confusion could introduce hazards to employees?

  Yes

  No

  N/A

• When pipelines are identified by color painting, are all visible parts of the line so identified?

  Yes

  No

  N/A

• When pipelines are identified by color painted bands or tapes, are the bands or tapes located at reasonable

  Yes

  No

  N/A

• When pipelines are identified by color, is the color code posted at all locations where confusion could introduce hazards to employees?

  Yes

  No

  N/A

• When the contents of pipelines are identified by name or name abbreviation, is the information readily visible on the pipe near each valve or outlet?

  Yes

  No

  N/A

• When pipelines carrying hazardous substances are identified by tags, are the tags constructed of durable materials, the message carried clearly ad permanently distinguishable and are tags installed at each valve or outlet?

  Yes

  No

  N/A

• When pipelines are heated by electricity, steam or other external source, are suitable warning signs or tags placed at unions, valves, or other serviceable parts of the system?

  Yes

  No

  N/A

MATERIAL HANDLING

• Is there safe clearance for equipment through aisles and doorways?

  Yes

  No

  N/A

• Are aisleways designated, permanently marked, and kept clear to allow unhindered passage?

  Yes

  No

  N/A

• Are motorized vehicles and mechanized equipment inspected daily or prior to use?

  Yes

  No

  N/A

• Are vehicles shut off and brakes set prior to loading or unloading?

  Yes

  No

  N/A

• Are containers or combustibles or flammables, when stacked while being moved, always separated by dunnage sufficient to provide stability?

  Yes

  No

  N/A

• Are dock boards (bridge plates) used when loading or unloading operations are taking place between vehicles and docks?

  Yes

  No

  N/A

• Are trucks and trailers secured from movement during loading and unloading operations?

  Yes

  No

  N/A

• Are dock plates and loading ramps constructed and maintained with sufficient strength to support imposed loading?

  Yes

  No

  N/A

• Are hand trucks maintained in safe operating condition?

  Yes

  No

  N/A

• Are chutes equipped with sideboards of sufficient height to prevent the materials being handled from falling off?

  Yes

  No

  N/A

• Are chutes and gravity roller sections firmly placed or secured to prevent displacement?

  Yes

  No

  N/A

• At the delivery end of rollers or chutes, are provisions made to brake the movement of the handled materials.

  Yes

  No

  N/A

• Are pallets usually inspected before being loaded or moved?

  Yes

  No

  N/A

• Are hooks with safety latches or other arrangements used when hoisting materials so that slings or load attachments won't accidentally slip off the hoist hooks?

  Yes

  No

  N/A

• Are securing chains, ropes, chockers or slings adequate for the job to be performed?

  Yes

  No

  N/A

• When hoisting material or equipment, are provisions made to assure no one will be passing under the suspended loads?

  Yes

  No

  N/A

• Are Material Safety Data Sheets available to employees handling hazardous substances?

  Yes

  No

  N/A

• Are any employees transported by company owned vehicles?

  Yes

  No

TRANSPORTING EMPLOYEES & MATERIALS

• Do employees who operate vehicles on public thoroughfares have valid operator's licenses?

  Yes

  No

  N/A

• When seven or more employees are regularly transported in a van, bus or truck, is the operator's license appropriate for the class of vehicle being driven?

  Yes

  No

  N/A

• Is each van, bus or truck used regularly to transport employees, equipped with an adequate number of seats?

  Yes

  No

  N/A

• When employees are transported by truck, are provision provided to prevent their falling from the vehicle?

  Yes

  No

  N/A

• Are vehicles used to transport employees, equipped with lamps, brakes, horns, mirrors, windshields and turn signals in good repair?

  Yes

  No

  N/A

• Are transport vehicles provided with handrails, steps, stirrups or similar devices, so placed and arranged that employees can safely mount or dismount?

  Yes

  No

  N/A

• Are employee transport vehicles equipped at all times with at least two reflective type flares?

  Yes

  No

  N/A

• Is a full charged fire extinguisher, in good condition, with at least 4 B:C rating maintained in each employee transport vehicle?

  Yes

  No

  N/A

• When cutting tools with sharp edges are carried in passenger compartments of employee transport vehicles, are they placed in closed boxes or containers which are secured in place?

  Yes

  No

  N/A

• Are employees prohibited from riding on top of any load, which can shift, topple, or otherwise become unstable?

  Yes

  No

  N/A

• Does the operation produce potential harmful dusts, Fumes, Mists, Vapors or Gasses?

  Yes

  No

CONTROL OF HARMFUL SUBSTANCES BY VENTILATION

• Is the volume and velocity of air in each exhaust system sufficient to gather the dusts, fumes, mists, vapors or gases to be controlled, and to convey them to a suitable point of disposal?

  Yes

  No

  N/A

• Are exhaust inlets, ducts and plenums designed, constructed, and supported to prevent collapse or failure of any part of the system?

  Yes

  No

  N/A

• Are clean-out ports or doors provided at intervals not to exceed 12 feet in all horizontal runs of exhaust ducts?

  Yes

  No

  N/A

• Where two or more different type of operations are being controlled through the same exhaust system, will the combination of substances being controlled, constitute a fire, explosion or chemical reaction hazard in the duct?

  Yes

  No

  N/A

• Is adequate makeup air provided to areas where exhaust systems are operating?

  Yes

  No

  N/A

• Is the intake for makeup air located so that only clean, fresh air, which is free of contaminates, will enter the work environment?

  Yes

  No

  N/A

• Where two or more ventilation systems are serving a work area, is their operation such that one will not offset the functions of the other?

  Yes

  No

  N/A

• Is equipment sanitation conducted by employees at this site?

  Yes

  No

SANITIZING EQUIPMENT & CLOTHING

• Is personal protective clothing or equipment, that employees are required to wear or use, of a type capable of being easily cleaned and disinfected?

  Yes

  No

  N/A

• Are employees prohibited from interchanging personal protective clothing or equipment, unless it has been properly cleaned?

  Yes

  No

  N/A

• Are machines and equipment, which processes, handle or apply materials that could be injurious to employees, cleaned and/or decontaminated before being overhauled or placed in storage?

  Yes

  No

  N/A

• Are employees prohibited from smoking or eating in any area where contaminates are present that could be injurious if ingested?

  Yes

  No

  N/A

• When employees are required to change from street clothing into protective clothing, is a clean changeroom with separate storage facility for street and protective clothing provided?

  Yes

  No

  N/A

• Are employees required to shower and wash their hair as soon as possible after a known contact has occurred with a carcinogen?

  Yes

  No

  N/A

• When equipment, materials, or other items are taken into or removed from a carcinogen regulated area, is it done in a manner that will not contaminate non-regulated areas or the external environment?

  Yes

  No

  N/A

EMERGENCY ACTION PLAN

• Does the site have an emergency action plan?

  Yes

  No

  N/A

• Have emergency escape procedures and routes been developed and communicated to all employers?

  Yes

  No

  N/A

• Is the employee alarm system that provides a warning for emergency action recognizable and perceptible above ambient conditions?

  Yes

  No

  N/A

• Do employees, who remain to operate critical plant operations before they evacuate, know the proper procedures?

  Yes

  No

  N/A

• Are alarm systems properly maintained and tested regularly?

  Yes

  No

  N/A

• Is the emergency action plan reviewed and revised periodically?

  Yes

  No

  N/A

• Interview, do employees:

• Know their responsibilities for reporting emergencies?

  Yes

  No

  N/A

• Know their responsibilities during an emergency?

  Yes

  No

  N/A

• Know their responsibilities for conducting rescue and medical duties?

  Yes

  No

  N/A

ERGONOMICS

• Can the work be performed without eyestrain or glare to the employees?

  Yes

  No

  N/A

• Does the task require prolonged raising of the arms?

  Yes

  No

  N/A

• Do the neck and shoulders have to be stooped to view the task?

  Yes

  No

  N/A

• Are there pressure points on any parts of the body (wrists, forearms, back of thighs)?

  Yes

  No

  N/A

• Can the work be done using the larger muscles of the body?

  Yes

  No

  N/A

• Can the work be done without twisting or overly bending the lower back?

  Yes

  No

  N/A

• Are there sufficient rest breaks, in addition to the regular rest breaks, to relieve stress from repetitive-motion tasks?

  Yes

  No

  N/A

• Are tools, instruments and machinery shaped, positioned and handled so that tasks can be performed comfortably?

  Yes

  No

  N/A

• Are all pieces of furniture adjusted, positioned and arranged to minimize strain on all parts of the body?

  Yes

  No

  N/A

VENTILATION FOR INDOOR AIR QUALITY

• Does your HVAC system provide at least the quantity of outdoor air required by the State Building Standards

  Yes

  No

  N/A

• Is the HVAC system inspected at least annually, and problems corrected?

  Yes

  No

  N/A

• Are inspection records retained for at least 5 years?

  Yes

  No

  N/A

• Are Cranes used on site?

  Yes

  No

CRANE CHECKLIST

• Are the cranes visually inspected for defective components prior to the beginning of any work shift?

  Yes

  No

  N/A

• Are all electrically operated cranes effectively grounded?

  Yes

  No

  N/A

• Is a crane preventive maintenance program established?

  Yes

  No

  N/A

• Is the load chart clearly visible to the operator?

  Yes

  No

  N/A

• Are operating controls clearly identified?

  Yes

  No

  N/A

• Is a fire extinguisher provided at the operator's station?

  Yes

  No

  N/A

• Is the rated capacity visibly marked on each crane?

  Yes

  No

  N/A

• Is an audible warning device mounted on each crane?

  Yes

  No

  N/A

• Is sufficient illumination provided for the operator to perform the work safely?

  Yes

  No

  N/A

• Are cranes of such design, that the boom could fall over backward, equipped with boomstops?

  Yes

  No

  N/A

• Does each crane have a certificate indicating that required testing and examinations have been performed?

  Yes

  No

  N/A

• Are crane inspection and maintenance records maintained and available for inspection?

  Yes

  No

  N/A

ADDITIONAL RECOMMENDATIONS

• Enter recommendations here

COMPLETION

• Full Name and Signature of the Inspector

  Sign

• Contact Info:

• Joshua@manufacturingutah.com Phone: 801-363-3885 ext.105