Control Room And Equipment Room Safety Inspection

• Safety Inspection

• Building

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1.0 - ADMINISTRATION

• 1.1 - Supervisory Safety Inspection form up to date?

  Yes

  No

  N/A

• 1.2 - Emergency plan and phone numbers posted?

  Yes

  No

  N/A

• 1.3 - PPE Available and inspected?

  Yes

  No

  N/A

2.0 - FIRE PREVENTION

• 2.1 - Evacuation plan displayed and understood by all employees?

  Yes

  No

  N/A

• 2.2 - Evacuation procedures discussed regularly?

  Yes

  No

  N/A

• 2.3 - Extinguishers in place, clearly marked for type of fire?

  Yes

  No

  N/A

• 2.4 - Extinguishers recently serviced? (check 6 monthly punch marks on tabs)

  Yes

  No

  N/A

• 2.5 - Extinguishers clear of obstructions?

  Yes

  No

  N/A

• 2.6 - Adequate direction notices for fire exits?

  Yes

  No

  N/A

• 2.7 - Exits clear of obstructions?<br>

  Yes

  No

  N/A

• 2.8 - Fire alarm system functioning correctly?

  Yes

  No

  N/A

3.0 - GENERAL LIGHTING

• 3.1 - Reflected light from walls and ceilings not causing glare to employees?

  Yes

  No

  N/A

• 3.2 - Light fittings clean and in good conditions?

  Yes

  No

  N/A

• 3.3 - Emergency exit lighting operable?

  Yes

  No

  N/A

4.0 - BUILDING SAFETY

• 4.1 - Floor surfaces even and uncluttered?

  Yes

  No

  N/A

• 4.2 - Entry and walkways kept clear?

  Yes

  No

  N/A

• 4.3 - Intersections kept clear of boxes, etc.?

  Yes

  No

  N/A

• 4.4 - Stair and raisers kept clear?

  Yes

  No

  N/A

• 4.5 - Furniture in sound condition?

  Yes

  No

  N/A

• 4.6 - Proper material storage and trash receptacles.

  Yes

  No

  N/A

• 4.7 - Work area and equipment clear of debris and materials?

  Yes

  No

  N/A

5.0 - ELECTRICAL HAZARDS

• 5.1 - Adequate lighting for working conditions.

  Yes

  No

  N/A

• 5.2 - Cords in good condition and protected from traffic.

  Yes

  No

  N/A

• 5.3 - Electrical panels protected.

  Yes

  No

  N/A

• 5.4 - Safety plates on outlets and j boxes.<br>

  Yes

  No

  N/A

• 5.5 - J-box knockouts covered?

  Yes

  No

  N/A

6.0 - PERSONNEL AND PHYSICAL SECURITY DIVISION

• 6.1 - Equipment room secured?

  Yes

  No

  N/A

• 6.2 - Control room secured?

  Yes

  No

  N/A

• 6.3 - Authorized Personnel Access List?

  Yes

  No

  N/A

• 6.4 - X-ray log utilized?

  Yes

  No

  N/A

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