Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Department:
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Inspected by:
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Select date
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Instructions: 1. Review each item on the list as it applies to the area of inspection and answer ‘yes’ ‘no’ or ‘n/a’ and also please comment as appropriate. 2. The hazards listed are intended only as prompts so please comment on any issues you feel may be of safety relevance outside of the specific questions. 3. It is not necessary to inspect every item, piece of equipment in every area during an inspection but please note the items, equipment or areas which were checked where possible whether in compliance or not. 4. If corrective actions are required please note suggestions or recommendations in the ‘Corrective Actions’ column. If no corrective actions are required leave this column blank. 5. All corrective actions not immediately addressed should be put up on EnviroManager by the person completing the DSI. 6. Completed DSI reports should be scanned and filed in the EHS Process Team folder on the LDrive
Chemicals
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Chemicals: are all chemicals clearly labelled, segregated correctly and storage areas in good condition?
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Observation and Corrective Action:
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EnviroManager Required?
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Fume Hoods/Ventilation: Are fume hood and<br>extraction devices services and service labels clearly<br>visible?
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Observation and Corrective Action:
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EnviroManager Required?
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Bunds: Are all tanks and chemicals stored in bunded areas/cabinets and are all bunds empty and free of anyvisible signs of leaks?
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Observation and Corrective Action:
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EnviroManager Required?
House Keeping & Waste Streams
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Hazardous Wastes: Are all hazardous wastes<br>correctly segregated and stored in appropriately<br>designated areas?
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Observation and corrective action
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EnviroManager Required?
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General Waste: Are waste segregation areas and bins relevant to area activities in clean and orderly condition, not full or overflowing?
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Observation and Corrective Action:
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EnviroManager Required?
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Eye Wash: Are eye wash stations flushed regularly and signed off?
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EnviroManager Required?
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Diphoterine Stations: Reagent available and In date?
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EnviroManager Required?
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First-Aid: Are first-aid kit locations in area<br>clearly visible, in good condition and signed off?
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EnviroManager Required?
Equipment, Electrical ,Mechanical, Utilities
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Ergonomic: Is all office equipment in good<br>condition?
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Observation and Corrective Action
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EnviroManager Required?
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Electrical: Is all portable electrical equipment<br>PAT testing, in good condition
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Observation and Corrective Action
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EnviroManager Required?
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Mechanical: Are all Emergency Stops clearly<br>visible and adequate machine guarding in place?
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Observation and Corrective Action
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EnviroManager Required?
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Compressed Gasses: Are all compressed<br>gases in good condition, stored in designated<br>locations, adequately secured and protective caps<br>in place.
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Observation and Corrective Action
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EnviroManager Required?
Work Area
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Manual Handling: Is there any manual handling of heavy loads in the area and if so are appropriate<br>lifting and transport equipment available relative to specific manual handling requirements?
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Observation & Corrective Action
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EnviroManager Required?
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Ladders and steps: Are all ladders and steps stored in designated areas, in good condition and<br>have a SAP identification number?
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Observation & Corrective Action
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EnviroManager Required?
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Material storage: Is material stored in correctly designated areas, material stored at height properly<br>secured and banding in use as required? Are racking structures, if in use, in good condition and<br>undamaged?
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Observation & Corrective Action
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EnviroManager Required?
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Lighting: Is all lighting in the area working, fitting and ceiling tiles in good condition?
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Observation & Corrective Action
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EnviroManager Required?
Working Enviornment
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Noise: Is any equipment in the area generating excessive noise and is warning signage and hearing<br>protection in place as required?
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Observation & Corrective Action
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EnviroManager Required?
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Personal Protection Equipment: Is required PPE for area and specific operations clearly<br>identified, readily available, stored appropriately and in good condition?
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Observation & Corrective Action
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Slips/Trips and Falls: Are all general walkways, access and egress routes free of trailing leads, obstruction and spillages?
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Observation and Corrective Action
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EnviroManager Required?
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Emergency Egress: Are emergency escape routes clearly identified, lighted and free of obstruction?
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Observation & Corrective Action
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EnviroManager Required?
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EHS Awareness/Visibility: Are EHS notice boards in the area maintained up-to-date with relevant information?
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Observation & Corrective Action
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EnviroManager Required?
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Fire Extinguishers: Are fire extinguishers in good condition, conspicuously identified, inspections tags up-to date, and seals in-tact and located in readily accessible locations free of obstruction?
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Observation & Corrective Action
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EnviroManager Required?
Other Issues/Comments/Observation etc.
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