Title Page
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Document No.
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Audit Title
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Client / Site
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Location
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Conducted on
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Prepared by
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Personnel present/joined
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Other information/Remarks
Training
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Do you want to perform the element "TRAINING"?
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Is training provided for each person newly assigned to a job?
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Does initial training include a thorough review of hazards and accidents associated with the job?
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Is adequate instruction in the use of personal protective equipment provided?
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Is training for the use of emergency equipment provided?
Work Process
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Do you want to perform the element "WORK PROCESS"?
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Are hazards signalled by signs and tags?
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Are the safety data sheets placed in (e)locations accessible to all employees?
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Are lockout or tagout procedures in place and followed?
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Is (central) ventilation equipment working effectively?
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Are fume hoods, weighing cabinets, exhaust arms working effectively and properly used?
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Are the safety showers and eye wash stations in the proper locations and in good working condition?
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Are repetitive motion tasks properly paced and kept to a minimum?
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Have all trucks, forklifts and other equipment been inspected and maintained?
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Are work permits provided to external parties and is safety measure implementation regularly checked?
Personal Protective Equipment (PPE)
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Do you want to perform the element "PERSONAL PROTECTIVE EQUIPMENT
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Is required equipment indicated, provided, maintained and used?
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Does equipment meet requirements?
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Is it reliable?
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Is personal protection utilized only when it is not reasonably practicable to eliminate or control the hazardous substance or process?
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Are the areas requiring PPE usage properly identified by warning signs?
Hazardous Substances and Storage
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Do you want to perform the element "HAZARDOUS SUBSTANCES"?
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Do colleagues receive general instruction on how to work safely with hazardous substances?
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Has the safety data sheet (SDS) been reviewed before handling, moving, or storing the product?
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Are colleagues instructed on containment (safety) measures to be used in different processes/tasks with specific hazardous substances?
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Are fumehoods, safety cabinets, isolators used in a proper way? Not cluttered, no blocked ventilation, proper maintenance.
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Are flasks, drums, boxes properly labelled (CLP/GHS labels, content description)
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Are incompatible chemicals stored in a proper way?
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Are containers stored in drip trays where necessary?
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Are containers checked for leaks or damage?
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Is spill cleanup material immediately available?
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Is there no long term storage of chemicals in working areas (only what is needed for the process)?
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Are bonding and grounding connections immediately available for flammable products?
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Is waste stored and disposed of in a in a safe manner?
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Is hazardous waste separated in different waste types?
Explosion/Fire Safety
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Do you want to perform the element "EXPLOSION/FIRE SAFETY"?
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Is an assessment of explosion risks available?
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Is equipment with explosion risk properly labelled?
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Have zones (processes) with explosion risks been indicated?
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Are rules related to explosion safety (e.g. ATEX equipment only) adhered to?
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Is grounding regularly checked (preventive maintenance?)
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Are hot work procedures in place aimed at preventing fire/explosions?
Materials Handling and Storage
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Do you want to perform the element "MATERIAL HANDLING AND STORAGE"?
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Is there safe clearance for all equipment through aisles and doors?
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Is stored material stable and secure?
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Are storage areas free from tipping hazards?
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Are only trained operators allowed to operate forklifts?
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Is charging of electric batteries performed only in designated areas?
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Are dock boards (bridge plates) used when loading or unloading from dock to truck or dock to rail car?
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Are necessary warning devices and signs in use for railway sidings?
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Are specifications posted for maximum loads which are approved for shelving, floors and roofs?
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Are racks and platforms loaded only within the limits of their capacity?
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Are chain hoists, ropes and slings adequate for the loads and marked accordingly?
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Are slings inspected daily before use?
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Are all new, repaired, or reconditioned alloy steel chain slings proof-tested before use?
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Are pallets and skids the correct type and inspected?
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Do personnel use proper lifting techniques?
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Is the size and condition of containers hazardous to workers?
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Are elevators, hoists, conveyors, balers, etc., properly used with appropriate signals and directional warning signs?
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Warehouse and Shipping
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Do you want to perform the element "WAREHOUSE AND SHIPPING"?
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Are dock platforms, bumpers, stairs and steps in good condition?
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Are light fixtures in good condition?
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Are all work areas clean and free of debris?
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Are stored materials properly stacked and spaced?
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Are tools kept in their proper place?
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Are there metal containers for oily rags and for rubbish?
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Are floors free of oil spillage or leakage?
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Is absorbent available for immediate clean-up of spills and leaks?
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Are all flammable and combustible products stored appropriately? Is storage requirement analysis available; are special storage units/conditions in place or are (bulk quantities) stored outside the warehouse?
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Loading/Unloading Racks
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Do you want to perform the element "LOADING/UNLOADING RACKS"?
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Are steps, railings and retractable ramps on raised platforms in good repair?
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Is piping and in-line equipment in good condition and free of leaks?
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Are loading arms operating satisfactorily?
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Do submerged filling two-stage valves operate properly?
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Are bonding and grounding cables free of breaks or damage?
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Are connections tight and sound?
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Is the general condition of wiring and junction boxes, etc. in good condition (visual inspection)?
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Electrical
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Do you want to perform the element "ELECTRICAL"?
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Do policies/practices with respect to electricity adhere to local legislation (e.g. NEN3140) during operation, use, repair and maintenance?
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Are all machines properly grounded?
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Are portable hand tools grounded or double insulated?
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Are junction boxes closed?
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Are extension cords out of the aisles where they can be damager by (heavy) traffic?
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Is permanent wiring used instead of extension cords?
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Machine Guards
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Do you want to perform the element "MACHINE GUARDS"?
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Are all dangerous machine parts adequately guarded?
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Do machine guards meet standards?
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Are lockout procedures followed when performing maintenance with guards removed?
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Lighting
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Do you want to perform the element "LIGHTING"?
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Is the level of light adequate for safe and comfortable performance of work?
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Does lighting produce glare on work surfaces, monitors, screens and keyboards?
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Is emergency lighting adequate and regularly tested?
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Tools and Machinery
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Do you want to perform the element "TOOLS AND MACHINERY"?
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Are manufacturers' manuals kept for all tools and machinery?
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Do power tools conform to standards?
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Are tools properly designed for use by employees?
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Are defective tools tagged and removed from service as part of a regular maintenance program?
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Are tools and machinery used so as to avoid electrical hazards?
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Is proper training given in the safe use of tools and machinery?
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Temporary Work Structures
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Do you want to perform the element "TEMPORARY WORK STRUCTURES"?
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Are temporary work structures used only when it is not reasonably practicable to use permanent ones?
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Are excavations properly shored, free of large objects (rocks, etc.) at the edges?
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Floor and Wall Openings
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Do you want to perform the element "FLOOR AND WALL OPENINGS"?
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Are ladder-ways and door openings guarded by a railing?
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Do temporary floor openings have standard railings or someone constantly on guard?
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Confined Spaces
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Do you want to perform the element "CONFINED SPACES"?
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Are the confined space procedures and training available and followed by all involved?
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Are entry and exit procedures adequate?
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Are emergency and rescue procedures in place (e.g. trained safety watchers)?
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Are measuring devices (e.g.O2, CO2, CO) available and has personnel been instructed on their use?
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Stairs, Ladders and Platforms
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Do you want to perform the element "STAIRS, LADDERS AND PLATFORMS"?
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Are stairs and handrails in good condition?
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Are ladders free of defects?
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Are ladders set up properly before use?
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Are the elevated platforms properly secured and do they have handrails?
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Are stairs and ladders used in a safe manner (e.g. handrail use, mobile phone use...)
Elevating Devices
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Do you want to perform the element "ELEVATING DEVICES"?
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Are elevating devices used only within capacity?
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Are capacities posted on equipment?
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Are they regularly inspected, tested and maintained?
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Are controls of the dead man" type?"
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Are operators trained?
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Sound level/noise
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Do you want to perform the element " Sound Level/Noise "?
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Are regular noise surveys conducted?
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Is hearing protection available and used properly?
Housekeeping
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Do you want to perform the element "HOUSEKEEPING"?
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Is the work area clean and orderly?
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Are floors free from protruding nails, splinters, holes and loose boards?
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Are aisles and passageways kept clear of obstructions?
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Are permanent aisles and passageways clearly marked?
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Are covers or guardrails in place around open pits, tanks and ditches?
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Employee Facilities
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Do you want to perform the element "EMPLOYEE FACILITIES"?
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Are facilities kept clean and sanitary?
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Are facilities in good repair?
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Are cafeteria facilities provided away from toxic chemicals?
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Are hand washing facilities available?
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Are measures preventing carry-over of chemicals from workplace to employee facilities in place?
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Means of Exit
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Do you want to perform the element "MEANS OF EXIT"?
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Are there enough exits to allow prompt escape?
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Do employees have easy access to exits?
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Are exits unlocked to allow egress?
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Are exits clearly marked?
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Are exits and exit routes equipped with emergency lighting?
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Fire Emergency Procedures
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Do you want to perform the element "FIRE EMERGENCY PROCEDURES"?
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Is there a clear fire response plan posted for each work area?
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Do all workers know the plan?
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Are drills held regularly?
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Are fire extinguishers chosen for the type of fire most likely in that area?
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Are there enough extinguishers present to do the job?
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Are extinguisher locations conspicuously marked?
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Are extinguishers properly mounted and easily accessible?
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Are all extinguishers fully charged and operable and properly maintained?
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Are special purpose extinguishers clearly marked?
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Medical and First Aid
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Do you want to perform the element "MEDICAL AND FIRST AID"?
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Do all employees know how to get first aid assistance when needed?
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Do the first-aiders know when and to which hospital or clinic an injured person should be taken?
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Are there employees trained as first-aid practitioners on each shift worked?
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Are first-aid supplies replenished as they are used?
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Are first-aid kits provided and clearly visible?
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Environment
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Do you want to perform the element "ENVIRONMENT"?
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Are resources available to deal with very hot or very cold conditions (drinking water, lined gloves, insulated boots)?
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Is the rain/cold weather gear that is provided comfortable, and light enough so as not to constitute a hazard?
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Are work surfaces and grip surfaces safe when wet?
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Do workers know the symptoms of heat cramps/heatstroke, or frost bite/hypothermia?
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General items/comments
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Any further comments or recommendations arising from this inspection?
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Add any additional relevant photos?
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Have all required corrective actions been added as Actions to this inspection?
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Please add any corrective actions to the appropriate questions above before completing this report
Signature
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Inspection completed by: