Croell Plant/Shop Safety & Environmental Inspection

• Croell Plant / Shop Safety Inspection Form

• Location
  Address

• Conducted On

  Date

• Completed By

• Document No.

Office / Plant

• Emergency Phone Numbers Posted?

  Yes

  No

  N/A

• Evacuation routes posted and unobstructed.

  Yes

  No

  N/A

• State and Federal Labor Law postings up to date?

  Yes

  No

  N/A

• Handbook & Health and Safety manual available and up to date?

  Yes

  No

  N/A

• Chemical inventory SDS list posted.

  Yes

  No

  N/A

• MSDS Online up to date? Check one product online.

  Yes

  No

  N/A

• Incident Report Forms available?

  Yes

  No

  N/A

• Warning signs posted throughout facility?

  Yes

  No

  N/A

• Man in Drum sign available?

  Yes

  No

  N/A

• Check Returned Concrete Areas (Block forms or dumping location) -- Take Photo

  Good

  Fair

  Poor

  N/A

• First Aid Kit and BBP kit maintained?

  Yes

  No

  N/A

• Fire extinguishers accessible and inspections done?

  Yes

  No

  N/A

• Eyewash station clean and inspected? Check Expiration Dates & Tags

  Yes

  No

  N/A

Personal Protective Equipment

• Is PPE available and in use?

  Yes

  No

  N/A

• If respirators are used (other than dust masks worn on a voluntary basis) employees are medically qualified, trained and fit tested for respirator use?

  Yes

  No

  N/A

• Types of PPE in use:

  Select Hard Hats Safety Glasses Ear Protection Vests or Hi Vis Work Boots Bump Caps

  • Hard Hats
  • Safety Glasses
  • Ear Protection
  • Vests or Hi Vis
  • Work Boots
  • Bump Caps

• Torching and welding shields available and in use?

  Yes

  No

  N/A

Electrical Hazards

• Are GFCI outlets or breakers provided around water sources?

  Yes

  No

  N/A

• 3ft clearance around electrical boxes and panels?

  Yes

  No

  N/A

• Electrical switches and breakers labeled and warning signs posted?

  Yes

  No

  N/A

• Are repairs on extension cords and other wiring done correctly?

  Yes

  No

  N/A

• Is electrical wiring free of damage and fraying?

  Yes

  No

  N/A

Guards

• Are all belts, pulleys, and other moving parts within 7 foot of walking/working surfaces fully guarded?

  Safe

  At Risk

  N/A

• Are all conveyor systems within 7 foot of walking/working surface equipped with a shut-off cable, guard, or proper signage?

  Yes

  No

  N/A

• Chains, cables, slings, hooks, and hoist in good condition and inspections current?

  Yes

  No

  N/A

• Air compressor guarded and in good working condition?

  Yes

  No

  N/A

• Guards and shields in place for stationary and portable power/hand tools?

  Yes

  No

  N/A

Lockout / Tagout

• Lockout / Tagout procedures being used properly?<br>

  Yes

  No

  N/A

• Lockout kit fully stocked with locks, tags, etc?

  Yes

  No

  N/A

Confined Space

• Confined Space procedures in place and being used properly?

  Yes

  No

  N/A

• Confined Space Monitor being calibrated and logged?

  Yes

  No

  N/A

• Bump Test being performed before each entry and logged?

  Yes

  No

  N/A

• All confined space areas properly labeled?

  Yes

  No

  N/A

Fall Protection/Fall Hazards

• All fall protection devices in good working condition?

  Yes

  No

  N/A

• Ladders being inspected before each use?

  Yes

  No

  N/A

• Check ladders for damage.

• Proper height on all handrails? At least 42"

  Yes

  No

  N/A

• Railings, toe boards, stairs in good condition?

  Safe

  At Risk

  N/A

• All stairs and walkways in good working condition?

  Safe

  At Risk

  N/A

• Swing Gates or safety chains on all working platforms?

  Yes

  No

  N/A

Heavy Equipment

• Take Photo of Loading Area

  Media

• Daily equipment inspections being done?

  Yes

  No

  N/A

• Check one piece of equipment

• Take picture of equipment and unit number

  Media

• Good house keeping in cab of equipment?

  Yes

  No

  N/A

• Take picture of interior

  Media

• Seat and seat belt in good working condition?

  Yes

  No

  N/A

• Wheels chocks in good working condition?

  Yes

  No

  N/A

• Mirror adjusted properly and good working condition?

  Yes

  No

  N/A

• Back up alarm and horn working properly?

  Yes

  No

  N/A

• Access steps and railing in good working condtion?

  Yes

  No

  N/A

• Are parking brakes capable of holding mobile equipment with typical load on max grade?

  Yes

  No

  N/A

• All ramps bermed half the distance of the largest equipment being used on ramps?

  Yes

  No

  N/A

Fuel/Flammable/Conveyance & Storage of materials under pressure.

• All compressed gas cyclinders secured in safe manner and properly capped when not in use?

  Yes

  No

  N/A

• Are oxygen cylinders stored away from flammable materials and at least 25 feet from flammable gas cylinders?

  Yes

  No

  N/A

• Annual inspection done on all pressure vessels/compressors? (Minnesota Only)

  Yes

  No

  N/A

• Are storage areas for cylinder bottles labeled, Full and Empty?

  Yes

  No

  N/A

• Do all high pressure lines have the approved high pressure clamp? No radiator clamps-

  Yes

  No

  N/A

• Flammable Liquids stored an approved Safety Can and Containers?

  Yes

  No

  N/A

• Are no smoking signs/labels posted around flammable materials?

  Yes

  No

  N/A

• Are all spills cleaned up?

  Yes

  No

  N/A

• Proper labels on containers per GHS?

  Yes

  No

  N/A

• Oil catch basin & waste storage condition?

  Good

  Fair

  Poor

  N/A

• Bag houses, pop off valves? (Visual Inspection if plant in use)

  Pass

  Fail

  N/A

Environmental

• Is air quality permit on site?

  Yes

  No

  N/A

• Is air quality record-keeping up to date?

  Yes

  No

  N/A

• Take a photo of the Weekly Bag House Inspection Log

  Media

• Take a photo of the Monthly Bag House Inspection Log

  Media

• Visual emissions evaluated and under 20% opacity?

  Compliant

  Non-Compliant

  N/A

• Storm Water Pollution Prevention Plan (SWPPP) on site?

  Yes

  No

  N/A

• SWPPP inspections up to date?

  Yes

  No

  N/A

• Take a photo of SWPPP inspection logs.

  Media

• Outfall present at this site?

  Yes

  No

  N/A

• Take a photo of any Best Management Practises (BMPs).

  Media

• Spill Prevention Control Countermeasure Plan (SPCC) required? (1,320 gallons)

  Yes

  No

• SPCC inspections current?

  Yes

  No

  N/A

• Fuel tanks appropriately labeled?

  Yes

  No

  N/A

• Take photo of any fuel tanks and containment.

  Media

• Fuel stains present in containment or yard? Take Photo if present.

  Yes

  No

  N/A

• Overall how is the safety performance at this location?

  Good

  Fair

  Poor

  N/A

• Overall Housekeeping site, plant, and shop?

  Good

  Fair

  Poor

  N/A

• Vehicles/mixers kept in good condition? Clean inside and out?

  Media

• Other Hazards Observed

  Yes

  No

  N/A

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