Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Aisles/Walkways

  • Aisles/walkways are kept clean and orderly (1910.22)

  • Aisles/walkways are kept dry (to extent feasible) / in wet operations, drainage or dry standing mats are provided (1910.22)

  • Aisles/walkways are kept in good repair/free of hazards (1910.22)

  • Aisles/walkways are kept in good repair/free of hazards (1910.22)

  • Permanent aisles/passageways are appropriately marked

  • There is sufficient aisle width for pedestrians and/or equipment in work areas where mechanical handling equipment is used

  • Changes in elevation are marked/delineated to minimize trip hazards (Best Practice)

Behaviors

  • Workers observed keeping eyes on path (i.e. looks in direction of travel)

  • Workers observed looking back prior to stepping backwards

  • Workers observed pushing (when possible) as opposed to pulling

  • Workers avoid overhead work when possible

  • Workers observed lifting with legs not back

  • Workers observed forming a bridge with free hand when lifting

  • Workers avoid lifting more than one can lift safely

  • Workers observed keeping load close to body when lifting

  • Workers observed using a lift assist device for heavy loads

  • Workers avoid lifting unstable loads

  • Workers observed working at safe pace/not rushed

Bloodborne Pathogens

  • PPE is readily accessible and appropriate sizes are available as needed (1910.1030)

  • Contaminated sharps are discarded in an approved container (1910.1030)

  • Sharps containers are readily accessible as needed (1910.1030)

  • Contaminated laundry is placed in approved bags or containers that are properly labeled (1910.1030)

  • Warning labels are affixed to containers used to store, transport or ship regulated waste (1910.1030)

  • Employees with occupation exposure to BBP have been properly trained at time of hire and annually thereafter (1910.1030)

Compressed Air

  • Compressors are equipped with a safety relief valve (1910.169)

  • Compressed air have safety nozzles (under 30 psi) and are not used to clean clothes

  • Compressors are equipped with working pressure gauges (1910.169)

  • Compressors are periodically drained of moisture/oil (1910.169)

  • Air nozzles are equipped with relief ports to discharge air when nozzle tip is obstructed (1910.242)

  • Airhose connections are designed for rated pressure/service (1910.243)

  • Safety cables are used on compressed air hose connections to prevent hose ends from whipping if the coupling blows out of the hose (Best Practice)

Compressed Gas Cylinders

  • Cylinders are protected from ignition sources (1910.101)

  • Cylinders are stored in vertical position (1910.101)

  • Cylinders are secured to prevent tipping (1910.101)

  • Cylinders are stored away from vehicular traffic (1910.101)

  • Valve caps are replaced when cylinders are not in use (1910.101)

  • Valves on gas cylinder are closed when work is finished (1910.253)

Confined Space

  • The employer has evaluated the workplace to determine if Permit Required Confined Spaces exist (1910.146)

  • Danger signs are posted at or near entry to permit spaces (1910.146)

  • There is a written program available for employees who enter permit spaces (1910.146)

  • Air monitoring is completed prior to entry (1910.146)

  • Periodic air sampling is completed as required (1910.146)

  • Forced air ventilation is used for duration of entry (1910.146)

  • Entrants are protected from external hazards by barricades as needed (1910.146)

  • Proper illumination is provided (1910.146)

  • Attendant is on duty outside the permit space (1910.146)

  • Rescue plan/procedures have been established (1910.146)

  • Entry permit is completed and signed (1910.146)

  • Employees with assigned PRCS duties are properly trained (1910.146)

  • Attendant only performs monitoring duties (1910.146)

  • Rescue team is trained and readily available (1910.146)

  • Retrieval system is available/utilized (1910.146)

  • Entrants are attached to retrieval line (1910.146)

Electrical Safety

  • The top of electrical equipment is kept clear / no items are allowed stored on equipment (1910.303)

  • Electrical equipment is installed/used as listed or per manufacturer specifications (1910.303)

  • Extension cords and/or power strip cords are not connected to one another (i.e. not "daisy-chained") (1910.303)

  • Extension cords and/or power strip cords are not connected to one another (i.e. not "daisy-chained") (1910.303)

  • Unused openings in electrical equipment are closed (1910.303)

  • Electrical equipment is free of significant damage (1910.303)

  • Electrical equipment is firmly secured to surface (1910.303)

  • Splices/free ends of conductors are properly insulated (1910.303)

  • Warning labels/decals are placed on electrical equipment indicating the voltage, current, wattage, etc.

  • Breaker switches are identified/legibly marked to indicate their purpose (1910.303)

  • Proper clearance is maintained around breaker panels, disconnects, etc. (1910.303)

  • Access to breaker panels, disconnects, etc. are not obstructed (i.e. proper clearance not maintained) and/or the area around transformers and other electrical equipment is not kept clear (1910.303)

  • All live parts of electrical equipment were protected against accidental contact(1910.303)

  • All live parts of electrical equipment were protected against accidental contact(1910.303)

  • Electrical equipment is adequately guarded/protected from damage (1910.303)

  • GFCI receptacles are used/located within 6 feet of water source (1910.304)

  • The use of multi-plug outlet devices is discouraged and/or prohibited (except for temporary use of low powered loads) (1910.304)

  • Cord-and-plug electrical equipment is either grounded (i.e. 3 prong cord) or double-insulated (1910.304)

  • Light bulbs/lamps are protected from accidental damage (1910.305)

  • Electrical cords/conductors entering boxes/panels are protected from abrasion (1910.305)

  • Pull/Junction Boxes (over 600V) are completely enclosed (1910.305)

  • Pull/Junction Boxes (over 600V) are enclosed with a suitable cover that is securely fastened (1910.305)

  • Panel boards/dead fronts are installed on electrical enclosures (1910.305)

Exits/Egress

  • Exit pathways are at least 28 inches wide (1910.36)

  • All exit discharges lead directly outside the facility (1910.36)

  • Exit doors are kept unlocked when building is occupied, no latches or special tools are needed to open door (1910.36)

  • Exit doors in high occupancy/high hazard areas open out in direction of travel (1910.36)

  • There are at least two exit doors in high occupancy rooms (1910.36)

  • The direction of travel to exits is marked when not apparent (1910.37)

  • All exit signs are illuminated (1910.37)

  • Non-exit doors are marked NOT AN EXIT as required (1910.37)

  • Exits are clearly visible and marked by EXIT signs (1910.37)

  • Exits and pathway to exits are all free of obstructions (1910.37)

  • Exit routes avoid high hazard areas (1910.37)

  • Flammable/combustible liquids not stored next to exits (1910.106)

  • Emergency lights are provided and functional (1910.37)

  • Employee alarm system is functional and audible throughout the facilities (1910.38)

Fire Safety

  • Containers are located to minimize exposure to temp rise, damage and/or tampering (1910.110)

  • Portable fire extinguishers are mounted (1910.157)

  • Portable fire extinguisher(s) were found to be unobstructed (1910.157)

  • Portable fire extinguishers identified by signage (1910.157)

  • When fire extinguishers are relocated, fire extinguisher signs are removed (1910.157)

  • Fire extinguishers are kept fully charged and operable (1910.157)

  • Fire extinguishers are kept in their designated locations (1910.157)

  • The travel distance to the nearest fire extinguisher is within 75 feet (1910.157)

  • Portable fire extinguishers are inspected monthly (1910.157)

  • Portable fire extinguishers are maintained annually (1910.157)

  • A minimum clearance of 18 inches is maintained below sprinkler heads (1910.159)

  • Sprinkler heads are protected by metal guards when needed (1910.159)

  • The sprinkler system is inspected annually (1910.160)

  • Fire doors are in good operating condition (NFPA 80)

  • Fire doors are unobstructed (NFPA 80)

  • The fire alarm system is tested annually (NFPA 25)

  • Smoke alarms are functional when test button is depressed (NFPA 72)

  • Outside hydrants are tested annually (NFPA 25/291)

  • Combustible items are kept at least 3 feet away from heating equipment (NFPA 86)

  • Proper clearance is maintained around water heaters (NFPA 54 & 70]

  • Dust collectors and ductwork are properly grounded (NFPA 664)

  • The space on floor directly below fire extinguishers is marked/striped (Best Practice)

Flammable Liquids

  • Flammable liquids are kept in closed containers when not in use (1910.106)

  • Containers are bonded when transferring flammables (1910.106)

  • No Smoking signs are posted in flammable storage areas (1910.106)

  • Ignition sources are controlled/eliminated near flammable storage areas (1910.106)

  • Fire extinguishers are located near flammable storage areas (1910.106)

  • Combustible waste (i.e. oily rags) is stored in covered metal containers (1910.106)

  • Spill response/cleanup supplies are readily available (1910.106)

  • Spill containment is provided in bulk transfer/storage areas (i.e. tank farms) (1910.106)

  • Ventilation is provided at bulk storage areas when transferring flammables (1910.106)

  • Flammable storage cabinets meet OSHA’s minimum design/construction requirements (1910.106)

  • Flammable storage cabinets labeled properly (1910.106)

  • Self-closing valve is used when dispensing flammables (1910.106)

  • A fill pipe is used when top filling containers to minimize splashing (1910.106)

  • Air is exchanged 6 times/hour in inside chemical storage rooms (1910.106)

  • The aisle width in chemical storage room is maintained at a minimum of 3 feet (1910.106)

  • Outside flammable storage areas are secured (1910.106)

  • Good housekeeping is maintained in outside storage areas (1910.106)

  • Spill containment is provided for outdoor storage areas (1910.106)

  • No more than 25 gallons of Category 1 flammable liquids are stored outside of an approved storage cabinet or flammable storage room (1910.106)

Grinders (Bench/Pedestal)

  • Work rest is adjusted to within 1/8 inch of wheel (1910.215)

  • The tongue guard is adjusted to within 1/4 inch of wheel (1910.215)

  • Side guards cover 75 percent of wheel diameter (1910.215)

  • Bench/pedestal grinders are permanently mounted (1910.212)

  • Safety glasses/faceshield are worn when grinding (1910.132)

  • Wheel RPM ratings are compatible with motor RPM ratings (1910.215)

  • Abrasive wheels are ring tested before mounting (1910.215)

Hazard Communication

  • A chemical inventory list or index is maintained (1910.1200)

  • Safety Data Sheets (SDS) for hazardous chemicals are kept on site (1910.1200)

  • Safety Data Sheets (SDS's) for hazardous chemicals are readily accessible to all employees/all shifts (1910.1200)

  • Chemicals in supplier containers are properly labeled (1910.1200)

  • Secondary chemical containers are properly labeled and/or legible (1910.1200)

  • Hazcom training has been completed and employees demonstrate knowledge of Hazcom requirements (1910.1200)

  • Noncompatible chemicals are segregated in storage (1910.1200)

Housekeeping

  • Work areas are kept generally clean and orderly (1910.141)

  • Working surfaces are kept in good repair and level to minimize slip/trip/fall hazards (1910.141)

  • Work surfaces are kept reasonably dry as work allows (1910.141)

  • Waste/garbage is removed regularly (1910.141)

  • Entrance or harborage of vermin to workplace is controlled and maintained (1910.141)

  • Employees are not allowed to consume food and beverages in areas exposed to a toxic material(1910.141)

  • Positive Finding Restrooms are maintained in a clean and sanitary condition (1910.141)

  • Break areas are clean and sanitary (1910.141)

  • Potable water is provided as required (1910.141)

Personal Protective Equipment

  • PPE Hazard Assessment has been completed and certified (1910.132)

  • PPE was maintained in good condition, there were no obvious signs of damage or defects (1910.132)

  • ANSI approved safety glasses with side protection are worn as required (1910.133)

  • Face shields are worn when there is danger of flying particles (1910.133)

  • Goggles are worn as needed for protection against splashing chemicals (1910.133)

  • Filter/shaded lenses are used as required (1910.133)

  • Eye/face protection is ANSI approved (1910.133)

  • Hard hats are worn where there is danger of falling objects (1910.135)

  • Hard hats are rated (E or G) for electrical hazards as required (1910.135)

  • Appropriate footwear is being worn as required (1910.136)

  • Hearing protection is being used as required (1910.95)

  • Hearing protection is being worn properly (1910.95)

  • Appropriate hand protection is used as required (1910.138)

  • FR clothing/gear worn when danger of arc flash exists (NFPA70e)

  • All harnesses/lanyards are maintained in good condition (1910.132)

  • Signage requiring use of PPE (i.e. Safety Glasses required beyond this point) is posted near entrances to areas where policy requires PPE to be used (Best Practice)

Stairs and Stairways

  • Stairs have uniform riser height/tread depth (1910.25)

  • Stair landings and /or platforms are at least 30 inches in depth (1910.25)

  • Standard stairs are minimum 22 inches wide (1910.25)

  • Standard stair tread is at least 9.5 inches deep, and stair riser is limited to 9.5 inches in height (1910.25)

  • Exposed or unprotected sides of stairway landings (4 or more feet high) are protected by guardrail system (1910.28)

  • Stairways having 3 treads and 4 risers are equipped with a handrail system (1910.28)

  • Handrails are at a proper height of 30-38 in. as measured from leading edge of stair to top of rail (1910.29)

  • Stair railings are installed at proper height (30 in. before 1/17/17 and 42 in. after 1/17/17) (1910.29)

  • The top rail of a stair rail system is 36-38 in. in height when used as handrail

  • Handrail has min. 2.25 in. finger clearance (1910.29)

  • Handrails are capable of withstanding 200 lb. force (1910.29)

Tools (Hands & Power)

  • Angle grinders are equipped with safety guards (1910.243)

  • Explosive actuated tools are properly guarded (1910.243)

  • Explosive actuated fastening tools are unloaded when unattended (1910.243)

  • Load capacities are identified on hydraulic jacks (1910.244)

  • Loads are cribbed or blocked after being raised (1910.244)

  • Load limits are legibly marked on jack stands (1910.244)

Walking-Working Surfaces

  • Surfaces are kept in dry condition to the extent feasible (1910.22)

  • Surfaces are free of hazards (loose boards, spills, etc.) (1910.22)

  • Surfaces are free of hazards (loose boards, spills, etc.) (1910.22)

  • Surfaces support the maximum intended load (1910.22)

  • Safe access/egress to surfaces is provided/used (1910.22)

  • Surfaces are inspected regularly/as needed (1910.22)

  • Access to hazardous surfaces is guarded until hazard fixed (1910.22)

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.