CSUSA Service Safety Inspection form

Are lockout tagout procedures in place and in use when required? Is there a lockout tagout kit including locks and tags available for use?

Was a 5x5 conducted and what was it? List the answer below.<br>

Are all work sites adequately illuminated?

Are safety data sheets on site and available to employees?

Is fall protection provided and in use when required?

Are pits, floor openings and holes covered or otherwise guarded?

Are safety gloves (ANSI Cut level 4) used on site and as required while performing work?

Are hard hats or bump caps provided and in use as required? <br>

Are safety glasses and face shields (or goggles) on site and used when necessary?<br>

Are safety vests or high visibility shirts used on site and used when necessary?

Are all work sites clean, sanitary and orderly?

Are walking and working surfaces properly guarded when exposure to fall is present?

Are all extension cords in good condition, properly grounded, equipped with ground plugs, and used for temporary applications?

Are all ladders free from defects, properly labeled, approved and used as intended?

Are all tools and equipment used by employees in good condition?

Are employees aware of the hazards caused by fault or improperly used hand tools?

Is personal protective equipment inspected and in good condition?

Is protection against the affects of occupational noise exposure provided and used?