DAF Safety Inspection Checklist

• Site conducted

• Conducted on

  Date

• Prepared by

• Location
  Address

• Operator and Techs

Outside

Totes

• In good condition

  Yes

  No

  N/A

• Full totes in containment

  Yes

  No

  N/A

• Lids and caps in place on empties

  Yes

  No

  N/A

• Containment in good condition

  Yes

  No

  N/A

• Brackets in place

  Yes

  No

  N/A

Chem Hoses

• in good condition

  Yes

  No

  N/A

• Camlocks not leaking(Unit & tote)

  Yes

  No

  N/A

• Pins/zipties in place

  Yes

  No

  N/A

• Pulling from bottom of tote

  Yes

  No

  N/A

• Coiled and neat from totes to pump

  Yes

  No

  N/A

Water/sludge hoses

• Influent line in good condition

  Yes

  No

  N/A

• Influent connections/camlocks in good condition

  Yes

  No

  N/A

• Effluent line in good condition

  Yes

  No

  N/A

• Effluent connections/camlocks in good condition

  Yes

  No

  N/A

• Sludge hose in good condition

  Yes

  No

  N/A

• Sludge line connections/camlocks not leaking

  Yes

  No

  N/A

• Pins/zipties in place

  Yes

  No

  N/A

General Area

• Tools picked up

  Yes

  No

  N/A

• Area free of trash

  Yes

  No

  N/A

• Trip hazards minimized

  Yes

  No

  N/A

• Trucks parked "back in"

  Yes

  No

  N/A

• Spill kit available

  Yes

  No

  N/A

• Fire extinguisher near generator

  Yes

  No

  N/A

• Fire ext monthly inspection performed

  Yes

  No

  N/A

• Extra hoses coiled and neat

  Yes

  No

  N/A

• Extension cords protected

  Yes

  No

  N/A

Generator/Diesel pumps

• Grounded

  Yes

  No

  N/A

• Serviced recently

  Yes

  No

  N/A

• Alarms noted and reported

  Yes

  No

  N/A

• Fuel and DEF filled

  Yes

  No

  N/A

• Power cord coiled and neat from unit to generator

  Yes

  No

  N/A

• Hooked up properly

  Yes

  No

  N/A

• Wheels chocked

  Yes

  No

  N/A

Unit/trailer

• Wheels chocked

  Yes

  No

  N/A

• Unit leveled

  Yes

  No

  N/A

• Grounded

  Yes

  No

  N/A

• External lights functioning

  Yes

  No

  N/A

Inside

• Daily JSA completed

  Yes

  No

  N/A

• SDS available

  Yes

  No

  N/A

• Unit/trailer organized and neat(swept recently; no trash around, no trip hazards)

  Yes

  No

  N/A

• Food stored properly

  Yes

  No

  N/A

• Drinking water available

  Yes

  No

  N/A

• AC/heat working

  Yes

  No

  N/A

• No exposed wires/lights working

  Yes

  No

  N/A

• Refrigerator working

  Yes

  No

  N/A

Safety Equipment Present

• Apron

  Yes

  No

  N/A

• Faceshield

  Yes

  No

  N/A

• Gloves

  Yes

  No

  N/A

• Ear plugs

  Yes

  No

  N/A

• First Aid Kit

  Yes

  No

  N/A

• First Aid kit stocked

  Yes

  No

  N/A

• Bloodborne Pathogen Kit

  Yes

  No

  N/A

• BBP Kit stocked

  Yes

  No

  N/A

• Eyewash bottles current

  Yes

  No

  N/A

• Disposable Masks

  Yes

  No

  N/A

Lab Area

• Neat and organized

  Yes

  No

  N/A

• No food in lab area

  Yes

  No

  N/A

• Items properly labeled

  Yes

  No

  N/A

Operator & Techs

• Wearing FR

  Yes

  No

  N/A

• Training cards: H2S, SafeLand(PEC or Rig ID), Forklift

  Yes

  No

  N/A

• PPE present: H2S monitor, safety glasses, hard hat

  Yes

  No

  N/A

• Problems Fixed:

• Location Needs:

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