Dallas Gemba Walk - Administrative Office Areas - Zone C

• Zone C includes Administrative Office Areas

  Select

• Conducted on

  Date

• Prepared by

• Inspection Team

First Aid Kit #2

• Scan QR Code for First Aid Kit #2

• Are you inspecting the correct First Aid Kit?

  Yes

  No

  N/A

• Is the FIrst Aid Kit fully stocked and easy to access if needed?

  Yes

  No

  N/A

• Equipment is in good condition & properly guarded

  Yes

  No

  N/A

• PPE is available, in good condition and properly stored

  Yes

  No

  N/A

• Employees are wearing proper PPE for the task they are performing

  Yes

  No

  N/A

• Any other unsafe conditions or behaviors?

  Safe

  At Risk

  N/A

• Exit doors and routes are free of obstruction

  Yes

  No

  N/A

• Emergency lights are functioning

  Yes

  No

  N/A

• Any other fire safety or emergency response issues noted

  No

  Yes

  N/A

Reference Instructions

• Reference document for fire extinguisher inspection.

Fire Extinguisher #1

• Scan Barcode for Fire Extinguisher #1

• Wrong QR code scanned. Are you inspecting the correct Fire Extinguisher?

  Yes

  No

  N/A

• Access to fire extinguisher is clear and free of obstacles.

  Yes

  No

  N/A

• Fire extinguisher is free of visible damage including handle.

  Yes

  No

  N/A

• Safety pin is in place and secured.

  Yes

  No

  N/A

• Hose is free of defects, clean and free of obstructions.

  Yes

  No

  N/A

• Gauge needle is in the "Green" zone.

  Yes

  No

  N/A

• Maintenance inspection tag (annual tag) is in place and valid for current year.

  Yes

  No

  N/A

• Fire extinguisher is securely mounted.

  Yes

  No

  N/A

• Any other issues noted.

  No

  Yes

  N/A

Fire Extinguisher #2

• Scan Barcode for Fire Extinguisher #2

• Wrong QR code scanned. Are you inspecting the correct Fire Extinguisher?

  Yes

  No

  N/A

• Access to fire extinguisher is clear and free of obstacles.

  Yes

  No

  N/A

• Fire extinguisher is free of visible damage including handle.

  Yes

  No

  N/A

• Safety pin is in place and secured.

  Yes

  No

  N/A

• Hose is free of defects, clean and free of obstructions.

  Yes

  No

  N/A

• Gauge needle is in the "Green" zone.

  Yes

  No

  N/A

• Maintenance inspection tag (annual tag) is in place and valid for current year.

  Yes

  No

  N/A

• Fire extinguisher is securely mounted.

  Yes

  No

  N/A

• Any other issues noted.

  No

  Yes

  N/A

Fire Extinguisher #3

• Scan Barcode for Fire Extinguisher #3

• Wrong QR code scanned. Are you inspecting the correct Fire Extinguisher?

  Yes

  No

  N/A

• Access to fire extinguisher is clear and free of obstacles.

  Yes

  No

  N/A

• Fire extinguisher is free of visible damage including handle.

  Yes

  No

  N/A

• Safety pin is in place and secured.

  Yes

  No

  N/A

• Hose is free of defects, clean and free of obstructions.

  Yes

  No

  N/A

• Gauge needle is in the "Green" zone.

  Yes

  No

  N/A

• Maintenance inspection tag (annual tag) is in place and valid for current year.

  Yes

  No

  N/A

• Fire extinguisher is securely mounted.

  Yes

  No

  N/A

• Any other issues noted.

  No

  Yes

  N/A

Fire Extinguisher #4

• Scan Barcode for Fire Extinguisher #4

• Wrong QR code scanned. Are you inspecting the correct Fire Extinguisher?

  Yes

  No

  N/A

• Access to fire extinguisher is clear and free of obstacles.

  Yes

  No

  N/A

• Fire extinguisher is free of visible damage including handle.

  Yes

  No

  N/A

• Safety pin is in place and secured.

  Yes

  No

  N/A

• Hose is free of defects, clean and free of obstructions.

  Yes

  No

  N/A

• Gauge needle is in the "Green" zone.

  Yes

  No

  N/A

• Maintenance inspection tag (annual tag) is in place and valid for current year.

  Yes

  No

  N/A

• Fire extinguisher is securely mounted.

  Yes

  No

  N/A

• Any other issues noted.

  No

  Yes

  N/A

Fire Extinguisher #5

• Scan Barcode for Fire Extinguisher #5

• Wrong QR code scanned. Are you inspecting the correct Fire Extinguisher?

  Yes

  No

  N/A

• Access to fire extinguisher is clear and free of obstacles.

  Yes

  No

  N/A

• Fire extinguisher is free of visible damage including handle.

  Yes

  No

  N/A

• Safety pin is in place and secured.

  Yes

  No

  N/A

• Hose is free of defects, clean and free of obstructions.

  Yes

  No

  N/A

• Gauge needle is in the "Green" zone.

  Yes

  No

  N/A

• Maintenance inspection tag (annual tag) is in place and valid for current year.

  Yes

  No

  N/A

• Fire extinguisher is securely mounted.

  Yes

  No

  N/A

• Any other issues noted.

  No

  Yes

  N/A

Fire Extinguisher #13

• Scan Barcode for Fire Extinguisher #13

• Wrong QR code scanned. Are you inspecting the correct Fire Extinguisher?

  Yes

  No

  N/A

• Access to fire extinguisher is clear and free of obstacles.

  Yes

  No

  N/A

• Fire extinguisher is free of visible damage including handle.

  Yes

  No

  N/A

• Safety pin is in place and secured.

  Yes

  No

  N/A

• Hose is free of defects, clean and free of obstructions.

  Yes

  No

  N/A

• Gauge needle is in the "Green" zone.

  Yes

  No

  N/A

• Maintenance inspection tag (annual tag) is in place and valid for current year.

  Yes

  No

  N/A

• Fire extinguisher is securely mounted.

  Yes

  No

  N/A

• Any other issues noted.

  No

  Yes

  N/A

Fire Extinguisher #14

• Scan Barcode for Fire Extinguisher #14

• Wrong QR code scanned. Are you inspecting the correct Fire Extinguisher?

  Yes

  No

  N/A

• Access to fire extinguisher is clear and free of obstacles.

  Yes

  No

  N/A

• Fire extinguisher is free of visible damage including handle.

  Yes

  No

  N/A

• Safety pin is in place and secured.

  Yes

  No

  N/A

• Hose is free of defects, clean and free of obstructions.

  Yes

  No

  N/A

• Gauge needle is in the "Green" zone.

  Yes

  No

  N/A

• Maintenance inspection tag (annual tag) is in place and valid for current year.

  Yes

  No

  N/A

• Fire extinguisher is securely mounted.

  Yes

  No

  N/A

• Any other issues noted.

  Yes

  No

  N/A

Fire Extinguisher #17

• Scan Barcode for Fire Extinguisher #17

• Wrong QR code scanned. Are you inspecting the correct Fire Extinguisher?

  Yes

  No

  N/A

• Access to fire extinguisher is clear and free of obstacles.

  Yes

  No

  N/A

• Fire extinguisher is free of visible damage including handle.

  Yes

  No

  N/A

• Safety pin is in place and secured.

  Yes

  No

  N/A

• Hose is free of defects, clean and free of obstructions.

  Yes

  No

  N/A

• Gauge needle is in the "Green" zone.

  Yes

  No

  N/A

• Maintenance inspection tag (annual tag) is in place and valid for current year.

  Yes

  No

  N/A

• Fire extinguisher is securely mounted.

  Yes

  No

  N/A

• Any other issues noted.

  Yes

  No

  N/A

Fire Extinguisher #18

• Scan Barcode for Fire Extinguisher #18

• Wrong QR code scanned. Are you inspecting the correct Fire Extinguisher?

  Yes

  No

  N/A

• Access to fire extinguisher is clear and free of obstacles.

  Yes

  No

  N/A

• Fire extinguisher is free of visible damage including handle.

  Yes

  No

  N/A

• Safety pin is in place and secured.

  Yes

  No

  N/A

• Hose is free of defects, clean and free of obstructions.

  Yes

  No

  N/A

• Gauge needle is in the "Green" zone.

  Yes

  No

  N/A

• Maintenance inspection tag (annual tag) is in place and valid for current year.

  Yes

  No

  N/A

• Fire extinguisher is securely mounted.

  Yes

  No

  N/A

• Any other issues noted.

  Yes

  No

  N/A

• Area is clean and free of debris, standing water and leaks

  Yes

  No

  N/A

• Aisles are clear and free of debris or obstructions

  Yes

  No

  N/A

• Pallets are lying flat and not in aisles

  Yes

  No

  N/A

• Any other housekeeping issues noted?

  No

  Yes

  N/A

• Chemicals are properly stored and all containers labeled

  Yes

  No

  N/A

• Any other chemical hazard or concern?

  No

  Yes

  N/A

• All electrical panels are closed, labeled and free of obstructions (located on dock)

  Yes

  No

  N/A

• Do electrical panels have at least 40" clearance from the front and side clearance is the width of the panel or 30" whichever is greater

  Yes

  No

  N/A

• Cords and other electrical components are free of damage

  Yes

  No

  N/A

• Any other electrical hazards or concerns

  No

  Yes

  N/A

• Area is free or trash including trash cans dumped daily to minimize fire risk

  Yes

  No

  N/A

• Any other Waste or Environmental issues or concerns?

  No

  Yes

  N/A

• Items handled by employees are stored below shoulder height?

  Yes

  No

  N/A

• Heavy items are kept at mid level and team lift or a mechanical aid is used?

  Yes

  No

  N/A

• Any other ergonomic risk or concern?

  No

  Yes

  N/A

• Add any additional needs, comments or actions that need escalated which were not noted already in this report.