DEALERSHIP MONTHLY INSPECTION

• Document No.

• Conducted on (required every 30 days)

  Date

• Dealer Safety Manager/email

  Select Adam Orzechowski Andy Sempert Andrew Whitte Brad Wrest Chad Runions Chris Schouman Chris Spade Chris Tkaczyk Christopher Giuseppetti Daryl Kempf Dave Ciesielski Dennis Brusehaber Dennis Guzdek Dominick Farbo Doug Emmons Doug Lynden Doug Martin Dylan Bruso Eric Pattison Frank Guagliano Firas Sallaj Gary Bellinger Geoff Fahrner Glenn August George Achtziger Hanah Contestabile James Boyd James ling Jason Sobcynski Jeff Moncynski Jeremy Lewis Jerry Deionno John Connors John Furey John Kroll Keith Wiesinger Ken Meyer Kate Fink Madison Garcia Mark Huber Marc Sempert Mark Zeisz Michael Domster Michael Harris Michael Rippe Mike Ziegler Mike Rice Mindy Warner Pat Holzerland Rich Dipaolo Robert Valerio Ross Guarino Russ Vandewall Scott Hornberger Sean Coddington Steve Barnard Tim Gannon Tim Gaspar Tim Mahar Todd Nicosia Tyler Sulski William DeSimone

  • Adam Orzechowski
  • Andy Sempert
  • Andrew Whitte
  • Brad Wrest
  • Chad Runions
  • Chris Schouman
  • Chris Spade
  • Chris Tkaczyk
  • Christopher Giuseppetti
  • Daryl Kempf
  • Dave Ciesielski
  • Dennis Brusehaber
  • Dennis Guzdek
  • Dominick Farbo
  • Doug Emmons
  • Doug Lynden
  • Doug Martin
  • Dylan Bruso
  • Eric Pattison
  • Frank Guagliano
  • Firas Sallaj
  • Gary Bellinger
  • Geoff Fahrner
  • Glenn August
  • George Achtziger
  • Hanah Contestabile
  • James Boyd
  • James ling
  • Jason Sobcynski
  • Jeff Moncynski
  • Jeremy Lewis
  • Jerry Deionno
  • John Connors
  • John Furey
  • John Kroll
  • Keith Wiesinger
  • Ken Meyer
  • Kate Fink
  • Madison Garcia
  • Mark Huber
  • Marc Sempert
  • Mark Zeisz
  • Michael Domster
  • Michael Harris
  • Michael Rippe
  • Mike Ziegler
  • Mike Rice
  • Mindy Warner
  • Pat Holzerland
  • Rich Dipaolo
  • Robert Valerio
  • Ross Guarino
  • Russ Vandewall
  • Scott Hornberger
  • Sean Coddington
  • Steve Barnard
  • Tim Gannon
  • Tim Gaspar
  • Tim Mahar
  • Todd Nicosia
  • Tyler Sulski
  • William DeSimone

• Check if you have a Sales Dept

EXIT ROUTES

• Exit signs and emergency lighting in good working condition? (Test)1910.37(b)<br>

  Yes

  No

  N/A

• Exits routes clear?<br>1910.37(a)(3)

  Yes

  No

  N/A

• Is evacuation maps posted?1910.38<br>

  Yes

  No

  N/A

FIRE SAFETY

• Fire extinguishers, fully charged, pin lock in place, 30 day inspection documented, sign posted?1910.157(a)

  Yes

  No

  N/A

• Fire doors closed?

  Yes

  No

  N/A

ELECTRICAL

• Electrical cords on machines in good conditions (not torn,taped or missing grounds)

  Yes

  No

  N/A

• Electrical panels-36" clear space, no missing breakers or blanks, circuits labeled?

  Yes

  No

  N/A

• Are extension cords used for temporary use only<br>Surge protectors are not plugged into extension cords or other surge protectors <br>NO non-grounded (household) cords in use?<br>

  Yes

  No

  N/A

MISC.

• Are helium tanks secured and spare tanks capped

  Yes

  No

  N/A

• Are bathrooms kept sanitary condition? (29 CFR 1910.141)

  Poor

  Fair

  Good

  N/A

• General housekeeping ok

  Poor

  Fair

  Good

  N/A

• Check the box if you have a Truck Shop?

EXIT ROUTES

• Exit signs and emergency lighting in good working condition? (Test)<br>

  Yes

  No

  N/A

• Exits routes clear?<br>

  Yes

  No

  N/A

• Is evacuation maps posted?<br>

  Yes

  No

  N/A

FIRE SAFETY

• Fire extinguishers, fully charged, pin lock in place, 30 day inspection documented, sign posted?

  Yes

  No

  N/A

• Emergency doors closed?

  Yes

  No

  N/A

ELECTRICAL

• Electrical cords on machines in good conditions (not torn,taped or missing grounds)

  Yes

  No

  N/A

• Electrical panels-36" clear space, no missing breakers or blanks, circuits labeled?

  Yes

  No

  N/A

• Are extension cords used for temporary use only<br>Surge protectors are not plugged into extension cords or other surge protectors <br>NO non-grounded (household) cords in use?<br>

  Yes

  No

  N/A

MACHINES/EQUIPMENT

• Bench grinder, <br>Signage (wear safety glasses...)<br>Grinder securely mounted <br>1/4"spec for spark rest<br>1/8" for work rest

  Yes

  No

  N/A

• Parts washers-fusible link?

  Yes

  No

  N/A

• Are Lifts- cables, safety latches, oil level, motors in good working condition?

  Yes

  No

  N/A

• Are all jacks labeled with Capacity?

  Yes

  No

  N/A

MISC.

• Used oily rags stored in non-combustible container?

  Yes

  No

  N/A

• Are all Used Oil Buckets/Used Oil Filter Containers labeled (used oil, used oil filter)

  Yes

  No

  N/A

• Are bathrooms kept sanitary condition? (29 CFR 1910.141)

  Poor

  Fair

  Good

  N/A

• Are all containers (spray bottles) of hazardous chemicals properly labeled? (chemical name,hazards,first aid,and emergency number) (29CFR 1910.1200 (f) (5) (i) )

  Yes

  No

  N/A

• General housekeeping ok

  Poor

  Fair

  Good

  N/A

• Notes:

• Check the box if you have a Detail Department

EXIT ROUTES

• Exit signs and emergency lighting in good working condition? (Test)<br>

  Yes

  No

  N/A

• Exits routes clear?<br>

  Yes

  No

  N/A

• Is evacuation maps posted?<br>

  Yes

  No

  N/A

FIRE SAFETY

• Fire extinguishers, fully charged, pin lock in place, 30 day inspection documented, sign posted?

  Yes

  No

  N/A

• Emergency doors closed?

  Yes

  No

  N/A

ELECTRICAL

• Electrical cords on machines in good conditions (not torn,taped or missing grounds)

  Yes

  No

  N/A

• Electrical panels-36" clear space, no missing breakers or blanks, circuits labeled?

  Yes

  No

  N/A

• Are extension cords used for temporary use only<br>Surge protectors are not plugged into extension cords or other surge protectors <br>NO non-grounded (household) cords in use?<br>

  Yes

  No

  N/A

MISC.

• Are all containers (spray bottles) of hazardous chemicals properly labeled? (chemical name,hazards,first aid,and emergency number) (29CFR 1910.1200 (f) (5) (i) )

  Yes

  No

  N/A

• Are bathrooms kept sanitary condition? (29 CFR 1910.141)

  Poor

  Fair

  Good

  N/A

• General house keeping ok

  Poor

  Fair

  Good

  N/A

• Notes:

• Check the box if you have a Parts Department

EXIT ROUTES

• Exit signs and emergency lighting in good working condition? (Test)<br>

  Yes

  No

  N/A

• Exits routes clear?<br>

  Yes

  No

  N/A

• Is evacuation maps posted?<br>

  Yes

  No

  N/A

FIRE SAFETY

• Fire extinguishers, fully charged, pin lock in place, 30 day inspection documented, sign posted?

  Yes

  No

  N/A

• Emergency doors closed?

  Yes

  No

  N/A

• Does the department avoid storing combustibles under stairs If stairs are metal and enclosed, this question is not applicable; mark N/A (29 CFR 1910.106)

  Yes

  No

  N/A

• Does the Battery storage area have "No Smoking/Caution Corrosive Warning signs and are the batteries stored in a spill-controlled area tote or tray (so corrosives don't leak? (NYSDEC 5 NYCRR 374-3.2 (d) (1) (i)) If stored outside tote must be covered.

  Yes

  No

  N/A

ELECTRICAL

• Electrical cords on machines in good conditions (not torn,taped or missing grounds)

  Yes

  No

  N/A

• Electrical panels-36" clear space, no missing breakers or blanks, circuits labeled?

  Yes

  No

  N/A

• Are extension cords used for temporary use only<br>Surge protectors are not plugged into extension cords or other surge protectors <br>NO non-grounded (household) cords in use?<br>

  Yes

  No

  N/A

MISC.

• Are bathrooms kept sanitary condition? (29 CFR 1910.141)

  Poor

  Fair

  Good

  N/A

• General house keeping ok

  Poor

  Fair

  Good

  N/A

• Notes:

MISC.

• Is your West Herr Safety Poster displayed in the proper areas

  Yes

  No

  N/A

• Does the water heater have 36" of clearance?

  Yes

  No

  N/A

• Are carpet runners in place by all exit doors?

  Yes

  No

  N/A

• Eye wash station clear and fluid level ok and changed asper Manufactory Spefications?

  Yes

  No

  N/A

• Is the eye wash station not blocked and have a clear pathway.

  Yes

  No

  N/A

• Are Ladders properly stored (Standing must be secured to wall)

  Yes

  No

  N/A

• Compressorbelts fully guarded, pressure relief valve and gauge?

  Yes

  No

  N/A

• Floor grates in good condition? (loose, bent, missing, gaps- greater than 1")

  Yes

  No

  N/A

• If you have a gas grille is the propane tank stored outside and 15ft from a exit?

  Yes

  No

  N/A

• Parking lot free from trip hazards (pot holes, etc)<br>

  Yes

  No

  N/A

• First aid kit stocked

  Yes

  No

  N/A

• MINIMUM REQUIREMENTS ANSI 6/2016
  16- Adhesive bandages 1x3"
  1- Adhesive tape 2 1/2 Yards
  10- Antibiotic applications .14 Fluid Ounces
  10- Antiseptic .14 Fluid Ounces
  1- Breathing barrier
  1- Burn dressing Gel Soaked 4x4"
  10- Burn treatment 1.32 Fluid Ounces
  1- Cold pack 4x5"
  2- Eye covering with means of attachment 2.9 square inches
  1- Eye/skin wash 1 Fluid Ounce
  1- First aid guide
  6- Hand sanitizer 1/32 Ounces
  2- Medical exam gloves Pair
  1- Roller bandage 2"x4 Yards
  1- Scissors
  2- Sterile pads 3x3"
  2- Trauma pads 5x9"
  1- Triangular bandage 40x40x56"
  

• Is the temperature below 30 degrees outside

  Yes

  No

• Are portable space heaters plugged directly into a wall outlet?

  Yes

  No

  N/A

• Are all the space heater equipment with automatic shut off of heater element and or heater<br>

  Yes

  No

  N/A

• To test a space heater for automatic shut off
  Tip heater on a angle
  if heater element and or heater shuts off it is in compliance
  If does not shut off element and or heater " the heater is not in compliance"

• At time of inspection are all the sidewalks shoveled and salted?

  Yes

  No

  No Snow/Ice

• Notes:

• Check the box if you have Bulk Storage Tanks

Bulk Storage Audit

• Select date

  Date

• Is the Tank Permit up to Date and Posted in the Service Write-up Area?

  Yes

  No

  N/A

• Dealership Location (Please Choose:

  Select Audi Buffalo (9-601885) BMW of Buffalo (9-600545) BMW of Rochester (PBS 8-600641) East Syracuse Chevrolet (7-422436) Mercedes of Rochester (PBS 8-601569) Mini of Buffalo (9-601439) West Herr Acura (PBS 9-600961) West Herr Auto Exchange (PBS 9-601786) West Herr Chevy of Hamburg (PBS 9-600578) West Herr Chevy of Orchard Park (PBS 9-600537) West Herr Chevrolet of Rochester (8-076945) West Herr Chevy Williamsville (PBS 9-383031) West Herr Chrysler Dodge Jeep Ram of Lockport (PBS-9-439894) West Herr CDRJ Fiat of Rochester (8-601120) West Herr Collision Center South (9-901406) West Herr Dodge (PBS 9-600398) West Herr East Aurora (PBS 9-423416) West Herr Express Maintenance 9-601814 West Herr Fleet Services (9-601920) West Herr Ford Amherst (9-221422) West Herr Ford Hamburg (PBS 9-222976) West Here Ford Rochester (PBS 8-010472) West Herr Ford of Webster (8-601259) West Herr Honda (9-600975) West Herr Honda of Canandaigua (8-600452) West Herr Hyundai of Williamsville (9-601292) West Herr Jeep OP (9-600536) West Herr KIA (PBS 9-600630) West Herr Mazda of Canandaigua (8-600451) West Herr Nissan Lockport (PBS 9-600147) West Herr Nissan OP (PBS 9-601033) West Herr Nissan of Williamsville (PBS 9-600956) West Herr Quicklane Lockport West Herr Subaru Brockport (8-600845) West Herr Subaru (PBS 9-601430) West Herr Subaru of Lockport West Herr Toyota OP (PBS 9-600628) West Herr Toyota Williamsville (PBS 9-438251) West Herr LeBrun Toyota (8-601143) West Herr Toyota Rochester (8-600509) West Herr Used Car Outlet (9-600470) West Herr Volkswagen (9-600214

  • Audi Buffalo (9-601885)
  • BMW of Buffalo (9-600545)
  • BMW of Rochester (PBS 8-600641)
  • East Syracuse Chevrolet (7-422436)
  • Mercedes of Rochester (PBS 8-601569)
  • Mini of Buffalo (9-601439)
  • West Herr Acura (PBS 9-600961)
  • West Herr Auto Exchange (PBS 9-601786)
  • West Herr Chevy of Hamburg (PBS 9-600578)
  • West Herr Chevy of Orchard Park (PBS 9-600537)
  • West Herr Chevrolet of Rochester (8-076945)
  • West Herr Chevy Williamsville (PBS 9-383031)
  • West Herr Chrysler Dodge Jeep Ram of Lockport (PBS-9-439894)
  • West Herr CDRJ Fiat of Rochester (8-601120)
  • West Herr Collision Center South (9-901406)
  • West Herr Dodge (PBS 9-600398)
  • West Herr East Aurora (PBS 9-423416)
  • West Herr Express Maintenance 9-601814
  • West Herr Fleet Services (9-601920)
  • West Herr Ford Amherst (9-221422)
  • West Herr Ford Hamburg (PBS 9-222976)
  • West Here Ford Rochester (PBS 8-010472)
  • West Herr Ford of Webster (8-601259)
  • West Herr Honda (9-600975)
  • West Herr Honda of Canandaigua (8-600452)
  • West Herr Hyundai of Williamsville (9-601292)
  • West Herr Jeep OP (9-600536)
  • West Herr KIA (PBS 9-600630)
  • West Herr Mazda of Canandaigua (8-600451)
  • West Herr Nissan Lockport (PBS 9-600147)
  • West Herr Nissan OP (PBS 9-601033)
  • West Herr Nissan of Williamsville (PBS 9-600956)
  • West Herr Quicklane Lockport
  • West Herr Subaru Brockport (8-600845)
  • West Herr Subaru (PBS 9-601430)
  • West Herr Subaru of Lockport
  • West Herr Toyota OP (PBS 9-600628)
  • West Herr Toyota Williamsville (PBS 9-438251)
  • West Herr LeBrun Toyota (8-601143)
  • West Herr Toyota Rochester (8-600509)
  • West Herr Used Car Outlet (9-600470)
  • West Herr Volkswagen (9-600214

Underground Gas Tank

• Tank Number

• Did you Visually check spill prevention equipment for damage, remove liquid and or debris?

  Yes

  No

  N/A

• Did you check and remove obstructions from fill pipe?

  Yes

  No

  N/A

• Did you check fill cap to ensure it is securely on fill pipe?

  Yes

  No

  N/A

• Are the test filed with the gas log sheets?<br>Test Liquid Status<br>Test Tank Sensors<br>This needs to be completed weekly!

  Yes

  No

  N/A

• Did you check release detection equipment to ensure it is operating with no alarms or something unusual operating conditions present?

  Yes

  No

  N/A

• Do you review and keep current release detection records?

  Yes

  No

  N/A

• To Obtain a Sensor Report
  >Press the "FUNCTION" button until the display reads "Liquid Status"
  >Press the "Step" button
  >Press "Print" button
  >Press the "Tank/Sensor" button to advance to the next sensor.
  >Press "Print" button
  >Continue this procedure until all sensors reports have been printed.
  >Press the "Function" button until the display reads "All Functions Normal"
  This Report should be taken every week to comply with the D.E.C!

• Is the Tank Double Wall?

  Yes

  No

• Is the interstitial monitoring equipment in good working condition?

  Yes

  No

  N/A

• Is the interstitial free of Liquid?

  Yes

  No

  N/A

Bulk Storage Tank Above Ground

PBS Tank

• Scan QR Code on TANK LABEL!

• Is there a West Herr Label with Tank#- Content and Capacity and is posted on the Tank?

  Yes

  No

  N/A

• Does the Tank Have a Gauge and is Functioning Properly?

  Yes

  No

  N/A

• Does the Tank have High Level Alarm?

  Yes

  No

• Is the Alarm Functioning Properly?

  Yes

  No

  N/A

• Is the Tank in Good Condition? (No Rust, Cracking,Buldges,Paint in Good Condition)

  Yes

  No

  N/A

• Is the Tank, Piping, Dispenser Free from any Visible Leaks?

  Yes

  No

  N/A

• Is the Tank Double Wall?

  Yes

  No

• Is the interstice free of Liquid?

  Yes

  No

  N/A

• Is the interstitial monitoring equipment in good working condition?

  Yes

  No

  N/A

• Does the Tank have a Dike (Second Containment)?

  Yes

  No

• Is the containment (Dike) free of liquid, debris, and flammable material?

  Yes

  No

  N/A

• If Equipped with a Drain Valve, Is the Valve Closed and Locked?

  Yes

  No

  N/A

• Notes

• PLEASE PRINT NAME BELOW AND CLICK THE SIGN BUTTON ON THE RIGHT!

  Sign

• 6NYCRR Part 613-4.3(a) requires that all ASTs be visually inspected at least monthly and records maintained for at least 3 years.

• Notes

• Reviewed with Safe T First contact (Service, Bodyshop Manager)

  Sign

• PLEASE MAKE SURE TO HIT THE COMPLETE BUTTON ON THE BOTTOM OF THE PAGE!

• Date and time of approval

  Date

• Approver's signature

  Sign