Office
Floor mats in good condition?
Electric, phone cords minimized/properly covered?
Drawers & file cabinets properly closed?
Adequate housekeeping?
Trash emptied daily?
No tripping hazards, wet spots, protruding objects?
#1 Fire extinguisher- tagged/charged/inspected/accessible?
#2 Fire extinguisher- tagged/charged/inspected/accessible?
#3 Fire extinguisher- tagged/charged/inspected/accessible?
Emergency exit #1 correctly marked and accessible (main entrance)?
Emergency exit #2 correctly marked and accessible (west side)?
Emergency lighting operational? (9 units)
Exit signs lit?
Electrical outlets in good condition?
Other items?
item?
Route Sales Office
Floor mats in good condition?
Electric, phone cords minimized/properly covered?
Drawers & file cabinets properly closed?
Adequate housekeeping?
Trash emptied daily?
Are doorways clear?
No tripping hazards, wet spots, protruding objects?
Electrical outlets in good condition?
Other items?
item?
Kitchen/Lunchroom Area
Floor mats in good condition?
Wiring ok (no exposed wires, frayed cords)?
Adequate housekeeping?
GFCIs pass push test?
#5 Fire extinguisher- tagged/charged/inspected/accessible?
Lunchroom exit sign lit?
Electrical outlets in good condition?
Other items?
item?
Co-orkers Entrance?
Emergency exit #3 correctly marked and accessible?
#4 Fire extinguisher- tagged/charged/inspected/accessible?
November 1- May 1, salt available?
Other items?
item?
First Aid Room?
AED Charged and inspected?
First aid supplies adequate?
1"x3" Bandages (Check box only if needed)
2"x2" Gauze Pads (Check box only if needed)
Burn Ointment (Check box only if needed)
Eye Wash Solution (Check box only if needed)
Ice Pack (Check box only if needed)
Instant Cold Spray (Check box only if needed)
Scissors (Check box only if needed)
Adequate housekeeping?
Incident/Accident Reports availabe?
Electrical outs in good condition?
Other items?
item?
Front Dock Area
No slip, trip or fall hazzards?
Steps, railings walk way clean and free from obstruction?
Railings intact and secured?
Adequate housekeeping?
Emergency exit #5 correctly marked and accessible?
November 1- May 1, salt spreader available?
#6 Fire extinguisher- tagged/charged/inspected/accessible?
Door #5 exit sign lit?
Electrical junction boxes in good condition/properly protected?
Other items?
item?
Green Zone
Floor clean and dry, free from slip, trip or fall hazards?
Electrical panel boxes labeled and closed?
Adequate housekeeping?
Emergency exit #4 correctly marked and accessible?
#9 Fire extinguisher- tagged/charged/inspected/accessible?
Eye wash station clean and operational?
#7 Fire extinguisher- tagged/charged/inspected/accessible?
#8 Fire extinguisher- tagged/charged/inspected/accessible?
Other items?
item?
Mending/Sorting/Press Area
Floor clean and dry?
Electrical equipment properly grounded?
Wiring ok (no exposed wires, frayed cords)?
Chain guard in place?
#10 Fire extinguisher- tagged/charged/inspected/accessible?
#11 Fire extinguisher- tagged/charged/inspected/accessible?
Adequate housekeeping?
Other items?
item?
Mechanical Room
Floors clean and dry?
Floor free of slip, trip and fall hazards?
Adequate housekeeping?
Exit doors identified and clear of obstacles?
No steam/air/water leaks?
Eye wash station/emergency shower clean and operational?
#12 Fire extinguisher- tagged/charged/inspected/accessible?
#13 Fire extinguisher- tagged/charged/inspected/accessible?
Other items?
item?
Tunnel Hanging Area
Floor mats in good condition?
Adequate housekeeping?
#17 Fire extinguisher- tagged/charged/inspected/accessible?
Other items?
item?
Tunnel Mezzanine Area
Access Chain to mezzanine restricting access?
Mezzanine stairs clean with no obstructions?
Mezzanine railings intact and decking checked for tripping hazards?
#16 Fire extinguisher- tagged/charged/inspected/accessible?
Other items?
item?
Wash Aisle
Floors free from slip, trip and fall hazards?
Adequate housekeeping?
Chemical containers properly labeled with specific hazards and are closed/sealed?
Chemical containers properly secured?
Chemical delivery system free of leaks?
Walkway behind Ellis washers clean & free of tripping hazards?
PPE provided as required?
MSDS readily available for all products used in this area?
Eye wash/shower station cleean, capped tagged, functional, free of obstructions?
Lockout/Tagout board supplied, locks accounted for?
Pits and drain covers in place?
#14 Fire extinguisher- tagged/charged/inspected/accessible?
#15 Fire extinguisher- tagged/charged/inspected/accessible?
#17 Fire extinguisher- tagged/charged/inspected/accessible?
#18 Fire extinguisher- tagged/charged/inspected/accessible?
#19 Fire extinguisher- tagged/charged/inspected/accessible?
#21 Fire extinguisher- tagged/charged/inspected/accessible?
Rolling ladders have rubber stoppers on drop legs?
Electrical control box on conveyer 5.4 closed? (Check box only if needed)
Machine guards properly installed?
Emergency stops operational?
Water/sprinkler valves
Other items?
item?
Stockroom
Floor mats in good condition?
Electric, phone cords minimized/properly covered?
Adequate housekeeping?
Floor free of slip, trip and fall hazards?
Drawers & file cabinets properly closed?
#20 Fire extinguisher- tagged/charged/inspected/accessible?
Emergency exit #6 correctly marked and accessible?
Machine guards in place?
Other items?
item?
Mat Folding/Rolling Area
Floor free of slip, trip and fall hazards?
Mat conveyer operational with guards in place?
Electrical panel accessible with 3' clearance on both sides?
Other items?
item?
Maintenance Shop
Shop equipment properly guarded and in good working order?
PPE provided as required?
Combustible materials stored safely?
Emergency exit #8 correctly marked and accessible?
No open containers unless in use?
#28 Fire extinguisher- tagged/charged/inspected/accessible?
#29 Fire extinguisher- tagged/charged/inspected/accessible?
Other items?
item?
Truck Garage/Loading & Unloading Area
Floor free of slip, trip and fall hazards?
Emergency exit #7 correctly marked and accessible?
Safety containers used for combustible in good working order?
Full and empty propane tanks properly secured?
Are propane tanks stored away from hat sources of ignition?
#23 Fire extinguisher- tagged/charged/inspected/accessible?
#24 Fire extinguisher- tagged/charged/inspected/accessible?
#25 Fire extinguisher- tagged/charged/inspected/accessible?
Emergency exit #9 correctly marked and accessible? (north wall)
Forklift #1 and #2 inspected daily?
All forklift equipment functions properly-brakes, horn, controls, backup alarm?
All forklift equipment functions properly-brakes, horn, controls, backup alarm?
Forklift seat belts used?
Are broken pallets removed from service and stored separately?
Are empty pallets stored flat?
Other items?
item?
Rear Garage
Floor free of slip, trip and fall hazards?
#26 Fire extinguisher- tagged/charged/inspected/accessible?
#27 Fire extinguisher- tagged/charged/inspected/accessible?
Other items?
item?
Fire Pump House
Floor free of slip, trip and fall hazards?
#30 Fire extinguisher- tagged/charged/inspected/accessible?
Valves and gauges not leaking?
Fire pump started?
Other items?
item?
Parking Lot and Grounds
All exits free of obstructions?
Walkways clear?
Broken glass or metal objects
Other items?
item?
Other Items
Is OSHA posted displayed where Co-Workers can see it?
Is OSHA 300 log available? February 1st - April 30th
Are emergency phone numbers posted?
Open electrical junction boxes properly covered?
Electrical panel boxes marked to indicate service and voltage?
Electrical panels have 3' clearance each side?
Adequate lighting in all areas?
Extension cords in good condition? (not taped or broken)
Extension cords grounded with 3 prongs?
Notes and Signature Page
Remarks/Comments
PPE Storage Cabinet Inventory
Safety Glasses (Emedco.com)
Safety Goggles (Emedco.com)
Headgear for face shield (LSS.com) product # 6635-3
Chemical resistant replacement face shield (LSS.com) product # 6635-2
Metal lens cleaning station (LSS.com) product # 54621
Lens cleaning tissues (LSS.com) product # 962
Rubber coated cloth apron 27"x36" (LSS.com) product # 926-1
Back support size small (Tuffrhino.com) product # GS2065
Back support size medium (Tuffrhino.com) product # GS2065
Back support size large (Tuffrhino.com) product # GS2065
Back support size xlarge (Tuffrhino.com) product # GS2065
Back support size 2xlarge (Tuffrhino.com) product # GS2065
Back support size 3xlarge (Tuffrhino.com) product # GS2065
Lab coat 46rg (Red Kap) product # KP14NV
Lab coat 50rg (Red Kap) product # KP14NV
Lab coat 54rg (Red Kap) product # KP14NV
Coverall 46rg (Red Kap) product # CT10NV
Coverall 50rg (Red Kap) product # CT10NV
Coverall 54rg (Red Kap) product # CT10NV
Nitrile gloves medium (boxes)
Nitrile gloves medium (boxes)
Nitrile gloves large (boxes)
Nitrile gloves xlarge (boxes)
Cellulose sweatbands (Occunomix.com) 100/pkg
Dust masks (Emedco.com) 50/box
Ear plugs (Emedco.com) 200/box
Miracool bandanas (Occunomix.com)
Emedco.com
http://www.emedco.com
LSS.com
http://www.grainger.com/Grainger/wwg/start.shtml?r=l&cm_mmc=LabSafety-_-Integration-_-AllPages-_-AllPages
Tuffrhino.com
http://www.tuffrhino.com/Default.asp
Occunomix.com
http://www.occunomix.com
Redkap.com
http://www.redkap.com
