Information

  • Document No.

  • Audit Title

  • Conducted on

  • Prepared by

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
  • 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
  • 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
  • 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
  • item?

First Aid Room?

  • AED Charged and inspected?

  • First aid supplies adequate?

  • 1"x3" Bandages (Check box only if needed)

  • Please order.

  • 2"x2" Gauze Pads (Check box only if needed)

  • Please order.

  • Burn Ointment (Check box only if needed)

  • Please order.

  • Eye Wash Solution (Check box only if needed)

  • Please order.

  • Ice Pack (Check box only if needed)

  • Please order.

  • Instant Cold Spray (Check box only if needed)

  • Please order.

  • Scissors (Check box only if needed)

  • Please order.

  • Adequate housekeeping?

  • Incident/Accident Reports availabe?

  • Electrical outs in good condition?

  • Other items?

  • item
  • 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
  • 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
  • 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
  • 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
  • item?

Tunnel Hanging Area

  • Floor mats in good condition?

  • Adequate housekeeping?

  • #17 Fire extinguisher- tagged/charged/inspected/accessible?

  • Other items?

  • item
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • item?

Parking Lot and Grounds

  • All exits free of obstructions?

  • Walkways clear?

  • Broken glass or metal objects

  • Other items?

  • item
  • 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

  • Audit Completed By?

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)

  • Date Inventoried?

  • Inventoried by?

  • 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

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