Dorsey Trailer, LLC EHS Weekly Compliance Audit

• Audit Number

• Physical Location
  Address

• Work Department

  Select

• Departmental Supervisor/Line Pro

  Sign

• Prepared by

• Date & Time

  Date

Personal Protective Equipment Policy Enforcement

Personal Protective Equipment (PPE) Employee Check

• List any employee that is not correctly wearing the mandatory PPE (Eye Protection).

• List any employee that is not correctly wearing the mandatory PPE (Safety Footwear).

• List any employee that is not correctly wearing the mandatory PPE (Hearing Protection).

• List any employee that is not correctly wearing the mandatory PPE (Hand Protection).

• List any employee that is not correctly wearing the mandatory PPE (Respirators).

Housekeeping

• Work and storage areas are clean and uncluttered?

  Yes

  No

  N/A

• Work stations are well organized and no trip hazards are present?

  Yes

  No

  N/A

• Emergency equipment (eyewash, etc.) is easily accessible.

  Yes

  No

  N/A

• Emergency routes and emergency doors are kept clear and fully accessible. Emergency doors are not locked.

  Yes

  No

  N/A

• Equipment and tools (chains, slings, electrical & hand tools, etc.) are stored properly?

  Select Yes No N/A

  • Yes
  • No
  • N/A

Safety Signage

• Signs indicating required Personal Protective Equipments are in place.

  Yes

  No

  N/A

• Signs indicating eyewash/safety shower, emergency exits, , etc. are in place?

  Yes

  No

  N/A

• Evacuation maps and emergency numbers are posted throughout the plant?

  Yes

  No

  N/A

Environment

• Liquid chemicals are stored in secondary containment?

  Yes

  No

  N/A

• Flammable chemicals are stored in flammable cabinets (or in a dedicated storage room) when not in use?

  Yes

  No

  N/A

• Waste area is properly maintained?

  Yes

  No

  N/A

Maintenance

• Equipment (lighting fixtures, machine guarding, vehicles, etc.) are maintained in good working condition and in place.

  Yes

  No

  N/A

Ergonomics

• Do workers avoid repetitive awkward positioning, excessive or overhead reaching, or continuous bending and twisting?<br>

  Yes

  No

  N/A

Tools, Equipment and Machines

• Have operator's received proper tool and/or machine specific training?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Appropriate machine safety guards are in place?<br>.

  Yes

  No

  N/A

• Tools, equipment and machines are operating properly?

  Yes

  No

  N/A

Overall Notes

• What is the overall condition of the department?

  Exceptional

  Exceeds Standards

  Meets Standards

  Needs Improvement

  Needs Significant Improvement

• Any additional info?

• Are any safety concerns present that require immediate attention?

  Safe

  At Risk

  N/A

• Ensure all safety issues are noted in the audit above, with associated corrective actions created

Accomplishments

• Log below any examples of excellent work practices that were noted on this safety walk.

Positive Observations

• Employee Name

• Observed Action

Sign Off

• I declare that the audit above was conducted and completed accurately.

• Full name and signature of auditor

  Sign