DUNN TIRE-FACILITY SAFETY INSPECTION.

• Facility Name/Number

• Audit title: Facility/number

• Location
  Address

• Conducted on

  Date

• Facility Manager name/email

• Additional Copies (name (s)/email (s))

• Prepared by

• Check the box if you have a Sales Dept.

EXIT ROUTES

• Are floor mats in place at entrances?

  Yes

  No

  N/A

• Are they of sufficient length to accommodate at least 4 strides (2 steps for each foot)

  Yes

  No

  N/A

• Clearly marked with approved signs? (6"x3/4" letters) (29 CFR 1910.37)

  Yes

  No

  N/A

• What type of exit sign?

  Internally luminated

  Self-luminous

  Non reflective

• Are bulbs working <br>(29CFR 1910.36)<br>

  Yes

  No

  N/A

• Are there emergency lights in the department?

  Yes

  No

  N/A

• Are the lights working properly?

  Yes

  No

  Unable to determine

  N/A

• Are the directions to exits, when not immediately apparent, marked with visible signs?

  Yes

  No

  N/A

• Are doors which could be confused with emergency exits marked "not an exit" or otherwise identified? <br>(29 CFR 1910.37)

  Yes

  No

  N/A

• Free of locks and easily opened (e.g. Crash Bars) to allow emergency egress from the building? (29 CFR 1910.36 (d) (1) and or (d) (2)

  Yes

  No

  N/A

• Free from obstruction?

  Yes

  No

  N/A

• Is the distance between exit doors and the ground no more than 10 inches in height, or are steps installed? (29 CFR 1910.37)

  Yes

  No

  N/A

• Does the department have fire doors?

  Yes

  No

  N/A

• Fire door from kick down stops?

  Yes

  No

  N/A

• Fire door fire rating label readable?

  Yes

  No

  N/A

• Fire door closed?

  Yes

  No

  N/A

• Are there rolling fire doors present in department?

  Yes

  No

  N/A

• Rolling fire door is the path clear from obstructions?

  Yes

  No

  N/A

• Fire rolling door fusible link free from paint? (not painted)

  Yes

  No

  N/A

• Fire rolling fire door has been inspected in the last 12 months and documentation has been filed in the Safety T First binder?

  Yes

  No

  N/A

FIRE SAFETY

• Does the department have sufficient fire extinguishers in good working order?<br>(29 CFR 1910.157)

  Yes

  No

  N/A

• Is the monthly inspection documented on the tag?

  Yes

  No

  N/A

• Is the fire extinguisher accessible?

  Yes

  No

  N/A

• Do space heaters have automatic shutoff feature?

  Yes

  No

  Unable to determine

  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

• Is there a written emergency evacuation plan (with map) posted?

  Yes

  No

  N/A

ELECTRICAL SAFETY

• Are electrical outlets securely fastened to a wall? (29 CFR 1910.303 (b)(8)(i))

  Yes

  No

  N/A

• Are cords, wiring and plugs in good condition and grounded? (29 CFR 1010.303 (h)(3))

  Yes

  No

  N/A

• Does the department prohibit use of multiple plug adapters? (29 CFR 1910.303)

  Yes

  No

  N/A

• Does the department only use extension cords for temporary work ?(29 CFR 1910.305)

  Yes

  No

  N/A

• Are extension cords that are used for temporary work properly grounded with a three-prong plug? (29 CFR 1910.304 and 305)

  Yes

  No

  N/A

• Are ground fault circuit interrupters (GFCI) installed near electrical equipment which has the potential for contact with moisture? (29 CFR 1910.394)

  Yes

  No

  Unable to determine

  N/A

• Is there a circuit panel box in this department?

  Yes

  No

• Are all circuits labeled properly? (29 CFR 1910.303)

  Yes

  No

  N/A

• Is there 3 feet of clerance around circuit panel boxes?

  Yes

  No

  N/A

• Are all spaces in panel filled with breakers or blanks?

  Yes

  No

Miscellaneous

• General housekeeping

  Poor 1

  Good 2

  Excellent 3

• Additional items?

  Yes

  No

• Check the box if you have a Service Department

EXIT ROUTES

• Clearly marked with approved signs? (6"x3/4" letters) (29 CFR 1910.37)

  Yes

  No

  N/A

• What type of exit sign?

  Internally luminated

  Self-luminous

  Non reflective

• Are bulbs working (exit sign and emergency light)<br>(29CFR 1910.36)<br>

  Yes

  No

  N/A

• Are there emergency lights in the department?

  Yes

  No

  N/A

• Are the lights working properly?

  Yes

  No

  Unable to determine

  N/A

• Are the directions to exits, when not immediately apparent, marked with visible signs?

  Yes

  No

  N/A

• Are doors which could be confused with emergency exits marked "not an exit" or otherwise identified? <br>(29 CFR 1910.37)

  Yes

  No

  N/A

• Free of locks and easily opened (e.g. Crash Bars) to allow emergency egress from the building? (29 CFR 1910.36 (d) (1) and or (d) (2)

  Yes

  No

  N/A

• Free from obstruction?

  Yes

  No

  N/A

• Is the distance between exit doors and the ground no more than 10 inches in height, or are steps installed? (29 CFR 1910.37)

  Yes

  No

  N/A

• Does the department have fire doors?

  Yes

  No

  N/A

• Fire door from kick down stops?

  Yes

  No

  N/A

• Fire door fire rating label readable?

  Yes

  No

  N/A

• Fire door closed?

  Yes

  No

  N/A

• Are there rolling fire doors present in department?

  Yes

  No

  N/A

• Rolling fire door is the path clear from obstructions?

  Yes

  No

  N/A

• Fire rolling door fusible link free from paint? (not painted)

  Yes

  No

  N/A

• Fire rolling fire door has been inspected in the last 12 months and documentation has been filed in the Safety T First binder?

  Yes

  No

  N/A

FIRE SAFETY

• Does the department have sufficient fire extinguishers and are they readily accessible, mounted, identified with signs. <br>Is the required monthly inspection (EVERY 30 days) documented on back of tag? <br>Annual inspection current? (29 CFR 1910.157)

  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

• Are open flames and spark-producing equipment such as bench grinders kept away from flammable dip tanks? (29 CFR 1910.38)

  Yes

  No

  N/A

• Are oily, used rags properly stored in closed, non-flammable containers and properly disposed of or recycled by a laundry service? (DEC; fire regulaions)

  Yes

  No

  N/A

• Is there a written emergency evacuation plan (with map) posted?

  Yes

  No

  N/A

ELECTRICAL SAFETY

• Are electrical outlets securely fastened to a wall? (29 CFR 1910.303 (b)(8)(i))

  Yes

  No

  N/A

• Are cords, wiring and plugs in good condition and grounded? (29 CFR 1010.303 (h)(3))

  Yes

  No

  N/A

• Does the department avoid taping flexible cords which are frayed or missing insulation? (29 CFR 1910.305)

  Yes

  No

  N/A

• Does the department prohibit use of multiple plug adapters? (29 CFR 1910.303)

  Yes

  No

  N/A

• Does the department only use extension cords for temporary work? (29 CFR 1910.305)

  Yes

  No

  N/A

• Are extension cords that are used for temporary work properly grounded with a three-prong plug? (29 CFR 1910.304 and 305)

  Yes

  No

  N/A

• Are ground circuit fault interrupters (GFICI's) installed near electrical equipment which has the potential for contact with moisture? (29 CFR 1910.394)

  Yes

  No

  Unable to determine

  N/A

• Is there a circuit panel box in this department?

  Yes

  No

• Are all circuits labeled properly? (29 CFR 1910.303)

  Yes

  No

  N/A

• Is there 3 feet of clerance around circuit panel boxes?

  Yes

  No

  N/A

• Are all spaces in panel filled with breakers or blanks?

  Yes

  No

• Is there sufficient work space around electrical equipment in order to permit its safe operation? (29 CFR 1910.303)

  Yes

  No

  N/A

PHYSICAL, SANITATION & HEALTH HAZARDS

• Are all floor openings covered? (29 CFR 1910.23)

  Yes

  No

  N/A

• Are spilled materials cleaned up immediately ? (29 CFR 1910.1200)

  Yes

  ?

  No

• Are the floors as dry as possible? (29 CFR 1910.22 (a)(2)

  Yes

  ?

  No

• Does the department maintain work areas and aisles free from trip hazards? (29 CFR 1910.176)

  Yes

  No

  N/A

• Are any fans that are within seven feet of floor totally enclosed? (29 CFR 1910.212)

  Yes

  No

  N/A

• Is residue and debris disposed of a timely manner? (29 CFR 1910.22)

  Yes

  ?

  No

• Are lights which may be hit, encased in protective shields or otherwise guarded to prevent breakage? (29 CFR 1910.303)

  Yes

  No

  N/A

• Is food waste removed so to eliminate health hazards? (29 CFR 1910.141)

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• If employees use compressed air for cleaning parts or equipment, do they reduce compressed air to less than 30 PSI dor cleaning parts or equipment? <br>NOTE; Compressed air should not be used to clean clothing, (29 CFR 1910.242)

  Yes

  No

  N/A

• Are shop reels installed and properly positioned to keep cords and hoses off the shop floors?

  Yes

  No

  N/A

• Are air hoses in good condition and not repaired with hose clamps,but with proper repair kit?<br>Air hose repair kit are available from NFADA or NAPA

  Yes

  No

  N/A

• (29 CFR 11910.243(b)(2) air hose. Hose and hose connections used for conducting compressed air to utilization equipment shall be designed for the pressure and service to which they are subjected.

PERSONAL PROTECTIVE EQUIPMENT AND FIRST AID

• Does the department provide personal protective equipment (e.g., googles,gloves,hearing protection) to all employees and kept in sanitary condition? (29 CFR 1910.132 (e))

  Yes

  No

  N/A

• Are eyewash units located within 100 feet of a potential hazard site, providing 15 minutes of a continuous flow of water? (29 CFR 1910.151 and ANSI Z358.1-2009))

  Yes

  No

  N/A

• Type of unit?

  Self contained unit

  plumbed in unit

• Is the unit full, clean, accessible, fluid changed when required and documented (EVERY 90 days)?

  Yes

  No

  N/A

• Is clean, accessible and flushed weekly?

  Yes

  No

  N/A

GAS CYLINDERS/TORCHES

• Do torches have a back-flow regulator (i.e., flash guard, or check valve)? (29 CFR 1910.253)

  Yes

  No

  N/A

• Are cylinders legibly marked? (29 CFR 1910.101)

  Yes

  No

  N/A

• Do the cylinders: (1) require a special wrench for each acetylene cylinder in order to quickly turn it off in event of an emergency, and (2) keep one on each cylinder? (29 CFR 1910.252)

  Yes

  No

  N/A

• Where cylinders were designed to accept valve protection caps, are they in place and hand tightened, except for when they are in use or connected for use? (29 CFR 1910.253 (b) (2) (iv) )

  Yes

  No

  N/A

• Are they chained to a cart when moved? (29 CFR 1910.253(b) (2) (ii))

  Yes

  No

  N/A

• If the facility stores extra gas cylinders on-site, do they meet all the following standards:

• Chaining gas cylinders to a stationary object when they are not in use. (29 CFR 1910.253 (b) (2) (ii) )<br>

  Yes

  No

  N/A

• Storing them away from elevators or stairs where they could be knocked over or damaged (falling objects). (29 CFR 1910.253 (b) (2) (ii) )

  Yes

  No

  N/A

• Storing them away from flammables and combustibles (oil,grease,or fuel gas) by at least 20 feet. (29 CFR 1910.253 (b) (4) (i) )

  Yes

  No

  N/A

• Store extra oxygen and acetylene gas cylinders at least 20 feet apart from one another (unless separated by non-combustible barrier at least 5 feet high (29 CFR 1910.253)

  Yes

  No

  N/A

MACHINES & EQUIPMENT

• Does each jack or jack stand have its rated load legibly marked? (29 CFR 1910.244 (a) (1) (ii))

  Yes

  No

  N/A

• Are safety devices on lifts in working condition and is the lift mechanism free of tampering? (OSHA Act, section 5a)

  Yes

  No

  N/A

• Do all lifts include, the manufacturer's name,model,serial number and load rate?

  Yes

  No

  N/A

Miscellaneous

• General housekeeping

  Poor 1

  Good 2

  Excellent 3

• Additional items?

  Yes

  No

• Check the box if you have a Tire Storage Area.

EXIT ROUTES

• Clearly marked with approved signs? (6"x3/4" letters) (29 CFR 1910.37)

  Yes

  No

  N/A

• What type of exit sign?

  Internally luminated

  Self-luminous

  Non reflective

• Are bulbs working (exit sign and emergency light)<br>(29CFR 1910.36)<br>

  Yes

  No

  N/A

• Are there emergency lights in the department?

  Yes

  No

  N/A

• Are the lights working properly?

  Yes

  No

  Unable to determine

  N/A

• Are the directions to exits, when not immediately apparent, marked with visible signs?

  Yes

  No

  N/A

• Are doors which could be confused with emergency exits marked "not an exit" or otherwise identified? <br>(29 CFR 1910.37)

  Yes

  No

  N/A

• Free of locks and easily opened (e.g. Crash Bars) to allow emergency egress from the building? (29 CFR 1910.36 (d) (1) and or (d) (2)

  Yes

  No

  N/A

• Free from obstruction?

  Yes

  No

  N/A

• Is the distance between exit doors and the ground no more than 10 inches in height, or are steps installed? (29 CFR 1910.37)

  Yes

  No

  N/A

• Does the department have fire doors?

  Yes

  No

  N/A

• Fire door from kick down stops?

  Yes

  No

  N/A

• Fire door fire rating label readable?

  Yes

  No

  N/A

• Fire door closed?

  Yes

  No

  N/A

• Are there rolling fire doors present in department?

  Yes

  No

  N/A

• Rolling fire door is the path clear from obstructions?

  Yes

  No

  N/A

• Fire rolling door fusible link free from paint? (not painted)

  Yes

  No

  N/A

• Fire rolling fire door has been inspected in the last 12 months and documentation has been filed in the Safety T First binder?

  Yes

  No

  N/A

FIRE SAFETY

• Does the department have sufficient fire extinguishers and are they readily accessible, mounted, identified with signs. <br>Is the required monthly inspection (EVERY 30 days) documented on back of tag? <br>Annual inspection current? (29 CFR 1910.157)

  Yes

  No

  N/A

• Do space heaters have automatic shutoff feature?

  Yes

  No

  Unable to determine

  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

• Is there a written emergency evacuation plan (with map) posted?

  Yes

  No

  N/A

ELECTRICAL SAFETY

• Are electrical outlets securely fastened to a wall? (29 CFR 1910.303 (b)(8)(i))

  Yes

  No

  N/A

• Are cords, wiring and plugs in good condition and grounded? (29 CFR 1010.303 (h)(3))

  Yes

  No

  N/A

• Does the department avoid taping flexible cords which are frayed or missing insulation? (29 CFR 1910.305)

  Yes

  No

  N/A

• Does the department prohibit use of multiple plug adapters? (29 CFR 1910.303)

  Yes

  No

  N/A

• Does the department only use extension cords for temporary work? (29 CFR 1910.305)

  Yes

  No

  N/A

• Are extension cords that are used for temporary work properly grounded with a three-prong plug? (29 CFR 1910.304 and 305)

  Yes

  No

  N/A

• Are ground fault circuit interrupters (GFCI's) installed near electrical equipment which has the potential for contact with moisture? (29 CFR 1910.394)

  Yes

  No

  Unable to determine

  N/A

• Is there a circuit panel box in this department?

  Yes

  No

• Are all circuits labeled properly? (29 CFR 1910.303)

  Yes

  No

  N/A

• Is there 3 feet of clerance around circuit panel boxes?

  Yes

  No

  N/A

• Are all spaces in panel filled with breakers or blanks?

  Yes

  No

PHYSICAL, SANITATION & HEALTH HAZZARDS

• Does the department maintain work areas and aisles free from trip hazards? (29 CFR 1910.176)

  Yes

  No

  N/A

• Are materials stored so that they will not slip or collapse? (29 CFR 1910.176)

  Yes

  No

  N/A

• Are any fans that are within seven feet of floor totally enclosed? (29 CFR 1910.212)

  Yes

  No

  N/A

• Is residue and debris disposed of in a timely manner? (29 CFR 1910.22)

  Yes

  ?

  No

• Are lights, which may be hit, encased in protective shields or otherwise guarded to prevent breakage? (29 CFR 1910.303)

  Yes

  No

  N/A

• Is food waste removed so to eliminate health hazards? (29 CFR 1910.141)

  Yes

  No

  N/A

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

  Yes

  No

  N/A

Miscellaneous

• General housekeeping

  Poor 1

  Good 2

  Excellent 3

• Additional items?

  Yes

  No

• Does the Facility have a fire/security alarm?

  Yes

  No

  N/A

• Fire Alarm Local or Monitored?

  Local Fire Alarm

  Monitored Alarm System

• Company name:

• Last inspection date?

• Is there a Sprinkler System and has it been inspected in the last 12 months?

  Yes

  No

• Sprinkler heads have 18" of clearance top of head?

  Yes

  No

  N/A

• Sprinkler bell area free from birds nests?

  Yes

  No

  N/A

• Sprinkler outside hose connection area free from obstructions?

  Yes

  No

  N/A

• Sprinkler Inspection by

• Last inspection date?

Equipment

• Are all belts and moving parts fully guarded on equipment such as compressors?(29 CFR 1910.213)

  Yes

  No

  N/A

• Are compressors equipped with a pressure relief valves and pressure gauges? (29 CFR 1910.169)

  Yes

  No

  N/A

• Does the facility have a bench grinder?

  Yes

  No

• Is there a properly aligned and fastened safety guard with a tongue guard adjusted to within 1/4 inch of wheel, for each abrasive wheel of bench grinder?

  Yes

  No

  N/A

• Do you have a tool rest (i.e,. work rest) for each abrasive wheel, and is each tool rest no more than 1/8 inch from each wheel?

  Yes

  No

  N/A

• Is each bench grinder properly grounded with a three prong plug?

  Yes

  No

  N/A

• Is each bench grinder securely attached and stable?

  Yes

  No

  N/A

• Does the department post a sign requiring employees to wear googles or face shields when grinding, and supply this PPE to ensure adequate face protection? (29 CFR 1910.215)

  Yes

  No

  N/A

• Is there a hot water tank present?

  Yes

  No

  N/A

• Is there 18" of clearance around the burner area?

  Yes

  No

  N/A

• Is the pressure relief valve tube within 6" of the floor?

  Yes

  No

  N/A

• Is propane storage tank (ex. gas grille tank) stored outside, secured, 10ft from a exit?

  Yes

  No

  N/A

First Aid/Safety

• Are first aid supplies and bloodborne pathogen kit (gloves,and one-way valve mask) available? (29 CFR 1910.151)

  Yes

  No

  N/A

• MINIMUM REQUIREMENTS
  1-Absorbent Compress 5"x9"
  100-Adhesive Bandage 1"x3"
  1-Adhesive Tape 1/2"x10 yds
  1-Antiseptic Spray 3oz
  1-Burn Relief Spray 3oz
  1pr-Latex Gloves
  10-Sterile Pads 3"x3"
  1-Triangular Bandage
  60-First Aid/Burn Cream
  1-One Way CPR Valve mask/barrier
  
  
  
  
  

• Are MSDS's (SDS) in the building (29 CFR 1910.1200(g)(8)

  Yes

  No

  N/A

• Is there an MSDS/SDS for every chemical in the building?

  Yes

  No

  N/A

• Is there an index in the front and each section of MSDS binder?

  Yes

  No

  N/A

• Misc.

  Yes

  No

  N/A

• Seasonal Item (Winter) Check if applies:

• Is salt/ice melt available at entranceways?

  Yes

  No

  N/A

• Are walks, and locations where employees/customers may travel, cleared of snow and ice?

  Yes

  No

  N/A

• Notes

• Store Representative

  Sign