Title Page

  • PCN #

  • Resource / Equipment :

  • Conducted on

  • EEHS reviewer:

  • 1.0 Which type of change applies:

  • 1.06.a) Has the ( REAF ) Real Estate Approval Form been submitted to Magna Real Estate for the applicable Change(s)

  • 1.06. b) Magna corporate has been notified 6 weeks in advance for any new lease, new property construction on exisiting property, decomissioning a building, soil excavation

  • 1.06. c) Is landlord approval / authorization required?

  • 1.02.a) Has Magna corporate been notified ?

  • 1.02. b) Has a REAF, Real Estate Approval Form been sent to Magna for applicable changes?

  • 1.01.a) Do areas involved in the renovation have asbestos, lead based paint or PCBs?

  • 1.01.b) Have you notified Magna corporate of change ?

  • 1.10. a)Have you notified Magna Corporate

  • 1.10. b) Will change require importing fill soil onto the site?

  • 1.10. c) Does change require an amendment to site operational permits or approvals ? ( IE. land use zoning, environmental impact approvals)

  • 1.13.a) Has decomissioning checklist been completed?

  • 1.13.b) Has ECA modification log been updated to reflect change?

  • If change involves construction, renovation, building demolition, new property, modifications to existing HVAC or pollution control equipment, changes in operation, equipment installations or removals that may require pollution control ( painting- changes to ECA permit operations, changes in plant or process) Magna Environmental Department MUST be notified as soon as possible.

  • 1.1 Information on change or modification

  • 1.2 Are contractors working on the project / change / modification? WSIB, COI, Contractor Orientation, Contractor hazard assesment completed? If yes, which contractor?

  • 1.3 Will approved production limits on ECA permit be affected or require a increase ?

  • 1.4 Is this a modification to an existing process already documented?

  • 1.5 Does this process need to be added to the Environmental Aspects list?

  • 1.6 Does this process need to be added to the Significant Environmental Aspects list?

  • 1.7 Is a Controlled Environment needed for this process?

2.0 Training/ Key Personnel / Resources

  • 2.1 Are there personnel changes such as Emergency planning contacts, Permit notifictions, Notification updates or other resources changes to be made?

  • 2.1.a) What change needs to be made ?

  • 2.1.b) Has training matrix been updated and reviewed?

  • 2.1.c) Has Magna corporate been notified of change?

3.0 Interior / Exterior Subgrade Features

  • 3.1 If any vegetation or land use around the building is impacted by change, has Magna been notified

  • 3.2 Will soil be removed?

  • 3.3 Subgrade Features have been added to the inventory and updated?

  • 3.4 Are any subgrade features being coated or sealed to prevent contamination?

  • 3.5 Are subgrade features being closed?

  • 3.6 Will any materials, waste, or equipent be stored outside ?

  • 3.7 Is there a risk of contamination to sewers, stormceptors or sanitary system from change? (Now or in the future)

4.0 Wastes, Chemicals, Spills,Designated Substances

  • 4.1 Are there new chemicals or materials being used in the process?

  • 4.1 a) Has a New Product Submission been completed and product added to SDS database?

  • 4.1 b) Has SDS been reviewed for regualtory reportable substances, magna prohibited substances, chemical compatability, proper labelling requirements?

  • 4.2 Is there any potential for a spill from the change or process?

  • 4.3 Are there any new hazards or risks with the chemicals involved?

  • 4.3 a) What new hazards have been identified with the chemicals?

  • 4.4 Has spill plan inventory been updated including spill kit location /quanity for the new material/ chemical / waste?

  • 4.5 Are new spill kits required ? if yes,which type of material

  • 4.6 Does the process /change include the use of flammables or combustibles?

  • 4.7 Are there any hazardous wastes, liquid industrial wastes,or by-products from this process or change?

  • 4.7 a) Which hazardous waste area will the wastes be stored in?

  • 4.7 b) Waste class :

  • 4.8 Will quantities for chemicals ( resins, adhesive, lubricants, plastic pellets, ect) or metals ( stainless steel, aluminum, coils, wires) increase ? If yes verify substance notification requirements, NPRI, Spill plan

  • 4.9 Will change increase lubricant, water or scrap in press pit ?

  • 4.10 Can any of the waste generated be recycled?

  • 4.11 Are new or specific recycling, hazardous waste or additional garbage bins required ?

  • 4.11 a) List Type /Details

  • 4.12 Does the process/change use acids , corrosives or alkalies?

  • 4.13 Is there any Designated Substances used in this process?

  • 4.13 a) Has the Designated Substance list been updated ?

5.0 Air Emissions, Energy

  • 5.1 Does change affect air emissions or are emissions generated?

  • 5.1 a) Is air emission inventory updated

  • 5.2 Does this process vent or exhaust to the outside?

  • 5.2 a) If Yes, Stack or Exhaust number or location:

  • 5.3 Does change have Ozone depleting substances or refrigerants?

  • 5.3 a) Has Refrigerant Containing Equipment list been updated and ODS removed or added?

  • 5.4 Is an exhaust system or air scrubber required? (Laser, chemicals hazardous/ combustible fumes or dusts created in process, check dust is not accumulating on items )

  • 5.5 Would the machine / process increase the energy usage ? Water, Electricity,Gas

6.0 General Safety, Ergonomics, Environmental

  • 6.1 Is there a fire risk associated with the change or process?

  • 6.2 Is any Environmental Legislation affected by this process?

  • 6.3 Are any permits / certificates or testing required before process begins?

  • 6.4 Industrial hygiene testing recommended for Air, Noise or Vibration?

  • 6.5 Internal Noise Measurement db Reading ( if applicable )

  • 6.6 Does Electrical equipment have the ESA sticker?

  • 6.7 Has a Pre-Start Safety Review been completed by an engineer and all non-conformances corrected?

  • 6.8 Is a Ergonomic Design Checklist Required ?

  • 6.8 a) Was the EDC completed? Are all design guidelines met and EDC added to HSELinx?

  • 6.9 Is a Ergonomic Risk Assessment required? (NIOSH, snook,ERA or other)

  • 6.9 a) Was the ERA completed and added to HSElinx?

  • 6.10 Has a JSA been completed by Engineering ?

  • 6.10 a) Does the JSA align with JES? Risk ratings must match, risk methodologies need to be the same

  • 6.11 Does all equipment conform to Reg. 851 for Industrial Establishments?

  • 6.12 Are there any new interested parties with this change?

  • 6.12 a) Update Scope of EEHS Management System SOP 00014 with any new needs and expectations for new interested parties

  • 6.13 Has a lock out / tag out placard been posted? Lock out points identified and labelled ?

  • 6.14 Have Job Element Sheets and Safe Work Instructions been completed and posted?

  • 6.15 Have equipment specific Pre-Use Inspection sheets been implemented?

  • 6.16 Are additional emergency response or specific procedures or postings required? ( robot placards , press specific entrapment, Injection molding shut down steps, chemical warnings ect)

  • 6.16 a) What is required? Robot Placards, Press Entrapment, Injection Molding Shut Down Steps, Chemical Warnings, Laser Warning Placards, ect

  • 6. 17 Additional Personal Protective Equipment Recommended

  • 6.18 Enter PPE required for the task to be completed safely ( if applicable)

  • 6.19 Can employees safely access the new area or equipment

  • 6.19 a) What is required and or what is the issue that requires investigation?

7.0 Coils Press Safety

  • 7.1Does change involve coils?

  • 7.1 a) Is the crane in the stamping/coil area able to lift and move the coil safely? (Crane max lift weight acceptable)

  • 7.1 b) Is there room to safely store the coils in coil area? Do they have a home location ?

  • 7.1 c) Are the coils in plastic or strapped / wrapped two coils together? ( No black plastic allowed)

  • Can the coils be loaded onto mandrel without issue?

Summary

  • Signature

  • Summary / Notes:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.