Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
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01 Mar 2022 / Victor Murillo
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Score
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Failed items
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Actions
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Which Building are you inspecting?
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Which department / area are you inspecting?
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Conducted on
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Document No
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Prepared by : Enter your name
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Complete
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1 Mar 2022 13:17 PST
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Victor Murillo
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Victor Murillo 000003
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Private & Confidential
Failed Items
Walking / Working Surfaces / Stairs / LADDERS / SCAFFOLDING
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Are all ladders inspected and in good condition with no structural damage?
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4 failed
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Photo 1
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Photo 2
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Photo 3
Walking / Working Surfaces / Stairs / LADDERS / SCAFFOLDING
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Are there no metal or aluminum ladders in electrical areas?
Crane / Hoist / Lifting Devices
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Do air nozzles have relief valves to decrease pressure to 29 psi or lower?
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Photo 4
Equipment
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Photo 5
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Private & Confidential
Aisles / Exits / Egress
AISLES/EXITS/EGRESS
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Are Aisles/ Exits / Egresses to be inspected in this audit?
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Private & Confidential
Walking / Working Surfaces / Stairs
WALKING / WORKING SURFACES / STAIRS
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Are walking / working surfaces / stairs to be inspected in this audit?
LADDERS / SCAFFOLDING
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Are Ladders / Scaffolding to be inspected in this audit?
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Are all step ladders under 20 feet in length?
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Are rubber feet on ladders in good repair?
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Are all ladders inspected and in good condition with no structural damage?
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Photo 1
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Photo 2
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Photo 3
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Are there no metal or aluminum ladders in electrical areas?
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Are ladders being used properly (only one person on ladder at a time and no one standing above the second step down from the top)?
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2 failed, 50%
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2 failed, 60%
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Private & Confidential
Electrical Grounding
ELECTRICAL GROUNDING
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Is Electrical Grounding to be inspected in this audit?
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Private & Confidential
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Personal Protective Equipment (PPE)
PERSONAL PROTECTIVE EQUIPMENT (PPE):
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EYE/FACE, RESPIRATORY, HEARING
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Is PPE to be inspected in this audit?
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Private & Confidential
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Fall Protection
FALL PROTECTION
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Is Fall Protection to be inspected in this audit?
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Private & Confidential
Crane / Hoist / Lifting Devices
CRANE / HOIST / LIFTING DEVICES
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Are Crane / Hoist / Lifting Devices to be inspected in this audit?
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Photo 4
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Does the operator have a full, unrestricted view before lifting load?
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Are all loads being lifted overhead secured?
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Is there no one beneath the load while it is suspended?
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Does the crane operator have a current license or certificate?
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Is the move checklist being used for Critical Lifts?
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1 failed, 83.33%
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Private & Confidential
Equipment
EQUIPMENT
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Is Equipment to be inspected in this audit?
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Grinding wheel surface not damaged or worn (must be square and no grinding on side of wheel)
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No aluminum found in grinding wheel surface?
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Are fans inspected annually for damage (cracked blades, guards, cords, etc)?
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Are heat lamps and work light bulbs guarded?
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Are all fixed machines bolted to the floor?
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Do air nozzles have relief valves to decrease pressure to 29 psi or lower?
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Photo 5
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Are air disconnects and safety nozzles the correct type (safety relief vents may not be covered or sealed in any way)?
Machinery
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Are you inspecting a specific piece of equipment?
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Private & Confidential
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1 failed, 77.78%
Forklift / Powered Industrial Truck
FORKLIFT / POWERED INDUSTRIAL TRUCK
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Are Forklifts / Powered Industrial Trucks to be inspected in this audit?
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Private & Confidential
Compressed Gas Cylinders
COMPRESSED GAS CYLINDERS
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Are you inspecting Compressed Gas Cylinders?
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Are cylinders legibly marked to clearly identify the gas contained?
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Are valve protector caps placed on cylinders when not in use?
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Are flammables and combustibles stored properly?
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Private & Confidential
Ergonomics
ERGONOMICS
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Are you inspecting ergonomics?
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Private & Confidential
Emergency, Health, & Safety Information
EMERGENCY, HEALTH & SAFETY INFORMATION
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Are Emergency. Health & Safety information to be inspected in this audit?
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Are fire alarm "Air Horn" locations marked and unobstructed?
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Are sign for emergency numbers, routes, and evacuation routes posted?
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Are the Emergency Response Team Members (ERT) assigned?
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Do employees know who their ERT Members are?
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Name of ERT Member for this work area
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Does the ERT Member have their numbers readily available, functional?
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Are employees trained on emergency procedures (primary and secondary routes)? Do they know where to go?
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Private & Confidential
Hazardous Communication - Chemical Safety
HAZARD COMMUNICATION - CHEMICAL SAFETY
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Is Chemical Safety to be inspected in this audit?
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Are all chemical containers not in use closed with lids?
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Are all chemicals removed from fume hoods and stored in proper cabinets?
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Are all plating/chemical tanks not in use clean, dry, and covered?
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Is grit blast cabinet area clean and garnet hopper emptied daily?
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Is food separated and away from chemicals in the work area?
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Private & Confidential
Satellite Waste Accumulation - B2
SATELLITE WASTE ACCUMULATION - B2
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Are you Inspecting Building 2 Satellite Accumulation?
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Private & Confidential
Satellite Waste Accumulation - B 3
HAZARDOUS WASTE - SATELLITE WASTE
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ACCUMULATION
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Are you Inspecting Building 3 Satellite Accumulation?
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Private & Confidential
Satellite Waste Accumulation - B4
HAZARDOUS WASTE - SATELLITE WASTE
ACCUMULATION - PLATING
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Are you inspecting B4 Satellite Waste Accumulation?
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Are you inspecting Ceramics ?
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Private & Confidential
Satellite Waste Accumulation - B7
SATELLITE WASTE ACCUMULATION - B 7
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Are you Inspecting Building 7 Satellite Accumulation?
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Private & Confidential
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Appendix
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Photo 1
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Photo 2
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Photo 3
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Photo 4
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Private & Confidential
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Photo 5
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Private