Title Page
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Conducted on
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Completed by
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Department
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Building
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Requirements for Communicating & Reviewing Inspection Results with Plant Management
General Safety Observations
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1. Are employees wearing appropriate PPE?
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Specify lack of or inappropriate PPE
- Safety Glasses/Goggles
- Rx Safety Glasses/Over the Glasses Safety Glasses
- Face Shields
- Gloves
- Steel Toes
- Weld Helmet
- Respiratory Protection
- Other
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Enter employees
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2. Is PPE being worn correctly?
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Enter employee names
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3. Is PPE maintained in a sanitary condition and ready for use?
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Specify work station(s)
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4. Employees wearing ID Badges as required per EHS General Rules?
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Enter employee names
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5. Are Red Badge employees operating equipment alone, with another Red Badge Employee or without supervision?
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Provide employee names
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6. Forklift Operators are wearing Forklift ID Badges & training is current?
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List employees not wearing Forklift ID Badges
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7. Are employees adhering to cell phone and earbud policy?
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Specify work station(s)
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8. All spray bottles are labeled with a GHS Compliant Label.
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Specify work station(s)
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9. Safe guards are in use (light curtains, cage doors, mezzanine gates, machine guards, dock chains, LOTO if applicable etc.)?
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Specify work station(s)dt
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10. Emergency stop buttons are mushroom shaped, colored red and have a yellow collar legend plate labeled "EMERGENCY STOP".
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Specify work station(s)
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11. Abrasive grinders have safety guards that cover the spindle, nut and flange projections; the guards are mounted to maintain proper alignment with the wheel.
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Specify work station(s)
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11. Multiple plug adaptors (e.g., power strips) are not used.
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Specify work station(s)
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12. Extension cords are being used as permanent powers sources.
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Specify work station(s)
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13. Drums of new and/or used oil stored on a proper secondary containment pad.
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Specify work station(s)
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1b. Secondary containment pads is in good condition (no leaks, damage, dents).
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Specify work station(s)
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Indicate any issues found during inspection
- Possible Leakage
- Dents/Damage
- Needs Emptying
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14. Are Compressed Gas cylinders stored in assigned areas where they will not be damaged by passing or falling objects?
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15. Are Compressed Gas cylinders secured by Safety Chains?
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16. Are valve protectors always placed on Compressed Gas cylinders when the cylinders are not in use or connected for use?
Sign-off
Sign-off
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Auditor
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Plant Manager
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Plant EHS
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Additional Personnel
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Additional Personnel