Title Page

  • Conducted on

  • Completed by

  • Department

  • Building

  • Requirements for Communicating & Reviewing Inspection Results with Plant Management

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General Safety Observations

  • 1. Are employees wearing appropriate PPE?

  • Specify lack of or inappropriate PPE

  • Enter employees

  • 2. Is PPE being worn correctly?

  • Enter employee names

  • 3. Is PPE maintained in a sanitary condition and ready for use?

  • Specify work station(s)

  • 4. Employees wearing ID Badges as required per EHS General Rules?

  • Enter employee names

  • 5. Are Red Badge employees operating equipment alone, with another Red Badge Employee or without supervision?

  • Provide employee names

  • 6. Forklift Operators are wearing Forklift ID Badges & training is current?

  • List employees not wearing Forklift ID Badges

  • 7. Are employees adhering to cell phone and earbud policy?

  • Specify work station(s)

  • 8. All spray bottles are labeled with a GHS Compliant Label.

  • Specify work station(s)

  • 9. Safe guards are in use (light curtains, cage doors, mezzanine gates, machine guards, dock chains, LOTO if applicable etc.)?

  • Specify work station(s)dt

  • 10. Emergency stop buttons are mushroom shaped, colored red and have a yellow collar legend plate labeled "EMERGENCY STOP".

  • Specify work station(s)

  • 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.

  • Specify work station(s)

  • 11. Multiple plug adaptors (e.g., power strips) are not used.

  • Specify work station(s)

  • 12. Extension cords are being used as permanent powers sources.

  • Specify work station(s)

  • 13. Drums of new and/or used oil stored on a proper secondary containment pad.

  • Specify work station(s)

  • 1b. Secondary containment pads is in good condition (no leaks, damage, dents).

  • Specify work station(s)

  • Indicate any issues found during inspection

  • 14. Are Compressed Gas cylinders stored in assigned areas where they will not be damaged by passing or falling objects?

  • 15. Are Compressed Gas cylinders secured by Safety Chains?

  • 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

  • Auditor

  • Plant Manager

  • Plant EHS

  • Additional Personnel

  • Additional Personnel

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.