EHS INSPECTION

• Planned Workplace Inspection

• Document No.

• Select date

  Date

• Prepared by

• Location
  Address

• Inspected by:

EHS PROGRAM

• Is all required training completed<br>?

  Yes

  No

  N/A

• Have risk assessments / FLRAs been completed, reviewed and signed off by leader/supervisor?

  Yes

  No

  N/A

• Other

  Safe

  At Risk

  N/A

PPE

• Is eye protection (sealed, goggle, faceshield, etc.)<br>- Worn when/where required?<br>- In good condition, no damage?

  Yes

  No

  N/A

• Is foot protection (metatarsal guards):<br>- Worn when/where required?<br>- In good condition?<br>- Slip guards used where appropriate?

  Yes

  No

  N/A

• Is hand protection (proper glove for the job):<br>- Worn when/where required?<br>- In good condition?

  Safe

  At Risk

  N/A

• Is hearing protection (plugs, muffs, both):<br>- Worn when/where required?<br>- In good condition?

  Safe

  At Risk

  N/A

• Is respiratory protection (1/2 face, full face, PAPR, Air-Supplied):<br>- Worn when/where required?<br>- Appropriate use of filters/cartridges for the contaminant(s) present?<br>- Apparatus and filters/cartridges in good condition?

  Safe

  At Risk

  N/A

• Is fall protection (Harness, SRL, Lanyards, etc.):<br>- Worn when/where required and properly fitted?<br>- In good condition?<br>- Pre-Use inspection completed?<br>- Certified and correct harness used for the application? (fall arrest, evacuation/retrieval etc.)

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

General Facility/Site Conditions/Housekeeping

• Are surface/floor/wall/ceilings:<br>- In good condition, free of hazards?

  Safe

  At Risk

  N/A

• Are exits/egress routes clear and signage posted?

  Safe

  At Risk

  N/A

• Are stairways/walkways/ramps/platforms:<br>- clear and free of hazards

  Safe

  At Risk

  N/A

• Are driveways / aisles:<br>- Unobstructed, have good visibility and clear of hazards?

  Safe

  At Risk

  N/A

• Are there sufficient warning signs/markings/postings and do they clearly identify the hazards that may be present?

  Safe

  At Risk

  N/A

• Is general and emergency lighting/alarms in good working order and inspected regularly?

  Yes

  No

  N/A

• Are handrails secure and free of excessive defects?<br> -Heavily damaged handrails that require replacement? Loose? Broken welds? Bent handrails and/or toe boards?<br> -Handrails do not contain excessive oil/grease?

  Safe

  At Risk

  N/A

• Other

  Yes

  No

  N/A

Tools, Equipment and Rigging

• Are hand-power tools free of defects?<br>- Damaged/broken equipment tagged and taken out of service?

  Yes

  No

  N/A

• Are air guns & hoses pinned / are valves in good condition?

  Yes

  No

  N/A

• Are Slings, Chains, Rigging Inspected & Tagged?

  Yes

  No

  N/A

• Are horses/cribbing in good condition and stored properly when not in use?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Orderliness & Material / Chemical Storage

• Are materials stacked securely and storage organized and free of clutter?<br>- Are stored materials easily and safely accessible?

  Safe

  At Risk

  N/A

• Are there adequate containers provided for debris and is proper waste disposal in practice?

  Safe

  At Risk

  N/A

• Is there effective spill containment & response / proper resources available?<br>- Spill kit visible and accessible?

  Safe

  At Risk

  N/A

• Are proper container in use - and properly labeled?

  Safe

  At Risk

  N/A

• Are MSDS/SDS available/ reviewed?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Emergency Response/Fire Protection

• Are Fire extinguishers available, inspected monthly and unblocked?

  Safe

  At Risk

  N/A

• Are Employees aware of emergency procedures and where assembly areas are? (Interview >=2 employees)

  Safe

  At Risk

  N/A

• Are Eyewash/Safety Shower stations inspected and unblocked?

  Safe

  At Risk

  N/A

• Is there sufficient emergency equipment installed in the area?<br> -Fire extinguishers, eyewash, safety shower, spill kits, alarm pull stations, etc.

  Safe

  At Risk

  N/A

• Are fire suppression systems unblocked and free of damage?

  Safe

  At Risk

  N/A

• Is signage - No Smoking, Flammable, Combustible Signs installed, visible and in good condition?

  Yes

  No

  N/A

• Is Emergency Contact Information current?<br>- updated contact list posted?<br>- evacuation route updated and posted?

  Yes

  No

  N/A

• Are Flammables/Combustible Liquids / Material Storage<br>- Properly labeled and stored?

  Yes

  No

  N/A

• Are there Welding & Cutting (Flash Arrestors) available and being used? (interview employees)

  Yes

  No

  N/A

• Are Oxy - Fuel Cylinders Stored 25' apart?

  Yes

  No

  N/A

• Are Hot Work Permits / Emergency Controls in place where required?

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Mobile Equipment

• Is equipment inspected as per frequency requirements?<br>- Inspection booklet on equipment and completed to date

  Safe

  At Risk

  N/A

• Are operators using horns and warning devices where required?

  Safe

  At Risk

  N/A

• Are spotters used when there is limited visibility?<br>( Interview equipment operators/area supervisor if available)

  Yes

  No

  N/A

Electrical Hazards/Arc Flash

• Are High voltage signs in place and visible?

  Safe

  At Risk

  N/A

• Are Electrical cabinets closed and in good repair?<br> -Do the cabinets close securely?

  Safe

  At Risk

  N/A

• Are Electrical cabinets unblocked?<br> -Nothing within 36 inches of the front of the cabinet?<br> -Clear access/pathway to electrical cabinets?

  Safe

  At Risk

  N/A

• Is Arc flash signage in place?<br> -Indicates arc flash category?

  Safe

  At Risk

  N/A

• Is Proper arc flash PPE available and in use?

  Safe

  At Risk

  N/A

• Are GFCI in place and being used?

  Yes

  No

  N/A

• Are Cords, Tools, Plugs Inspected and Color-Coded?

  Yes

  No

  N/A

• Generators and Welders Grounded

  Yes

  No

  N/A

Lockout Tagout - Energy Control

• Are employees expected to conduct lockout trained and equipped properly?<br> -Employees understand their role and requirements?<br> -Employees have locks available if needed?

  Safe

  At Risk

  N/A

• Are employees locked out during a change over and/or other tasks that require lockout?<br> -All employees who are working on the equipment have their own lock affixed to the proper energy source(s)?<br> -Lockout was verified, stored energy was dissipated and equipment will not operate?

  Safe

  At Risk

  N/A

• Are energy control procedures exist for all equipment in the area and employees know where to find them?

  Safe

  At Risk

  N/A

• Have lockout exceptions been adequately evaluated and determined safe?<br> -Do regular tool/machine adjustments introduce hazards with unacceptable risk?<br> -Other exceptions?

  Safe

  At Risk

  N/A

Equipment - Crane/Hoists, Loaders, Forklifts, Aerial Lifts & All Other Machines

• Are pre-use inspections completed as per requirements?<br>- Inspections signed off by leader/supervisor?<br>- Completed Daily?

  Safe

  At Risk

  N/A

• Are employees working under suspended loads?

  Safe

  At Risk

  N/A

• Are cranes working within their operating limits?<br> -Capacity not exceeded?<br> -Upper limit switch not used as a stop?

  Safe

  At Risk

  N/A

• Are Alarms, Horns and Warning Lights Working?

  Yes

  No

  N/A

• Are all Equipment Guards in Place / Wheel Chocks available and in use?

  Yes

  No

  N/A

• Is operating condition safe overall?<br>

  Yes

  No

  N/A

• Other

  Yes

  No

  N/A

Fall Protection

• Is the underfoot walking working surface safe?<br>

  Yes

  No

  N/A

• Are handrail systems / perimeter guards installed and in good condition?

  Yes

  No

  N/A

• Is scaffolding properly installed, inspected and tagged?

  Yes

  No

  N/A

• Is the ladder in good condition? Setup correctly? Tied Off & Use?

  Yes

  No

  N/A

• Are personnel practicing 100% tie off as required?

  Yes

  No

  N/A

• Are wall openings guarded and holes covered?

  Yes

  No

  N/A

Signature and Finalization

• I have completed this assessment to the best of my knowledge. This audit is not intended to identify all safety and health hazards, but to identify all visible/known hazards as of the date printed on the completed assessment. assessment.

  Sign

• Select date

  Date

• General Comments

• Overall Safety Score