EHS&S

Safety is in your hands

• Audit check list number

• Choose department

  Select Primary Secondary Supply Chain Quality Assurance Engineering Office Other

  • Primary
  • Secondary
  • Supply Chain
  • Quality Assurance
  • Engineering
  • Office
  • Other

• Choose location

  Building 19

  Building 20

  Building 23

  Building 24

  Other

• Date & Time

  Date

• Auditor

  Sign

• Department host

  Sign

Inspection area included

• 1. Workplace conditions

  Yes

  No

  N/A

• 2. Work at height

  Yes

  No

  N/A

• 3. Machinery/equipment safety

  Yes

  No

  N/A

• 4. Internal transport

  Yes

  No

  N/A

• 5. Material Storage

  Yes

  No

  N/A

• 6. Electro-safety

  Yes

  No

  N/A

• 7. Hazardous materials

  Yes

  No

  N/A

• 8. Personal protective equipment

  Yes

  No

  N/A

• 9. Emergency System

  Yes

  No

  N/A

• 10. Hazard Controls

  Yes

  No

  N/A

• 11. Documentation

  Yes

  No

  N/A

• 12. Employee's documentation

  Yes

  No

  N/A

• 13. Other location's specific matters

  Yes

  No

  N/A

UNNSAFE ACTS

• 1. Unnecessary Working on Moving or Dangerous Equipment

• Turn switch ON

  Off

  On
Tap to enter information

• Choose from selection

  Select Packing, equipment under pressure Cleaning, oiling, adjusting, etc. Welding, repairing, etc. Working on electrically charged equipment

  • Packing, equipment under pressure
  • Cleaning, oiling, adjusting, etc.
  • Welding, repairing, etc.
  • Working on electrically charged equipment
Tap to enter information

• Answer for selected

  Yes

  No

  N/A

• 2. Failure to Wear Personal Protective Equipment

• Turn switch ON

  Off

  On
Tap to enter information

• Choose from selection

  Select Failure to use available personal protective equipment such as goggles, gloves, safety shoes, gas masks, safety helmets, respirators, face shields, aprons, etc.

  • Failure to use available personal protective equipment such as goggles, gloves, safety shoes, gas masks, safety helmets, respirators, face shields, aprons, etc.
Tap to enter information

• Answer for selected

  Yes

  No

  N/A

• 3. Wearing Unsafe Clothing

• Turn switch ON

  Off

  On
Tap to enter information

• Choose from selection

  Select Failure to wear safe personal clothing - wearing high heels, loose hair, long sleeves, loose clothing.

  • Failure to wear safe personal clothing - wearing high heels, loose hair, long sleeves, loose clothing.
Tap to enter information

• Answer for selected

  Yes

  No

  N/A

• Tap to enter information

• Turn switch ON

  Off

  On
Tap to enter information

• Choose from selection

  Select Failure to wear safe personal clothing - wearing high heels, loose hair, long sleeves, loose clothing.

  • Failure to wear safe personal clothing - wearing high heels, loose hair, long sleeves, loose clothing.
Tap to enter information

• Answer for selected

  Yes

  No

  N/A

UNSAFE CONDITIONS

• Unsafe clothing

  Off

  On
Choose selection

• Tap to enter information

  Dress or apparel hazard

  Unavailability of nesessary personal protective equipment

  Improper or inadequate clothing
Tap to enter information

• Answer next

  Yes

  No

  N/A

• Near miss description

• Suggestions for improvement

Actions taken

• Check if are taken
Describe actions

• Description of taken actions

• Attach a photo

  Media