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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Address
General
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Facility identification and address signage
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Emergency contact signs posted at least all sides
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No Trespassing signs posted at least all sides
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Facility entrance secured
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Parking plan is clear
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Driving hazard survey conducted
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PPE assessment completed
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Confined Space Inventory completed
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TENORM survey completed
OFFICE
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Are you conducting an office or occupied area inspection?
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General structure in good condition
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Lighting adequate and installed properly
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General housekeeping in good condition
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Aisles/Walkways - unobstructed
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Exit signs posted and illuminated
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Exits not blocked
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Fire extinguishers identified, stored properly, and accessible
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Fire extinguishers are being inspected monthly and yearly
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Fire Panel Current Inspection
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Smoke / CO detector present where needed
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Eye wash in good condition and inspected
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Visitor sign in log being used
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Electrical fixtures and equipment installed properly
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Switches and Outlet labeled with breaker IDs
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Extension cables used for temporary use
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Heat/ Air/ Ventilation adequate
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Do employees know how to access SDS inventory
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OSHA 300A posted
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Evacuation plan posted
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Emergency phone numbers posted
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No additional misc. items
FACILITY PUMP AREA
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Are you conducting inspection on Facility Pump Room?
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General Structure in Good Condition
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Lighting Adequate and Installed Properly
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General Housekeeping In Good Condition
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Aisles/Walkways - Unobstructed
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Exit Signs Posted and illuminated
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Exits not blocked
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Fire Extinguishers Identified, Stored Properly, and Accessible
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Fire Extinguishers are being inspected yearly and monthly
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LEL/Fire Eye Inspection
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Electrical fixtures and equipment installed properly
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Extension cables used for temporary use
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Heat/ Air/ Ventilation Adequate
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Noise Area - Hearing Protection Required Signage
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Equipment Starts Automatically Signage
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All containers properly labeled
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Proper chemical storage; fire cabinet/spill pad
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For Platforms > 4 ft: toprail ~42 inches, midrail, 4" toeboards, decking in good condition
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Stair/Steps- Railing provided on open sides with 4 or more risers; Uniform in rise & run
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Electrical panels clearance maintained
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Electrical / Control panels are closed and secured
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Electrical panels labeled
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Pumps Shafts Adequately Guarded
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Pumps Adequately Grounded
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Yearly crane inspection completed
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Load rating posted on shelving and/or crane rails
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ESD Located and accessible
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Lock Out/Tag Out being used properly
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No additional misc. items
PDC BUILDING OR OTHER NON STORAGE
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Used for PDC buildings and other non storage or maintenance building.
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Are you conducting inspection on PDC or other type of building?
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General Structure in Good Condition
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Lighting Adequate and Installed Properly
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General Housekeeping In Good Condition
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Aisles/Walkways - Unobstructed
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Exit signs posted and illuminated
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Exits not blocked
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Fire Extinguishers Identified and Accessible
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Fire Extinguishers are being inspected yearly and monthly
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Electrical fixtures and equipment installed properly
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Extension cables used for temporary use
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Heat/ Air/ Ventilation Adequate
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Electrical panels clearance maintained
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Electrical / Control panels are closed and secured
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Electrical panels labeled
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Hazards are properly identified
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Lock Out/Tag Out being used properly
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Stair/Steps- Railing provided on open sides with 4 or more risers; Uniform in rise & run
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Battery Terminals?
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Terminals covered
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Lead Acid?
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PPE Available and in good condition
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Eye Wash Available and in good condition
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No additional misc. items
VALVE SITE OR MANIFOLD
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Are you conducting an inspection of a valve site or manifold area?
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Fencing adequate and secure
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Area clean and free of clutter
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Area free of leaks
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Fire Extinguishers Identified and Accessible
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Fire Extinguishers are being inspected yearly and monthly
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LEL/Fire Eye Inspection
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Walking/Working surfaces in good condition; access not blocked
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External Corrosion Control: Piping Painted
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Valves secured by lock
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Equipment IDed and flow communicated
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Hazard tags in good condition; confined space, hearing protection, etc.
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Lock Out/Tag Out being used properly
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All low laying structures/equipment are visible at 6ft?
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ROW markers clearly visible
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Confined Space Identified
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No additional misc. items
TANK AREA
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Are you conducting an inspection of a tank area
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Dikes Integrity Adequate
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Dike Drains Closed
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Inside Diked Area Free of Oil Residue, Weeds & Debris
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Tanks have Appropriate Labels in Visible Locations:
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Tank Numbers (12" Letters)
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Product ID or API colored symbols
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NFPA diamond (where required by local code)
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Pipe racks labeled, flow direction indicated
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Roof Drains Closed
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Water Draw Valves Closed, Locked and Capped
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Tanks Adequately Grounded
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For Platforms > 4 ft: toprail ~42 inches, midrail, 4" toeboards
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Railings provided on open sides with 4 or more risers
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Stair steps uniform in height and tread depth
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Confined Spaces Identified
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Lock Out/Tag Out being used properly
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No driving hazards, overhead or low lying equipment
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No additional misc. items
YARD
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Use this for the larger area from equipment to the fence line.
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Are you conducting an inspection of a yard/outdoor area?
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No driving hazards, overhead or low lying equipment
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Driveways/Walkways in Good Condition/ Free of Obstructions
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General Housekeeping In Good Condition
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Lighting Adequate and Installed Properly
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Emergency egress marked and clear
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Perimeter Fence Secure- No Gaps or Breaks
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Perimeter Fence Topped with Taunt Barbed Wire, No Trespassing Signs Posted 150'
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Hazard Warning Signs
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Wind socks visible and in good condition
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Fire Extinguishers Identified and Accessible
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Fire Extinguishers are being inspected yearly and monthly
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Drainage Adequate
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No Overgrown Vegetation
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Pipe racks labeled, flow direction indicated
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ROW markers clearly visible
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Containers labeled and in good condition
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Waste Areas Identified (i.e. Universal Waste, Satellite Acc.), meet hold time requirements
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High Voltage/ Control Panels are Closed and Secured
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Electrical Equipment Locked/ Authorized Access Maintained
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Confined Spaces Identified
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No additional misc. items
MAINTENANCE SHOP & STORAGE AREA
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Are you conducting and inspection of a maintenance shop or storage area?
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General Housekeeping In Good Condition
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Floors, Aisles & Exit Routes Clean & Free of Obstructions
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Exit Signs Posted and Illuminated
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Exits not blocked
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Fire Extinguishers Identified and Accessible
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Fire Extinguishers are being inspected yearly and monthly
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Platforms Used for Storage has Load Ratings Posted
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Portable Ladders in Good Condition
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Heat/ Air Properly Vented
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Flammable Liquids Stored in Flammable Cabinets
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Indoor Flammable Liquid Storage Kept to Minimum
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Bulk Drums Grounded & Bonded When Dispensing
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Battery Charging Areas Ventilated & No Smoking Signs Posted
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Rubber Gloves Provided & Worn When Using Solvents & Oils
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Solvent/ Oily Rag Disposal In Covered Metal Container
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Respirators Provided & Worn During Dusty Operations, Etc
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Ear Plugs/ Muffs Provided & Worn In Noisy Conditions
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Compressed Air Reduced to 30 PSI For Cleaning
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Compressed Air Tanks Drained Regularly
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Relief Valves On Compressed Air Tanks Operate Properly
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Points of Power Transmission Properly Guarded (Belts/ Gears)
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Equipment Effectively Grounded
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Adjustable Tongue of Grinder Kept to 1/4" of Wheel
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Goggles/Face Shield Required Sign Posted When Grinding
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Faceshield Provided Near Grinder
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Hand Tools in Proper Condition
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All Cylinders Stored Away From Heat
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Oxygen/ Acetylene Cylinder Storage at least 25 feet apart
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Cylinders Stored Securely/ Valve Caps in Place
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All Junction Boxes, Outlets Covered
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All Breaker Switches Identified as to Use
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All Plugs Equipped With Ground Pins
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Extension Cords Have Ground Pin and are Free of Splicing
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Lockout/Tagout being used properly
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Confined Spaces Identified
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No additional misc. items
HAZCOM
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List of chemicals in the field to confirm SDS
Tools & Equipment
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List of T/E observed during the inspection