Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

  • Address

General

  • Facility identification and address signage

  • Emergency contact signs posted at least all sides

  • No Trespassing signs posted at least all sides

  • Facility entrance secured

  • Parking plan is clear

  • Driving hazard survey conducted

  • PPE assessment completed

  • Confined Space Inventory completed

  • TENORM survey completed

OFFICE

  • Are you conducting an office or occupied area inspection?

  • General structure in good condition

  • Lighting adequate and installed properly

  • General housekeeping in good condition

  • Aisles/Walkways - unobstructed

  • Exit signs posted and illuminated

  • Exits not blocked

  • Fire extinguishers identified, stored properly, and accessible

  • Fire extinguishers are being inspected monthly and yearly

  • Fire Panel Current Inspection

  • Smoke / CO detector present where needed

  • Eye wash in good condition and inspected

  • Visitor sign in log being used

  • Electrical fixtures and equipment installed properly

  • Switches and Outlet labeled with breaker IDs

  • Extension cables used for temporary use

  • Heat/ Air/ Ventilation adequate

  • Do employees know how to access SDS inventory

  • OSHA 300A posted

  • Evacuation plan posted

  • Emergency phone numbers posted

  • No additional misc. items

FACILITY PUMP AREA

  • Are you conducting inspection on Facility Pump Room?

  • General Structure in Good Condition

  • Lighting Adequate and Installed Properly

  • General Housekeeping In Good Condition

  • Aisles/Walkways - Unobstructed

  • Exit Signs Posted and illuminated

  • Exits not blocked

  • Fire Extinguishers Identified, Stored Properly, and Accessible

  • Fire Extinguishers are being inspected yearly and monthly

  • LEL/Fire Eye Inspection

  • Electrical fixtures and equipment installed properly

  • Extension cables used for temporary use

  • Heat/ Air/ Ventilation Adequate

  • Noise Area - Hearing Protection Required Signage

  • Equipment Starts Automatically Signage

  • All containers properly labeled

  • Proper chemical storage; fire cabinet/spill pad

  • For Platforms > 4 ft: toprail ~42 inches, midrail, 4" toeboards, decking in good condition

  • Stair/Steps- Railing provided on open sides with 4 or more risers; Uniform in rise & run

  • Electrical panels clearance maintained

  • Electrical / Control panels are closed and secured

  • Electrical panels labeled

  • Pumps Shafts Adequately Guarded

  • Pumps Adequately Grounded

  • Yearly crane inspection completed

  • Load rating posted on shelving and/or crane rails

  • ESD Located and accessible

  • Lock Out/Tag Out being used properly

  • No additional misc. items

PDC BUILDING OR OTHER NON STORAGE

  • Used for PDC buildings and other non storage or maintenance building.

  • Are you conducting inspection on PDC or other type of building?

  • General Structure in Good Condition

  • Lighting Adequate and Installed Properly

  • General Housekeeping In Good Condition

  • Aisles/Walkways - Unobstructed

  • Exit signs posted and illuminated

  • Exits not blocked

  • Fire Extinguishers Identified and Accessible

  • Fire Extinguishers are being inspected yearly and monthly

  • Electrical fixtures and equipment installed properly

  • Extension cables used for temporary use

  • Heat/ Air/ Ventilation Adequate

  • Electrical panels clearance maintained

  • Electrical / Control panels are closed and secured

  • Electrical panels labeled

  • Hazards are properly identified

  • Lock Out/Tag Out being used properly

  • Stair/Steps- Railing provided on open sides with 4 or more risers; Uniform in rise & run

  • Battery Terminals?

  • Terminals covered

  • Lead Acid?

  • PPE Available and in good condition

  • Eye Wash Available and in good condition

  • No additional misc. items

VALVE SITE OR MANIFOLD

  • Are you conducting an inspection of a valve site or manifold area?

  • Fencing adequate and secure

  • Area clean and free of clutter

  • Area free of leaks

  • Fire Extinguishers Identified and Accessible

  • Fire Extinguishers are being inspected yearly and monthly

  • LEL/Fire Eye Inspection

  • Walking/Working surfaces in good condition; access not blocked

  • External Corrosion Control: Piping Painted

  • Valves secured by lock

  • Equipment IDed and flow communicated

  • Hazard tags in good condition; confined space, hearing protection, etc.

  • Lock Out/Tag Out being used properly

  • All low laying structures/equipment are visible at 6ft?

  • ROW markers clearly visible

  • Confined Space Identified

  • No additional misc. items

TANK AREA

  • Are you conducting an inspection of a tank area

  • Dikes Integrity Adequate

  • Dike Drains Closed

  • Inside Diked Area Free of Oil Residue, Weeds & Debris

  • Tanks have Appropriate Labels in Visible Locations:

  • Tank Numbers (12" Letters)

  • Product ID or API colored symbols

  • NFPA diamond (where required by local code)

  • Pipe racks labeled, flow direction indicated

  • Roof Drains Closed

  • Water Draw Valves Closed, Locked and Capped

  • Tanks Adequately Grounded

  • For Platforms > 4 ft: toprail ~42 inches, midrail, 4" toeboards

  • Railings provided on open sides with 4 or more risers

  • Stair steps uniform in height and tread depth

  • Confined Spaces Identified

  • Lock Out/Tag Out being used properly

  • No driving hazards, overhead or low lying equipment

  • No additional misc. items

YARD

  • Use this for the larger area from equipment to the fence line.

  • Are you conducting an inspection of a yard/outdoor area?

  • No driving hazards, overhead or low lying equipment

  • Driveways/Walkways in Good Condition/ Free of Obstructions

  • General Housekeeping In Good Condition

  • Lighting Adequate and Installed Properly

  • Emergency egress marked and clear

  • Perimeter Fence Secure- No Gaps or Breaks

  • Perimeter Fence Topped with Taunt Barbed Wire, No Trespassing Signs Posted 150'

  • Hazard Warning Signs

  • Wind socks visible and in good condition

  • Fire Extinguishers Identified and Accessible

  • Fire Extinguishers are being inspected yearly and monthly

  • Drainage Adequate

  • No Overgrown Vegetation

  • Pipe racks labeled, flow direction indicated

  • ROW markers clearly visible

  • Containers labeled and in good condition

  • Waste Areas Identified (i.e. Universal Waste, Satellite Acc.), meet hold time requirements

  • High Voltage/ Control Panels are Closed and Secured

  • Electrical Equipment Locked/ Authorized Access Maintained

  • Confined Spaces Identified

  • No additional misc. items

MAINTENANCE SHOP & STORAGE AREA

  • Are you conducting and inspection of a maintenance shop or storage area?

  • General Housekeeping In Good Condition

  • Floors, Aisles & Exit Routes Clean & Free of Obstructions

  • Exit Signs Posted and Illuminated

  • Exits not blocked

  • Fire Extinguishers Identified and Accessible

  • Fire Extinguishers are being inspected yearly and monthly

  • Platforms Used for Storage has Load Ratings Posted

  • Portable Ladders in Good Condition

  • Heat/ Air Properly Vented

  • Flammable Liquids Stored in Flammable Cabinets

  • Indoor Flammable Liquid Storage Kept to Minimum

  • Bulk Drums Grounded & Bonded When Dispensing

  • Battery Charging Areas Ventilated & No Smoking Signs Posted

  • Rubber Gloves Provided & Worn When Using Solvents & Oils

  • Solvent/ Oily Rag Disposal In Covered Metal Container

  • Respirators Provided & Worn During Dusty Operations, Etc

  • Ear Plugs/ Muffs Provided & Worn In Noisy Conditions

  • Compressed Air Reduced to 30 PSI For Cleaning

  • Compressed Air Tanks Drained Regularly

  • Relief Valves On Compressed Air Tanks Operate Properly

  • Points of Power Transmission Properly Guarded (Belts/ Gears)

  • Equipment Effectively Grounded

  • Adjustable Tongue of Grinder Kept to 1/4" of Wheel

  • Goggles/Face Shield Required Sign Posted When Grinding

  • Faceshield Provided Near Grinder

  • Hand Tools in Proper Condition

  • All Cylinders Stored Away From Heat

  • Oxygen/ Acetylene Cylinder Storage at least 25 feet apart

  • Cylinders Stored Securely/ Valve Caps in Place

  • All Junction Boxes, Outlets Covered

  • All Breaker Switches Identified as to Use

  • All Plugs Equipped With Ground Pins

  • Extension Cords Have Ground Pin and are Free of Splicing

  • Lockout/Tagout being used properly

  • Confined Spaces Identified

  • No additional misc. items

HAZCOM

  • List of chemicals in the field to confirm SDS

Tools & Equipment

  • List of T/E observed during the inspection

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.