Title Page

  • Inspector

  • Conducted on

  • Location

General Facility

AISLES/EXITS/EGRESS

  • Minimum width of any aisle leading to an exit is at least 44 inches wide

  • Are exits marked, free of debris and readily accessible at all times?

  • Is emergency lighting operating? (Test by using test button if you can do so from the ground or floor.)

  • Can you see marked exits or exit signs from the aisles in your area?

  • Are aisles and doorways kept clear; and free of obstructions with trip hazards minimized to permit visibility and movement?

  • Are doors not used for egress (closets, offices, etc) that could incorrectly be thought to be an exit labeled “NOT AN EXIT?”

  • Are floor surfaces clean, dry, level, not slippery or sticky and in good condition?

COMPRESSED GAS CYLINDERS

  • Are cylinders legibly marked to clearly identify the gas contained?

  • Are cylinders stored away from heat source and do they have separation between flammables and oxidizers?

  • Are cylinders located or stored in a manner to prevent them from creating a chained with protective cap in place (including empty containers)

  • Are valve protector caps placed on cylinders when not in use?

  • Are flammables and combustibles stored properly?

EMERGENCY, HEALTH, AND SAFETY INFORMATION

  • Are area hazard sign visible, legible, understandable and in compliance with regulations?

  • Are procedures established for alerting employees of an emergency in the workplace (i.e., fire and shelter)?

  • Are fire alarm pull station locations marked and unobstructed?

  • Are sign for emergency numbers, routes, and evacuation plans posted?

  • Are the Evacuation Coordinators and PI/Safety Designates assigned?

  • Do employees know who their Evacuation Coordinators and PI/Safety Designates are?

  • Does the Evacuation Coordinators have their numbers readily available, functional?

  • Is a copy of the Emergency Action Plan (EAP) for the area available for employees to read?

  • Are employees trained on emergency procedures (primary and secondary routes)? Do they know where to go?

  • Does the EAP include a way to alert employees, including disabled workers, to<br>evacuate or take other action and include instructions on how to report<br>emergencies?

FIRE EMERGENCY

  • Are fire extinguishers fully charged and have current inspection dates? All previous months should be signed off

  • Are fire extinguishers and hoses, mounted, visible, and accessible?

  • Do employees know where the fire extinguishers are and how to use them?

  • Do fire doors and shutters appear to be in good operating condition?

FIRE PREVENTION

  • Is there a minimum 24 inches clearance between storage and sprinkler heads?

  • Are “NO SMOKING” areas enforced?

  • Are electrical outlets or cords not overloaded? Only allowable number of connections (i.e., a 4-way outlet only has 4 pieces of equipment connected and not loaded with additional extension cords). NOTE: Isolated power not included

  • Are fire sprinkler heads unobstructed and free of dirt and corrosion?

FLAMMABLES/COMBUSTIBLES

  • Are hazardous materials properly stored?

  • Are chemicals properly stored and returned to appropriate cabinet at end of shift?

  • Are safety cans in good condition (no corrosion, damage, etc) with flame arrestor in place?

  • Are flammable cabinets grounded and containers bonded when dispensing need to be grounded

  • Are flammable liquids stored in approved safety containers?

  • Are materials that could burn kept away from ignition sources?

  • Is area free of excessive trash or combustibles?

  • Do all can with red lids have fusible links?

  • Are the tops of the flammable cabinets clear (nothing stored on top)?

  • Are all flammable bottle tips unmodified and/or undamaged?

  • Are backflow valves working in all flammable bottles?

  • Is heat producing equipment turned off at night when no one is present?

HOUSEKEEPING/WORK ENVIRONMENT

  • Are desk/work and storage areas clean, organized, and sanitary?

  • Are trash containers (large 55 gallon) covered?

  • Are electrical/network cables organized to eliminate trip hazards?

  • Are drawers of desks and file cabinets kept closed when not in use?

  • Are file cabinets arranged so drawers do not open into aisles?

  • Is only one file drawer opened at a time?

  • Is knife blade on paper cutter lowered and latched when not in use?

  • Are mezzanines labeled with floor load capacity?

  • Is all lighting lit and/or appear adequate for the task performed?

  • Are floor openings covered and secure?

  • Are spilled or dropped items cleaned up and put away?

  • Are guardrails installed where required? (Guardrails are required where there is over 48 inches to next lower level.)

SECURITY ITEMS

  • Do employees have proper ID badges?

  • Do contractors/vendors have proper ID badges?

  • Are visitors escorted and have proper ID badges?

  • Are employees, contractors, and visitors displaying their ID badges above the waist and on an outer garment?

  • Are doors that should be secure not being propped open?

STRUCTURES

  • Ceiling tiles are not damaged, loose, or missing?

  • All overhead hazards have been identified?

ENVIRONMENTAL

CLEAN AIR ACT COMPLIANCE

  • Are any solvent contaminated rags lying about in the work area?

  • Are solvent contaminated rags properly disposed of?

  • Have all open top solvent pump cans been removed from the work area?

  • Are containers, solvent dispensing containers, paint gun cleaning containers,<br>and solvent dispensing bottles closed when not in use?

CLEAN WATER ACT COMPLIANCE

  • Employees do not dump wastes into drains or sinks unless authorized (including wash water and mop water)

  • No wastes dumped outside or in storm sewers or catch basins

  • Are pipes, pumps, hoses, and valves free of leaks or defects?

  • Do sumps, pits, lift station containment valves remain dry?

  • Are spills and leaks attended to and reported when required?

HAZARDOUS/NON-HAZARDOUS WASTE COMPLIANCE

  • Are hazardous waste containers properly identified and labeled with the words, “HAZARDOUS WASTE?”

  • Are used oil collection containers properly identified and clearly labeled with the words, “USED OIL?”

  • Are controlled and non-hazardous wastes being collected and managed properly

  • (i.e., returnable towels, coolant sludge, composite waste, fluorescent lamps)?

  • Are containers properly identified and clearly labeled with contents?

  • Are hazardous waste collection containers fully closed while not in use? Lids that “spring up” are not fully closed.

  • Are used oil waste containers closed while not in use?

  • Are trash cans free of hazardous waste?

  • Are trash cans free of scrap metal?

  • Is there less than 55 gallons per waste stream at satellite accumulation area(s)?

  • Are hazardous waste satellite accumulation area signs in place?

  • Are employees familiar with the waste materials generated in the work area and the proper disposal method(s)?

  • Are proper absorbent materials on hand for spills?

  • Is waste removed in a timely manner?

SAFETY

EMPLOYEE WORK PRACTICES

  • Is long hair tied back when around machinery? (Hair that touches shoulder must be tied back.) (Apron strings and non-breakaway badge lanyards, etc, should also be secure in some manner.)

  • Is Job Safety Analysis (JSA) information available for employee reference for<br>infrequently performed tasks and high value or high-risk tasks?

ELECTRICAL EQUIPMENT MARKINGS

  • Do circuit breakers clearly indicate whether they are in the “ON” or “OFF” position and are switch panels clearly marked?

  • Is electrical panel access clear – 36 inches clearance in front of panel?

  • Is equipment intended for long-term use hard wired into permanent facility wiring?

  • ELECTRICL GROUNDING

  • Are electrical appliances, portable electrical tools, and fixed electrical equipment grounded or UL rated/double insulated and in good repair?

  • Do extension cords being used have a grounding conductor and are in good repair?

  • Are extension cords used only for temporary wiring applications (60 days max.)?

EQUIPMENT

  • Proper guarding of any pinch points, rotating collars, cams, chucks, couplings, shafts flywheels, spindles, bolt ends, rotating mechanisms, etc?

  • Are all protective guards (including light curtains and interlocks) in place, effective, and checked daily or before use?

  • Are all controls and emergency stops clearly identified and within reach of operator?

  • Are all emergency stops, safety guards, and safety devices located on equipment and tools working and adjusted properly?

  • Are grinder gaps 1/8 inch from bottom of wheel and 1/4 inch from top of wheel?

  • Grinding wheel surface not damaged or worn (must be square and no grinding on side of wheel).

  • No aluminum found in grinding wheel surface?

  • Are fans inspected annually for damage (cracked blades, guards, cords, etc)?

  • Are heat lamp and work light bulbs guarded?

  • Are all fixed machines bolted to the floor?

  • Do air nozzles have relief valves to decrease pressure to 29 psi or lower?

  • Are air disconnects and safety nozzles the correct type (safety relief vents may not be covered or sealed in any way)?

  • Air lines and hydraulic lines free of damage?

ERGONOMICS

  • Ergonomic problems observed with workstation, keyboard, posture, or work habits

  • Employees are advised on the proper lifting techniques

  • Are mechanical lifting aids available for heavy or awkward items?

EYEWASH STATION

  • Eyewash station is clean and tested

  • Eyewash station is located in a way that assures free and unimpeded access

FORKLIFT/INDUSTRIAL TRUCKS – DAILY INSPECTION

  • Daily inspection performed prior to first use and log entry completed

  • Do all operators have current qualification?

  • Are service valves closed on all propane equipment left inside overnight?

  • Harness and lanyard used at all times with scissor-lift/Hi-Bob, aerial platform, etc?

  • Are vehicles driven backwards with awkward or bulky loads?

  • Are all traffic signs observed? (Operators must stop at stop signs.)

  • Are pedestrians given the right-of-way?

  • Are safety glasses and seatbelt worn while operating the truck?

HAZARD COMMUNICATION – CHEMICAL SAFETY

  • Do employees know what an MSDS (Material Safety Data Sheet) is, where to find them, and how to use them?

  • Is each container of hazardous chemicals in the work area properly labeled by<br>identifying the chemical it contains and marked with health hazards?

  • Are all chemicals that are used in the facility listed in the MSDS book and available?

  • Is food separated and away from chemicals in the work area?

HOIST/CRANES/LIFTING DEVICES

  • Are all slings, hoists, chains, jacks, and supports certified and tagged with load limits and inspection dates?

  • Is the weight of all loads known and is the crane (user) inspected before use?

  • Is there a full, unrestricted view for operator before lifting load?

  • Are all loads being lifted overhead secured?

  • Is there no one beneath the load while it is suspended?

  • Does the crane operator have a current license or certificate?

LADDERS/SCAFFOLDING

  • Are all step ladders under 20 feet in length?

  • Are rubber feet on ladders in good repair?

  • Are all ladders in good condition with no structural damage?

  • Are there no metal or aluminum ladders in electrical areas?

  • Are ladders being used properly (only one person on ladder at a time and no one standing above the second step down from the top)?

  • Are fixed stairs being used (instead of ladders) where regular travel is needed?

PERSONAL PROTECTION EQUIPMENT (PPE): EYE AND FACE/RESPIRATORY/HEARING

  • Are areas clearly marked as a “HEARING CONSERVATION” area, as needed?

  • Are approved safety glasses, face shields, gloves, palm guards, aprons, clothing, and hearing protection used in required areas?

  • Are employees using appropriate respirators for the work being done?

  • Are respirators clean and stored properly?

  • Are employees using respirators clean-shaven (so mask will seal against face)?

  • Are employees using paper respirators (paper masks) and trained in their proper use?

PPE: FALL PROTECTION

  • Is appropriate fall protection provided and used properly (safety harness, lanyard, and if needed, self-retracting lifeline)?

  • Is fall protection PPE stored properly, kept clean, and out of direct sunlight?

  • Is fall protection PPE inspected and certified annually?

WALKING SURFACES/STAIRS

  • Are all floor tracks covered or covered as much as possible when in use?

  • Is the angle of fixed stairs within 30 to 50 degrees?

  • Are non-slip surfaces in good condition on steps and platforms?

  • Are stairwells clear and handrails in good condition?

  • Are mobile work platforms available and used?

(Laboratory)

  • UNSATISFACTORY EHS CONDITIONS FOR:

Representatives

  • Month/Year: EHS Representative:

  • Lab Manager: PI/Safety Designate:

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