Information
Facility Inspection Report
TES-HS-1001
Document Number: TES-HS-1001
Section: HSSE
Revision Level: 2.0
Release Date: 04/02/13
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Manager Name:
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Location of Inspection:
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QHSSE Name:
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Date of Inspection:
GROUNDS
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Overall Appearance
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Parking Area
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Trash and Debris Removal
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Weeds and Overgrowth
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Condition of Fence and Gates
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External Lighting
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Visible Soil Conditions (Any Contamination?)
OFFICE AREA
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Overall Appearance
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Exits Clearly Marked and Illuminated (OSHA 29CFR1910.37 (b)(6))
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Exits Unobstructed (29CFR1910.37(a)(3))
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Evacuation Maps Posted (29CFR1910.39(a))
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Fire Extinguishers accessible and marked (29CFR1910.157(c)(1))
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Fire Extinguishers current on inspection (29CFR1910.157(c)(4))
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Smoke detectors installed
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Smoke detectors operational
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Storm Water Permit on file
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Storm Water Pollution Prevention Plan (SWPPP) on File
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DEQ Waste Water permit on File
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Training matrix current and posted
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Used oil/filters recycling records on file
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Facility Hazmat Security Plan on file
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Hazardous Waste Manifest on file
SHOP AREA
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Overall Appearance
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Exits Clearly Marked and Illuminated (OSHA 29CFR1910.37(b)(6))
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Exits Unobstructed (29CFR1910.37(a)(3))
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Evacuation Maps Posted (29CFR1910.39(a))
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Fire Extinguishers accessible and marked (29CFR1910.157(c)(1))
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Fire Extinguisher current on inspection (29CFR1910.157(c)(4))
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Lighting (All lights operating properly)
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Oxygen Bottles stored properly (29CFR1910.253(b)(2)(ii) & 253(b)(4))
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Acetylene Bottles stored properly
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Oxygen and Acetylene stored 20 feet apart (29CFR1910.253(b)(4)(iii))
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Cutting Torches and equipment stored properly
PERSONAL PROTECTIVE EQUIPMENT (PPE)
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Hard Hats
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Steel Toe Boots
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Eye Protection (29CFR1910.133(a)(1))
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Eye Protection criteria (ANSI Z 87)
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Side Shields (29CFR1910.133(a)(2))
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Gloves (29CFR1910.138(b))
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Chemical Aprons
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Chemical Gloves (29CFR1910.133(a)(1))
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Face Shields (When applicable)(29CFR1910.95(I)(1))
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Hearing Protection (When applicable)(29CFR1910.95(i)(1))
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Respiratory Protection (when applicable)
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Fall Protection (when applicable)
WASH BAY/SHOP
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Wash wand has on/off trigger
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PPE worn by employees
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Guards in place over moving parts on pump
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General Housekeeping
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Electrical components away from water
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Shop Equipment
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Flammable materials cabinet (29CFR1910.106(d)(3)(ii))
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Right-to-Know Station (29CFR1910.1200(a)(1))
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MSDS Sheets in order and current (29CFR1910.1200(a)(2))
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Electrical outlets (Polarity Check)(29CFR1910.304(a)(2))
FACILITY
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General Houskeeping
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Proper segregation of chemicals
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Eyewash Station (29CFR1910.151(a))
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Overall Condition (meets manufacturer Specification)
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Station Operational
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Chemical Shower
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Overall Condition (meets manufacturer Specification)
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Shower Operational
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Clear Access to shower
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Chemicals Shower weekly inspections current
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Fire Extinguishers
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Fire Extinguishers Accessible (29CFR1910.157(c)(1))
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Fire Extinguisher inspection current (monthly/Annual/6-year/12-year)
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Above ground Diesel Storage Tank
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Containment Integrity
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Physically Labeled (29CFR1910.1200(f)(5) & (f)(6))
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Valves secured with no leaks
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Piping
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Tank Condition
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Hoses
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Above ground Gasoline Storage Tank
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Containment Integrity
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Physically Labeled (29CFR1910.1200(f)(5) & (f)(6))
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Valves secured with no leaks
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Piping
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Tank Condition
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Hoses
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Secondary Containment (EPA 40CFR256.193)
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Containment area clean from debris
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Containment area free from rain water
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Drain plug in place
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Separator or drainage tanks in working order
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Visible soil contamination around storage area
CORRECTIVE ACTION
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Item #
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Description
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Assigned To
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Correction Date
VERIFICATION AND FINAL CLOSURE (QHSSE AND PRODUCT LINE MANAGER/DESIGNATE)
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Reviewed by:
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Date:
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Verified by:
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Date:
