Facility Inspection

• Conducted on

  Date

• Location

• Supervisor/Facility Manager

• Prepared by

  Jason Suter

  Jordan Wimer

EMPLOYER POSTINGS

• Does this Facility Have Mandatory Postings?

  Yes

  No

• CT Haz. Mat. Communications? Safety Order #5194

  Compliant

  Non-Compliant

  N/A

• Emergency Action Plan/Prevention Safety Order #3220 & 3221

  Compliant

  Non-Compliant

  N/A

• Cal OSHA poster? Safety Order #340

  Compliant

  Non-Compliant

  N/A

• Discrimination in employment?

  Compliant

  Non-Compliant

  N/A

• EDD Notice, Payday Notice?

  Compliant

  Non-Compliant

  N/A

• Listing - Doctor's & Clinics? Safety Order #1512 & 3400

  Compliant

  Non-Compliant

  N/A

• Cal OSHA 300 (February 1 - April 30)? Safety Order #14305

  Compliant

  Non-Compliant

  N/A

• Employee Assistance Program Notice?

  Compliant

  Non-Compliant

  N/A

• Safety and health in the workplace? CT Safety Manual

  Compliant

  Non-Compliant

  N/A

• Emergency telephone numbers? Safety Order #1512 & 3400

  Compliant

  Non-Compliant

  N/A

• Forklift operating rules? Safety Order #3664

  Compliant

  Non-Compliant

  N/A

• Exposure and medical records available? Safety Order #3204

  Compliant

  Non-Compliant

  N/A

RECORD KEEPING

• Does This Facility Store Records?

  Yes

  No

• Hazardous materials inventory? Safety Order #5194e.1.A.

  Compliant

  Non-Compliant

  N/A

• MSDS's (available on site)? Safety Order #5194

  Compliant

  Non-Compliant

  N/A

• Facility inspection checklist on file? Safety Manual Chapter 3

  Compliant

  Non-Compliant

  N/A

• IIPP available? Safety Order #1509 & 3203

  Compliant

  Non-Compliant

  N/A

• Code of Safe Practices available? Safety Order #1509 & 3203

  Compliant

  Non-Compliant

  N/A

• Appropriate manuals available (i.e. Safety)? Safety Order #1509 & 3203

  Compliant

  Non-Compliant

  N/A

• Cal OSHA Permits available for Air & LPG? Safety Order #461 & 470

  Compliant

  Non-Compliant

  N/A

• Safety Meeting reports on file? Safety Order #1509 & 3203

  Compliant

  Non-Compliant

  N/A

• Training records maintained? Safety Order #1509 & 3203

  Compliant

  Non-Compliant

  N/A

MEDICAL SERVICES

• Does This Facility Have Medical Supplies

  Yes

  No

• First Aid Kit accessible and complete? Safety Order #1512 & 3400

  Compliant

  Non-Compliant

  N/A

• Qualified person available? Safety Order #1512 & 3400

  Compliant

  Non-Compliant

  N/A

• Field staff trained? Safety Order #1512 & 3400

  Compliant

  Non-Compliant

  N/A

FIRE PROTECTION

• Does This Facility Have Fixed Fire Suppression Systems?

  Yes

  No

• Fixed extinguishing systems checked semi-annually, inspected annually? Safety Order #6175

  Compliant

  Non-Compliant

  N/A

• Employee Alarm Systems tested every two months? Safety Order #6184

  Compliant

  Non-Compliant

  N/A

• Automatic fire sprinkler systems maintenance inspection quarterly? Uniform Fire Code T19, Sec. 904

  Compliant

  Non-Compliant

  N/A

• Automatic sprinkler systems serviced every five years? Uniform Fire Code T19, Sec. 904

  Compliant

  Non-Compliant

  N/A

• Standpipe systems serviced every five years? Safety ORder #6165

  Compliant

  Non-Compliant

  N/A

• Fire hoses and hose cabinets inspected? Safety Order #6165

  Compliant

  Non-Compliant

  N/A

• Halon and CO2 systems serviced? Safety Order #6181

  Compliant

  Non-Compliant

  N/A

• Automatic system main drain flow tested annually? Safety Order #6170

  Compliant

  Non-Compliant

  N/A

• Smoke detectors and smoke activated door closures tested annually? Safety Order #6183, Uniform Fire Code 4-1, T19, Sec. 904

  Compliant

  Non-Compliant

  N/A

• Fire hydrants inspected and serviced? Uniform Fire Code T19, Sec. 901.6

  Compliant

  Non-Compliant

  N/A

• Halon Systems - employees trained? Safety Order #6175

  Compliant

  Non-Compliant

  N/A

• Halon and CO2 systems serviced? Safety Order #6181

  Compliant

  Non-Compliant

  N/A

FIRE PROTECTION CONT.

• Does This Facility Have Portable Extinguishers, Evacuation Plans, Etc?

  Yes

  No

• Portable extinguishers - accessible, location marked, checked monthly, maintained annually? Safety Order #6151

  Compliant

  Non-Compliant

  N/A

• Employees trained in Emergency Action Plan/Fire Prevention Plan? Safety Order #3220 & 3221

  Compliant

  Non-Compliant

  N/A

• Evacuation drills held periodically? Emerg. Sec. Plan

  Compliant

  Non-Compliant

  N/A

• Evacuation plans posted? Safety Order #3220

  Compliant

  Non-Compliant

  N/A

• Emergency plan kept at the workplace? Safety Order #3220

  Compliant

  Non-Compliant

  N/A

GENERAL WORK AREA

• Does This Facility Contain General Work Areas?

  Yes

  No

• Work sites, passageways, etc., are clean & orderly? Safety Order #3362 & 3273

  Compliant

  Non-Compliant

  N/A

• Work surfaces are dry or slip resistant, and no tripping hazards? Safety Order #3273 Safety Manual Chapter 5

  Compliant

  Non-Compliant

  N/A

• Exterior walkways are in good condition? Safety Order #3273

  Compliant

  Non-Compliant

  N/A

• Walkways are free of tripping and slipping hazards? Safety Order #3273

  Compliant

  Non-Compliant

  N/A

• Spills cleaned up immediately? Safety Order #3362

  Compliant

  Non-Compliant

  N/A

• All toilets and washing facilities are clean & sanitary (lockable or separate if used by men and women)? Water closet equipped with door & latch? Safety Order #3364 & 3365

  Compliant

  Non-Compliant

  N/A

• Is combustible dust cleaned up with a vacuum? Safety Order #5174

  Compliant

  Non-Compliant

  N/A

• Work area adequately illuminated? Safety Order #3317

  Compliant

  Non-Compliant

  N/A

• Aisles & passageways kept clear & proper width, corridor 44", adequate headroom (6'8", & marked as needed)? Safety Order #3372 Safety Manual Chapter 5.12

  Compliant

  Non-Compliant

  N/A

• Does facility have cracks in walls and/or support structure? Pits & floor openings are covered or guarded? Safety Order #3213

  Compliant

  Non-Compliant

  N/A

• Combustible debris & waste stored safely and removed promptly? Safety Order #3221

  Compliant

  Non-Compliant

  N/A

• Dip tanks, etc., cleaned regularly, inspected? Safety Order #5433

  Compliant

  Non-Compliant

  N/A

• Are accumulations of combustible dust routinely removed from enclosed areas? Safety Order #5174

  Compliant

  Non-Compliant

  N/A

• Is metallic or conductive dust prevented from entering or accumulating on or around electrical enclosures or equipment? <br>Safety Order #5174

  Compliant

  Non-Compliant

  N/A

• Are covered metal waste cans used for oily and paint soaked waste? Safety Order #5433 & 5551

  Compliant

  Non-Compliant

  N/A

• Are all oil and gas fired devices equipped with flame failure controls that will prevent flow of fuel if pilots and main burners are not working? Safety Order #781

  Compliant

  Non-Compliant

  N/A

• Aisles & passageways free from obstruction? Safety Order #3273 Safety Manual Chapter 5

  Compliant

  Non-Compliant

  N/A

• Material piled, racked, stacked, or stored properly? Storage racks & shelves properly attached to building? Safety Order #3241 Safety Manual Chapter 5.15

  Compliant

  Non-Compliant

  N/A

• No toxic or hazardous material in lunchroom? Safety Order #3368

  Compliant

  Non-Compliant

  N/A

• No eating near toxic or hazardous materials? Safety Order #3368

  Compliant

  Non-Compliant

  N/A

• Are cabinets >5' secured to walls, floors, and each other? Safety Manual Chapter 5.14

  Compliant

  Non-Compliant

  N/A

PERSONAL PROTECTIVE EQUIPMENT

• Does This Facility Require The Use Of PPE?

  Yes

  No

• Proper equipment provided? Safety Order #3380

  Compliant

  Non-Compliant

  N/A

• Kept clean & in good repair? Safety Order #3387

  Compliant

  Non-Compliant

  N/A

• Inspected regularly & before use? Safety Order #3380

  Compliant

  Non-Compliant

  N/A

• Employees trained in use? Safety Order #3203 & 3380

  Compliant

  Non-Compliant

  N/A

• Approved shower and/or eyewash? Safety Order #5162 & 3400d

  Compliant

  Non-Compliant

  N/A

• Inspected monthly and noted on tag? Safety Order #5162 Safety Manual Chapter 12.16

  Compliant

  Non-Compliant

  N/A

RESPIRATORS

• Does This Facility Require The Use Of Respirators?

  Yes

  No

• Annual medical exam, training, and Fit Test record? Safety Order #5144(e)(f) Safety Manual Chapter 15

  Compliant

  Non-Compliant

  N/A

• Proper type for exposure? Safety Order #5144(d)

  Compliant

  Non-Compliant

  N/A

• Use record properly maintained & stored? (Cartridges match brand of respirators.) Safety Order #5144(h)(2)

  Compliant

  Non-Compliant

  N/A

EXITING/EGRESS

• Does This Facility Have Emergency Exits?

  Yes

  No

• Exits properly marked with an exit sign and illuminated by a reliable light source? Safety Order #3216, Safety Manual Chapter 5

  Compliant

  Non-Compliant

  N/A

• Are exit signs provided with the word "EXIT" in lettering at least 5" high and the stroke of the lettering at least 1/2" wide? Safety Order #3216

  Compliant

  Non-Compliant

  N/A

• Are the exit doors side hinged? Safety Order #3235

  Compliant

  Non-Compliant

  N/A

• Are the directions to exits, when not immediately apparent, marked with visible signs? Safety Order #3216 Safety Manual Chapter 5

  Compliant

  Non-Compliant

  N/A

• Are doors, passageways, or stairways, that are neither exits nor access to exits and which could be mistaken for exits, appropriately marked "NOT AN EXIT," "TO BASEMENT," or "STOREROOM?" Safety Order #3216 & 3340

  Compliant

  Non-Compliant

  N/A

• Escalator inspection current? Safety Order #3000 & 3001

  Compliant

  Non-Compliant

  N/A

• Elevator inspection current? Safety Order #3000 & 3001

  Compliant

  Non-Compliant

  N/A

• Service contract in place? Safety Order #3001

  Compliant

  Non-Compliant

  N/A

• Are at least two means of egress provided from elevated platforms, pits, or rooms where the absence of a second exit would increase the risk of injury from hot, poisonous, corrosive, suffocating, flammable, or explosive substances? Safety Order #3228

  Compliant

  Non-Compliant

  N/A

• Are there sufficient exits to permit prompt escape in case of emergency? Safety Order #3228

  Compliant

  Non-Compliant

  N/A

• Emergency lighting functional?

  Compliant

  Non-Compliant

  N/A

• Is there a floor or landing on each side of the door (<than or = to 1" lower than the threshold)? Safety Order #2571.16

  Compliant

  Non-Compliant

  N/A

• Is the number of exits from each floor of building and the number of exits from the building itself appropriate for the building occupancy load? Safety Order #3228

  Compliant

  Non-Compliant

  N/A

• Are exit stairways that are required to be separated from other parts of a building enclosed by not less than one hour fire resistive construction? Safety Order #3231

  Compliant

  Non-Compliant

  N/A

• When ramps are used as part of required exiting from a building, is the ramp slope limited to 1 foot rise in 12 feet of horizontal run? Safety Order #3232

  Compliant

  Non-Compliant

  N/A

• Are doors that are required to serve as exits designed and constructed so that the way of travel is obvious and direct? Safety Order #3235

  Compliant

  Non-Compliant

  N/A

• Are exit doors openable from the direction of exit travel without the use of a key or any special knowledge or effort when building is occupied?

  Compliant

  Non-Compliant

  N/A

• Where panic hardware is installed on a required exit door, will it allow the door to open by applying a force of 15 lbs. or less in the direction of the exit traffic? Safety Order #3235

  Compliant

  Non-Compliant

  N/A

• Are there viewing panels in doors that swing in both directions and are located between rooms where there is frequent traffic? Safety Order #3235

  Compliant

  Non-Compliant

  N/A

• Stairways at least 36" wide with handrail 34-38" above leading edge of tread? Uniform risers, 4" minimum, maximum 7 1/2", 10" minimum run, slip resistant steps? 3/8" riser max variance? Safety Order #3231 & 3214

  Compliant

  Non-Compliant

  N/A

• Fixed industrial stairs >22" wide with rise tread in compliance to Table IS-1? Safety Order #3234

  Compliant

  Non-Compliant

  N/A

• Tread nose 1/2" to 1" beyond lower riser? Safety Order #3234

  Compliant

  Non-Compliant

  N/A

• Uniform leading edge? Safety Order #3134

  Compliant

  Non-Compliant

  N/A

• Where exit doors open directly onto any street, alley or other area where vehicles may be operated, are adequate barriers and warnings provided to prevent employees from stepping into the path of traffic? Safety Order #3227

  Compliant

  Non-Compliant

  N/A

• Are exits kept clear? Safety Order #3219

  Compliant

  Non-Compliant

  N/A

ELEVATED LOCATIONS

• Does This Facility Have Elevated Work/Storage Areas?

  Yes

  No

• Standard guardrails (top rail at 42-45" plus midrail) installed at all locations over 30" above ground (48" for installations built before 1/1/67)? Safety Order #3209 & 3210

  Compliant

  Non-Compliant

  N/A

• Toe boards (4") installed if needed? Safety Order #3210

  Compliant

  Non-Compliant

  N/A

• Load capacity marked on elevated storage areas? Safety Order #3241

  Compliant

  Non-Compliant

  N/A

• Permanent ladder or stairs to frequently used elevated locations? Safety Order #3270

  Compliant

  Non-Compliant

  N/A

ELECTRICAL

• Does This Facility Have Electricity, Electrical Panel(s), Extension Cords, Etc.

  Yes

  No

• Are energized parts of electrical circuits and equipment guarded against accidental contact? Safety Order #2340.17

  Compliant

  Non-Compliant

  N/A

• Are disconnecting switches & circuit breakers labeled? Safety Order #2340.22

  Compliant

  Non-Compliant

  N/A

• Are holes and openings in electrical boxes covered or plugged? Safety Order #2473.10 & 2340.24

  Compliant

  Non-Compliant

  N/A

• Are abandoned circuits removed or treated as live?

  Compliant

  Non-Compliant

  N/A

• Are all electrical receptacles of grounded type (no two pole to three pole adapters)? Safety Order #2510.7 & 2510.58

  Compliant

  Non-Compliant

  N/A

• Are all plugs insulated or dead front type? Safety Order #2510.56

  Compliant

  Non-Compliant

  N/A

• Do portable electric heaters shut off when tilted or turned over? California Fire Code 605.10.4, Title 19 3.14

  Compliant

  Non-Compliant

  N/A

• Extension cords are not to be used as a substitute for fixed wiring. Are flexible cords being used in continuous lengths without a splice or tap? Safety Order #2500.8

  Compliant

  Non-Compliant

  N/A

• Are hard service flexible cords No 12 or larger being repaired with a splice which retains the insulation or outer sheathing? Safety Order #2500.9

  Compliant

  Non-Compliant

  N/A

• Are extension cords in good condition?

  Compliant

  Non-Compliant

  N/A

• Is electrical equipment protected from physical damage? Safety Order #2340.56

  Compliant

  Non-Compliant

  N/A

• Is there clear space around electrical equipment (30"W x 36"D panel clearance)? Safety Order #2340.16

  Compliant

  Non-Compliant

  N/A

• Is electrical equipment approved for all locations (incl. wet/damp locations)? Safety Order #2510.5 & 2540.3

  Compliant

  Non-Compliant

  N/A

• Do portable handlamps have molded handle and substantial guard? Safety Order #2510.6

  Compliant

  Non-Compliant

  N/A

• Portable handlamps - repair garages - handle, lampholder hook & guard. Are all exterior surfaces non-conductive or insulated? No switch or receptacle plugs, unless arranged so lamp cannot reach within 18" of floor. They must be approved for Class 1, Div. 1 or 2. Safety Order #2540.5

  Compliant

  Non-Compliant

  N/A

• Do cords, etc., create a tripping hazard? Safety Manual Chapters 3, 5.13

  Compliant

  Non-Compliant

  N/A

FLAMMABLE LIQUID STORAGE

• Does This Facility Store Flammable Liquids?

  Yes

  No

• FLAMMABLE LIQUID CONTAINERS:

  Yes

  No

• Distinctive colors or labeled? Safety Order #5417

  Compliant

  Non-Compliant

  N/A

• Approved type only (safety can or original container)? Safety Order #5532

  Compliant

  Non-Compliant

  N/A

• Bonded during filling (metal containers)? Safety Order #5549

  Compliant

  Non-Compliant

  N/A

• Closed when not in use? Safety Order #5417 & 5545

  Compliant

  Non-Compliant

  N/A

• FLAMMABLE STORAGE CABINET:

  Yes

  No

• (maximum capacity 120 gal., 60 gal. Category I - III). No more than three in an area labeled "FLAMMABLE - KEEP FIRE AWAY." Safety Order #5533

  Compliant

  Non-Compliant

  N/A

• STORAGE INSIDE BUILDING:

  Yes

  No

• Office - No container of Category I - III over one gallon except in safety cans where <2 gal is allowed? Safety Order #5538

  Compliant

  Non-Compliant

  N/A

• <10 gal of Category I - III in safety cans? Safety Order #5538

  Compliant

  Non-Compliant

  N/A

• <25 gals outside of storage room or cabinet? Safety Order #5538

  Compliant

  Non-Compliant

  N/A

• <60 gal of Combustible liquids outside of a storage cabinet? Safety Order #5538

  Compliant

  Non-Compliant

  N/A

• Shop - in one area outside storage cabinet cannot exceed: Category I = 25 gal. Category II - 4 = 120 gal. Category II - 4 Portable tank < 660 gal. Safety Order #5545

  Compliant

  Non-Compliant

  N/A

• SERVICE STATIONS:

  Yes

  No

• Category I <25 gals in container. Safety Order #5568

  Compliant

  Non-Compliant

  N/A

• Category II - 4 Tanks <120 gal each. Safety Order #5568

  Compliant

  Non-Compliant

  N/A

• FIRE EXTINGUISHERS:

  Yes

  No

• 10:B rating, outside within 10 feet of door to storage area? Safety Order #5543

  Compliant

  Non-Compliant

  N/A

• 10:B rating, 10-25 feet from Category I or II storage area that is outside of storage room but inside building? Safety Order #5543

  Compliant

  Non-Compliant

  N/A

• No smoking or open flame within storage area? Safety Order #5543

  Compliant

  Non-Compliant

  N/A

• Are self closing valves or top mounted pumps on containers of Class I or II liquids? Use of air pressure is prohibited. Safety Order #5545

  Compliant

  Non-Compliant

  N/A

• Are liquid handling areas separated from other operations, spill control, & ventilation provided? Safety Order #5545

  Compliant

  Non-Compliant

  N/A

LADDERS

• Does This Facility Have Ladders?

  Yes

  No

• FIXED

  Yes

  No

• Good condition? Safety Order #3277

  Compliant

  Non-Compliant

  N/A

• Securely attached? Safety Order #3277

  Compliant

  Non-Compliant

  N/A

• 16 inch between rails? Safety Order #3277

  Compliant

  Non-Compliant

  N/A

• 12 inch between rungs? Safety Order #3277

  Compliant

  Non-Compliant

  N/A

• 7 inch back clearance? Safety Order #3277

  Compliant

  Non-Compliant

  N/A

• Extends at least 3'6" above top landing? Safety Order #3277

  Compliant

  Non-Compliant

  N/A

• Has cage or climbing device if over 20' high or landing at 20' intervals? Safety Order #3277

  Compliant

  Non-Compliant

  N/A

• PORTABLE

  Yes

  No

• No cracks, breaks, loose rungs? Safety Order #3276

  Compliant

  Non-Compliant

  N/A

• Metal ladders not used around electrical equipment? Safety Order #3276

  Compliant

  Non-Compliant

  N/A

• Wooden ladders not painted? Safety Order #3276

  Compliant

  Non-Compliant

  N/A

• Equipped with non slip safety feet? Safety Order #3276

  Compliant

  Non-Compliant

  N/A

• Extend three feet above upper landing? Safety Order #3276

  Compliant

  Non-Compliant

  N/A

• No grease/oil on rungs & steps? Safety Order #3276

  Compliant

  Non-Compliant

  N/A

• Used safely? Safety Order #3276

  Compliant

  Non-Compliant

  N/A

• Approved stickers affixed? Safety Order #3276

  Compliant

  Non-Compliant

  N/A

SAWS/GRINDERS/POWDER ACTUATED TOOLS

• Does This Facility Contain These Tools?

  Yes

  No

• SAWS

  Yes

  No

• Skill saw - lower guard works auto, no wedge? Safety Order #4307

  Compliant

  Non-Compliant

  N/A

• Table saw - guard installed, anti-kickback? Safety Order #4300

  Compliant

  Non-Compliant

  N/A

• Radial arm - upper half & arbor end of blade covered? Cannot pull out past end of table, automatic return to rear of table, anti-kickback when ripping? Safety Order #4309

  Compliant

  Non-Compliant

  N/A

• Band saw - upper and lower wheels covered, unused portion of blade guarded? Safety Order #4310

  Compliant

  Non-Compliant

  N/A

• Chain saw - good condition, at least two antikickback devices? ANSI B175.1-1985, 4.12.2.1

  Compliant

  Non-Compliant

  N/A

• GRINDERS

  Yes

  No

• RPM rating of grinder motor does not exceed RPM rating of abrasive wheel? Safety Order #3583

  Compliant

  Non-Compliant

  N/A

• Portable right angle; maximum wheel exposure 180 degrees, guard between wheel and operator? Safety Order #3583

  Compliant

  Non-Compliant

  N/A

• Stationary grinders securely mounted? Safety Order #3576

  Compliant

  Non-Compliant

  N/A

• Pedestal or bench mounted; spindle end & nut covered, wheel enclosed (75% of wheel diameter) except grinding opening; tool rest adjusted within 1/8", tongue guard adjusted within 1/4", securely mounted? Safety Order #3577 & 3576

  Compliant

  Non-Compliant

  N/A

• Buffers & wire wheels; acorn nut on spindle? Safety Order #4237

  Compliant

  Non-Compliant

  N/A

• POWDER ACTUATED TOOLS

  Yes

  No

• Operator trained and has valid card? Safety Order #1685 & 1687

  Compliant

  Non-Compliant

  N/A

• Tools stored in locked box when not in use? Safety Order #1689

  Compliant

  Non-Compliant

  N/A

EQUIPMENT AND POWER TOOLS

• Does This Facility Have Power Tools?

  Yes

  No

• Grounded or double insulated? Safety Order #2395.45

  Compliant

  Non-Compliant

  N/A

• Good condition, operable switch?

  Compliant

  Non-Compliant

  N/A

• Secured against movement? Safety Order #3328

  Compliant

  Non-Compliant

  N/A

• Power Transmission components (gear sprockets, belts, shafts, clutches, pulleys, etc.) & moving parts guarded against contact? Safety Order #3995 & 4075 (Guards see 3944)

  Compliant

  Non-Compliant

  N/A

• Point of operation (punching, shearing, squeezing, cutting, mixing, etc.) guarded against contact? (For specific equipment see GISO #4187-4647) Safety Order #4184

  Compliant

  Non-Compliant

  N/A

HAND TOOLS

• Does This Facility Use Hand Tools?

  Yes

  No

• Maintained in good condition, handle tight not mushroomed, and sharp? Safety Order #3556

  Compliant

  Non-Compliant

  N/A

• Proper tool used for job? Safety Order #3556

  Compliant

  Non-Compliant

  N/A

HOISTS AND LIFTS

• Does This Facility Have Hoist/Lifts

  Yes

  No

• OVERHEAD HOISTS

  Yes

  No

• Regularly inspected, annually certified if capacity over 3 tons? Document available on site? Safety Order #5021 & 5031

  Compliant

  Non-Compliant

  N/A

• Operators trained? Safety Order #5006

  Compliant

  Non-Compliant

  N/A

• Rated capacity plainly marked? Safety Order #4907

  Compliant

  Non-Compliant

  N/A

• Operating controls labeled? Safety Order #4896

  Compliant

  Non-Compliant

  N/A

• Equipped with safety latch hook? Safety Order #5002

  Compliant

  Non-Compliant

  N/A

• Load slings & chains labeled with capacity? Safety Order #5044

  Compliant

  Non-Compliant

  N/A

• Cable clamps applied properly: at least 3 clamps spaced 6 rope diameters apart, with the saddle on the load side? Larger cables require more clamps. Safety Order #4981

  Compliant

  Non-Compliant

  N/A

• AUTOMOTIVE LIFTS

  Yes

  No

• Legible label with: manufacturers name, capacity, date of installation, Cal OSHA - approval or ANZI B153.1 compliance? Safety Order #3543

  Compliant

  Non-Compliant

  N/A

• Controls nearby, automatically return to off? Safety Order #3544

  Compliant

  Non-Compliant

  N/A

• Floor surface under lift clear of oil/grease? Safety Order #3547

  Compliant

  Non-Compliant

  N/A

• Chassis & axle support designed for lift, no makeshift devices? Safety Order #3548

  Compliant

  Non-Compliant

  N/A

• JACKS

  Yes

  No

• Rated load permanently marked? Safety Order #3562

  Compliant

  Non-Compliant

  N/A

• No one allowed under load unless also blocked or cribbed?

  Compliant

  Non-Compliant

  N/A

AIR COMPRESSOR

• Does This Facility Use An Air Compressor?

  Yes

  No

• Cal OSHA "permit to operate" for air tank up to date, labeled "WARNING-COULD START AT ANY TIME" if automatically controlled? Safety Order #461 & 3320

  Compliant

  Non-Compliant

  N/A

• Are drive belts fully enclosed? Safety Order #4070

  Compliant

  Non-Compliant

  N/A

• No PVC pipe for air lines? Safety Order #462

  Compliant

  Non-Compliant

  N/A

• Do safety air nozzles generate < 10 PSI? Safety Order #3301

  Compliant

  Non-Compliant

  N/A

• Are air hose connections secure? Safety Order #3300

  Compliant

  Non-Compliant

  N/A

FORKLIFTS

• Does This Facility Have A Forklift?

  Yes

  No

• Are operators trained? Safety Order #3664

  Compliant

  Non-Compliant

  N/A

• Are operating rules posted? Safety Order #3664

  Compliant

  Non-Compliant

  N/A

• Equipment maintained in safe condition, brakes, parking brake, horn, seatbelts? Safety Order #3661, 3663 & 3653

  Compliant

  Non-Compliant

  N/A

• Capacity visible to operator? Safety Order #3660

  Compliant

  Non-Compliant

  N/A

• Equipped with overhead guard? Safety Order #3655

  Compliant

  Non-Compliant

  N/A

SPECIAL OPERATIONS

• Does This Facility Use Compressed Gas, Welding, or Tire Repair?

  Yes

  No

• COMPRESSED GAS CYLINDERS

  Yes

  No

• Stored with protective cap installed? Safety Order #1740 & 4650

  Compliant

  Non-Compliant

  N/A

• Secured against tipping or falling? Safety Order #4650

  Compliant

  Non-Compliant

  N/A

• Labeled as to contents? Safety Order #4649

  Compliant

  Non-Compliant

  N/A

• Stored >20 feet from highly combustible material? Safety Order #4650

  Compliant

  Non-Compliant

  N/A

• Cylinder valves closed when not in use and before moving? Safety Order #4650

  Compliant

  Non-Compliant

  N/A

• Cylinders in use secured in racks or carts? Safety Order #4650

  Compliant

  Non-Compliant

  N/A

• LP gas tanks inspected? Safety Order #470, CFR 173.34

  Compliant

  Non-Compliant

  N/A

• GAS WELDING AND CUTTING

  Yes

  No

• Regulators & hose well maintained, no oil or grease? Safety Order #4839 & 4845

  Compliant

  Non-Compliant

  N/A

• Fuel gas cylinder stored & used with valve up? Safety Order #4845

  Compliant

  Non-Compliant

  N/A

• Anti-flashback devices on fuel & oxygen hoses? Safety Order #4845

  Compliant

  Non-Compliant

  N/A

• Friction lighter or torches, no matches? Safety Order #4845

  Compliant

  Non-Compliant

  N/A

• Work in firesafe areas, separate if possible? Safety Order #4848

  Compliant

  Non-Compliant

  N/A

• Ventilation provided, local exhaust required for brazing or silver soldering? Safety Order #5150

  Compliant

  Non-Compliant

  N/A

• Cutters or welders and supervisors suitably trained? Safety Order #4848

  Compliant

  Non-Compliant

  N/A

• ARC WELDING AND CUTTING

  Yes

  No

• Work in shielded booth or with welding screens? Safety Order #4851

  Compliant

  Non-Compliant

  N/A

• Other workers in area shielded or wear goggles? Safety Order #4851

  Compliant

  Non-Compliant

  N/A

• Leads in good condition, well insulated? Safety Order #4851

  Compliant

  Non-Compliant

  N/A

• Electrodes removed when not in use? Safety Order #4851

  Compliant

  Non-Compliant

  N/A

• Machine off, when moved or not in use? Safety Order #4851

  Compliant

  Non-Compliant

  N/A

• Ventilation provided, local exhaust required for MIG or wire-feed welding on stainless steel? Safety Order #5150 & 4835

  Compliant

  Non-Compliant

  N/A

• TIRE REPAIR AND INFLATION

  Yes

  No

• Clip-on chuck with 24" hose, in line valve or gauge? Safety Order #3325

  Compliant

  Non-Compliant

  N/A

• Employees thoroughly trained? Safety Order #3326

  Compliant

  Non-Compliant

  N/A

• Restraining device available? Safety Order #3326

  Compliant

  Non-Compliant

  N/A

• A current split & multi-piece rim or wheel, matching chart, a typical rim contours and marking location chart, and a current Rim Manual or equivalent available? Safety Order #3326

  Compliant

  Non-Compliant

  N/A

• LOCK OUT PROGRAM

  Yes

  No

• Employees trained in procedure? Safety Order #3314

  Compliant

  Non-Compliant

  N/A

• Warning tags and locks provided and available? Safety Order #3314

  Compliant

  Non-Compliant

  N/A

CONFINED SPACES

• Does This Facility Have Confined Spaces?

  Yes

  No

• Employees trained in policy and specific hazards of location & use of instruments? Safety Order #5157 & 5158, Safety Manual 14.06,7

  Compliant

  Non-Compliant

  N/A

• Instruments recently identified and inventoried (permit/non-permit required)? Safety Order #5157 & 5158, Safety Manual 14.06,7

  Compliant

  Non-Compliant

  N/A

• Instruments recently calibrated? Safety Order #5157 & 5158, Safety Manual 14.06,7

  Compliant

  Non-Compliant

  N/A

• Location signed or otherwise identified? Safety Order #5157 & 5158, Safety Manual 14.06,7

  Compliant

  Non-Compliant

  N/A

• Rescue and communication equipment available? Safety Order #5157 & 5158, Safety Manual 14.06,7

  Compliant

  Non-Compliant

  N/A

• Entry permit file, record keeping? Safety Order #5157 & 5158, Safety Manual 14.06,7

  Compliant

  Non-Compliant

  N/A

HAZARDOUS MATERIAL

• Does This Facility Collect Use Or Store Hazardous Materials?

  Yes

  No

• Employees fully trained on material they use? Safety Order #5194

  Compliant

  Non-Compliant

  N/A

• All hazardous material containers labeled with contents where substance has been transferred from original container for temporary use? Labeled if not used immediately or by end of work shift? Safety Order #5194, Safety Manual Chapter 16

  Compliant

  Non-Compliant

  N/A

• Container in good condition? Safety Order #5194

  Compliant

  Non-Compliant

  N/A

• Appropriate protective equipment available? Safety Order #5194

  Compliant

  Non-Compliant

  N/A

• Inventory list and MSDSs on hand? Safety Order #5194

  Compliant

  Non-Compliant

  N/A

• Employees have asbestos awareness training? Safety Order #5208

  Compliant

  Non-Compliant

  N/A

• Employees have lead awareness training certificate? Safety Order #5216

  Compliant

  Non-Compliant

  N/A

SERVICE STATIONS

• Does This Facility Have Fuel Pumps?

  Yes

  No

• "NO SMOKING" signs posted in fueling areas, motors stopped? Safety Order #5580 & 3319

  Compliant

  Non-Compliant

  N/A

• Spills cleaned up promptly? Safety Order #3319

  Compliant

  Non-Compliant

  N/A

• Approved self-closing nozzle, approved hose? Safety Order #3319 & 5576

  Compliant

  Non-Compliant

  N/A

• Fire extinguisher of 5B, C rating within 100' of pumps? Safety Order #5581

  Compliant

  Non-Compliant

  N/A

• Spilled liquid prevented from running into building? Safety Order #5579

  Compliant

  Non-Compliant

  N/A

• Pumps Installed Inside after Jan. 1, 1976, must be separated by a one hour fire wall and have adequate ventilation? Safety Order #5571

  Compliant

  Non-Compliant

  N/A

• Pumps Installed Outside are at least 5 feet from any building opening? Safety Order #5570

  Compliant

  Non-Compliant

  N/A

• Pumps are anchored, protected from physical damage? Safety Order #5573 & 5574

  Compliant

  Non-Compliant

  N/A

• Sealed electrical wiring (Class 1, Div 1)? Safety Order #5571

  Compliant

  Non-Compliant

  N/A

• At least 20' from any fixed ignition source? Safety Order #5573

  Compliant

  Non-Compliant

  N/A

• Emergency power shutoff; clearly identified, easily accessible, remote location?

  Compliant

  Non-Compliant

  N/A

CONTROL OF HARMFUL SUBSTANCES BY VENTILATION

• Does This Facility Utilize Ventilation For Control Of Harmful Substances?

  Yes

  No

• Is the volume of air in each exhaust system sufficient to gather the dusts, fumes, mists, vapors or gases to be controlled, and to convey them to a suitable point of disposal? Safety Order #5142 & 5143

  Compliant

  Non-Compliant

  N/A

• Are ventilation hoods tested annually to ensure proper air flow? Safety Order #5143

  Compliant

  Non-Compliant

  N/A

• Are HVAC systems inspected annually by a qualified person? Safety Order #5142

  Compliant

  Non-Compliant

  N/A

• Is a log kept of inspections and maintenance? Safety Order #5142

  Compliant

  Non-Compliant

  N/A

• Are records of HVAC system inspected, maintenance, and filter changes available? (5-year retention) Safety Order #5142

  Compliant

  Non-Compliant

  N/A

• Are exhaust inlets, ducts and plenums designed, constructed, and supported to prevent collapse or failure of any part of the system? Safety Order #5143

  Compliant

  Non-Compliant

  N/A

• Are clean-out ports or doors provided at intervals not to exceed 12 feet in all horizontal runs of exhaust ducts? Safety Order #5143

  Compliant

  Non-Compliant

  N/A

• Where two or more different types of operations are being controlled through the same exhaust system, will the combination of substances being controlled constitute a fire, explosion or chemical reaction hazard in the duct? Safety Order #5143

  Compliant

  Non-Compliant

  N/A

• Is adequate makeup air provided to areas where exhaust systems are operating? Safety Order #5143

  Compliant

  Non-Compliant

  N/A

• Is the intake for makeup air located so that only clean, fresh air, which is free of contaminates, will enter the work environment? Safety Order #5143

  Compliant

  Non-Compliant

  N/A

• Where two or more ventilation systems are serving a work area, is their operation such that one will not offset the functions of the other? Safety Order #5143

  Compliant

  Non-Compliant

  N/A

MISCELLANEOUS

• Are their additional deficiencies?

  Yes

  No

SANDHOUSES

SANDHOUSE

• Does This Facility Have an Offsite Sandhouse?

  Yes

  No

• Location

• Are their deficiencies?

  Yes

  No

ACKNOWLEDGEMENT

• Deficiencies identified during this inspection will be corrected by the signee or his/her designee and reported to the D2 office of employee health and safety.

  Sign