Farmers Ranchers Co-op - Agronomy

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General Safety

• The parking area is well maintained?

  Yes

  No

  N/A

• Exterior walkways are in good physical condition and kept clear?

  Yes

  No

  N/A

• Exterior illumination is adequate?

  Yes

  No

  N/A

• General housekeeping is acceptable and storage is neat and orderly?

  Yes

  No

  N/A

• Floors are clear and aisles, hallways, and exits are unobstructed?

  Yes

  No

  N/A

• Walking surfaces are clean, clear of debris, and dry?

  Yes

  No

  N/A

• Stairs, steps, handrails, and landings are in good condition?

  Yes

  No

  N/A

Electrical and Mechanical

• Interior lighting is adequate?

  Yes

  No

  N/A

• There is no evidence of electrical equipment or wiring overheating, blown fuses, tripped circuit breakers or worn insulation?

  Yes

  No

  N/A

• Electrical cords and plugs are in good condition with proper grounding?

  Yes

  No

  N/A

• Extension cords and power strips are not daisy chained and no permanent extension cords are in use?

  Yes

  No

  N/A

• Equipment and machines are clean and working properly?

  Yes

  No

  N/A

• Adequate ventilation is provided?

  Yes

  No

  N/A

• Mechanical safeguards are in place and in proper working order (e.g. Machine Guards)?

  Yes

  No

  N/A

Storage

• Corridors and stairways are kept free of obstruction and are not used for storage?

  Yes

  No

  N/A

• Storage areas are uncluttered - providing clear evacuation routes?

  Yes

  No

  N/A

Eye Wash

• Access to eye wash stations / showers is clear and uncluttered?

  Yes

  No

  N/A

• Eye wash station is within expiration date?

  Yes

  No

  N/A

• Expiration Date?

  Date

Fire Extinguishers

• Portable fire extinguishers have current year tags and are checked monthly (see fire extinguisher checklist)?

  Yes

  No

  N/A

• Front Door

  Yes

  No

  N/A

• Shop - NW Walk-in Door

  Yes

  No

  N/A

• Shop - NW Overhead Door

  Yes

  No

  N/A

• Shop - SW Overhead Door

  Yes

  No

  N/A

• Shop - SE Overhead Door

  Yes

  No

  N/A

• Load-Out Bay by Shop Walk-In Door

  Yes

  No

  N/A

• Chemical Room by Load-Out Bay Walk-In Door

  Yes

  No

  N/A

• Chemical Room Stairs

  Yes

  No

  N/A

• Chemical Room East Walk-In Door

  Yes

  No

  N/A

• Dry Building - Front Door

  Yes

  No

  N/A

• Dry Building - East Door

  Yes

  No

  N/A

• Dry Building - West Overhead Door

  Yes

  No

  N/A

• Dry Building - East Overhead Door

  Yes

  No

  N/A

• Chemical Building - High Dock

  Yes

  No

  N/A

• Chemical Building - East Chemical

  Yes

  No

  N/A

• Old Shop

  Yes

  No

  N/A

• Upstairs

  Yes

  No

  N/A

• Bulk Propane Tanks

  Yes

  No

  N/A

• Bulk Fuel Plant

  Yes

  No

  N/A

• Unit #2 -Liquid Case 4420

  Yes

  No

  N/A

• Unit #11 - White GMC Liquid Truck - Single Axle

  Yes

  No

  N/A

• Unit #15 - White GMC Liquid Truck - Twin Axle

  Yes

  No

  N/A

• Unit #17 - White Chevy Liquid Truck - Single Axle

  Yes

  No

  N/A

• Unit #34 - Liquid Case 4420

  Yes

  No

  N/A

• Unit #45 - Dry Row

  Yes

  No

  N/A

• Unit #50 - White GMC Liquid Truck - Single Axle

  Yes

  No

  N/A

• Unit #62 - Burgundy Int'l Semi-Tractor

  Yes

  No

  N/A

• Unit #67 - Blue Freightliner Dry Truck - 3 Axle

  Yes

  No

  N/A

• Unit #76 - Yellow GMC Liquid Truck - Single Axle

  Yes

  No

  N/A

• Unit #79 - Red IHC Semi-Truck

  Yes

  No

  N/A

• Unit #98 - Yellow GMC Liquid Truck - Single Axle

  Yes

  No

  N/A

• Unit #100 - Tan Int'l Semi-Tractor

  Yes

  No

  N/A

• Unit #102 - Dry Titan

  Yes

  No

  N/A

• Unit #106 - Plum Peterbuilt Semi-Tractor

  Yes

  No

  N/A

• Unit #112 - White GMC Dry Truck

  Yes

  No

  N/A

• Unit #113 - Black Peterbuilt Semi-Tractor

  Yes

  No

  N/A

• Unit #125 - Gray/Purple Peterbuilt Semi- Tractor

  Yes

  No

  N/A

• Unit #126 - 2003 White IH Liquid Tuck - Single Axle

  Yes

  No

  N/A

• Unit #165 - White INt'l. Dry/Liquid Tuck - Single Axle

  Yes

  No

  N/A

• Unit #166 - White INt'l. Dry/Liquid Tuck - Single Axle

  Yes

  No

  N/A

• Unit #128 - Vector

  Yes

  No

  N/A

• Unit #129 - JP Murphy Pickup

  Yes

  No

  N/A

• Unit #132 - Red Pete

  Yes

  No

  N/A

• Unit #138 - Ford Flat Bed Pickup - Mark's

  Yes

  No

  N/A

Air Monitoring

• Bump test and/or calibrate air monitor?

  Yes

  No

  N/A

Other

• Other test performed or items needing attention?

  Safe

  At Risk

  N/A