Farmers Ranchers Co-op - Ainsworth Mr Tire

• 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

• NW Garage Door

  Yes

  No

  N/A

• Right of Alignment Machine

  Yes

  No

  N/A

• Restrooms

  Yes

  No

  N/A

• Oil Room by Stairs

  Yes

  No

  N/A

• West Outside Wall in Back

  Yes

  No

  N/A

• Oil Building Warehouse - Front Door

  Yes

  No

  N/A

• Oil Building Warehouse - Back Door

  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