Flowood PMC Quarterly Branch Safety Audit

1. Are Safety Meetings conducted as required and attendance documented? (Yes 10/No 0)

2. Are all New Hire technicians, yard workers, and parts warehouse personnel with less than 90 days assigned a mentor and is the Approved Task List being used and properly updated by the Mentor and Supervisor in compliance with the PMC Policy? (Yes 1/No -5)

3. Have employees who operate aerial work platforms and forklifts completed training and is the training current? (Yes = 1 No = -5)

4. Is food only consumed and stored in areas to prevent exposure to solvents, chemicals, or other hazardous materials and are all drinks covered with a top? (Yes =1 No =0)

5. Are Weekly Walk Through Inspections conducted as scheduled by the HSE Director? (Yes = 10 No = -15)

6. Is corrective action being taken in a timely manner to remedy deficiencies found during the Weekly Walkthrough Inspections? (Yes = 1 No = - 5)

7. Are Daily Forklift Inspections Conducted and Documented? (Yes = 1 No = - 5)

8. Are daily crane inspections conducted and documented, if no how long has it been since the cranes received a documented daily inspection? (Yes = 1 No = - 5)

9. Is a current Emergency Contact sheet displayed in the Training Room, the Conference Room, on the First Aid Kit, and in the immediate area of all landlines in the Branch? (Yes 1 No = 0)

10. Have all employees who wear Respiratory Face Masks been administered a Respiratory Fit Tests within the last 12 months? (Yes = 1 No = - 5)

1. Is parking only allowed in designated areas? (Yes = 1 No = 0)

2. Is the First Aid Kit properly stocked, accessible, and is the First Aid Kit Entry Log present and used? Is the Trauma Bag in a clear visible place in the manager's office? Are all employees familiar with it's location? (Yes = 1 No = 0)

3. Are Bloodborne pathogen kits accessible to all employees and all contents in serviceable condition? (Yes =1 No = 0)

4. Are all employees familiar with the location of the AED and who is First Aid and CPR Qualified? (Yes = 1 No = 0)

5. Are work stations clean and orderly? (Yes = 1 No = - 5)

6. Is the tool room neat and organized and items stored in a manner that prevents injury? (Yes = 1 No = 0)

7. Are all Emergency Routes and exit doors illuminated? Are exit routes clear of obstructions, all exit doors unlocked and is the area immediately outside of the exit free from tripping hazards and unobstructed? (Yes = 1 No = - 5)

8. Are ladders, parts, and other items stored in a manner that protects workers from potential falling objects, struck by, struck against, or overhead hazards? (Yes 1 No -5)

1. Are Daily Vehicle Inspections being conducted on all Commercial Vehicles? (Yes = 1 No = - 5)

2. Were there any DOT Violations issued during the Quarter to drivers assigned to the Branch? Provide explanation and details.. (None = 1 point Violations issued = -10)

3. Are all company vehicles clean? Is proof of registration, cab cards, insurance cards and a copy of DOT Annual Inspection present in all DOT vehicles? Is a Daily Log Book present in all vehicles with a GVWR of 10,001 pounds or more? (Yes = 1 No = - 5)

4. Are all vehicles assigned to the Branch with a B or an Apportioned License Plate equipped with a fire extinguisher, triangles, a first aid kit, and spare fuses? Are Field Service equipped with a Spill Kit and Wheel Chocks? (Yes = 1 No = - 5)

5. Do all Commercial Motor Vehicles have a current DOT Inspection? Are Commercial Motor Vehicles properly marked with the Company name, DOT Number, and reflective tape as required by 49 CFR 390.21? (Yes = 1 No = - 10)

1. Are all forklifts in a safe and serviceable condition? Tires and seat are in good condition; seat belts are not frayed, seat belt retracts properly; forks are not bent and have not been modified with holes or other type modifications). (Yes =1 No = -5)

2. Are Operator Manuals in the rear pocket of the Operator Seat of all Forklifts assigned to the Branch/Department? Yes 1 No 0

3. Are all Eyewash and emergency shower stations properly marked with signage and are they operational and functional with easy access by all occupants of the building? (Yes = 1 No = - 5)

4. Are employees who are using grinders, using pressure washer, working on equipment that has been operated in areas with dry chemicals, mud, or other conditions with increased eye hazards using face shields for additional protection? (Yes = 1 No = - 5)

5. Are only approved ANSI Z87 safety glasses with side shields worn at all times in areas marked "Safety Glasses Required" or "Safety Glasses Required Beyond This Point". (Yes = 1 No = - 5)

6. Are employees who require prescription eye glasses wearing approved prescription eye wear with side shields attached and provide above the eye protection? (Yes = 1 No = - 5)

7. Are face shields available and easily accessible for additional protection to the face and eyes of employees who may need increased protection due to increased hazards? (Yes = 1 No = - 5)

8. Is appropriate foot protection being worn where there is the risk of foot injuries from hot, corrosive, poisonous substances, falling objects, crushing or penetrating actions? (Yes = 1 No = - 5)

9. Are all personnel in compliance with the Hand Protection Policy and are they using the proper glove for task being performed? Are gloves in serviceable condition? (Yes = 1 No = - 10)

10. Are employees engaged in activities that pose above the head hazards using proper head protection? (Yes = 1 No = - 5)

11. Is head protection (hard hats) available and easily accessible to employees who are engaged in hazards to the head? (Yes = 1 No = - 5)

12. Are employees who are required to use Respiratory Face Masks assigned their own individual Mask? (Yes = 1 No = - 5)

13. Is all personal protective equipment maintained in a sanitary condition and ready for use? (Yes = 1 No = - 5)

14. Are employees who are working above four (4) feet using Fall Protection and securely tied off? (Yes = 1 No = - 5)

15. Is Fall Protection Equipment placed in a location that is easily accessible and available to employees? (Yes = 1 No = - 5)

16. Is a 30 Foot Retractable Lanyard and other Fall Protection equipment present at the Wash Rack and being used by persons working at a height of 4 foot or above? Are all wash rack pit railing systems in good repair? (Yes = 1 No = - 5)

17. Is all Fall Protection equipment serviceable with legible labels indicating the manufacturer of the equipment, the date of manufacture, the maximum weight capacity and dates of inspection recorded on the inspection label? (Yes = 1 No = - 5)

18. Are signs requiring the use of eye protection, hearing protection, and hard hats posted in required areas? (Yes = 1 No = 0)

19. Have all fire extinguishers in the facility, in company vehicles, and those mounted on equipment received a monthly inspection and have they been serviced by a certified Fire Extinguisher Technician in the last 12 months. (Yes = 1 No = -5)

20. Are all fire extinguishers readily accessible without subjecting employees to trip hazards or other possible injuries and are the locations of fire extinguishers clearly identified with a visible and legible sign? (Yes = 1 No = - 5)

21. Are flammable liquids such as gasoline and paint thinner kept in approved metal safety containers, Type 1 or Type 2, of not more than a five (5) gallon capacity with a spring closing lid or spout cover? (Yes = 1 No = - 5)

22. Are lifting capacities on all cranes marked in bold legible print and are all crane pendants fully functional and clearly and legibly marked to indicate the function of each button? (Yes = 1 No = - 5)

23. Are all pendants and pendant buttons in serviceable condition and are the labels indicating the function of the buttons on the pendant legible? (Yes = 1 No = 0)

24. Are all slings, hooks, binders, rings, spreader bars, leveling bars, and other items used in lifting or hoisting operations in a safe an serviceable condition? (Yes = 1 No = - 5)

25. Are tag lines being used to safely guide elevated loads to prevent potential injury from dropped or falling loads? (Yes = 1 No = - 5)

26. Are jacks and jack stands in serviceable condition and labeled to indicate the rated load capacity? (Yes = 1 No = - 5)

27. Is serviceable and satisfactory blocking and cribbing material being properly used to prevent unexpected movement of all parts or attachments on equipment in the shop or undergoing repair on the yard? (Yes = 1 No = - 5)

28. Are all ladders free from defects and are all labels which reflect the name of the manufacturer, date of manufacture, weight capacity, and caution labels present and legible? (Yes = 1 No = - 5)

29. Are ladders only used for climbing and not used as a working surface? (Yes = 1 No = - 5)

30. Is all shop machinery and equipment clean and properly maintained; are equipment guards, grinder guards secure and properly adjusted to prevent physical contact of moving parts? (Yes = 1 No = - 5)

31. Are all walking and working surfaces dry or have appropriate means been taken to assure the surfaces are slip-resistant? (Yes = 1 No = - 5)

32. Are Items such as air hoses and extension cords stored properly when not in use to prevent trip hazards in walkways, isles or work areas? (Yes = 1 No = - 5)

33. Are Pneumatic and hydraulic hoses used for and attached to power-operated tools and compressors in good condition, show no signs of wear, and connecting ends are properly attached with approved clamps and in serviceable condition? (Yes = 1 No = - 5)

34. Has all power been disconnected or master switch placed in the off position for machines in the shop or undergoing repair on the equipment yard? Use comment section to report the number found. (Yes = 1 No = - 10)

35. Are all machines on the yard and in the shop properly tagged in accordance with the Puckett Machinery Company Lockout and Tagout Policy? (Yes = 1 No = - 10)

36. Has all tooling, shop equipment, cranes, or power tools that are in an unsafe or unsatisfactory condition been tagged out by the supervisor or manager with their assigned tag? (Yes = 1 No = - 10)

37. Can technicians explain the purpose and use of the various tags used in Puckett Machinery Company's Lockout and Tag Out Program? (Yes = 1 No = - 5)

38. Are employees using proper lifting techniques to avoid back injuries? (Yes = 1 No = - 5)

39. Are hazardous chemicals and secondary containers used to handle hazardous chemicals properly labeled to identify the product name and appropriate warnings that pertain to the chemical? (Yes = 1 No = - 5)

40. Can all employees explain how to retrieve an electronic copy of a Safety Data Sheet for all hazardous chemicals in use or stored in the facility? Is the Safety Data Sheet Booklet current? (Yes = 1 No = 0)

41. Are fuel, natural gas, and butane tanks protected by a barrier to prevent accident striking or puncture from moving vehicles or equipment? Are all Propane Tanks for Forklifts secured in a cabinet when not in use? (Yes = 1 No = 0)

42. Are Gas Cylinders stored in a properly secured area away from any source of ignition and secured to prevent tipping or falling? (Yes = 1 No = - 5)

43. Are Gas Cylinder valves completely closed at the bottle when not in use or left unoccupied? Are bezels on gauges present and are they free from cracks and distortion? (Yes = 1 No = - 5)

44. Are storage shelves and racks labeled with capacity rating? (Yes = 1 No = - 5)

45. Are proper warning signs identifying electrical hazards posted on all electrical panels? Yes 1 No 0

46. Is all equipment on the yard that is for sale, for rent, awaiting service, or awaiting pickup stored away from overhead power lines? (Yes = 1 No = - 5)

47. Are electrical cords and extension cords removed from service when damaged or when showing visible signs of wear? (Yes = 1 No = - 5)

48. Are all electrical plugs on equipment or extension cords properly installed and all wiring properly enclosed in conduit? (Yes = 1 No = - 5)

49. Are all electrical panels and emergency disconnects free from obstruction so that at least 36 inches of clearance is maintained around the area of the box at all times? (Yes = 1 No = 0)

50. Are electrical enclosures such as switches, receptacles, junction boxes covered or sealed to prevent exposure of wires? Yes 1 No 0

51. Are technicians avoiding metal on metal activities by using Slide Sledges and Dead Blow Hammers? (Yes = 1 No = - 5)

52. Are employees using proper tooling in accordance with the procedure for the task they are performing? Is all equipment and tools in serviceable condition and in proper working order for the tasks that they are designed for? (Yes = 1 No = - 5)

53. Are hand tools such as chisels and punches free of mushroomed heads, serviceable handles, and heads that are securely attached and tight to the handle? (Yes = 1 No = 0)

1. Are fuel hoses and nozzles stored inside secondary containment to prevent fuel from spilling onto the ground?(Yes = 1 No = - 5)

2. Is used oil disposed of in a timely manner and are all used batteries marked with a 6 digit date to reflect the date that they were placed into the used battery storage area? (Yes = 1 No = 0)

3. Is all trash properly separated and disposed of in the proper containers? Are dumpster doors and lids closed at all times? (Yes = 1 No = 0)

4. Has the monthly SPCC Inspection been conducted for each month and has annual training been conducted for the SPCC response team? (Yes = 1 No = 0)

Were there PPE Violations that warrant a special deduction? If so provide details. - (Yes -5 No 1)

Are their repeat violations? Each repeat violation will result in a 2 point deduction per item. ( Yes - 5 No 1.)

Were any Observations of Unsafe Acts or Unsafe Conditions which warrant a special deduction? If so provide details. - 5 points. POINTS WILL BE DEDUCTED MANUALLY FROM FINAL SCORE.

Where there any observations of Safety Excellence. POINTS WILL BE ADDED MANUALLY TO THE FINAL SCORE.