Foam Plant Health and Safety Inspection

• Audit Title

• Conducted on

  Date

• Document Number

• Site
  Address

• Prepared by

• Auditors

General Safety

• Has the last inspection been reviewed?

  Yes

  No

  N/A

• Office hazards identified and addressed?

  Yes

  No

  N/A

• Ergonomic hazards identified and addressed?

  Yes

  No

  N/A

• Are there no outstanding actions?

  Yes

  No

  N/A

Housekeeping

• Floors clear of debris?

  Good

  Fair

  Poor

  N/A

• Floors clear of water/oil?

  Good

  Fair

  Poor

  N/A

• Tools put away in proper storage locations?

  Yes

  No

  N/A

• Work areas neat and tidy?

  Good

  Fair

  Poor

  N/A

Equipment

• Guards in place?

  Yes

  No

  N/A

• Pinchpoints identified and addressed?

  Yes

  No

  N/A

• Emergency stops functional and accessible?

  Yes

  No

  N/A

• Safety interlocks functional?

  Yes

  No

  N/A

Electrical

• Portable tools/equipment in good condition?

  Yes

  No

  N/A

• Panel doors closed and secured?

  Yes

  No

  N/A

• Lock out tag out points identified for energy control?

  Yes

  No

  N/A

• Wiring and cords appear in good condition?

  Yes

  No

  N/A

• Electrical panels kept clear for easy access?

  Yes

  No

  N/A

Fire protection and prevention

• Employees trained in hazards of blowing agent?

  Yes

  No

  N/A

• Employees aware of emergency action plan and their responsibilities?

  Yes

  No

  N/A

• Evacuation routes clearly identified and marked?

  Yes

  No

  N/A

• Fire detection/suppression system functional?

  Yes

  No

  N/A

• MSA system functional?

  Yes

  No

  N/A

• Fire extinguishers inspected monthly?

  Yes

  No

  N/A

• Fire extinguishers easily accessible (hanging and not blocked)?

  Yes

  No

  N/A

• Escape routes, including exits, unobstructed?

  Yes

  No

  N/A

• Roll-up doors functional and path kept clear?

  Yes

  No

  N/A

• Combustible materials properly stored?

  Yes

  No

  N/A

• Static Eliminators functioning and filters clean?

  Yes

  No

  N/A

• Static string grounded and clean?

  Yes

  No

  N/A

• Repel vents clear of debris?

  Yes

  No

  N/A

Personal Protective Equipment

• Employees trained in proper usage in storage?

  Yes

  No

  N/A

• Proper size available?

  Yes

  No

  N/A

• Hygienic and clean?

  Yes

  No

  N/A

• Stored properly?

  Yes

  No

  N/A

• Protects against all identified hazards?

  Yes

  No

  N/A

General Safety

• Fall hazards identified and protected against?

  Yes

  No

  N/A

• Ergonomic hazards identified and addressed?

  Yes

  No

  N/A

• Sharp edges identified and protected against?

  Yes

  No

  N/A

• Low clearance areas identified and marked?

  Yes

  No

  N/A

Housekeeping

• Is the silo pad area free of debris?

  Good

  Fair

  Poor

  N/A

• Have all drains cleared of debris?

  Compliant

  Non-Compliant

  N/A

• Are all silo doors secured and locked?

  Yes

  No

  N/A

• Are all silo blowers functioning and operating?

  Yes

  No

  N/A

• Is oxidizer running without alarm and at temperature?

  Yes

  No

  N/A

Housekeeping

• Floors clear of debris?

  Good

  Fair

  Poor

  N/A

• Floors clear of water/oil?

  Good

  Fair

  Poor

  N/A

• Trench is clear of debris?

  Yes

  No

  N/A

• Rolls stacked safely?

  Yes

  No

  N/A

• Aisle ways clear?

  Yes

  No

  N/A

Equipment/Fire Protection and Prevention

• Ventilation system functional?

  Yes

  No

  N/A

• MSA system functional?

  Yes

  No

  N/A

• Evacuation routes clearly identified and marked?

  Yes

  No

  N/A

• Fire extinguishers inspected monthly?

  Yes

  No

  N/A

• Fire extinguishers easily accessible (hanging and not blocked)?

  Yes

  No

  N/A

• Escape routes, including exits, unobstructed?

  Yes

  No

  N/A

• Roll/up doors functional and pass kept clear?

  Yes

  No

  N/A

• Static Eliminators functioning and filters clean?

  Yes

  No

  N/A

Housekeeping

• Floors clear of debris?

  Good

  Fair

  Poor

  N/A

• Floors clear of water/oil?

  Good

  Fair

  Poor

  N/A

• Tools put away in proper storage location?

  Yes

  No

  N/A

• Work areas generally neat and tidy?

  Yes

  No

  N/A

Equipment

• Guards are in place?

  Yes

  No

  N/A

• Pinch points identified and addressed?

  Yes

  No

  N/A

• Emergency stops functional and accessible?

  Yes

  No

  N/A

• Safety interlocks functional?

  Yes

  No

  N/A

• Portable tools/equipment in good condition?

  Yes

  No

  N/A

Electrical

• Panel doors closed and secured?

  Yes

  No

  N/A

• Lock out tag out points identified for energy control?

  Yes

  No

  N/A

• Wiring and cords appear in good condition?

  Yes

  No

  N/A

• Electrical panels kept clear for easy access?

  Yes

  No

  N/A

Fire protection and prevention

• Employees aware of emergency response plan and theirresponsibilities?

  Yes

  No

  N/A

• Evacuation routes clearly identified and marked?

  Yes

  No

  N/A

• Fire extinguishers inspected monthly?

  Yes

  No

  N/A

• Fire extinguishers easily accessible (hanging and not blocked)?

  Yes

  No

  N/A

• Escape routes, including exits, unobstructed?

  Yes

  No

  N/A

• Roll/up doors functional and path kept clear?

  Yes

  No

  N/A

• Combustible materials properly stored?

  Yes

  No

  N/A

• Static Eliminators functioning and filters clean?

  Yes

  No

  N/A

• Static string grounded and clean?

  Yes

  No

  N/A

Personal protective equipment

• Employees trained in proper usage in storage?

  Yes

  No

  N/A

• Proper size available?

  Yes

  No

  N/A

• Hygienic and clean?

  Yes

  No

  N/A

• Stored properly?

  Yes

  No

  N/A

• Protects against all identified hazard?

  Yes

  No

  N/A

General Safety

• Fall hazards identified and protected against?

  Yes

  No

  N/A

• Ergonomic hazards identified and protected against?

  Yes

  No

  N/A

• Sharp edges identified and protected against?

  Yes

  No

  N/A

• Low clearance areas identified and marked?

  Yes

  No

  N/A

Housekeeping

• Floors clear of debris?

  Yes

  No

  N/A

• Floors clear of water/oil?

  Yes

  No

  N/A

• Product stacked safely?

  Yes

  No

  N/A

• Aisle ways clear?

  Yes

  No

  N/A

Equipment

• Dock safety device is functional?

  Yes

  No

  N/A

• Dock locks or wheel chocks used?

  Yes

  No

  N/A

• Fork lift inspections complete and problems addressed?

  Yes

  No

  N/A

Fire protection and Prevention

• Escape routes, including exits, unobstructed?

  Yes

  No

  N/A

• Roll/up doors functional and pass kept clear?

  Yes

  No

  N/A

Personal protective equipment

• Employees trained in proper usage in storage?

  Yes

  No

  N/A

• Proper size available?

  Yes

  No

  N/A

• Hygienic and clean?

  Yes

  No

  N/A

• Stored properly?

  Yes

  No

  N/A

• Protects against all identified hazards?

  Yes

  No

  N/A

General Safety

• Forklift operation procedures/rules are being followed?

  Yes

  No

  N/A

• Forklift operators trained in forklift operation and procedures/rules?

  Yes

  No

  N/A

• Eye wash station at battery change location inspected and functional?

  Yes

  No

  N/A

• Are all containers on secondary containment?

  Yes

  No

  N/A

• Floors clear of oil/water?

  Yes

  No

  N/A

• Secondary containment lids closed and area clear of filled buckets?

  Yes

  No

  N/A

• Mop area clean and dry?

  Yes

  No

  N/A

• Mop water appears clean in filter trough?

  Good

  Fair

  Poor

  N/A

Housekeeping

• Floors clear of debris?

  Good

  Fair

  Poor

  N/A

• Floors clear of water/oil?

  Yes

  No

  N/A

• Tools/equipment put away in proper storage location?

  Yes

  No

  N/A

• Work areas generally neat and tidy?

  Yes

  No

  N/A

• Oily rags storage available and maintained?

  Yes

  No

  N/A

Equipment

• Guards are in place?

  Yes

  No

  N/A

• Portable tools/equipment in good condition?

  Yes

  No

  N/A

Personal protective equipment

• Proper size available?

  Yes

  No

  N/A

• Hygienic and clean?

  Yes

  No

  N/A

• Stored properly?

  Yes

  No

  N/A

• Protects against all identified hazards?

  Yes

  No

  N/A

• Weldon curtains available and in good condition?

  Yes

  No

  N/A

General Safety

• Forklift operation procedures/rules are being followed?

  Yes

  No

  N/A

• Forklift operators trained in forklift operation and procedures/rules?

  Yes

  No

  N/A

• Load ratings for storage racks predominantly displayed?

  Yes

  No

  N/A

• Storage racks in good condition?

  Yes

  No

  N/A

General Safety

• First aid kits available and stocked?

  Yes

  No

  N/A

• Automated external defibrillator available and inspected?

  Yes

  No

  N/A

• Eyewash stations inspected and functional?

  Yes

  No

  N/A

• Fire alarm system functional?

  Yes

  No

  N/A

• Sprinkler system functional?

  Yes

  No

  N/A

• Were all employees observed working in a safe manner?

  Safe

  At Risk

  N/A

• Auditors signature

  Sign

• Date

  Date