Information
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Facility Location
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Conducted on
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Prepared by
Part 1: General
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Are monthly GEMBA walks completed?
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Is the OSHA 300A posted from February 1 to April 30?
Part 2: Storage and Housekeeping
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Are there damaged rack legs, beams secured, and end of racks guarded?
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Storage shelving secured and beams marked with load capacity?
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Are containers stored, stacked, and limited in height so they are stable and secure?
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Push-through protection measures in place? (Bars, screens, administrative controls)
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Are work areas, passageways, storerooms, and service rooms kept clean, orderly, dry, and in a sanitary condition?
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Are wooden pallets stored flat on floor (not leaned on edge)?
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Are work areas free from trip hazards?
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Are locations for specific items/supplies clearly marked?
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Are broom handles in good condition (all capped)?
Part 3: Emergency Procedures
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Are building exits free from obstruction?
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Is there an unobstructed path from each workstation (minimum aisle width: 28 inches)?
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Are exits marked and adequately lighted?
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Are exit doors unlocked from inside the building, and do they open in the direction of travel?
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Is any door, passage, or stairway that could be mistaken for an exit or a way of exit access identified by a sign that reads "NOT AN EXIT" or similar wording?
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Is the first aid kit stocked and inspected monthly? Are there expired items in the kit?
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Is there an adequate amount of blood borne pathogen kits in the facility? Are they expired?
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Is the AED inspected monthly?
Part 4: Fall Protection
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Is fall protection equipment (lanyards, harness, etc.) inspected prior to each use, and is the inspection documented?
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Is fall protection being inspected annually by a competent person?
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Are ladders maintained in good condition?
Part 5: Hazard Assessments
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Are hazard assessments current and posted at job sites?
Part 6: Personal Protection Equipment (PPE)
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Are observed employees using the required PPE? (safety glasses in Lab, cut resistant gloves)
- Safe
- At Risk
- N/A
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Is PPE readily accessible in the work areas that require it?
Part 7: Lockout/Tagout (LOTO)
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Are proper LOTO procedures being followed?
Part 8: Fire Protection
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Are portable fire extinguishers provided, mounted, located, and identified so that they are readily accessible?
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Are portable fire extinguishers mounted at the correct height?
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Are portable fire extinguishers inspected on a monthly basis, and is the tag signed accordingly?
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Are portable fire extinguishers subject to an annual maintenance check?
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Fire pump room doors unobstructed?
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Are wood pallets stacked no taller than 6'?
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Are flammable and combustible liquids stored properly in flammable liquid storage cabinets?
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Are flammable and combustible material containers labeled, covered, and stored at least 35' away from ignition sources?
Part 9: Powered Industrial Trucks (PIT)
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Are PITs inspected before each shift, and is the inspection documented?
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Are PITs warning labels and data plates in legible condition?
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Do unattended PITs have the load engaging means fully lowered, controls neutralized, and breaks set to prevent movement?
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Are PITs observed being used in a safe manner?
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Are seatbelts worn on sit-down lifts?
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Are dock locks, wheel chocks, and jack stands utilized on trucks and trailers during loading/unloading operations?
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Two controls in place for trailers that cannot use dock locks?
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Does the battery charging area have a neutralizing agent readily accessible for spilled electrolyte and acid? PPE Available?
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Are combustible materials stored at least 8.2 feet away from charging area?
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Is the emergency eye wash station/shower being inspected weekly, and is the inspection documented?
Part 10: Equipment/Machines & Hand Tools
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Does observed equipment/machines appear to be in safe operating condition, and is PPE readily accessible?
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Are electrical, rotating, or moving parts on equipment/machines guarded to prevent physical contact?
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Are emergency stop buttons colored red?
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Are warning labels and signs in place?
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Machine keys assessed and marked to show approval for use? (i.e. green key)
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Are tool chuck keys spring loaded to prevent being left in the tool?
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Machines designed for fixed location are secured to prevent toppling or movement?
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Presence sensing device and interlocks verified to proper working condition on wood panel saw test equipment?
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Only OSHA approved nozzles used on compressed air hose? (limits air pressure to <30 psi)
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Are grinders properly adjusted (work rest within 1/8" of the wheel, tongue guard within 1/4" of the wheel)?
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Are grinding wheels subject to a ring test before being mounted, and is the test documented?
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All MAE has been reviewed and released for operation? (Marked with green sticker)
Part 11: Hazard Communication
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Is there a readily accessible SDS for all of the hazardous chemicals used in the facility?
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Is the SDS binder audited on an annual basis and is the audit documented?
Part 12: Hazardous Material
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Are all chemical containers properly labeled?
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Are waste containers properly marked and stored closed?
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Are all liquid hazardous material boxes being stored at the correct orientation according to the orientation arrows at all times?
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Flammable storage cabinets kept locked?
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Spill containment provided for chemical and waste containers?
Part 13: Electrical Safety
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Is there adequate space provided and maintained around all electrical equipment (depth=42", width=30", or width of the equipment (whichever is greater), height=6.5')?
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Are the tops of electrical boxes, service panels, and transformers free of materials?
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Are unused openings in electrical enclosures and fittings enclosed with appropriate covers, plugs, and/or plates?
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Are electrical box covers permanently marked "ARC FLASH", and is the marking visible and legible?
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Less than 50 volts labeling shall be on electrical panels or disconnects with systems below 50 volts.
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Is electrical equipment grounded?
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Are extension cords being used for their designated purpose as temporary wiring and not as permanent wiring?
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Are extension cords connected to GFCI?
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Electrical disconnect doors secured to prevent opening the panel without use of a tool?
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Are electrical cords spliced together with wire nuts, not tape?
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Are there any exposed wires or cords with frayed or deteriorated insulation?
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Is there tension relief on flexible electrical cords?
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Is the Energized Electrical Work Permit being used whenever work is performed on energized electrical equipment?
Part 14: Stormwater - No Exposure
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Outdoor areas clean and cleared of debris?
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Material placed outdoors covered to prevent contact with storm water?
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Outdoor areas free of any visual deposits of residue?
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Empty containers are stored so storm water is not collecting inside?
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Activities are not occurring outside that could cause runoff on the ground and stormwater? (Cleaning or storing equipment outdoors)
Part 15: Confined Space
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Confined spaces are marked?
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Confined space procedures being followed?