Information
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Audit Title
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Client / Site
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Conducted on
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Prepared by
Office
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Does this location have a "manned" office?
Safety Plans/Documentation
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There is a readily available site specific Emergency Action Plan.
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Observation
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Corrected By and Date Corrected:
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There is a readily available proof of training (sign in sheet, meeting minutes, etc...) regarding the information in the Emergency Action Plan.
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Observation
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Corrected By and Date Corrected:
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There is random proof of knowledge regarding the information in the Emergency Action Plan.
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Observation
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Corrected By and Date Corrected:
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The safety board is readily available to all employees and appears to meet company standards for content and compliance.
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Observation
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Corrected By and Date Corrected:
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The first aid kit and related supplies is readily available to all employees and appears to meet company standards for content and compliance.
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Observation
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Corrected By and Date Corrected:
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There is a plan in place to ensure all forklift operators have been adequately trained, evaluated, and certified.
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Observation
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Corrected By and Date Corrected:
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There is a site specific LOTO program, appropriate equipment, and proof of training/review.
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Observation
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Corrected By and Date Corrected:
Fire Extinguishers
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Fire extinguishers are hung properly.
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Observation
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Corrected By and Date Corrected:
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Monthly inspections have been properly documented.
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Observation
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Corrected By and Date Corrected:
Other Concerns
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Electrical breakers are properly labeled.
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Observation
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Corrected By and Date Corrected:
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Exits and non-exits are labeled properly.
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Observation
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Corrected By and Date Corrected:
Additional Safety Issues
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If this box is not checked you have the following additional concerns to address:
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Observation
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Corrected By and Date Corrected:
Shop
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Does this location have a shop?
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Does this facility have used oil?
Used Oil
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Used oil is properly labeled.
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Observation
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Corrected By and Date Corrected:
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Used oil is stored in proper receptacle.
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Observation
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Corrected By and Date Corrected:
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Proper disposal information is posted/available.
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Observation
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Corrected By and Date Corrected:
Fire Extinguishers
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Fire extinguishers are hung properly.
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Observation
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Corrected By and Date Corrected:
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Monthly inspections have been properly documented.
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Observation
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Corrected By and Date Corrected:
Guarding
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Does this area have equipment requiring a 6 sided guard?
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6 sided guards are complete and installed properly.
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Observation
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Corrected By and Date Corrected:
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Does this area have a bench grinder?
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Guards on grinder are set properly. 1/4" Tongue and 1/8" Rest
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Observation
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Corrected By and Date Corrected:
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Does this area have any other machines requiring guards?
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Guards on other machines are set properly.
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Observation
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Corrected By and Date Corrected:
Signage
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Are there areas requiring eye protection?
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Appropriate eye protection warning signs are posted.
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Observation
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Corrected By and Date Corrected:
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Exits and Non-Exits are properly labeled.
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Observation
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Corrected By and Date Corrected:
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Proper and adequate eyewash is available.
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Observation
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Corrected By and Date Corrected:
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Does this area have electrical overhead doors?
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All overhead doors have proper and adequate crush protection. (Sign or Photo Eyes)
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Observation
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Corrected By and Date Corrected:
Other Concerns
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Electrical breakers are properly labeled.
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Observation
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Corrected By and Date Corrected:
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Does this area have shelving and storage?
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Shelving and storage is properly anchored.
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Observation
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Corrected By and Date Corrected:
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Combustible materials/trash are in a steel can with lid.
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Observation
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Corrected By and Date Corrected:
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The general cleanliness of this area promotes prevention of slips, trips, and falls.
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Observation
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Corrected By and Date Corrected:
Additional Safety Issues
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If this box is not checked you have the following additional concerns to address:
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Observation
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Corrected By and Date Corrected:
Liquid Operations
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Does this location have Liquid Operations?
General
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Tanks and their contents are properly labeled.
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Observation
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Corrected By and Date Corrected:
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Does this facility have elevated walkways and/or platforms?
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Access to elevated walkways, platforms, and tanks is controlled to industry standards.
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Observation
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Corrected By and Date Corrected:
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Elevated walkways and platforms are constructed to industry standards.
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Observation
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Corrected By and Date Corrected:
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Adequate measures have been taken to provide site security.
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Observation
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Corrected By and Date Corrected:
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Containment structures are in good repair and appear to be functioning properly.
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Observation
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Corrected By and Date Corrected:
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There is a proper and adequate eyewash/safety shower station located on site.
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Observation
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Corrected By and Date Corrected:
Signage
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Exits and Non-Exits are properly labeled.
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Observation
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Corrected By and Date Corrected:
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Proper and adequate warning signs have been posted.
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Observation
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Corrected By and Date Corrected:
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Does this facility have electrical overhead doors?
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All overhead doors have proper and adequate crush protection. (Sign or Photo Eyes)
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Observation
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Corrected By and Date Corrected:
Fire Extinguishers
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Is this facility required to have a fire extinguisher?
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Fire extinguishers are hung properly.
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Observation
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Corrected By and Date Corrected:
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Monthly inspections have been properly documented.
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Observation
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Corrected By and Date Corrected:
Other Concerns
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Electrical breakers are properly labeled.
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Observation
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Corrected By and Date Corrected:
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Does this facility have shelving and storage?
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Shelving and storage is properly anchored.
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Observation
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Corrected By and Date Corrected:
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The general cleanliness of this area promotes prevention of slips, trips, and falls.
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Observation
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Corrected By and Date Corrected:
Additional Safety Issues
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If this box is not checked you have the following additional concerns to address:
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Observation
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Corrected By and Date Corrected:
Dry Operations
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Does this location have Dry Operations?
General
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The contents of all bins are properly labeled.
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Observation
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Corrected By and Date Corrected:
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Does this facility have elevated walkways and platforms?
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Access to elevated walkways and platforms is controlled to industry standards.
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Observation
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Corrected By and Date Corrected:
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Elevated walkways and platforms are constructed to industry standards.
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Observation
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Corrected By and Date Corrected:
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Adequate measures have been taken to provide site security.
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Observation
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Corrected By and Date Corrected:
Signage
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Exits and Non-Exits are properly labeled.
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Observation
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Corrected By and Date Corrected:
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Proper and adequate signage has been posted.
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Observation
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Corrected By and Date Corrected:
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Does this facility have electrical overhead doors?
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All overhead doors have proper and adequate crush protection. (Sign or Photo Eyes)
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Observation
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Corrected By and Date Corrected:
Guarding
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6 sided guards are complete and have been installed properly.
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Observation
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Corrected By and Date Corrected:
Fire Extinguishers
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Fire extinguishers are hung properly.
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Observation
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Corrected By and Date Corrected:
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Monthly inspections have been properly documented.
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Observation
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Corrected By and Date Corrected:
Other Concerns
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Electrical breakers are properly labeled.
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Observation
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Corrected By and Date Corrected:
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The general cleanliness of this area promotes prevention of slips, trips, and falls.
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Observation
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Corrected By and Date Corrected:
Additional Safety Issues
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If this box is not checked you have the following additional concerns to address:
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Observation
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Corrected By and Date Corrected:
Chemical Warehouse, Seed Storage, Treatment
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Does this location have a Chemical Warehouse, Seed Storage, Treatment area?
Signage
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Exits and Non-Exits are properly labeled.
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Observation
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Corrected By and Date Corrected:
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Proper and adequate warning signs have been posted.
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Observation
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Corrected By and Date Corrected:
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Does this facility have electrical overhead doors?
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All overhead doors have proper and adequate crush protection. (Sign or Photo Eyes)
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Observation
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Corrected By and Date Corrected:
Guarding
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Does this facility have equipment requiring 6 sided guards?
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6 sided guards are complete and installed properly.
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Observation
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Corrected By and Date Corrected:
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Does this facility have other equipment requiring guards?
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Other guards are complete and installed properly.
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Observation
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Corrected By and Date Corrected:
Fire Extinguishers
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Fire extinguishers are hung properly.
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Observation
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Corrected By and Date Corrected:
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Monthly inspections have been properly documented.
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Observation
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Corrected By and Date Corrected:
Other Concerns
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Electrical breakers are properly labeled.
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Observation
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Corrected By and Date Corrected:
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Does this facility have shelving and storage?
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Shelving and storage is properly anchored to floor or wall.
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Observation
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Corrected By and Date Corrected:
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The general cleanliness of this area promotes prevention of slips, trips, and falls.
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Observation
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Corrected By and Date Corrected:
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Adequate measures have been taken to provide site security.
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Observation
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Corrected By and Date Corrected:
Additional Safety Issues
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If this box is not checked you have the following additional concerns to address:
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Observation
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Corrected By and Date Corrected:
Grain Operations
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Does this location have Grain Operations?
Grain Storage
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Adequate and proper crash protection is installed as necessary.
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Observation
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Corrected By and Date Corrected:
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Adequate measures have been taken to provide site security.
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Observation
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Corrected By and Date Corrected:
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All guarding is installed, intact, and appears to be appropriately effective.
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Observation
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Corrected By and Date Corrected:
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Elevated walking/working surfaces are constructed to industry standards.
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Observation
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Corrected By and Date Corrected:
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Confined spaces and other potentially dangerous environments are marked according to company policy.
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Observation
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Corrected By and Date Corrected:
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The general cleanliness of working areas promotes, prevention of slips, trips, and falls.
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Observation
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Corrected By and Date Corrected:
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Energy sources are properly labeled and accounted for during operations as well as shutdown.
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Observation
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Corrected By and Date Corrected:
Grain Legs, Augers, Conveyors
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Adequate and proper crash protection is installed as necessary.
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Observation
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Corrected By and Date Corrected:
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Adequate measures have been taken to provide site security.
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Observation
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Corrected By and Date Corrected:
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All guarding is installed, intact, and appears to be appropriately effective.
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Observation
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Corrected By and Date Corrected:
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Elevated walking/working surfaces are constructed to industry standards.
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Observation
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Corrected By and Date Corrected:
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Confined spaces and other potentially dangerous environments are marked according to company policy.
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Observation
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Corrected By and Date Corrected:
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The general cleanliness of working areas promotes, prevention of slips, trips, and falls.
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Observation
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Corrected By and Date Corrected:
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Energy sources are properly labeled and accounted for during operations as well as shutdown.
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Observation
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Corrected By and Date Corrected:
Grain Pits
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Adequate and proper crash protection is installed as necessary.
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Observation
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Corrected By and Date Corrected:
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Adequate measures have been taken to provide site security.
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Observation
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Corrected By and Date Corrected:
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All guarding is installed, intact, and appears to be appropriately effective.
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Observation
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Corrected By and Date Corrected:
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Elevated walking/working surfaces are constructed to industry standards.
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Add media
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Observation
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Corrected By and Date Corrected:
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Confined spaces and other potentially dangerous environments are marked according to company policy.
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Add media
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Observation
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Corrected By and Date Corrected:
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The general cleanliness of working areas promotes, prevention of slips, trips, and falls.
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Add media
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Observation
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Corrected By and Date Corrected:
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Energy sources are properly labeled and accounted for during operations as well as shutdown.
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Observation
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Corrected By and Date Corrected:
Grain Dryers
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Adequate and proper crash protection is installed as necessary.
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Observation
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Corrected By and Date Corrected:
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Adequate measures have been taken to provide site security.
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Add media
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Observation
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Corrected By and Date Corrected:
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All guarding is installed, intact, and appears to be appropriately effective.
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Observation
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Corrected By and Date Corrected:
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Elevated walking/working surfaces are constructed to industry standards.
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Add media
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Observation
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Corrected By and Date Corrected:
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Confined spaces and other potentially dangerous environments are marked according to company policy.
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Add media
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Observation
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Corrected By and Date Corrected:
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The general cleanliness of working areas promotes, prevention of slips, trips, and falls.
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Add media
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Observation
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Corrected By and Date Corrected:
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Energy sources are properly labeled and accounted for during operations as well as shutdown.
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Observation
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Corrected By and Date Corrected:
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Does this facility have railroad operations?
Railroad Loadout
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Adequate measures have been taken to provide site security.
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Observation
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Corrected By and Date Corrected:
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All guarding is installed, intact, and appears to be appropriately effective.
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Observation
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Corrected By and Date Corrected:
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Elevated walking/working surfaces are constructed to industry standards.
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Add media
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Observation
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Corrected By and Date Corrected:
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Confined spaces and other potentially dangerous environments are marked according to company policy.
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Add media
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Observation
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Corrected By and Date Corrected:
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The general cleanliness of working areas promotes, prevention of slips, trips, and falls.
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Add media
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Observation
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Corrected By and Date Corrected:
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Energy sources are properly labeled and accounted for during operations as well as shutdown.
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Add media
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Observation
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Corrected By and Date Corrected:
Other Concerns
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Additional Safety Issues
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If this box is not checked you have the following additional concerns to address:
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Add media
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Observation
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Corrected By and Date Corrected:
LP Operations
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Does this location have LP Operations?
General
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Adequate and proper crash protection is installed.
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Observation
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Corrected By and Date Corrected:
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Adequate measures have been taken to provide site security.
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Observation
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Corrected By and Date Corrected:
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Tank is properly labeled.
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Observation
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Corrected By and Date Corrected:
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Emergency shutdowns are properly labeled and in working order.
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Observation
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Corrected By and Date Corrected:
Guarding
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6 sided guards are complete and properly installed.
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Observation
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Corrected By and Date Corrected:
Fire Extinguishers
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Fire extinguishers are hung properly.
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Observation
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Corrected By and Date Corrected:
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Monthly inspections have been properly documented.
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Observation
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Corrected By and Date Corrected:
Other Concerns
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Electrical breakers are properly labeled.
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Observation
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Corrected By and Date Corrected:
Additional Safety Issues
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If this box is not checked you have the following additional concerns to address:
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Observation
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Corrected By and Date Corrected:
Bulk Fuel Operations
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Does this location have Bulk Fuel Operations?
General
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All tanks are properly and adequately labeled.
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Observation
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Corrected By and Date Corrected:
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All loadout racks are constructed and maintained to industry standards.
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Observation
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Corrected By and Date Corrected:
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Adequate measures have been taken to provide site security.
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Observation
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Corrected By and Date Corrected:
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Means of containment are in good repair and appear to be working properly.
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Observation
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Corrected By and Date Corrected:
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Proper and adequate crash protection is installed to industry standards.
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Observation
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Corrected By and Date Corrected:
Fire Extinguishers
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Fire extinguishers are hung properly.
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Observation
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Corrected By and Date Corrected:
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Monthly inspections have been properly documented.
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Observation
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Corrected By and Date Corrected:
Other Concerns
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Electrical breakers are properly labeled.
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Observation
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Corrected By and Date Corrected:
Additional Safety Issues
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If this box is not checked you have the following additional concerns to address:
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Observation
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Corrected By and Date Corrected:
911 Information
Contact Information
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911 contact information sign is up to date.
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Observation
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Corrected By and Date Corrected:
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Non-essential 911 information is updated or removed.
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Observation
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Corrected By and Date Corrected:
Other Concerns
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Additional Safety Issues
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If this box is not checked you have the following additional concerns to address:
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Observation
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Corrected By and Date Corrected:
Forklift
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Does this location have a forklift?
General
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Horn is in working order.
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Observation
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Corrected By and Date Corrected:
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Seatbelt is in working order.
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Observation
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Corrected By and Date Corrected:
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Documented proof of visual inspection is readily available.
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Observation
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Corrected By and Date Corrected:
Other Concerns
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Additional Safety Issues
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If this box is not checked you have the following additional concerns to address:
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Observation
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Corrected By and Date Corrected:
Other Areas
Other Concerns
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Additional Safety Issues
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If this box is not checked you have the following additional concerns to address:
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Observation
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Corrected By and Date Corrected:
Review and Sign
Review and Sign
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Add signature
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Add signature
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Add signature
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Add signature
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Add signature
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