Gallatin Campus Monthly Safety Audit Template

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Emergency Exits/Routes, Fire Extinguishers, Sprinklers

• Are facility emergency escape route assignments posted where appropriate?

  Safe

  At Risk

  N/A

• Are sprinkler heads protected by guards when exposed to physical damage?

  Safe

  At Risk

  N/A

• Is proper clearance maintained below sprinkler heads?

  Safe

  At Risk

  N/A

• Are portable fire extinguishers provided in adequote number and type? Are they mounted in easily accessible locations?

  Safe

  At Risk

  N/A

• Are extinguishers serviced, maintained and tagged at intervals not to exceed one year?

  Safe

  At Risk

  N/A

• Are extinguishers free from obstructions or blockage?

  Safe

  At Risk

  N/A

• Are all extinguishers inspected monthly and found to be fully charged?

  Safe

  At Risk

  N/A

• Does the department control the accumulation of flammable and combustible waste/materials so they do not contribute to a fire emergency?

  Safe

  At Risk

  N/A

• Are all exit routes free from obstruction?

  Safe

  At Risk

  N/A

• Are the directions to exits, when not immediately apparent, marked with visible signs?

  Safe

  At Risk

  N/A

• Are all doors that could be confused for an exit marked with a sign indicating "NOT AN EXIT", "BASEMENT", or similar?

  Safe

  At Risk

  N/A

• Are all exits marked with an exit sign and illuminated by a reliable light source?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Voluntary Use of Respirators

• Are all respirators provided by the facility, or allowed onsite by associates, NIOSH approved N95 filtering face pieces?

  Safe

  At Risk

  N/A

• Are respirators stored properly in the workplace (not hanging in the open to collect dust, in lockers, etc.)?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Confined Space

• Are all permit required confined spaces posted with appropriate signs?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Bloodborne Pathogens

• Inspect Tagging Gun Stations. Ensure cabinet is locked. Once opened, ensure guns are numbered and in appropriate holders without needles. Sanicaps and a sharps container should be available. Inspect the sign in/out log to ensure compliance.

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Noise Exposure

• Is hearing protection available to all associates working in an area designated as a high noise/hearing protection required area?

  Safe

  At Risk

  N/A

• Are associates wearing hearing protection if they are working in an area designated as a high noise/hearing protection required area? Are associates wearing the hearing protection properly? Audit a minimum of 5 associates.

  Safe

  At Risk

  N/A

• Is the use of hearing protection enforced by leadership in areas designated as high noise/hearing protection required areas?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Lock Out/Tag Out

• If Lock Out/Tag Out is observed, were all proper procedures followed by associate personnel (do not bypass or remove) and maintenance associates (apply locks, de-energize, test, etc.)?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Machine Guarding

• Are guards in place and not easily removed? If netting is used, are all gaps closed?

  Safe

  At Risk

  N/A

• Are spindle caps/covers in place where appropriate?

  Safe

  At Risk

  N/A

• Is there a powered shut off within reach of the operator's position at each machine (i.e. induction stations, unloaders, etc.)

  Safe

  At Risk

  N/A

• Are foot operated switches/pedals guarded or arranged to prevent accidental actuatuion by personnel or falling objects (i.e. TDC Induction stations)

  Safe

  At Risk

  N/A

• Are all emergency stop buttons colored red?

  Safe

  At Risk

  N/A

• Are E-stop push buttons or cords present where appropriate? Are the cords tight and without excessive slack? Are the push buttons and/or cords free from damage? Are the cords accessible?

  Safe

  At Risk

  N/A

• Is the point of operation guarded on machines whose operation exposes an associates to injury? Is the guard designed and constructed to prevent the operator from having any part of their body in the danger zone during the operating cycle?

  Safe

  At Risk

  N/A

• Have fan blades less than 7 feet above the work station been guarded? Are the fan guards provided with openings no bigger than one-half inch?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Conveyors

• Are all rollers in place and no large gaps are present?

  Safe

  At Risk

  N/A

• Are e-stop cords accessible and not blocked by boxes, carts, etc?

  Safe

  At Risk

  N/A

• Is there any visible damage to the conveyor?

  Safe

  At Risk

  N/A

• If pass through gates are present, do they function well, are all parts attached and secure, and do the lock/secure in place?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Working/Walking Surfaces

• Are working/walking surfaces kept clean and dry?

  Safe

  At Risk

  N/A

• Are holes found in any working/walking surface? If yes, provide work order number for repair.

  Safe

  At Risk

  N/A

• Is there safe clearance for walking in aisles where motorized or mechanical handling equipment is operating?

  Safe

  At Risk

  N/A

• Are materials or equipment stored in such a way that sharp projections will not interfere with the walkway?

  Safe

  At Risk

  N/A

• Are changes of direction or elevation readily identifiable?

  Safe

  At Risk

  N/A

• Are aisles or walkways that pass near moving or operating machinery, welding, operations, or similar hazards arranged so associates will not be injured?

  Safe

  At Risk

  N/A

• Is there adequate head room provided for the entire length of any aisle or walkway?

  Safe

  At Risk

  N/A

• Are standard guardrails provided wherever aisle or walkway surfaces are elevated more than 30 inches above any adjacent floor on the ground?

  Safe

  At Risk

  N/A

• Are signs posted, where appropiate, showing the elevated surface load capacity?

  Safe

  At Risk

  N/A

• Are standard guardrails used to protect any time there are floor changes of 4 feet or more or where hazards exist at the bottom (equipment, electrical, etc.)?

  Safe

  At Risk

  N/A

• Are all elevated surfaces (beneath which people or machinery could be exposed to falling objects) provided with standard 4 inch toe boards?

  Safe

  At Risk

  N/A

• Are bridges (cross overs) provided over conveyors and similar hazards?

  Safe

  At Risk

  N/A

• Are all ladder openings protected by swing gates or so offset that a person cannot walk off?

  Safe

  At Risk

  N/A

• Are standard handrails and toe boards used to protect all open sides of work platforms four feet from the floor?

  Safe

  At Risk

  N/A

• Are standard stair rails or handrails on all stairways having 4 or more risers?

  Safe

  At Risk

  N/A

• Are steps on stairs and/or step stools designed to provide a surface that renders them slip resistent? Do all step stools and cotterman style ladders have required rubber feet on each corner/leg as required?

  Safe

  At Risk

  N/A

• Are all ladders maintained in good condition, joints between steps and side rails tight, all hardware and fittings securely attached and moveable parts operating freely without binding or undue play?

  Safe

  At Risk

  N/A

• Are ladders that are not in use, stored horizontally or chained/latched to a fixed object?

  Safe

  At Risk

  N/A

• Are ladders being used by one person at a time?

  Safe

  At Risk

  N/A

• Are portable metal ladders legibly marked with signs reading "CAUTION - Do Not Use Around Electrical Equipment" or equivalent wording?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Powered Industrial Vehicles

• Are drivers operating PIV's in a safe and efficient manner? (i.e. stopping fully at all stop signs/ends of BSL aisles, sounding horn, etc)

  Safe

  At Risk

  N/A

• Are associates completing PIV Pre-Operation Log books correctly? Inspect a minimum of 5 books.

  Safe

  At Risk

  N/A

• Is the driver wearing appropriate PPE if required? (i.e. Harness, tether, seat belt, etc.)

  Safe

  At Risk

  N/A

• If driver is wearing a harness, is it being worn appropriately? (i.e. leg straps tight and not hanging down, chest strap tight and at appropriate height, etc.) Inspect a minimum of 5 drivers with harnesses on.

  Safe

  At Risk

  N/A

• If driver has a visible license, inspect it for accuracy (i.e. authorization to drive equipment, corrective lenses needed, current license/not expired, etc.)

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Hazard Communication

• Inspect chemical storage areas. Ensure chemicals are stored properly and there is no food/drink present in the area.

  Safe

  At Risk

  N/A

• Verify SDS are available and current for a minimum of 5 chemicals (if applicable).

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Personal Protective Equipment

• Is PPE required for the job task (not applicable to PIV)? If yes, is the associate wearing the PPE and are they wearing it appropriately. Is the PPE in good condition and free from damage and/or excessive wear?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Electrical Safety

• Are there no examples of extension cords or power strips series connected (daisy chain) and are all extension cords directly connected to a permanently installed branch circuit receptacle?

  Safe

  At Risk

  N/A

• Is the working space around electrical panels maintained and not used for storage or work areas?

  Safe

  At Risk

  N/A

• Flexible cords (extension cords) are not used as a substitute for fixed wiring (not to exceed 90 days or when project is completed)?

  Safe

  At Risk

  N/A

• Are flexible cords and cables protected from accidental damage (i.e. sharp corners, projections, and doorways or other pinch points)

  Safe

  At Risk

  N/A

• Are all unused openings (including conduit knockouts) in electrical enclosures and fittings closed with appropriate covers, plugs, or plates?

  Safe

  At Risk

  N/A

• Are flexible cords and cables free of splice or taps?

  Safe

  At Risk

  N/A

• Are all opening in junction boxes and outlets sealed?

  Safe

  At Risk

  N/A

• Do all cords have the ground prong in place?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Inbound/Receiving

• Pallet boards stacked in stable manner and no more than 25 high? Skids stacked in a stable manner and no more than 10 high? No plastic pallets?

  Safe

  At Risk

  N/A

• Are printer covers closed?

  Safe

  At Risk

  N/A

• Are items, other than boxes, lying on conveyors (i.e. paperwork, water bottles, RF guns, etc.)?

  Safe

  At Risk

  N/A

• Are all fans functional and are wires without cuts/abrasion?

  Safe

  At Risk

  N/A

• Are all trailer lights functional? Are they being used as appropriate?

  Safe

  At Risk

  N/A

• For active doors, are the trailers locked in using the dock lock mechanism? If not, has an alternate means been put in place to ensure the trailer is secure?

  Safe

  At Risk

  N/A

• Are unloaders being used appropriately (i.e. raised/lowered to assist with lifting, extended into trailer, retracted from trailer, etc.)?

  Safe

  At Risk

  N/A

• Is trash overflowing, debris in and around dock doors/palletization lanes, load locks leaning between doors, etc?

  Safe

  At Risk

  N/A

• Are all dock lock, e-stop, etc indicator lights functioning properly?

  Safe

  At Risk

  N/A

• Are skate rails in good repair? Bump guards are in place?

  Safe

  At Risk

  N/A

• Is lighting in the area sufficient? Are there blown or missing bulbs from fixtures?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Multifunction

• Inspect tagging gun station. Is it locked? Are guns numbered, in appropriate holders and stored without needles? Sanicaps available? Sharps container available and being used? Sign in/out log completed correctly?

  Safe

  At Risk

  N/A

• Are work areas clean and neat? Is trash over flowing, labels on the floor, etc.?

  Safe

  At Risk

  N/A

• If tagging guns are being used, are associates maintining positive control of the guns at all times? Are they ensuring no one else is using their gun (no sharing)?

  Safe

  At Risk

  N/A

• If applicable, are fans operational, guards in place, and cords in good repair?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

SDC Only - Inbound ASRS and Residual ASRS

• Is Inbound ASRS Trouble Lane clean and free of debris on the floor? Is trash over flowing?

  Safe

  At Risk

  N/A

• Is Inbound ASRS palletization area clean and free of debris on the floor? Is trash over flowing?

  Safe

  At Risk

  N/A

• Inbound ASRS and/or Residual ASRS - are personal items lying on any conveyor (powered or non-powered)?

  Safe

  At Risk

  N/A

• Inbouns ASRS and/or Residual ASRS - are printer covers in place?

  Safe

  At Risk

  N/A

• Residual ASRS - All work areas clean, neat and free of debris on the floor and surrounding area? Is trash overflowing?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

SCD Palletization

• Area is clean and free of debris on the floor? Is trash overflowing?

  Safe

  At Risk

  N/A

• Are the brakes on descending conveyors functioning correctly?

  Safe

  At Risk

  N/A

• Are banger boards functioning and in good repair?

  Safe

  At Risk

  N/A

• Are all skate rails in good repair? Bump guards present if applicable?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Stocking - Throw On Areas

• Is area clean and free of debris from the floor? Is trash overflowing?

  Safe

  At Risk

  N/A

• Are pallet boards being stacked in a safe, stable manner, and no more than 25 high?

  Safe

  At Risk

  N/A

• Are lift tables being used properly?

  Safe

  At Risk

  N/A

• Are approved knives being used and appropriate cutting techniques being displayed?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

PIV Inspection

• Has inspection been completed and documented?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Harness Inspection

• Has inspection been completed and documented?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

SCD Depal

• Is area clean, neat, and free of debris? Is trash overlfowing?

  Safe

  At Risk

  N/A

• Are skate rails in good working order and are bump guards present if applicable?

  Safe

  At Risk

  N/A

• Are pallet boards stacked neat, stable, and no more than 25 high?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Put-to-store (PTS)

• Are all PTS areas neat, clean and without large amounts of debris on the floor? Is trash overflowing?

  Safe

  At Risk

  N/A

• Are boxes or other material being stored under powered conveyor?

  Safe

  At Risk

  N/A

• Are walkways and egress areas clear and free from trip hazards?

  Safe

  At Risk

  N/A

• Are pallet boards stacked neat, stable, and no more than 25 high?

  Safe

  At Risk

  N/A

• Are floor fans located out of the walkway so as to not create a trip hazard? Are cords out of the walkway? Are cords free from cuts/abrasions and are ground prongs entact?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

QA

• Is the QA area clean, neat, and free from large amounts of debris? Is trash overflowing?

  Safe

  At Risk

  N/A

• Are work stations in good working order (i.e. power supply for laptop's, lights working, etc.)?

  Safe

  At Risk

  N/A

• Are floor fans located out of the walkway so as to not create a trip hazard? Are cords out of the walkway? Are cords free from cuts/abrasions and are ground prongs entact

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Manual Picking

• Are manual picking areas neat, clean, and free of large amounts of debris? Is trash overflowing?

  Safe

  At Risk

  N/A

• Are cartons sticking out into the walkways?

  Safe

  At Risk

  N/A

• Are carts stored in such a manner as to prevent blocking egress areas? Are they stored in areas that create blind spots and prevent associates from seeing them?

  Safe

  At Risk

  N/A

• Are cartons, other materials, dirt/debris under powered conveyors?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Sorters

• Are closing areas neat, clean, and free of large amounts of debris?

  Safe

  At Risk

  N/A

• Are induction stations neat, clean and free of large amounts of debris?

  Safe

  At Risk

  N/A

• Are jam poles stored properly and not left in walkways, on stairs, etc?

  Safe

  At Risk

  N/A

• Are tape and/or label rolls (empty, partial, or full) lying on the ground in closing or on induction platforms?

  Safe

  At Risk

  N/A

• Are walkways and work area egress points clear?

  Safe

  At Risk

  N/A

• Do label printers at the RTA areas have covers in the proper operating position?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Shipping

• Is the area neat, clean, and free from large amounts of debris? Are load locks, broken pallet pieces, etc. stored between dock doors? Are trash cans overflowing?

  Safe

  At Risk

  N/A

• Are skids stacked in an area that keeps the walkway/drive path clear and are stacked no more than 10 high?

  Safe

  At Risk

  N/A

• Are staged pallets stored on the shipping dock in such a manner as to allow safe entry/exit in an emergency?

  Safe

  At Risk

  N/A

• Are all fans functional and wires are without cuts/abrasions?

  Safe

  At Risk

  N/A

• Are all trailer lights functional. Are they being used as appropriate?

  Safe

  At Risk

  N/A

• For active doors, are the trailers locked in using the dock lock mechanism? If not, has an alternate means been put into place to ensure th trailer is secure?

  Safe

  At Risk

  N/A

• Are step stools being used? Do they have rubber feet in all corners and no slip stepping/standing surfaces?

  Safe

  At Risk

  N/A

• Are function controls on fluid loaders working, to include the e-stop bar?

  Safe

  At Risk

  N/A

• Are all dock lock, e-stop, etc indicator lights functioning properly?

  Safe

  At Risk

  N/A

• Are skate rails, if applicable, in good repair?

  Safe

  At Risk

  N/A

• Is lighting in the area sufficient? Are there blown or missing bulbs from fixtures?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Maintenance - Shops and Storage Areas

• Are areas clean, neat, and free of debris?

  Safe

  At Risk

  N/A

• Is appropriate PPE available, in good condition, and being used as required?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Merge

• Are areas clean, neat, and free of debris?

  Safe

  At Risk

  N/A

• Are loose rollers lying in or on cat walk areas or other walking/working surfaces?

  Safe

  At Risk

  N/A

• Are items being stored under powered conveyors (i.e. jam poles, boxes, supplies, etc.)?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Trash/Baler Room

• Is area clean, neat, and free from debris?

  Safe

  At Risk

  N/A

• Are trash, corrugate, plastics, etc. bins empty and not piled up and stored in and outside of the trash/baler room?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Trouble Lane, Box Maker, and Recycle Center

• Are areas clean, neat, and free of debris?

  Safe

  At Risk

  N/A

• Is corrugate stored so that it does not block walkways, egress, or present trip hazards? Are binding straps removed and disposed of and not left lying in the floor?

  Safe

  At Risk

  N/A

• Are associates correctly wearing PPE if required? (Box maker operators are required to wear safety glasses and gloves when working within 36" of the box making machine. This includes loading boxes, machine adjustments, changing tape, etc. Some locations require hearing protection as well.)

  Safe

  At Risk

  N/A

• If tugger and/or sitdown/dock stocker are being used, has the equipment been properly signed out?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Office and Break Areas

• Are areas neat and clean? Is trash overflowing? Are there large accumulations of supplies (i.e. paper, paper products, cups, etc.)

  Safe

  At Risk

  N/A

• Are walkpaths kept clear at all times?

  Safe

  At Risk

  N/A

• Is there any open food/drink stored in the refridgerators?

  Safe

  At Risk

  N/A

• Any signs of bugs, rodents, etc.?

  Safe

  At Risk

  N/A

• Are there any other callouts not already listed in this section?

  Safe

  At Risk

  N/A

Associate Observations

• Are associates exhibiting good material handling practices (i.e. safe lifting, safe cutting, etc.)?

  Safe

  At Risk

  N/A

• Are drivers displaying safe driving techniques (i.e. sounding horn, stopping at stop signs, etc.)?

  Safe

  At Risk

  N/A

• If drivers observed, check a minimum of 3 PIV Pre-Operation Inspection Books. Are these completed correctly for the current operator as well as others?

  Safe

  At Risk

  N/A

• Are associates in the area being audited following all safety trainings and protocol? To include, but not limited to, hair, jewelry, shoes, cell phone, PPE, etc?

  Safe

  At Risk

  N/A

• Any other callouts not previously listed in any other section?

  Safe

  At Risk

  N/A

• Safety Supervisor

  Sign

• Supervisor

  Sign

• Manager

  Sign

• Maintenance Supervisor

  Sign

• Maintenance Manager

  Sign