General Industry Safety Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1.0 - Health & Safety Management and Administration- A. - General Safety Policy

• 01.A.01 Does the facility have a written safety and health policy? (If "NO" , then the next two questions should also be scored as "NO".)

  Yes

  No

  N/A

• 01.A.02 Is the safety and health policy statement signed by a senior manager?

  Yes

  No

  N/A

• 01.A.03 Is the safety and health policy statement posted in various locations?

  Yes

  No

  N/A

• 01.A.04 What are your responsibilities under the plant's safety and health program?

  Yes

  No

  N/A

1.0 Health and safety Management and Administration- B. - Program Coordinator

• 01.B.01 Has one person been designated as safety and health coordinator?

  Yes

  No

  N/A

• 01.B.02 Does the safety and health coordinator report directly to a senior manager?

  Yes

  No

  N/A

• 01.B.03 Who is the safety & health coordinator for the plant?

  Yes

  No

  N/A

1.0 Health and Safety Management and Administration - C. - Senior Management Participation.

• 01.C.01 Do the general manager and his staff make documented periodic safety and health inspection System?

  Yes

  No

  N/A

• 01.C.02 Do the general manager and his staff attend safety and health?

  Yes

  No

  N/A

• 01.C.03 Do the general manager and his staff openly demonstrate his support for safety and health programs?

  Yes

  No

  N/A

• 01.C.04 Do the senior manager's direct reports make formal safety and health reviews of their areas of responsibility, at least quarterly?

  Yes

  No

  N/A

• 01.C.05 Do the general manager's direct reports lead at least two meetings each year where safety and health is a major topic?

  Yes

  No

  N/A

1.0 - Health & Safety Management and Administration- D.- Health & Safety Objectives

• 01.D.01 Are safety and health responsibilities clearly defined in written job descriptions?

  Yes

  No

  N/A

• 01.D.02 Are written safety and health performance objectives posted or published annually?

  Yes

  No

  N/A

• 01.D.03 Are these written safety and health performance objectives evaluated, annually?

  Yes

  No

  N/A

• 01.D.04 What are the plants safety goals for this year?

  Yes

  No

  N/A

• 01.D.05 What are the specific safety initiatives for operations employees?

  Yes

  No

  N/A

• 01.D.06 Have managers consistently communicated the safety procedures?

  Yes

  No

  N/A

• 01.D.07 What are the specific safety initiatives for sales employees?

  Yes

  No

  N/A

• 01.D.08 Have managers consistently communicated the safety procedures?

  Yes

  No

  N/A

• 01.D.09 How much time is devoted to safety training/communication in the operations department per month?

  Yes

  No

  N/A

• 01.D.10 How much time is devoted to safety training/communication in the sales department each month?

  Yes

  No

  N/A

• 01.D.11 Detail some of the main safety issues within your job in the operations departments? How are they addressed?

  Yes

  No

  N/A

• 01.D.12 Detail some of the main safety issues within your job in the sales department? How are they addressed?

  Yes

  No

  N/A

1.0 - Health & Safety Management and Administration- E.- Management Controls & Committees

• 01.E.01 Does senior management review the allocation of safety and health resources, annually?

  Yes

  No

  N/A

• 01.E.02 Does the facility have an active safety committee?

  Yes

  No

  N/A

• 01.E.03 Have written rules, responsibilities, structure and function been established for the committee?

  Yes

  No

  N/A

• 01.E.04 Is there a follow up mechanism to ensure that committee recommendations are properly addressed?

  Yes

  No

  N/A

• 01.E.05 Are items discussed at safety committee meetings communicated to all employees?

  Yes

  No

  N/A

• 01.E.06 Who are safety committee members?

  Yes

  No

  N/A

1.0 Health & Safety Management and Administration- F- Group Meetings

• 01.F.01 Do supervisors conduct safety and health group/department meetings with their employee Said?

  Yes

  No

  N/A

• 01.F.02 Is a mechanism in place to ensure the follow up of significant items reported during these safety and health group meetings?

  Yes

  No

  N/A

• 01.F.03 Does the HR manager evaluate the quality of the safety and health group/department meetings, annually?

  Yes

  No

  N/A

• 01.F.04 What safety topics were at the last group/department meeting?

  Yes

  No

  N/A

1.0 Health & Safety Management and Administration- G. - Reference Materials

• 01.G.01 Does the facility have a plant specific safety and health reference manual?

  Yes

  No

  N/A

• 01.G.02 Does the facility have a copy of current applicable government safety and health standards?

  Yes

  No

  N/A

1.0 Health & Safety Management and Administration- H.- General Safety Rules

• 01.H.01 Are there written health and safety rules?

  Yes

  No

  N/A

• 01.H.02 Are these rules reviewed with each employee, annually?

  Yes

  No

  N/A

• 01.H.03 Are these safety rules posted in locations that are easily accessible to all employees?

  Yes

  No

  N/A

• 01.H.04 Are these safety rules evaluated each year to determine their effectiveness and applicability?

  Yes

  No

  N/A

• 01.H.05 Is a written disciplinary policy used as a guide in dealing with violators of safety rules?

  Yes

  No

  N/A

• 01.H.06 Are these policies enforced?

  Yes

  No

  N/A

• 01.H.07 Has anyone been issued formal discipline for safety violations in the last 12 months?

  Yes

  No

  N/A

• 01.H.08 Do you know what the consequences are for violating safety rules?

  Yes

  No

  N/A

1.0 Health & Safety Management and Administration - I.- Job Specific Work Rules

• 01.I.01 Have job specific work rules been developed for all jobs?

  Yes

  No

  N/A

• 01.I.02 Are these rules reviewed with each employee, annually?

  Yes

  No

  N/A

• 01.I.03 Are job specific work rules evaluated and revised when processes and equipment are changed?

  Yes

  No

  N/A

• 01.I.04 What specific safety rules/procedures apply to your job?

  Yes

  No

  N/A

1.0 Health & Safety Management and Administration - J. - General Promotion

• 01.J.01 Is there a mechanism to communicate current safety and health information to all employees?

  Yes

  No

  N/A

• 01.J.02 Is there a safety recognition program?

  Yes

  No

  N/A

2.0 Health & Safety Orientation and Training- B - Employee Job Specific Orientation

• 02.B.01 Is there a written job specific orientation for newly hired, seasonal, transferred and temporary employees?

  Yes

  No

  N/A

• 02.B.02 Are "departmental rules and procedures" included in the job specific orientation?

  Yes

  No

  N/A

• 02.B.03 Is "hazard communication" (SDS) included in the job specific orientation? (29CFR1910.1200(h)(2)(II))

  Yes

  No

  N/A

• 02.B.04 is "hazard awareness and reporting" included in the job specific orientation?

  Yes

  No

  N/A

• 02.B.05 Are "health controls" included in the job specific orientation?

  Yes

  No

  N/A

• 02.B.06 Is "personal protective equipment" included in the job specific orientation?

  Yes

  No

  N/A

• 02.B.07 Is "lockout/tagout for authorized employees included in the job specific orientation?

  Yes

  No

  N/A

• 02.B.08 Are "emergency procedures" included in the job specific orientation?

  Yes

  No

  N/A

• 02.B.09 Is "fire extinguisher awareness" included in the job specific orientation?

  Yes

  No

  N/A

• 02.B.10 Are "mod safety analyses" (JSA's)" included in the job specific orientation?

  Yes

  No

  N/A

• 02.B.11 Is attendance at job specific orientation documented for new, transferred, or temporary employees?

  Yes

  No

  N/A

• 02.B.12 What topics were covered in your job specific safety orientation?

  Yes

  No

  N/A

2.0 - Health & Safety Orientation and Training- C. - Training

• 02.C.01 Has a comprehensive list of safety and health training requirements been developed for all jobs?

  Yes

  No

  N/A

• 02.C.04 Has the training been performed and documented?

  Yes

  No

  N/A

• 02.C.02 Have training programs been established for all identified training needs?

  Yes

  No

  N/A

• 02.C.03 Has the facility developed a training schedule for all identified training needs?

  Yes

  No

  N/A

2.0 - Health & Safety Orientation and Training- D. - Training of Safety Trainers

• 02.D.01 Have the designated safety trainers completed basic safety training courses?

  Yes

  No

  N/A

• 02.D.02 Do the designated safety trainers receive annual refresher trainings?

  Yes

  No

  N/A

3.0 - Health & Safety Inspections and Audits - A. - Safety/Housekeeping Inspections

• 03.A.01 Has an In-house safety inspection process been developed?

  Yes

  No

  N/A

• 03.A.02 Are these inspections conducted at least quarterly?

  Yes

  No

  N/A

• 03.A.03 Is the entire facility included in the inspections?

  Yes

  No

  N/A

• 03.A.04 Is the inspection checklist reviewed and updated?

  Yes

  No

  N/A

• 03.A.05 Are inspection records retained for one year or until all items are corrected, whichever is longer?

  Yes

  No

  N/A

• 03.A.06 Have inspectors received inspection training?

  Yes

  No

  N/A

• 03.A.07 Who conducts safety and health inspections?

  Yes

  No

  N/A

3.0 - Health & Safety Inspections and Audits - B. - Follow-up Procedures

• 03.B.01 Is there an Internal procedure in place that ensures that all problems noted in inspections are corrected?

  Yes

  No

  N/A

• 03.B.02 Is a copy of each inspection report given to the appropriate individual for remedial action?

  Yes

  No

  N/A

• 03.B.03 Does the general manager of his direct reports review the results of safety and health inspections?

  Yes

  No

  N/A

• 03.B.04 How are the results of safety and health inspections communicated to you?

  Yes

  No

  N/A

3.0 Health & Safety Inspections and Audits- C. - Conditions Reporting

• 03.C.01 Is a mechanism in place that gives the employees the opportunity to report hazardous conditions?

  Yes

  No

  N/A

• 03.C.02 How are hazardous condition reports responded to?

  Yes

  No

  N/A

• 03.C.03 How are the hazardous condition reports responded to?

  Yes

  No

  N/A

3.0 Health & Safety Inspections and Audits - D. - Program Monitoring

• 03.D.01 Is the quality of the inspection program evaluated at least annually and the results communicated to the general manager?

  Yes

  No

  N/A

4.0 Health & Safety Accident Investigation & Analysis - A. - Accident Investigation Procedure

• 04.A.01 Is a plant specific written investigation procedure in place?

  Yes

  No

  N/A

• 04.A.02 Is a directive prominently posted requiring employees to immediately report all work related injuries and illnesses?

  Yes

  No

  N/A

• 04.A.03 Is an accident investigation form used?

  Yes

  No

  N/A

• 04.A.04 Does the investigation procedure require the reporting and investigation of "lost time injuries and illnesses" ?

  Yes

  No

  N/A

• 04.A.05 Does the investigation procedure require the reporting and investigation of recordable cases?

  Yes

  No

  N/A

• 04.A.06 Does the investigation procedure require the reporting and investigation of "first aid cases"?

  Yes

  No

  N/A

• 04.A.07 Does the investigation procedure require the reporting and investigation of "near misses"?

  Yes

  No

  N/A

• 04.A.08 Is there a written procedure that ensures remedial actions are carried out as recommended in the accident investigation report?

  Yes

  No

  N/A

• 04.A.09 Have appropriate personnel received training in accident investigation and reporting?

  Yes

  No

  N/A

• 04.A.10 What is the procedure for reporting accidents?

  Yes

  No

  N/A

4.0 - Health & Safety Accident & Analysis - B. - Management Participation

• 04.B.01 Is the senior manager made aware of the progress of corrective actions resulting from accident investigations?

  Yes

  No

  N/A

• 04.B.02 Does the written procedure outline management responsibilities?

  Yes

  No

  N/A

• 04.B.03 How are managers held accountable for properly following investigation reporting forms and procedures?

  Yes

  No

  N/A

• 04.B.04 What is the procedure for reporting accidents?

  Yes

  No

  N/A

4.0 - Health & Safety Accident & Analysis- C. - Communications

• 04.C.01 Are work related accident statistics communicated annually, in writing to senior management, support staff and supervisory level?

  Yes

  No

  N/A

• 04.C.02 Is information regarding a major injury or illness communicated to the entire facility?

  Yes

  No

  N/A

• 04.C.03 What are the safety statistics for your facility?

  Yes

  No

  N/A

4.0 - Health & Safety Accident Investigation & Analysis- D. - Report Maintenance

• 04.D.01 Are records of accident investigation reports maintained at the facility for at least 5 years?

  Yes

  No

  N/A

4.0 - Health & Safety Accident Investigation & Analysis- E. - Program Monitoring

• 04.E.01 Is the accident investigation program evaluated annually and the results reported to senior management?

  Yes

  No

  N/A

4.0 - Health & Safety Accident Investigation & Analysis- F. - Occupational Injury and Illness Trend Analysis

• 04.F.01 Has an injury/illness trend analysis, been conducted within the last 2 years?

  Yes

  No

  N/A

• 04.F.02 Are these injury/illness trend analyses distributed to appropriate personnel?

  Yes

  No

  N/A

• 04.F.03 Have written recommendations from these analyses been developed and acted on?

  Yes

  No

  N/A

5.0 - Health & Safety Hazard Recognition- A.- Job Safety Analysis

• 05.A.01 Has a written plant procedure been developed for job safety analysis?

  Yes

  No

  N/A

• 05.A.02 Have objectives been established for the completion or review of job safety analyses for all job tasks?

  Yes

  No

  N/A

• 05.A.03 Have appropriate personnel received job safety analysis training?

  Yes

  No

  N/A

• 05.A.04 Does each employee receive a formal review of his/her job safety analysis, annually?

  Yes

  No

  N/A

• 05.A.05 Do work procedures incorporate the safety & health controls recommended in the job safety analyses?

  Yes

  No

  N/A

• 05.A.06 Is a review of the job safety analysis included within the accident investigation procedure?

  Yes

  No

  N/A

• 05.A.07 Has your applicable job safety analysis been reviewed with you?

  Yes

  No

  N/A

5.0 - Health & Safety Hazard Recognition- B.- Safety Training & Observation Program

• 05.B.01 Does the facility have a plant specific employee safety & health behavior modification program?

  Yes

  No

  N/A

• 05.B.02 Does the facility have a plant specific written program detailing the implementation and maintenance of employee behavior modification?

  Yes

  No

  N/A

• 05.B.03 Have appropriate individuals received initial employee health & safety behavior modification training?

  Yes

  No

  N/A

• 05.B.04 Is a mechanism in place to track the program to determine significant trends?

  Yes

  No

  N/A

• 05.B.05 Do appropriate personnel comply with the tracking requirements set forth in the facility's written program?

  Yes

  No

  N/A

• 05.B.06 Are employee safety & health behavior modification reviews conducted with report development and follow-up?

  Yes

  No

  N/A

• 05.B.07 Are the results of the reviews communicated to all employees?

  Yes

  No

  N/A

• 05.B.08 What is the main reason for the plant's safety & health behavior modification program?

  Yes

  No

  N/A

6.0 Health & Safety Emergency Preparedness - A.- Leadership & Administration

• 06.A.01 Does the facility have emergency evacuation procedures?

  Yes

  No

  N/A

• 06.A.02 Has a coordinator been appointed to administer the procedures?

  Yes

  No

  N/A

• 06.A.03 Does the coordinator have the appropriate training for the type of emergencies which could occur?

  Yes

  No

  N/A

• 06.A.04 If the facility has chosen to respond to serious emergencies such as large fires and serious chemical spills(as opposed to "notify and evacuate") has an emergency response team been formed?

  Yes

  No

  N/A

• 06.A.05 Has a structured training format been developed, which would include training subjects, procedures and drills? (29CFR1910.38(b)(4)(II))

  Yes

  No

  N/A

• 06.A.06 Is emergency response team training conducted annually for all emergency response team members?

  Yes

  No

  N/A

6.0- Health & Safety Emergency Preparedness- B.- Emergency Plan

• 06.B.01 Has a plant specific emergency plan been developed that addresses all probable emergencies including "fire"? (29CFR1910.38(a)(1))

  Yes

  No

  N/A

• 06.B.02 Has a plant specific written emergency plan been developed, which addresses all probable emergencies including "chemical release"?

  Yes

  No

  N/A

• 06.B.03 Has a plant specific written emergency plan been developed which addresses all probable emergencies including "major medical"? (29CFR1910.38(a)(2Xiv))

  Yes

  No

  N/A

• 06.B.04 Has a plant specific written emergency plan been developed which addresses all probable emergencies including "adverse weather "?

  Yes

  No

  N/A

• 06.B.05 Has a plant specific written emergency plan been developed which addresses all probable emergencies including "plant shutdown"?

  Yes

  No

  N/A

• 06.B.06 Does the emergency plan address the alarm activation procedure?

  Yes

  No

  N/A

• 06.B.07 Does the emergency plan address the evacuation routes? (29CFR1910.38(a)(4))

  Yes

  No

  N/A

• 06.B.08 Does the emergency plan include a description of the system used to alert all personnel for evacuation? (29CFR1910.38(a)(3)(i))

  Yes

  No

  N/A

• 06.B.09 Does the emergency plan include designated rendezvous points during an evacuation? (29CFR.38(a)(2Xiii))

  Yes

  No

  N/A

• 06.B.10 Does the emergency plan address head count procedures during an evacuation? (29CFR1910.38(a)(2)(iii)

  Yes

  No

  N/A

• 06.B.11 Does the emergency plan address all clear and re-entry procedures following an evacuation?

  Yes

  No

  N/A

• 06.B.12 Does the emergency plan address the procedure to to notify emergency response personnel of emergencies and to assign their duties?

  Yes

  No

  N/A

• 06.B.13 Does the emergency plan address the specific actions to be taken in particular areas or departments in the event of procedures, etc...an emergency?

  Yes

  No

  N/A

• 06.B.14 Does the emergency plan address the procedures for the control of potential hazardous material releases? (29CFR 1910.120(q)(1))

  Yes

  No

  N/A

• 06.B.15 Are evacuation routes posted where affected employees will see them?

  Yes

  No

  N/A

• 06.B.16 Are evacuation drills for the entire facility conducted annually?

  Yes

  No

  N/A

• 06.B.17 Are these evacuation drills documented, reviewed and modified, if necessary?

  Yes

  No

  N/A

• 06.B.18 Are local agencies present during the drills to participate in or critique performance?

  Yes

  No

  N/A

• 06.B.19 Has a list been developed of all emergency services and telephone numbers and addresses?

  Yes

  No

  N/A

• 06.B.20 Are emergency service telephone numbers and addresses prominently displayed by all outgoing telephones?

  Yes

  No

  N/A

• 06.B.21 Are functional tests conducted and documented on all emergency lighting systems at 30-day intervals for a minimum of thirty seconds?

  Yes

  No

  N/A

• 06.B.22 Are ninety minute functional tests conducted and documented each year for all required emergency lighting systems?

  Yes

  No

  N/A

• 06.B.23 Are all authorized employees given annual hands-on fire extinguisher training?

  Yes

  No

  N/A

• 06.B.24 What is your primary evacuation route?

  Yes

  No

  N/A

• 06.B.25 Where is your designated meeting place?

  Yes

  No

  N/A

6.0- Health & Safety Emergency Preparedness -C- First Aid

• 06.C.01 Are at least two facility personnel qualified in first aid available during all working hours?

  Yes

  No

  N/A

• 06.C.02 Has an evaluation been made by a qualified individual (i.e.,health care professional) to determine the content of the first aid units?

  Yes

  No

  N/A

• 06.C.03 Who would you contact, and how, in a medical emergency?

  Yes

  No

  N/A

7.0 - Health & Safety Controls -A- Health Hazard Identification

• 07.A.01 Has the facility conducted Industrial Hygiene Surveys? (Chemical exposure, noise hazards, etc.)

  Yes

  No

  N/A

• 07.A.02 What types of surveys/testing have been conducted in your area?

  Yes

  No

  N/A

• 07.A.03 What were the results of surveys/testing?

  Yes

  No

  N/A

7.0 -Health & Safety Controls -B- Health Hazard Control

• 07.B.01 Does the facility have documented industrial hygiene plans and goals to address and control all potential health hazards identified in Industrial Hygiene Survey?

  Yes

  No

  N/A

• 07.B.02 Is the facility addressing the completion of exposure prevention controls?

  Yes

  No

  N/A

• 07.B.03 Do controls reduce and/or eliminate potential employee exposures?

  Yes

  No

  N/A

• 07.B.04 Are monthly preventative maintenance inspections conducted and documented for all exhaust ventilation systems that are required to maintain process or employee capabilities?

  Yes

  No

  N/A

7.0 Health & Safety Controls -C- Industrial Hygiene Monitoring

• 07.C.01 Are regular industrial hygiene evaluations being conducted as scheduled?

  Yes

  No

  N/A

• 07.C.02 Is a mechanism in place for the review of industrial hygiene monitoring reports, and for implementation of recommendations and modifications of controls, as necessary?

  Yes

  No

  N/A

• 07.C.03 Is a record keeping system in place that ensures all industrial hygiene monitoring data is maintained for at least thirty years beyond the last date of employment for all affected employees?

  Yes

  No

  N/A

7.0 -Health & Safety Controls -D.- Ergonomics Program

• 07.D.01 Has an assessment been made of the need for an ergonomics program?

  Yes

  No

  N/A

• 07.D.02 Has a written ergonomics program been developed which includes identification of responsibilities for upper management, operations as well as sales personnel, and support staff?

  Yes

  No

  N/A

• 07.D.03 Has a written ergonomics program been developed which includes a mechanism for the assessment of job task?

  Yes

  No

  N/A

• 07.D.04 Has a written ergonomics program been developed which includes a mechanism for the development of controls?

  Yes

  No

  N/A

• 07.D.05 Has a written ergonomics program been developed which includes a follow up mechanism to track implementation of controls?

  Yes

  No

  N/A

• 07.D.06 Has a written ergonomics program been developed which includes ergonomic training for all personnel involved?

  Yes

  No

  N/A

• 07.D.07 Has a written ergonomics program been developed which includes a mechanism for early intervention/medical management of soft tissue injuries?

  Yes

  No

  N/A

• 07.D.08 Has formal ergonomics training been conducted for both operations and sales personnel?

  Yes

  No

  N/A

• 07.D.09 H formal ergonomic training been conducted for support staff(office staff etc.)?

  Yes

  No

  N/A

• 07.D.10 Has formal ergonomic training been conducted for non-exempt personnel?

  Yes

  No

  N/A

• 07.D.11 Has an ergonomic committee been developed which includes operations and sales management?

  Yes

  No

  N/A

• 07.D.12 Has the safety committee developed ergonomic safety initiatives?

  Yes

  No

  N/A

• 07.D.13 Is a health care provider used for early intervention/medical management of soft tissue injuries?

  Yes

  No

  N/A

• 07.D.14 Has the health care provider been on-site to tour the facility and consult with plant personnel on managing and reducing these claims?

  Yes

  No

  N/A

• 07.D.15 Is there a mechanism to formally communicate the results of the ergonomic program to senior plant management, supervision, support staff and hourly employees?

  Yes

  No

  N/A

• 07.D.16 Are new/changed processes and equipment formally reviewed/inspected for ergonomic considerations?

  Yes

  No

  N/A

• 07.D.17 What steps do you take to initiate ergonomic improvements?

  Yes

  No

  N/A

• 07.D.18 What ergonomic improvements have been implemented?

  Yes

  No

  N/A

7.0 -Health & Safety Controls-E- Physical Examinations

• 07.E.01 Are all newly hired personnel given a general physical examination, following the job offer, and prior to assuming job duties?

  Yes

  No

  N/A

• 07.E.02 Are audiograms made available to all employees whose noise exposure equals or exceeds an 8 hour time waited average of 85 decibels? (29 CFR 1910.95(g)(1))

  Yes

  No

  N/A

• 07.E.03 Is a drug screen performed for all employees according to company policy?

  Yes

  No

  N/A

8.0 -Health & Safety Purchasing & Engineering Controls -A- Procurement

• 08.A.01 Is a mechanism in place to identify safety & health issues associated with significant purchases?

  Yes

  No

  N/A

• 08.A.02 Is a formal chemical review process in place?

  Yes

  No

  N/A

8.0 -Health & Safety Purchasing & Engineering Controls -B- Section & Control of Contractors

• 08.B.01 Does the facility have a written plant specific contractor safety program?

  Yes

  No

  N/A

• 08.B.02 Are plant safety program requirements contained in contracts?

  Yes

  No

  N/A

• 08.B.03 Does the facility hold pre-job meetings with the contractors to review safety and health program requirements and designate a contact person for contractor safety program coordination?

  Yes

  No

  N/A

8.0 -Health & Safety Purchasing & Engineering Controls -C- Process Method Changes

• 08.C.01 Does the facility have a mechanism in place to identify safety & health concerns prior to process changes?

  Yes

  No

  N/A

9.0 -Health & Safety Standards -A- Injury and Illness Recordkeeping

• 09.A.01 Are injury and illness records maintained as required by government standards? (29 CFR 1904.2(a))

  Yes

  No

  N/A

• 09.A.02 Are injuries and illnesses recorded properly in the OSHA 300 log? (29CFR 1904.2(a))

  Yes

  No

  N/A

• 09.A.03 Are the records current with each page totaled and signed? (29CFR 1904.2(a))

  Yes

  No

  N/A

9.0 -Health & Safety Standards -B- Required Postings

• 09.B.01 Are employee safety information documents posted per government standards?

  Yes

  No

  N/A

• 09.B.02 Is a document posted annually explaining employees' right of access to exposure and medical records? (29CFR 1910.1020(a))

  Yes

  No

  N/A

• 09.B.03 Are the necessary postings displayed for compensation to injured workers? (For example; social security, workers' compensation etc.)

  Yes

  No

  N/A

9.0 - Health & Safety Standards -C- Hazard Communication

• 09.C.01 Has a current written plant specific hazard communication program been developed? (29CFR 1910.1200(a))

  Yes

  No

  N/A

• 09.C.02 Does the facility have a chemical and physical agent inventory? (29CFR 1910.12(c)(iv))

  Yes

  No

  N/A

• 09.C.03 Is the chemical inventory updated annually?

  Yes

  No

  N/A

• 09.C.04 Are current MSDS on file? (App. E of 29CFR 1910.1200)

  Yes

  No

  N/A

• 09.C.05 Have MSDS's been updated?

  Yes

  No

  N/A

• 09.C.06 Do employees have access to MSDS's? (29CFR 1910.1200(b)(4)(ii))

  Yes

  No

  N/A

• 09.C.07 Is hazard communication training performed annually?

  Yes

  No

  N/A

• 09.C.08 Is a mechanism in place to ensure the proper labeling of primary and secondary containers? (29CFR 1910.1200(f)(7))

  Yes

  No

  N/A

• 09.C.09 What hazardous chemicals do you work with while performing your job?

  Yes

  No

  N/A

• 09.C.10 What is a MSDS?

  Yes

  No

  N/A

• 09.C.11 Where are MSDS's located?

  Yes

  No

  N/A

9.0 -Health & Safety Standards -D- Personal Protective Equipment Standards

• 09.D.01 Has a written plant specific Personal Protective Equipment (PPE) program been developed? (29CFR 1910.132(a))

  Yes

  No

  N/A

• 09.D.02 Has an assessment been conducted to identify PPE requirements for all occupations? (CFR1910.132(d)(1))

  Yes

  No

  N/A

• 09.D.03 Are employees instructed in the need for, proper use, cleaning and maintenance of, PPE? (Ref. Subpart I App.B)

  Yes

  No

  N/A

• 09.D.04 Are proper storage and/or cleaning facilities provided for PPE?

  Yes

  No

  N/A

• 09.D.05 Are inspections of PPE usage/conditions included as part of safety and health inspections?

  Yes

  No

  N/A

• 09.D.06 Is an annual evaluation of the PPE program conducted?

  Yes

  No

  N/A

• 09.D.07 What types of PPE do you wear on your job?

  Yes

  No

  N/A

• 09.D.08 What hazard(s) does the PPE protect you from?

  Yes

  No

  N/A

9.0 - Health & Safety Standards -E- Respirator Program

• 09.E.01 Has a written plant specific respirator program been developed?(29CFR 1910.134(b)) Must include respirator cartridge changeout schedule.

  Yes

  No

  N/A

• 09.E.02 Are medical exams conducted to confirm respirator users' physical capability to wear a respirator? (29CFR 1910.134(b)(10))

  Yes

  No

  N/A

• 09.E.03 Is fit-testing conducted and documented, for all respirator users? (29CFR 1910.134(e)(5))

  Yes

  No

  N/A

• 09.E.04 Are all respirator users, and their supervisors, trained annually in the proper use, care, maintenance, and inspection f this equipment? (29CFR 1910.134(b)(3))

  Yes

  No

  N/A

• 09.E.05 Has a list been developed of which respirators are required for specific applications?

  Yes

  No

  N/A

• 09.E.06 Are clean-up, maintenance, and storage facilities, provided foe the respirators? (29CFR 1910.134(f)(iv))

  Yes

  No

  N/A

• 09.E.07 If you use a respirator, what type is it?

  Yes

  No

  N/A

9.0 -Health & Safety Standards -F- Bloodborne Pathogens Program

• 09.F.01 Has a written plant specific bloodborne pathogen program been developed? (29CFR 1910.1030(c)(1)(i))

  Yes

  No

  N/A

• 09.F.02 Is annual training conducted and documented regarding proper cleanup procedures, and the use of personal protective equipment for all affected personnel? (29CFR1910.1030(c)(2)(I)(K))

  Yes

  No

  N/A

• 09.F.03 Is general awareness training conducted annually for all employees? (29CFR 1910.1030(g)(2)(iv))

  Yes

  No

  N/A

• 09.F.04 Are vaccinations made to all affected employees? (29CFR1910.1030(f)(1X0))

  Yes

  No

  N/A

• 09.F.05 Is each employee's acceptance/refusal documented? (29CFR 1910.1030 App A)

  Yes

  No

  N/A

• 09.F.06 Who is authorized to clean up blood or other body fluids?

  Yes

  No

  N/A

9.0 -Health & Safety Standards -G- Hearing Conservation Program

• 09.G.01 Has a written plant specific Hearing Conservation Program been developed?

  Yes

  No

  N/A

• 09.G.02 Have sound level surveys been conducted within the last three years?

  Yes

  No

  N/A

• 09.G.03 Are signs posted in areas where hearing protection is required?

  Yes

  No

  N/A

• 09.G.04 Is hearing protection provided, and it's use enforced, in work areas where noise levels exceed 85 dBA? (29CFR 1910.95(c)(1))

  Yes

  No

  N/A

• 09.G.05 Are annual audiograms and training conducted for affected employees? (29CFR1910.95(g)(6))

  Yes

  No

  N/A

• 09.G.06 Is the follow-up and re-training of affected employees documented? (29CFR 1910.95(g)(8))

  Yes

  No

  N/A

• 09.G.07 What job do you perform where you wear hearing protection?

  Yes

  No

  N/A

9.0 -Health & Safety Standards -H- Confined Space Entry

• 09.H.01 Has a written plant specific Confined Space Entry Program been developed? (29CFR1910.146(c)(4))

  Yes

  No

  N/A

• 09.H.02 Are all affected personnel trained annually on proper procedures, air monitoring equipment use and calibration, and rescue equipment use, with the training documented?

  Yes

  No

  N/A

• 09.H.03 Have all confined spaces been identified and labeled? (29CFR1910.146(c)(2))

  Yes

  No

  N/A

• 09.H.04 Is the air monitoring and rescue equipment readily available?

  Yes

  No

  N/A

• 09.H.05 Is the air monitoring data documented?

  Yes

  No

  N/A

• 09.H.06 Have response procedures been developed for confined space emergencies?

  Yes

  No

  N/A

• 09.H.07 What is a confined space and were are they located in this facility?

  Yes

  No

  N/A

• 09.H.08 Who can go into confined spaces?

  Yes

  No

  N/A

• 09.H.09 If you are authorized to enter confined spaces, what equipment is needed for confined space entry?

  Yes

  No

  N/A

9.0 -Health & Safety Standards -I- Specific Chemical Safety Programs

• 09.I.01 Has a written plant specific chemical safety program been developed?

  Yes

  No

  N/A

• 09.I.02 Is the required training conducted and documented?

  Yes

  No

  N/A

• 09.I.03 Has a written plant specific chemical safety program or monitoring been conducted and documented?

  Yes

  No

  N/A

• 09.I.04 Is employee medical monitoring being conducted where necessary, with results communicated to affected employee?

  Yes

  No

  N/A

9.0 -Health & Safety Standards -J- Lockout/Tagout Program

• 09.J.01 Has a written plant specific lockout/tagout program been developed? (29CFR 1910.147(c)(4)(I))

  Yes

  No

  N/A

• 09.J.02 Are all authorized personnel trained annually?

  Yes

  No

  N/A

• 09.J.03 Is multiple energy source equipment identified, and provided with written procedures for shutdown and lockout?

  Yes

  No

  N/A

• 09.J.04 Does the program address multiple user situations and shift changes?

  Yes

  No

  N/A

• 09.J.05 Is the lockout/tagout program audited on an annual basis and documented? (29CFR1910.147(c)(6)(i))

  Yes

  No

  N/A

• 09.J.06 What is a lockout/tagout procedure?

  Yes

  No

  N/A

• 09.J.07 If you are an authorized lockout user, what energy sources do you look for on multiple energy source equipment?

  Yes

  No

  N/A

• 09.J.08 If you are an authorized lockout user, what is the procedure regarding lockout/tagout at shift change?

  Yes

  No

  N/A

9.0 -Health & Safety Standards -K- Electrical Safety

• 09.K.01 Has a written plant specific Electrical Safety Program been developed?

  Yes

  No

  N/A

• 09.K.02 Does the written plan identify personnel requiring training, and the level of that training?

  Yes

  No

  N/A

• 09.K.03 Is annual training conducted and documented for affected personnel?

  Yes

  No

  N/A

9.0 -Health & Safety Standards -L- Powered Industrial Truck Program

• 09.L.01 Has a written plant specific forklift safety program been developed?

  Yes

  No

  N/A

• 09.L.02 Is initial training conducted and documented for affected personnel? (29CFR 1910.178(1))

  Yes

  No

  N/A

• 09.L.03 Is the training updated at least every 3 years?

  Yes

  No

  N/A

• 09.L.04 Are certificates required for industrial powered trucks?

  Yes

  No

  N/A

• 09.L.05 If you are authorized to drive a forklift, what type of license did you receive?

  Yes

  No

  N/A

• 09.L.06 If you are authorized to drive a forklift, how often do you perform inspections on your forklift?

  Yes

  No

  N/A

• 09.L.07 If you are authorized to drive a forklift, what items are included in the inspection?

  Yes

  No

  N/A

9.0 -Health & Safety Standards -O- Overhead Hoist and Crane Inspections

• 09.O.01 Are required crane and hoist inspections conducted monthly as required? (29CFR1910.179(j)(3))

  Yes

  No

  N/A

• 09.O.02 Are lifting devices inspected daily of prior to use?

  Yes

  No

  N/A

• 09.O.03 Do all affected employees receive annual training on how to conduct these inspections?

  Yes

  No

  N/A

• 09.O.04 Do all affected employees receive annual training on safe crane/ hoist operation?

  Yes

  No

  N/A

• 09.O.05 Are required crane/hoist inspections conducted annually, and documented?

  Yes

  No

  N/A

9.0 -Health & Safety Standards -P- Fall Protection Procedures / Ladder Safety

• 09.P.01 Has a written plant specific Fall Protection Program been developed?

  Yes

  No

  N/A

• 09.P.02 Are daily, weekly, and monthly inspections of harnesses conducted and recorded?

  Yes

  No

  N/A

• 09.P.03 Has a procedure been established which requires employees and contractors to utilize a fall restraint system when applicable?

  Yes

  No

  N/A

• 09.P.04 Are all ladders inspected on a monthly basis, with defective ladders withdrawn from service and tagged as "Dangerous, Do Not Use"?

  Yes

  No

  N/A

9.0 -Health & Safety Standards -Q- Property Conservation

• 09.Q.01 Is a Hot Work Permit System used?

  Yes

  No

  N/A

• 09.Q.02 Are all affected employees trained on the hot work permit system?

  Yes

  No

  N/A

• 09.Q.03 Is there a mechanism in place to ensure that recommendations from property inspection reports are reviewed and considered?

  Yes

  No

  N/A

10.0 -Health & Safety General Plant Conditions -A- Floor Condition

• 10.A.01 Are floors kept clean and orderly, free of slip or trip hazards? (29CFR1910.22(a)(2))

  Yes

  No

  N/A

• 10.A.02 Are designated aisles marked and kept clean? (29CFR1910.22(b)(2))

  Yes

  No

  N/A

10.0 -Health & Safety General Plant Conditions -B- Exits/Means of Egress

• 10.B.01 Are routes and exits clearly marked?

  Yes

  No

  N/A

• 10.B.02 Are exit and signs adequately illuminated? (29CFR1910.37(g)(1))

  Yes

  No

  N/A

• 10.B.03 Are approaches to exits kept clear? (29CFR1910.37(f)(1))

  Yes

  No

  N/A

• 10.B.04 Do exit doors open outward to a level surface?

  Yes

  No

  N/A

10.0 -Health & Safety General Plant Conditions -C- Materials and Storage

• 10.C.01 Are all stacks stable and secure against falling or collapsing?

  Yes

  No

  N/A

• 10.C.02 Is a clearance of at least three feet maintained between sprinkler heads and the tops of stored materials?

  Yes

  No

  N/A

• 10.C.03 Is access to fire extinguishers maintained? (29CFR1910Subpart 1)

  Yes

  No

  N/A

• 10.C.04 Are tanks and drums containing flammable liquids grounded?

  Yes

  No

  N/A

• 10.C.05 Are bonding cables used when dispensing flammable liquids?

  Yes

  No

  N/A

• 10.C.06 Are flammable storage cabinets provided where needed?

  Yes

  No

  N/A

• 10.C.07 Are approved containers provided and used for oily rags?

  Yes

  No

  N/A

• 10.C.08 Are explosion fixtures used in flammable vapor or dust areas? (29CFR1910.36(a)(4))

  Yes

  No

  N/A

• 10.C.09 Are compressed gas bottles stored upright from falling over?

  Yes

  No

  N/A

• 10.C.10 Are compressed gas bottles segregated by contents clearly marked?

  Yes

  No

  N/A

• 10.C.11 Are all lift truck propane cylinders properly secured? (29CFR1910.147(c)(3)(iii)

  Yes

  No

  N/A

10.0 -Health & Safety General Plant Conditions -D- Equipment and Machinery

• 10.D.01 Are tools, (wrenches, hammers etc.) in good condition?

  Yes

  No

  N/A

• 10.D.02 Are electrical cords in good condition?

  Yes

  No

  N/A

• 10.D.03 Are air hoses in good condition?

  Yes

  No

  N/A

• 10.D.04 Do air nozzles reduce pressure to less than 30 psi?

  Yes

  No

  N/A

• 10.D.05 Are power tools grounded or double insulated?

  Yes

  No

  N/A

• 10.D.06 Are fixed guards in position?

  Yes

  No

  N/A

• 10.D.07 Are points-of-operation, pinch points, and in-running nip points guarded?

  Yes

  No

  N/A

• 10.D.08 Are guards provided for rotating parts, flying chips or particles, sparks, etc.?

  Yes

  No

  N/A

• 10.D.09 Are interlocked guards operating properly?

  Yes

  No

  N/A

• 10.D.10 Are emergency stop buttons correctly positioned, properly labeled and functioning?

  Yes

  No

  N/A

• 10.D.11 Are there adequate lock-out provisions on all machinery? (29CFR1910.147(c)(2)(iii))

  Yes

  No

  N/A

• 10.D.12 Are cables, chains and slings adequate for loads and in good repair? (29CFR1910.261(k)(24)(ii))

  Yes

  No

  N/A

• 10.D.13 Are cables free of kinks, twists and broken strands? (29CFR1910.261(k)(24)(ii))

  Yes

  No

  N/A

• 10.D.14 Are slings free of fraying beyond allowable limits? (29CFR1910.261(k)(24)(ii))

  Yes

  No

  N/A

• 10.D.15 Are hooks free of deformity or damage and safety latches intact?

  Yes

  No

  N/A

• 10.D.16 Are all lifting devices tested and labeled with capacity?

  Yes

  No

  N/A

• 10.D.17 Are dock plates and wheel chicks provided and used? (29CFR1926.600(a)(3)(ii))

  Yes

  No

  N/A

• 10.D.18 Is guarding provided for electrical exposures of over 50 volts? (29CFR1910.303(g)(2)(i))

  Yes

  No

  N/A

• 10.D.19 Are warning signs posted?

  Yes

  No

  N/A

10.0 -Health & Safety General Plant Conditions -E- Elevated Work

• 10.E.01 Have standard railings ( and toe boards, if required), been installed on all open-sided floors, platforms or runways,four feet or more above adjacent floor or ground level? (29CFR1910.23(a)(3)(ii)

  Yes

  No

  N/A

• 10.E.02 Are ladders kept free of sharp edges and splinters? Are ladder rungs free or grease and oil? (29CFR1910.25(d)(2)(xix))

  Yes

  No

  N/A

• 10.E.03 Are safety feet and other auxiliary equipment on the ladders kept in good condition? (29CFR1910.25(d)(1)(iv))

  Yes

  No

  N/A

10.0 -Health & Safety General Plant Conditions -F- Hearing Protection

• 10.F.01 Are areas adequately marked where noise levels exceed the standard, (85 dBA)?

  Yes

  No

  N/A

• 10.F.02 Is hearing protection properly worn by employees working in these designated areas? (29CFR1910.95(b)(1)

  Yes

  No

  N/A

10.0 -Health & Safety General Plant Conditions -G- Personal Protective Equipment

• 10.G.01 Are safety glasses worn as required by local policy? (29CFR1910.133(a)(D)

  Yes

  No

  N/A

• 10.G.02 Are respirators worn properly where required,and maintained? (29CFR1910.134(e)(4))

  Yes

  No

  N/A

• 10.G.03 Is other personal protective equipment used/worn properly as required in designated areas? (29CFR1910.132(a))

  Yes

  No

  N/A

10.0 - Health & Safety General Plant Conditions -H- Emergency Eyewash and Shower

• 10.H.01 Are emergency eyewash and shower facilities readily available? (29CFR1910.268(b)(2)(i)

  Yes

  No

  N/A

• 10.H.02 Is access maintained to these facilities? (29CFR1910.268(b)(3))

  Yes

  No

  N/A

• 10.H.03 Are signs and instructions posted?

  Yes

  No

  N/A

• 10.H.04 Is monthly testing of the emergency shower and eyewash units conducted and documented?

  Yes

  No

  N/A

• 10.H.05 Are affected employees trained annually in the proper use of the units?

  Yes

  No

  N/A

• 10.H.06 Are all units rated for 15 minutes flushing capability?

  Yes

  No

  N/A