Executive Summary

  • District Representative

Audit Location or Map

  • Building room number

  • Is map available for building?

  • Insert photo if Yes

1.0 General Information

  • Name of CESA 10 Inspector(s)

2.0 Machine Guarding Information

    Machine Information
  • Name of Machine

3.0 General Machine Guarding Requirements (29 CFR 1910.212)

  • Does the machine have safeguards?

  • Are required safeguards installed on the machine?

  • Are the safeguards firmly secured and not easily removable?

  • Is there a point of operation safeguard provided for the machine?

  • Are there any unguarded gears, sprockets, pulleys, or flywheels on the apparatus?

  • Insert photo if yes

  • Are there any exposed belts or chain drives?

  • Insert photo if yes

  • Do the safeguards insure that no object will fall into the moving parts?

  • Is there evidence that the safeguards have been tampered with or removed?

  • Insert photo if Yes

  • Do the point of operation safeguards keep the operators hands, fingers, body out of the danger area?

  • Are hand tools available to permit easy handling of material without the operator placing a hand in the danger zone? (I.E. Push sticks)

  • Are blades of a fan less than 7 feet above the floor or working level safeguarded?

  • Do fan blade safeguards have openings no less than 1/2 inch?

  • Are starting and stopping controls within easy reach of the operator?

  • Is there a system for shutting down the machinery before safeguards are removed?

  • Do the safeguards permit safe, comfortable, and relatively easy operation of the machine?

  • Can the existing safeguards be improved?

4.0 Personal Protective Equipment (29 CFR 1910.132)

  • Is personal protective equipment(PPE) required?

  • Is appropriate PPE available to reduce hazards for operators?

  • Are staff and students utilizing the proper PPE when required?

  • Is PPE in good condition?

  • Insert photo if No

5.0 General Electrical Information

  • Is the machine properly grounded?

  • Insert photo if No

  • Are there loose conduit fittings?

  • Is the machine installed in accordance with National Fire Protection Association and National Electrical Code requirements?

  • Is the power supply correctly fused and protected?

  • Insert photo if No

  • Are extension cords used as permanent wiring to power machines?

  • Insert photo if Yes

6.0 Machine Training

  • Have operators and maintenance workers been trained in how to use, install, and maintain the safeguards and equipment?

  • Have operators and maintenance workers been trained in how and under what circumstances guards can be removed?

7.0 Machine Maintenance

  • Are maintenance and servicing workers trained in the requirements of 29 CFR 1910.147, lockout/tagout?

  • Do maintenance persons use appropriate lockout tag out methods before servicing machines?

8.0 Notes

  • Any other relevant information?

Sign Off

  • Inspector's signature CESA 10 Employee:

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