Title Page

  • Client / Site

  • Conducted on

  • Prepared by Robyn Edwards

ELECTRICAL SAFETY

  • Electrical control panels clearly identified and secured?

  • Electrical control panel(s) requiring action:

  • Hazard
  • Add media

  • Damaged/exposed electrical wiring?

  • Damaged/exposed electrical wiring requiring action:

  • Hazard
  • Add media

  • Switch and cover plates in place?

  • Switch and/or cover plates requiring action:

  • Hazard
  • Add media

  • Flexible extension cords fray-free, absent of splices, and only used as temporary power supply?

  • Flexible extension cord hazard(s) requiring action:

  • Hazard
  • Add media

  • Electrical knock-outs in place?

  • Missing knock-outs requiring action:

  • Hazard
  • Add media

FLOORS & STAIRS

  • Areas free of slip, trip, and/or fall hazards?

  • Slip, trip, and/or fall hazard(s) requiring action:

  • Hazard
  • Add media

  • Apertures or openings enclosed or covered?

  • Apertures and/or opening(s) requiring action:

  • Hazard
  • Add media

  • Clean, orderly, and free of oil/grease?

  • Housekeeping and/or oil/grease hazards requiring action:

  • Hazard
  • Add media

  • Sturdy railings on all open sides?

  • Railing(s) requiring action:

  • Hazard
  • Add media

  • Stairs free of damage?

  • Stair(s) requiring action:

  • Hazard
  • Add media

MACHINE GUARDING

  • Guards secure and in place at each point of operation?

  • Guard(s) requiring action:

  • Hazard
  • Add media

FIRE PREVENTION/PROTECTION

  • Fire extinguishers checked, readily accessible, and inspected monthly?

  • Fire extinguisher(s) requiring action:

  • Hazard
  • Add media

  • Flammable materials (i.e., gasoline, diesel, etc.) stored in metal safety cans?

  • Flammable materials requiring action:

  • Hazard
  • Add media

HAZARDOUS CHEMICALS

  • Labels on all supplier drums and/or chemicals?

  • Supplier drums and/or chemicals requiring action:

  • Hazard
  • Add media

OTHER

  • Other hazards/non-compliance items found?

  • Other hazard/non-compliance item(s) found requiring action:

  • Hazard
  • Add media

  • Unsafe practices observed?

  • Unsafe practices observed requiring action:

  • Unsafe Practice
  • Add media

  • By signing below, I acknowledge the inspection/audit findings and corrective actions have been reviewed with me.

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