Title Page
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Conducted on
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Prepared by
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Location
DOT and Program Compliance
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Are there additional incentives for improving safety?
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Remediation
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Is Branch currently under Mendoza line?
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Remediation
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Are all accidents/injuries investigated/reported promptly?
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Remediation
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Are all temporary employees utilized and/or trained?
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Remediation
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Are drivers off duty 10 hours or more before returning to work?
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Are DOT files complete and up to date?
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Remediation
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Does Branch have a system to maintain medical cards and driver's licenses?
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Remediation
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Are DOT files in locked cabinet or secure location?
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Remediation
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Do CDL holders drive less than 11 hours daily?
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Remediation
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Are drivers on clock less than 60 hours in 7 days?
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Remediation
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Do drivers meet 100 air mile exemption? If not, are logs complete?
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Remediation
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CDL holders do not operate vehicles after 14 hours on the clock?
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Remediation
General Work Environment
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Are controls in place to prevent unauthorized entry and theft of equipment?
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Remediation
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Are all work areas adequately illuminated?
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Remediation
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Are work areas ventilated appropriately?
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Remediation
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Remediation
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Is minimum number of toilet facilities provided and sanitary?
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Remediation
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Is all water provided for drinking potable and if not, clearly identified? Are ice machines safe and clean?
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Remediation
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Are all spilled hazardous materials cleaned up immediately?
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Remediation
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Are break areas sanitary (kitchens, refrigerators, microwaves)?
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Remediation
Employer Postings
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Is an approved Panel of Physicians posted?
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Remediation
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Is OSHA Job Safety displayed?
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Remediation
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Is OSHA 300 posted?
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Remediation
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Is "Safety Scoreboard" being used and up to date?
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Remediation
Branch Compliance Folder and HazCom Standards
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Is the Branch Compliance Folder up to date?
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Remediation
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Is there a current hazard assessment on file?
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Remediation
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Is there a list of updated hazardous substances used and SDS readily available for each used?
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Remediation
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Is the current written exposure control plan for blood borne pathogens?
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Remediation
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Is there an updated written HazCom program with SDS, labeling and training?
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Remediation
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Is RRED ONE Plan in SDS binder?
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Remediation
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Are COIs on file for all vendors and subcontractors?
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Remediation
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Is each container labeled with product identity and a hazard warning?
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Remediation
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Are Hepatitis B vaccines completed or declination forms filed?
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Remediation
Record Keeping - LF/TS
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Scales inspected as required?
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Remediation
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Waste screening records completed in accordance with operations plan?
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Remediation
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Record from applicable agency allowing alternative daily covers available?
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Remediation
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Operations plan and engineering drawings available?
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Remediation
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Permitted stabilization/landscaping plan available?
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Remediation
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Permitted contingency plan available?
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Remediation
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Permitted groundwater monitoring plan available?
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Remediation
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Permitted post-closure plan available?
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Remediation
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Tittle V Air Permit available?
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Remediation
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Leachate handling permit available?
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Remediation
Environmental Compliance and Stormwater
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Is dust generated or tracked into roadways?
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Is excessive debris on yard?
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Is yard free of standing water?
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Is NPDES Stormwater Permit or No Exposure Certification on file?
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Are no elicit discharges detected?
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Are stormwater ponds permitted and in compliance within maintenance agreement?
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Are Stormwater Ponds compliant with best management practices (BMP’s)?
Environmental Compliance - LF/TS
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Signage present to control traffic?
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Remediation
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Signs posted at gate displaying hours, emergency contact, no smoking, prohibited wastes, etc.?
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Remediation
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Leachate collection system compliant?
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Remediation
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Windblown debris controlled?
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Remediation
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Prohibited wastes effectively prevented?
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Remediation
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Scavenging effectively prevented?
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Remediation
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Vectors effectively prevented?
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Remediation
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Roadways maintained with berms or guardrails present if necessary?
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Remediation
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Final slopes are 3:1 with vegetation or seeding in process?
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Remediation
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Erosion effectively controlled and BMPs in place?
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Remediation
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Buffer areas maintained?
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Remediation
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Working face of manageable size in accordance with operations plan?
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Remediation
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Waste covered daily (MSW) or as required by permit (C&D)?
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Remediation
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Yard trimmings, compost, or woodchips appropriately maintained?
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Remediation
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Asbestos handled in accordance with permit?
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Remediation
Medical Services and First Aid
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Are universal precautions observed where BBP exposure can occur?
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Remediation
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Is medical care 3 minutes or 3 miles from workplace or an employee(s) qualified in first aid?
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Are first aid kits accessible, inspected, and replenished as needed?
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Remediation
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Are first aid responders trained?
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Remediation
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Is there an eyewash and/or shower station for quick drenching of the eyes and body?
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Remediation
Fire Protection
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Are fire suppression systems inspected annually?
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Remediation
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Are fire extinguishers properly located, identified, mounted and accessible?
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Remediation
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Are fire extinguishers inspected monthly and annually?
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Remediation
Personal Protective Equipment
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Are safety glasses available and worn as needed?
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Remediation
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Are protective gloves or other means provided?
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Remediation
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Are hard hats required, provided, and worn?
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Remediation
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Do employees working on roadways wear reflective clothing (ANSI Class II)?
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Remediation
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Is appropriate foot protection being worn?
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Remediation
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Is protection against occupational noise provided?
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Remediation
Walking Working Surfaces
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Are aisles and passageways clear and marked?
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Remediation
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Are there standard guardrails where working surfaces are elevated (≥48")?
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Remediation
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Are floor openings guarded by a cover or guardrail?
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Remediation
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Are toe boards around permanent floor openings where persons would pass below?
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Remediation
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Can handrails withstand 200 impact pounds?
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Remediation
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Are signs posted showing elevated surface load capacity?
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Remediation
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Are handrails on stairways and elevated surfaces?
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Remediation
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Are all stairways at least 22" wide and risers uniform?
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Remediation
Exit or Egress
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Are all exits marked, illuminated and visibly marked?
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Remediation
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Are doors that could be mistake for exits marked "NOT AN EXIT"?
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Remediation
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Are all exits kept free of obstructions?
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Remediation
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Can exit doors be opened from direction of travel with single action?
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Remediation
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If exit(s) open into vehicle path are barriers and warnings provided?
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Remediation
Machine Guarding and Lockout/Tag Out Procedures
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Is equipment capable of movement, de-energized, blocked & locked out during servicing?
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Remediation
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Can equipment be tagged out if it can't be locked?
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Remediation
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Is stored energy (mechanical, hydraulic, etc.) released or blocked before repairs?
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Remediation
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Are authorized employees certified and provided with individually keyed personal safety locks?
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Remediation
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Can only authorized employee place or remove the safety lock?
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Remediation
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Is there a means to identify all employees working on locked-out equipment?
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Remediation
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Are a sufficient number of tags and safety padlocks provided?
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Remediation
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Are LOTO certification/s available?
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Remediation
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Is machinery securely anchored to prevent tipping or movement?
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Remediation
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Are all emergency stop buttons colored red?
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Remediation
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Are all pulleys and belts within 7 feet of the floor guarded?
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Remediation
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Are all moving chains and gears properly guarded?
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Remediation
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Fan blades: openings no larger than l/2 inch if within 7 feet of floor?
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Remediation
Welding, Cutting, Brazing
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Are cylinders kept away from sources of heat?
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Remediation
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Are empty cylinders appropriately marked and valves closed?
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Remediation
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Are signs posted "NO SMOKING," or the equivalent?
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Remediation
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Are cylinders, valves, regulators & hoses kept free of oily substances?
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Remediation
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When not in use, the valve is closed and gas released?
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Remediation
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Are fire extinguishers available for immediate use?
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Remediation
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Are employees who are exposed to welding & cutting protected with PPE?
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Remediation
Compressors, Compressed Air and Cylinders
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Are compressors equipped with pressure relief valves and gauges?
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Remediation
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Are safety devices on compressed air systems checked frequently?
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Remediation
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Are signs posted to warn of the automatic starting of the compressors?
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Remediation
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Are belt drive systems totally enclosed?
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Remediation
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When inflating tires, are clip-on chuck and an inline regulator used?
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Remediation
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Are compressed air receivers periodically drained (moisture & oil)?
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Remediation
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Are valves closed when cylinder is empty & at completion of each job?
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Remediation
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Are cylinders legibly marked to identify the type of gas?
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Remediation
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Are fuel gas and oxygen cylinders separated by distance or fire-resistant barriers?
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Remediation
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Are cylinders stored in areas protected from external heat sources?
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Remediation
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Are cylinders securely stored to prevent tipping, damaged or tampering?
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Remediation
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Are valve protectors placed on cylinders when not in use?
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Remediation
Hoist, Auxiliary Equipment and Materials Handling
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Is rated load legibly marked and visible to the operator?
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Remediation
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Are cranes/hoisting equipment inspected regularly?
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Remediation
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Are controls plainly marked to indicate the direction of travel or motion?
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Remediation
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Are employees prohibited from using chains or rope slings that are kinked, twisted, or otherwise damaged?
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Remediation
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Is there safe clearance for equipment through aisles and doorways?
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Remediation
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Are dock boards used when loading or unloading between vehicles and docks?
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Remediation
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Are trailers secured from movement (chocked) during loading and unloading?
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Remediation
Industrial Trucks- Forklift/Yellow Iron
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Are only trained personnel allowed to operate?
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Remediation
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Is warning horn and backup device clearly heard above noise?
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Remediation
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Are inspections done daily and taken out of services if repairs can't be made?
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Remediation
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Are all identification and load capacity plates legible?
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Remediation
Confined Spaces
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Are all moving parts inside confined spaces locked out and restrained if needed?
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Remediation
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Is lockout tag out always performed prior to confined space entry?
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Remediation
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Are employees prohibited (posted) from entering permitted confined spaces?
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Remediation
Flammable and Combustible Materials
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Are combustible debris and waste materials (oily rags, etc.) stored in covered metal receptacles?
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Remediation
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Are approved containers used to store flammables & combustibles?
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Remediation
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Are "NO SMOKING" signs posted on LPG tanks and where flammable/combustible materials are used or stored?
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Remediation
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Where corrosive liquids are drawn from storage vessels, are adequate means available for neutralizing or disposing of spills or overflows?
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Remediation
Electrical
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Are all outlets labeled with voltage?
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Remediation
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Are electrical appliances, including extension cords, grounded?
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Remediation
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Are multiple plug adaptors (daisy chains) prohibited?
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Remediation
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Are cords with cursor frayed insulation repaired or replaced promptly?
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Remediation
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In wet or damp locations, is ground fault provided?
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Remediation
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Are all disconnecting switches and circuit breakers labeled?
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Remediation
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Is sufficient access and working space around all electrical equipment?
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Remediation
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Are electrical receptacles, junction boxes, etc., provided with tight-fitting covers and unused openings/knockouts closed properly?
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Remediation
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Is motor located within sight of its disconnecting means or able to be locked open?
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Remediation
Fueling, AST, and UST Compliance
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Are employees prohibited from fueling while engine is running?
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Remediation
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Are fueling operations performed to minimize spillage?
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Remediation
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Are employees prohibited from transferring gasoline in open containers?
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Remediation
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Are open flames, sparking or arcing prohibited near fueling operations?
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Remediation
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Is smoking prohibited near fueling operations?
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Remediation
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Are ASTs and associated piping free of rust and obvious damage?
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Remediation
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Are UST system inspections (line tightness, cathode, sumps, etc.) up to date?
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Remediation
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Is UST operator training complete?
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Remediation
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Are UST emergency signage put up?
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Remediation
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Are spill kits available near significant sources?
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Remediation
Containers
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Are commercial containers labeled? (“Do Not Play On or Around or Occupy This Container”. “Stand Clear When Container is in Motion”, & “Load Evenly Container must be placed on hard level surface”)
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Remediation
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Are open top containers labeled with maximum loading level?
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Remediation
Vehicles
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Are vehicles in generally good condition?
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Remediation
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Are cabs clean and free of debris or unnecessary equipment?
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Remediation
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Is emergency equipment maintained (2- 10 lbs. of extinguishing agent, 3 reflective triangles, spill kit)?
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Remediation
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Is Safety Lane utilized daily?
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Remediation
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Is an over height device installed and used on the yard?
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Remediation
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Are VCR's completed daily?
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Remediation
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Are VCR's filed by vehicle for prior 90 days?
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Remediation
Closing Comments
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Closing Comments
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Safety Representative
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Branch Representative