Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by Paul Schrupp
Administration
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Certifications (Crane, Hoist and Winch)
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Certifications (Forklift Operators and CO monitoring
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Checklists (Ladder, Monthly Yard and Plant)
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Checklists (Fire Extinguishers, Forklifts and First aid)
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All Training has been completed (LOTO, Annual, Forklift, New hire)
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Safety committee and tool box talk documentation
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SDS book and OSHA posters are available/adequate
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Site map and Evacuation plan posted/adequate
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Plant address and Location posted/adequate
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Meeting place for emergencies is understood
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Emergency numbers are posted (911, Hospital, Fire, Police and Poison control)
PPE / Environmental
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Safety knives are used when possible
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Ear plugs and muffs are available/worn
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Safety Glasses and Face shields are available/worn
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Cut Resistant and Heat gloves are available/worn
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Cold weather and Insulated rubber gloves are available/worn
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Purging jackets, hoods and welding hoods are available/worn
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Proper clothing and footwear are worn/enforced
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Adequate fresh water, Shaded areas and restrooms are adequate/nearby
Fire safety
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All Fire Extinguishers are adequately placed
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All Fire Extinguishers have been inspected monthly/annually
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Class "C" fire extinguisher placed in the MCC room
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All flammable items have been removed from hazardous areas
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All Flammables are stored in a proper container (Spray paint, Rags, etc.)
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Flammable cabinets are installed/used
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All equipment is free of oil leaks (extruders, corrugators, perforators, Vac pumps and etc.)
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Oil is stored in an adequate area and has spill containment for bulk oil
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Acetylene and Oxygen tanks are stored 25' apart and are properly secured
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Fuel tank berming, signage is adequate and protected from damage
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Liquid propane tanks are stored properly
Electrical
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Electrical doors are closed
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Electrical boxes are clear of debris and there have safe clearance
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All breakers are labeled
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Extension cords are in good condition/used temporarily
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Extension cords are 12 ga. or larger
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Exposed, Bare wires or loose electrical connections are not present
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All electrical cords, leads, strain reliefs and conduit are in good condition
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Wire nuts and heater studs are not exposed
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Ceramic covers are used on heater bands
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Transformers and Electrical boxes are securely fastened
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Cord drops and SAF starts are installed where needed
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Outlets are in good condition and electrical boxes are not missing knockouts
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Dock lighting is adequate/functional
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Emergency lighting and exit signs are adequately placed/working properly
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Perforator interlocks are installed/functioning properly
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LOTO Procedures are posted on or near all equipment, are adequate/accurate
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LOTO being followed per tracking log
First Aid
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Accident Procedure is posted and forms are available
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Sharps container is available, convenient and sharps log is present
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Eye wash stations are installed/current
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Blood borne kit and Bio hazard bags are available/adequate
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First aid kits (plant and forklift) are available/adequate and tracked
Housekeeping / Stairs
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Floors are clean and dry (including resin spills)
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Cool purgings have been picked up
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Dock areas are clean and free of debris
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Exits and designated walkways are clear of debris
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Interior exit routes and Exterior exit routes are clear of debris
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All doors (including overhead) are functional and clear of obstructions
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Twine and scrap pipe is reasonably picked up/disposed of
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Stairways meet OSHA standards, are clear/unobstructed
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Mobile stairs and Tie down ladders are in good condition, straight and unmodified
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Drainage and dust control measures are in place
Storage / Signage
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Unused and other equipment is stored properly
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Center cores and fittings are reasonably organized
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Pipe is reasonably and safely stacked
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Twine, Sock and Pallets are stacked straight and properly
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Mezzanine storage, pallet racking and steel racks are labeled with 3x5" load limits
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Items stored on mezzanine are secure
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Pallet racking and steel racks are sufficient/properly anchored (1per leg)
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All handrails are secure/adequate (200#)
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Signage and speed limits are clearly posted for customers/are being followed
Forklifts / Yard vehicles
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Windows are clear, clean, free of cracks/breaks
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Head lights, brake lights and flashers are functional
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Forklift attachments and masts are adequate
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Forklift attachments are free of bends, cracks and defects
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Seats, seat belts and horn are functional
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Liquid propane tanks are secure and the alignment pin on the forklift is good
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Wheel chocks and trailer jacks are available/used
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Safety chains are being used on trailers
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Ratchet straps and other straps function properly/undamaged
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All vehicles are parked properly and in adequate areas
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All tires appear to be in good condition
Guarding / Equipment
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Extruder gearbox and drive motor guarding is adequate
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Screen changer and melt pump guarding is adequate
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Purging guard is in place
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Purging guard is being used and adequate
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Purging chains and signs are installed/being used
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Corrugator guarding (gearbox, track, upstream and downstream) is adequate
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Water bath, Haul-off and pulling wheel guarding is adequate
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Perforator and Coiler guarding is adequate
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Drill presses have chuck guards and are securely fastened
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Band saw guarding is adequate and adjusted correctly
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Bench grinders securely fastened, wheel has been ring tested, and guards are adjusted properly
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Guarding on Auxiliary equipment is adequate
Misc. Safety
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Air wands have safety tips and air hoses have crimps
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Brooms, shovels and hand tool handles are in factory condition
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GHS/HAZ COM chemicals are communicated
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Striper hose in good working order no leaks
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Bag, Trash and Cardboard compactors functioning properly
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Yard lanes are adequate width for loading and traffic flow
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Additional safety concerns
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Completion Date
