Gold Stripe Safety Audit 2.0

Office Administration

• All Certifications are up to date (Crane/Hoist/Winch, CO monitoring)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Crane / Hoist / Winch

  Yes

  No

• Completed on

  Date

• CO monitoring

  Yes

  No

• Completed on

  Date

• Plant has all checklists up to date (forklift, fire extinguishers, ladder inspection, audits, first aid)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Forklift

  Yes

  No

• Completed on

  Date

• Fire extinguishers

  Yes

  No

• Completed on

  Date

• Ladder inspection

  Yes

  No

• Completed on

  Date

• Monthly Plant/Yard audit

  Yes

  No

• Completed on

  Date

• First aid tracking

  Yes

  No

• Completed on

  Date

• All training completed (LOTO, Annual, Forklift, Safety)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• LOTO

  Yes

  No

• Completed on

  Date

• Annual

  Yes

  No

• Completed on

  Date

• Forklift

  Yes

  No

• Completed on

  Date

• Safety

  Yes

  No

• Completed on

  Date

• Safety Meeting notes documented (Safety committee, Tool box talks)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Safety Committee

  Yes

  No

• Completed on

  Date

• Tool box talks

  Yes

  No

• Completed on

  Date

• Misc. safety items communicated/posted (Site map, Evac. plan, GHS/HAZ, Meeting place)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Site map is complete and adequate

  Yes

  No

• Completed on

  Date

• Evacuation plan posted and adequate

  Yes

  No

• Completed on

  Date

• GHS/HAZ com chemicals communicated

  Yes

  No

• Completed on

  Date

• Meeting place for emergencies is understood

  Yes

  No

• Completed on

  Date

Administrative - Plant and Yard

• Kits (First aid, Blood borne, Sharps container, eye wash)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• First aid kits are available and adequate

  Yes

  No

• Completed on

  Date

• Blood borne kits are available and adequate

  Yes

  No

• Completed on

  Date

• Sharps container available and convenient

  Yes

  No

• Completed on

  Date

• Eye wash station installed and current

  Yes

  No

• Completed on

  Date

• First aid logs/forms (first aid, sharps, accident)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• First aid tracking complete

  Yes

  No

• Completed on

  Date

• Sharps log present

  Yes

  No

• Completed on

  Date

• Accident investigation forms available

  Yes

  No

• Completed on

  Date

• First aid communications (SDS, Emergency numbers)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• SDS book available and adequate

  Yes

  No

• Completed on

  Date

• 911 numbers posted (Hospital, Fire and Police)

  Yes

  No

• Completed on

  Date

• Poison control numbers posted

  Yes

  No

• Completed on

  Date

• General Communications (Plant location, OSHA, Accident, Yard signs)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Plant location and address posted

  Yes

  No

• Completed on

  Date

• OSHA posters posted and current

  Yes

  No

• Completed on

  Date

• Accident procedure posted

  Yes

  No

• Completed on

  Date

• Signage clearly posted for customers

  Yes

  No

• Completed on

  Date

• Fuel tanks have adequate signage

  Yes

  No

• Completed on

  Date

PPE - Plant and Yard

• Safety knives used when possible

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Completed on

  Date

• Hands (Gloves)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Heat resistant gloves available and worn

  Yes

  No

• Completed on

  Date

• Cut resistant gloves available and worn

  Yes

  No

• Completed on

  Date

• Cold weather gloves available

  Yes

  No

• Completed on

  Date

• Insulated rubber gloves for fueling provided

  Yes

  No

• Completed on

  Date

• Head (Ear plugs, glasses, shields, hoods)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Ear plugs/muff available and worn

  Yes

  No

• Completed on

  Date

• Safety glasses available and worn

  Yes

  No

• Completed on

  Date

• Face shields available and worn

  Yes

  No

• Completed on

  Date

• Welding hoods available and worn

  Yes

  No

• Completed on

  Date

• Body/Feet (clothing, footwear, rain gear, safety vests)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Proper clothing worn/enforced

  Yes

  No

• Completed on

  Date

• Proper footwear (observed)

  Yes

  No

• Completed on

  Date

• Rain gear available

  Yes

  No

• Completed on

  Date

• Safety vests or Hi-Vis shirts being worn

  Yes

  No

• Completed on

  Date

• Purging PPE (jackets, hoods)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Purging jackets available and worn

  Yes

  No

• Completed on

  Date

• Purging hoods available and worn

  Yes

  No

• Completed on

  Date

Housekeeping/Fire Safety/Exits - Plant and Yard

• GHS (Floors/Walkways, doors functional, emergency lighting, purgings, dust)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Floors clean, dry, organized

  Yes

  No

• Completed on

  Date

• All doors are functional

  Yes

  No

• Completed on

  Date

• Designated walkways are clear of debris

  Yes

  No

• Completed on

  Date

• Emergency lighting is in working order and adequately placed

  Yes

  No

• Completed on

  Date

• Overhead doors are free of debris

  Yes

  No

• Completed on

  Date

• Proper dust control measures are in place

  Yes

  No

• Completed on

  Date

• Twine is reasonably picked up and disposed

  Yes

  No

• Completed on

  Date

• Dock areas are clean and free of debris

  Yes

  No

• Completed on

  Date

• Resin spills are contained (no open drains)

  Yes

  No

• Completed on

  Date

• Purgings have been picked up and stored properly

  Yes

  No

• Completed on

  Date

• Equipment/Inventory organization (Equipment stored, twine stacked, center cores, pipe stacked)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Unused equipment is being stored properly

  Yes

  No

• Completed on

  Date

• Pallets are stacked straight

  Yes

  No

• Completed on

  Date

• Twine and sock are stacked properly

  Yes

  No

• Completed on

  Date

• Fittings area is reasonably organized

  Yes

  No

• Completed on

  Date

• Center cores are stacked neatly and not scattered through out

  Yes

  No

• Completed on

  Date

• Pipe is reasonably and safely stacked

  Yes

  No

• Completed on

  Date

• Exits (Clear, routes, signs)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Exits are clear of debris

  Yes

  No

• Completed on

  Date

• Exit routes are clear of debris

  Yes

  No

• Completed on

  Date

• Exterior exit routes are clear of debris

  Yes

  No

• Completed on

  Date

• Exit signs are adequately placed

  Yes

  No

• Completed on

  Date

• Exit signs are in working order

  Yes

  No

• Completed on

  Date

• Fire Safety (Flammables, propane, heaters, Oxy, acetylene tanks)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• All flammables are kept in cabinets

  Yes

  No

• Completed on

  Date

• Flammable rags kept in proper conatiner

  Yes

  No

• Completed on

  Date

• Flammable cabinets installed and used

  Yes

  No

• Completed on

  Date

• Heaters are free of flammable items nearby

  Yes

  No

• Completed on

  Date

• Extra Acetylene and Oxygen tanks stored 25' apart

  Yes

  No

• Completed on

  Date

• Acetylene and Oxygen tanks are stored properly

  Yes

  No

• Completed on

  Date

• Liquid propane tanks are stored properly

  Yes

  No

• Completed on

  Date

• Fire extinguishers (location, inspection, Class "C")

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Fire extinguishers are adequately placed

  Yes

  No

• Completed on

  Date

• Fire extinguishers have been inspected annually

  Yes

  No

• Completed on

  Date

• Fire extinguishers have been inspected monthly

  Yes

  No

• Completed on

  Date

• Class C fire extinguisher present in MCC room

  Yes

  No

• Completed on

  Date

Electrical - Plant and Yard

• Electrical boxes/cabinets/transformers (Doors, safe clearance, debris, securely fastened, knockouts)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Electrical doors are closed

  Yes

  No

• Completed on

  Date

• Electrical cabinets are clear of debris

  Yes

  No

• Completed on

  Date

• There is safe electrical clearance

  Yes

  No

• Completed on

  Date

• All breakers have been labeled properly and none are missing

  Yes

  No

• Completed on

  Date

• Transformers and electrical boxes have been securely fastened

  Yes

  No

• Completed on

  Date

• There are no missing knockout plugs in electrical boxes

  Yes

  No

• Completed on

  Date

• Wires (Insulation, loose, condition, 12 gauge, wire nuts, temporary, cord drops)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• There are no exposed or bare wires present

  Yes

  No

• Completed on

  Date

• All electrical connections are tight

  Yes

  No

• Completed on

  Date

• All electrical cords/leads are in good condition

  Yes

  No

• Completed on

  Date

• Only 12 gauge or larger extension cords are being used

  Yes

  No

• Completed on

  Date

• Extension cords are being use only for temporary use

  Yes

  No

• Completed on

  Date

• There are no heater studs exposed or wire nuts being used

  Yes

  No

• Completed on

  Date

• Drop cords are installed where needed

  Yes

  No

• Completed on

  Date

• LOTO (Procedures, tracking, materials)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• LOTO procedures are posted on or near all equipment

  Yes

  No

• Completed on

  Date

• LOTO procedures are adequate and accurate

  Yes

  No

• Completed on

  Date

• LOTO is being followed per the tracking log

  Yes

  No

• Completed on

  Date

• LOTO Materials are available and adequate

  Yes

  No

• Completed on

  Date

• Interlocks (installed, functioning)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Perforator interlocks have been installed

  Yes

  No

• Completed on

  Date

• Perforator interlocks are functioning properly

  Yes

  No

• Completed on

  Date

• Misc. electrical (strain reliefs, ceramic covers, outlets, conduit, SAF starts, dock lighting)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• All strain reliefs have been adequately installed

  Yes

  No

• Completed on

  Date

• Ceramic covers are being used on heater bands

  Yes

  No

• Completed on

  Date

• Outlets are in good condition

  Yes

  No

• Completed on

  Date

• Conduit is straight and not damaged

  Yes

  No

• Completed on

  Date

• SAF starts are installed where needed

  Yes

  No

• Completed on

  Date

• Dock lighting is adequate and functional

  Yes

  No

• Completed on

  Date

Guarding - Plant and Yard

• Extruder (extruder, screen changer, melt pump, striper hose)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Extruder gear box guarding is adequate

  Yes

  No

• Completed on

  Date

• Extruder drive motor guarding is adequate

  Yes

  No

• Completed on

  Date

• Screen changer guarding is adequate

  Yes

  No

• Completed on

  Date

• Melt pump guarding is adequate

  Yes

  No

• Completed on

  Date

• Striper hose is in good working order with no leaks

  Yes

  No

• Completed on

  Date

• Purging (chains, guards, used)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Purging guard is in place and adequate

  Yes

  No

• Completed on

  Date

• Purging guard is being used

  Yes

  No

• Completed on

  Date

• Purging chains and signs have been installed and used

  Yes

  No

• Completed on

  Date

• Corrugator (gearbox, track, handrails)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Corrugator gearbox guarding is adequate

  Yes

  No

• Completed on

  Date

• Corrugator track guarding is adequate

  Yes

  No

• Completed on

  Date

• Corrugator handrails adequate if applicable

  Yes

  No

• Completed on

  Date

• Corrugator upstream guarding is adequate

  Yes

  No

• Completed on

  Date

• Corrugator downstream guarding is adequate

  Yes

  No

• Completed on

  Date

• Downstream equipment (waterbath, wheels, perforator, coiler, auxiliary)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Waterbath guarding is adequate

  Yes

  No

• Completed on

  Date

• Haul-off/Pulling wheels guarding is adequate

  Yes

  No

• Completed on

  Date

• Perforator guarding is adequate

  Yes

  No

• Completed on

  Date

• Coiler guarding is adequate

  Yes

  No

• Completed on

  Date

• Guarding on auxiliary equipment is adequate

  Yes

  No

• Completed on

  Date

• Misc. equipment (drill press, bandsaw, grinder)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Drill press has adequate chuck guards

  Yes

  No

• Completed on

  Date

• Drill press is securely fastened

  Yes

  No

• Completed on

  Date

• Bandsaw guarding is adequate

  Yes

  No

• Completed on

  Date

• Bandsaw guards are adjusted correctly per part

  Yes

  No

• Completed on

  Date

• Bench grinder is securely fastened

  Yes

  No

• Completed on

  Date

• Bench grinder wheel has been ring tested, or replaced yearly

  Yes

  No

• Completed on

  Date

• Bench grinder tongue and tool rest guards have been adjusted properly

  Yes

  No

• Completed on

  Date

• Fuel tanks (berming, protection)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Fuel tank berming is adequate

  Yes

  No

• Completed on

  Date

• Fuel tanks are protected against damage

  Yes

  No

• Completed on

  Date

Oil leaks and Bulk oil - Plant and Yard

• Oil leaks (extruders, corrugators, perforators, vacuum pumps)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Extruders are free of oil leaks

  Yes

  No

• Completed on

  Date

• Corrugators are free of oil leaks

  Yes

  No

• Completed on

  Date

• Perforators are free of oil leaks

  Yes

  No

• Completed on

  Date

• Vacuum pumps are free of oil leaks

  Yes

  No

• Completed on

  Date

• Bulk oil (storage, containment)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Oil stored in an adequate area

  Yes

  No

• Completed on

  Date

• Spill containment is used and adequate for bulk oil

  Yes

  No

• Completed on

  Date

Mezzanine/Stairs/Handrails/Racking - Plant and Yard

• Mezzanine (labels, handrails, items stored)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Mezzanine storage labeled with 3"x5" limits

  Yes

  No

• Completed on

  Date

• Mezzanine storage has adequate handrails

  Yes

  No

• Completed on

  Date

• Items stored on mezzanine are secure

  Yes

  No

• Completed on

  Date

• Stairs/Tie down Ladders (Stairways, mobile stairs)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Stairways meet OSHA standards

  Yes

  No

• Completed on

  Date

• Stairways are clear and unobstructed

  Yes

  No

• Completed on

  Date

• Mobile stairs are in good condition/straight

  Yes

  No

• Completed on

  Date

• Mobile stairs have not been modified

  Yes

  No

• Completed on

  Date

• Tie down ladders available for rack trailers

  Yes

  No

• Completed on

  Date

• Handrails

  Safe

  At risk

  Repeat

  Corrected

  N/A

• All other areas that need handrails have adequate handrails

  Yes

  No

• Completed on

  Date

• Handrails on stairways are secure (200#)

  Yes

  No

• Completed on

  Date

• Pallet racking (anchored, load limits, items stored)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Pallet racking is anchored properly

  Yes

  No

• Completed on

  Date

• Pallet racking has posted weight limits on each shelf

  Yes

  No

• Completed on

  Date

• Items on pallet racking are stored safely

  Yes

  No

• Completed on

  Date

• Steel racks (anchored, load limits, sufficient)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Steel racks are properly anchored

  Yes

  No

• Completed on

  Date

• Steel racks are labeled with 3"x5" load rating on each shelf

  Yes

  No

• Completed on

  Date

• Steel racks are sufficient to hold current load

  Yes

  No

• Completed on

  Date

Forklifts - Plant and Yard

• Safety Features (horn, seat/seatbelt, glass, lights)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Seat belt is installed and functional

  Yes

  No

• Completed on

  Date

• Seat is in factory condition

  Yes

  No

• Completed on

  Date

• Lights, break lights and flashers are functional

  Yes

  No

• Completed on

  Date

• Horn is functional

  Yes

  No

• Completed on

  Date

• Windows are free of cracks/breaks

  Yes

  No

• Completed on

  Date

• Windows are clean and clear

  Yes

  No

• Completed on

  Date

• Attachments (condition)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Forklift attachments are adequate

  Yes

  No

• Completed on

  Date

• Forklift attachments are not bent

  Yes

  No

• Completed on

  Date

• Forklift attachments are free of cracks/defects

  Yes

  No

• Completed on

  Date

• Misc. forklift items (propane tanks, parked, mast, speed)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Liquid propane tank (if LP) is secured properly

  Yes

  No

• Completed on

  Date

• Liquid propane tank (if LP) is aligned on the alignment pin

  Yes

  No

• Completed on

  Date

• Forklift is parked properly (brake engaged and forks are down)

  Yes

  No

• Completed on

  Date

• Mast is free of defects, cracks or damage

  Yes

  No

• Completed on

  Date

• Forklifts are operating at adequate speeds

  Yes

  No

• Completed on

  Date

Trucks/Trailers/Other yard vehicles

• Safety features (windshield and lights)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Truck windshields are free of cracks

  Yes

  No

• Completed on

  Date

• Pickup windshields are free of cracks

  Yes

  No

• Completed on

  Date

• Truck lights appear to be in good condition

  Yes

  No

• Completed on

  Date

• Pickup lights appear to be in good condition

  Yes

  No

• Completed on

  Date

• Trailer lights appear to be in good condition

  Yes

  No

• Completed on

  Date

• Straps/Tie downs (function, good working order)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Ratchet straps function properly

  Yes

  No

• Completed on

  Date

• Straps are undamaged - Good working order

  Yes

  No

• Completed on

  Date

• Misc. trucks/trailers/other yard vehicles (safety chains, tires, chocks, jacks)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Safety chains present on slant undercarriage

  Yes

  No

• Completed on

  Date

• Truck tires appear to be in good condition

  Yes

  No

• Completed on

  Date

• Trailer tires appear to be in good condition

  Yes

  No

• Completed on

  Date

• Wheel chocks available and used

  Yes

  No

• Completed on

  Date

• Trailer jacks available and being used for docked vans

  Yes

  No

• Completed on

  Date

Miscellaneous safety items - Plant and yard

• Traffic (lanes, speed limits)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Lanes are adequate width for loading

  Yes

  No

• Completed on

  Date

• Lanes are adequate width for traffic flow

  Yes

  No

• Completed on

  Date

• Speed limits are posted and followed

  Yes

  No

• Completed on

  Date

• Misc. equipment (bag/trash/cardboard compactors)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Bag compactor functioning properly

  Yes

  No

• Completed on

  Date

• Trash compactor functioning properly

  Yes

  No

• Completed on

  Date

• Cardboard compactor functioning properly

  Yes

  No

• Completed on

  Date

• Environment/ergonomics (water, restrooms, shade, lifting)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Adequate and fresh water is provided

  Yes

  No

• Completed on

  Date

• Restrooms are adequate and nearby

  Yes

  No

• Completed on

  Date

• Adequate shaded area available for breaks

  Yes

  No

• Completed on

  Date

• Proper lifting techniques observed

  Yes

  No

• Completed on

  Date

• Lifting chains/Straps (condition, Inspection tag)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Lifting chains/straps have inspected tag attached to them

  Yes

  No

• Completed on

  Date

• Lifting chains and straps are in good condition with no frays

  Yes

  No

• Completed on

  Date

• Other safety items (air wands, handles, drainage, other safety items)

  Safe

  At risk

  Repeat

  Corrected

  N/A

• Air wands/hoses are approved

  Yes

  No

• Completed on

  Date

• Brooms/Shovels have factory handles

  Yes

  No

• Completed on

  Date

• Drainage is controlled adequately

  Yes

  No

• Completed on

  Date

• Other safety items

  Yes

  No

• Completed on

  Date

• Due date to complete "At risk" items

  Date