Grain Elevator - Shelby Shuttle January 2021

• Document No.

• Conducted on

  Date

• Prepared by Scott T Murray

• Location
  Address

• Personnel Ken Sl Mike A Ty A Travis M Weston M

1.0 Previous Inspection

• 1.1 Was last Inspection Reviewed?

  Yes

  No

  N/A

• 1.2 Were issues from last Inspection resolved and corrected?

  Yes

  No

  N/A

• 1.3 Are all records in place and up to date (house keeping, daily leg inspection, maintenance, pits and CMVs)?

  Yes

  No

  N/A

2.0 Emergency Plan

• 2.1 Are evacuation plans and facility emergency route map, displayed throughout the facility and understood by employees ?

  Yes

  No

  N/A

• 2.2 Are Emergency Drills completed at least once per year, and Documented in the Emergency Program.

  Yes

  No

  N/A

• 2.3 Has the Fire Department tour been completed for the current year?<br>

  Safe

  At Risk

  N/A

• 2.4 Are fire extinguishers in place, clearly marked and free of obstruction to immediate access?

  Yes

  No

  N/A

• 2.5 Are extinguishers checked monthly by employees?

  Yes

  No

  N/A

• 2.6 Have Annual extinguisher inspections been done, by a qualified inspector?

  Yes

  No

  N/A

• 2.7 Are extinguisher location signage visible and 6' above floor level?

  Yes

  No

  N/A

• 2.8 Are fire extinguishers placed at between 3' and 5' above the floor level?

  Yes

  No

  N/A

• 2.9 Exits are clearly marked and free of obstructions?

  Yes

  No

  N/A

• 2.10 Exit doors are unlocked during business hours and easily open from inside?

  Yes

  No

  N/A

• 2.11 Does facility have a fire alarm system?

  Yes

  No

  N/A

• Fire Alarm System<br>Air Horn<br>Other

  Yes

  No

  N/A

3.0 Housekeeping

Interior 3.1

3.1-1 Office

• Work areas are clean and free of clutter?

  Yes

  No

  N/A

• Desks chairs and computers allow for correct ergonomics?

  Yes

  No

  N/A

• Heating and cooling adequate and comfortable for space?

  Yes

  No

  N/A

3.1-2Driveway

• Driveway is clean ( less than 1/8 inch of dust and debris) no grain ?

  Yes

  No

  N/A

• Driveway clear of debris and unnecessary materials (tools etc picked up and properly stored?

  Yes

  No

  N/A

3.1-3 House

• Ledges floors / working surfaces clean ( less than 1/8 " of dust or grain)?

  Yes

  No

  N/A

• Boot Pit clean ( dust and grain less than 1/8" , no standing water) ? No unusual odors or conditions?

  Yes

  No

  N/A

3.1-4 Bin /Annex / Silo

• Working surfaces floors ledges clean and free of less than 1/8" dust or grain?

  Yes

  No

  N/A

• Walkways and exit points are clear and free of clutter?

  Yes

  No

  N/A

3.1-5 Distributor & Head House

• Working surfaces floors ledges clean and free of less than 1/8" dust or grain?

  Yes

  No

  N/A

• Walkways and exit points are clear and free of clutter?

  Yes

  No

  N/A

4.0 Exterior

• 4.1 Exterior of facility is clean and free of clutter, no piles of grain etc.?

  Yes

  No

  N/A

5.0 Electrical

• 5.1 Electrical Room is clean free of clutter and has no materials within 36" of front of electrical panels?

  Yes

  No

  N/A

• 5.2 No extension cords used as permanent wiring?

  Yes

  No

  N/A

• 5.3 Extension cords are in good shape ( no damage or missing prongs) ?

  Yes

  No

  N/A

6.0 Fall Protection

6.1 Ladders

• 6.1-1 Are all ladders approved (type 1 or 2) No type 3?

  Yes

  No

  N/A

• 6.1-2 Ladders are inspected and are determined in good condition?

  Yes

  No

  N/A

• 6.1-3 Ladders are stored properly when not in use?

  Yes

  No

  N/A

• 6.1-4 Fixed Ladders have proper cages and runs do not exceed 20' with step off?<br>

  Yes

  No

  N/A

6.2 Docks / Platforms / Walkways

• 6.2-1 All docks, platforms and walkways over 4' from ground have proper guarding?

  Yes

  No

  N/A

• 6.2-2 All top rails are 42" high mid rails are 21" and a toe board on all that are over 6'?

  Yes

  No

  N/A

6.3 Harness/Lanyards

• 6.3-1 Where there are no cages on fixed ladders or runs exceed the 20' maximum, harnesses and cable grabs or crab claws are provided?

  Yes

  No

  N/A

• 6.3-2 All facilities that have rail car access have have fall protection systems in place, or have No climb policy in place?

  Yes

  No

  N/A

7.0 Manlift

• 7.1 Manlift has been inspected quarterly by on site staff?

  Yes

  No

  N/A

• 7.2 Manlift has annual Inspection completed by qualified inspector?

  Yes

  No

  N/A

• 7.3 Manlift Shaft is clean and free of dust of 1/8 inch?

  Yes

  No

  N/A

8.0 Maintenance

• 8.1 Facility has a LOTO Program in place for all employees who may work on any equipment that has a potential to cause harm from hazardous energy?

  Yes

  No

  N/A

• 8.2 Maintenance is scheduled and performed per a routine and documented when completed?

  Yes

  No

  N/A

• 8.3 Inspection of equipment is routine and completed on a scheduled basis?

  Yes

  No

  N/A

• 8.4 Leg inspections are completed daily and documented?

  Yes

  No

  N/A

9.0 Vehicles and Power Industrial Trucks

• 9.1All vehicles and PITs are maintained in working condition?

  Yes

  No

  N/A

• 9.2 Prior to operation of any vehicle or PIT a proper inspection is completed and documented?

  Yes

  No

  N/A

• 9.3 All operators have proper license and or certification?

  Yes

  No

  N/A

10.0 Shop / Garage

• 10.1 Is the shop clean organized and free of clutter?

  Yes

  No

  N/A

• 10.2 Does the Shop have flammable liquids or canisters that contain flammable containers, and Does facility have a proper flammable cabinet?

  Yes

  No

  N/A

General information & Comments

• Facility Manager:

  Sign

• Safety Leader:

  Sign